Score 1 For Health - REACH Annual Report - 2016



During the school year, Alex Martinez-Munoz can be found several times a week seated at the front desk at Scuola Vita Nuova, a charter elementary school located in the northeast area of Kansas City, MO. The community health worker chose that spot to be visible to families as they arrive at school so that he can become a recognized face and ready resource for parents who have questions about their children’s oral health and other health needs.

Trained locally in community health work, Martinez-Munoz was hired by the Kansas City University of Medicine and Biosciences (KCU) to improve access to oral health care primarily for Latino children and families through its Score 1 for Health® program, which works in 43 elementary schools in the Greater Kansas City area to provide health, dental, vision and other screenings and follow-up referrals and health care navigation for preventive care, dental services and other health needs. The target population for Score 1 for Health is diverse – 35 percent are African American, nearly 40 percent are Latino, and 4 percent are Asian with the remainder identifying as white or of other racial and ethnic background. Martinez-Munoz’ role is to be a liaison between parents and guardians of Latino children who are screened through Score 1 and the health care system, and help families obtain the services children need.

Score 1 program staff often heard from families that information and language challenges were some of the biggest obstacles they faced in accessing care for their children. Families shared that they didn’t know where to go for medical or dental care, how to qualify for health insurance and services, and how to schedule appointments. Data collected through encounters showed that information and assistance and language barriers were some of the biggest obstacles to care. Score 1 employs a Spanish-language interpreter and uses an interpretation service for other languages, but program leaders increasingly recognized that the program’s ability to effectively serve their target population depended upon strengthening cultural competence and the capacity to develop relationships with families in their familiar school settings.

Martinez-Munoz’ charge is to increase oral health access by providing consistent outreach, oral health information and care coordination, focusing on those whose primary language is Spanish. In 2016, he served 588 families. At the pilot school, he connected with 113 – more than half of the student body.

Following Score 1 screenings, Martinez-Munoz contacts the families of children who need a dental referral to provide them information about services, schedule appointments, discuss coverage options and costs, and help children and their parents overcome fears about dental care. Martinez-Munoz works to identify each family’s needs, such as help with making an appointment, securing transportation or selecting a provider that would be a good fit for the child. He provides information about Medicaid benefits, accompanies families to appointments if needed and maintains records of completed services, ongoing concerns or barriers, and follow-up needs.

The REACH Foundation has awarded grants totaling $488,396 to Score 1 for Health over the past several years. In 2016, REACH awarded the program $29,939 grant to support the Latino-family focused health project. The Scuola Vita Nuova school pilot effort introduced in 2016 has been one way to assess the placement of a bilingual community health worker at a school site to see if having a regular, physical presence at school increases access to services, parent receptivity to information and oral health education, and parent satisfaction. On one afternoon, students and parents stopping by the front office chatted with Martinez-Munoz about school, upcoming dental visits and any follow-up needs. The school’s administrative staff members readily share front desk space with the health worker as they recognize the additional value these outreach services bring to their families.

Annette Campbell, director of Score 1 for Health, says her team worked with the school’s principal, vice principal and office staff to develop a plan for integrating Martinez-Munoz into the culture of the school. He attends school events, staff meetings, acts as a greeter during morning drop-off times and makes sure he is at school on parent-teacher conference days, which generate high parent turnout.

“Having Alex on site has helped us create a bridge between our Score 1 screenings and health initiatives and improving access to services for elementary children,” Campbell says. “We have enjoyed watching how he has been welcomed into this school and the success he has had in building strong relationships with school staff and acceptance with the families.”

While this project has enabled Score 1 to test this approach in this one school, Martinez-Munoz coordinates referrals and works with Spanish-speaking families within all of the Score 1 schools. Referrals are generated by the Score 1 outreach nurses, school nurses and social workers with an emphasis on dental referrals, but the work also includes assisting with vision and other health needs. Score 1 program leaders have worked to educate partners about the purpose and function of a community health worker, providing information and making introductions to their network of dental providers, school nurses and safety net clinics. Campbell says the community health worker services are not reimbursable by Medicaid, but the investment in this model has shown early success in helping Score 1 achieve its goal – that is, expanding access to health care.