Smile, rural Minnesota!
AN INNOVATIVE PARTNERSHIP BRINGS CARE TO PEOPLE IN PLACES WHERE DENTISTRY IS SCARCE
On a recent Wednesday morning, a 44-foot bus painted robin’s egg blue and emblazoned with the UCare logo pulled into a church parking lot in Blaine. The door opened and out stepped a couple of students from the University of Minnesota School of Dentistry. One of them attached a power cord to an outlet inside the building. Another pushed a set of stairs into place, allowing easy access to a door on the side of the bus. Inside, bright lights flickered on, revealing a full-fledged dental clinic complete with three stations, sinks, X-ray equipment, and even a sterilization lab.
The Mobile Dental Clinic, as the bus is known, is a successful collaboration between the School of Dentistry and UCare, which was established in 1984 by the U’s Department of Family Medicine and Community Health. UCare is now an independent nonprofit insurance provider that also serves people enrolled in the state's Medicaid program. For more than 15 years, the clinic has been run by Paul Schulz, director of outreach for the U’s School of Dentistry, serving people insured through UCare who lack dental services in their region. Last year, it visited 11 sites—more than half of which were in rural Minnesota—providing basic cleanings, fillings, and extractions to more than 1,000 patients.
In addition to providing care, the clinic staff connects patients with local dental clinics when possible. “Ultimately we want to help people find a dental home,” Schulz says. “We offer referrals, but while we’re with them, we do what we can.”
A SHORTAGE OF DENTISTS
Finding a dentist can be a challenge in many rural communities. All told, more than 45 million people in the United States live in areas where there aren’t enough dentists to serve the population, according to the Health Resources and Services Administration. Roughly 10 to 15 percent of Minnesota residents live within so-called Health Professional Shortage Areas. Those areas have few clinics. Many of their dentists are at capacity or don’t accept Medicaid patients, compounding the problem.
In 2002, a UCare administrator and a School of Dentistry staff member were discussing the challenges of serving patients in outstate Minnesota when they hit upon an idea: Why not bring dental services directly to rural communities through a mobile clinic? They pooled their resources, ordered a custom-built bus, and asked Schulz if he was interested in operating the clinic. “I think they forgot that they actually needed to hire people. They called me three weeks before they wanted the bus to be on the road,” he says with a smile.
A public health dentist, Schulz was working for the Indian Health Board of Minneapolis at the time. “They said, ‘How would you like to be the director of a mobile dental clinic and work at the University of Minnesota?’ I’d always been interested in joining the faculty, and
said, ‘Let’s give it a go.’”
A new bus has since replaced the original vehicle. It’s equipped with everything you’d find in one of the dental school’s clinics. “We’ve got similar chairs. We can take X-rays. Through Wi-Fi connections, we’ve got access to the same electronic dental records that the school uses. We’ve got everything a non-mobile clinic has, but it’s just nice and compact,” Schulz says.
A NEEDED JUMP-START
UCare had provided financial support and marketingservices for the clinic, publicizing its arrival in advance of visits to Duluth, Montevideo, Rochester, Mankato, and other locations. But in 2016, when the insurer failed to secure a contract with the State of Minnesota to provide care to Medicaid patients, the mobile clinic was parked and the program’s future in jeopardy.
Fortunately, a $1 million gift to the U from the Richard M. Schulze Family Foundation got it back on the road nine months later. Ultimately, the clinic required only a year of stop-gap funding, as the Legislature approved recurring funding last year.
In addition to helping patients, the clinic provides supervised hands-on experience to U of M students seeking to become dentists, dental hygienists, and dental therapists. Gabrielle Salisbury, a senior dental hygiene student, says working in the mobile clinic has exposed her to the kind of real-life situations she’ll one day see in practice. “These experiences will allow me to grow as a provider,” she says.
Kyle Rasmussen, a senior dentistry student, says he is now considering working in a rural practice. “I’ve found I mesh really well with the rural communities, and the patients tend to connect well with me,” he says.
Overall, the mobile clinic is a win-win for both UCare clients and future dental providers being trained at the U, Schulz says. “We’re treating underserved populations, and we’re showing students what it’s like to live and practice in underserved areas. In the short run and the long run, we’re making a difference.”
Joel Hoekstra is a freelance writer and editor in Minneapolis.
Go inside the clinic: