President George H. W. Bush signing the Omnibus Budget Reconciliation Act of 1989.
The Omnibus Budget Reconciliation Act of 1989 (OBRA ’89) (Public Law 101-239) specified how Title V funds were to be allocated between state block grant awards and discretionary grants and mandated a more rigorous system of guidance, compliance, and reviews than had previously been in effect. States were required to submit a comprehensive statewide needs assessment every 5 years, consistent with health status goals and national health objectives (e.g., Healthy People), that identifies the need for (1) preventive and primary care services for pregnant women, mothers, infants, and children and (2) family-centered, community-based services for children with special health care needs and their families. In their applications, states were required to include reviews of data items to be used in needs assessments, plans for meeting identified needs, and descriptions of how funds would be used for the provision and coordination of services. In addition, OBRA ‘89 continued the federal set-aside for Special Projects of Regional and National Significance (SPRANS) discretionary grants and established a new discretionary grant program, Community Integrated Service Systems (CISS).
The emphasis on “comprehensive” needs assessment enabled states to use Title V block grant funds to conduct surveys to collect oral health data and develop a plan for meeting the needs identified by the survey. To assist states with this activity, the Maternal and Child Health Bureau (MCHB) awarded funding to the Association of State and Territorial Dental Directors for the development of a model oral health needs assessment. The project included field-testing, a four-state pilot, and dissemination of the model, which became Assessing Oral Health Needs: ASTDD Seven-Step Model. States conducting oral health needs assessments in the 1990s include California (1995), Colorado (1994), Connecticut (1995–1996), Maryland (1995), Montana (1996), Nevada (1992), Ohio (1995), and Washington (1996).
MCHB CISS and SPRANS discretionary grants have supported other oral health project activities, including the following:
California Department of Health Services, Maternal and Child Health Branch. 1995. Our Children’s Teeth: Beyond Brushing and Braces. Sacramento, CA: California Department of Health Services, Maternal and Child Health Branch.
Colorado Department of Public Health and Environment, Oral Health Program. 1994. The Oral Health of Coloradans 1994. Denver, CO: Colorado Department of Public Health and Environment, Office of Oral Health.
Cristman Associates. 1992. A Youth Oral Health Needs Assessment for the State of Nevada. Las Vegas, NV: Cristman Associates.
Maternal and Child Health Bureau. 2001. Celebrating 65 Years of Title V: The Maternal and Child Health Program 1935–2000—A Review of Federal Appropriations and Allocations to States for Maternal and Child Health Programs Under Title V of the Social Security Act. Rockville, MD: Maternal and Child Health Bureau.
Maternal and Child Health Bureau. 2000. Understanding Title V of the Social Security Act: A Guide to the Provision of the Federal Maternal and Child Health Block Grant. Rockville, MD: Maternal and Child Health Bureau.
McLaughlin J, Martin D. 1996. Washington State Smile Survey: A Children’s Oral Health Assessment Report. Olympia, WA: Washington State Department of Health, Oral Health Program.
Montana Department of Public Health and Human Services, Family and Community Health Bureau. 1996. Montana Dental Needs Assessment: Secondary Data. Helena, MT: Montana Department of Public Health and Human Services, Family and Community Health Bureau.
Ohio Department of Health, Bureau of Dental Health. 1995. The Oral Health of Ohioans, 1993. Columbus, OH: Ohio Department of Health, Bureau of Dental Health.
Ohio Department of Health, Division of Dental Health. 1989. Oral Health Survey Manual. Columbus, OH: Ohio Department of Health.
Personal communication with John Rossetti, 2010.
Wagner ML, Rule J. 1997. Oral Health Status of Maryland School Children: Executive Summary. Unpublished paper.
Wolfe SH. 1995–1996. The Oral Health Survey and Needs Assessment in Connecticut: A Determination of the Prevalence of Dental Disease in Grade School Children. Hartford, CT: Connecticut Department of Public Health.
In 1988, a consultant group of health professionals met in San Antonio, TX, to identify pertinent issues affecting the oral health of mothers and children. One of the seven recommendations presented was to convene a broad-based workshop to propose solutions to address these multiple and diverse issues.
The workshop, Public Health Workshop on the Oral Health of Mothers and Children, was held on September 10–12, 1989, in Alexandria, VA. Workshop topics included integration of oral and general health, advocacy, oral health policy, oral health status of women and children, factors contributing to women’s and children’s oral health, standards of health care and oral health, and documentation and evaluation. The workshop was attended by individuals from a wide range of disciplines and organizations, including oral health professionals, other health professionals, policymakers, administrators, parents, and consumer advocates.
The workshop identified the need for a national focus to coordinate oral health efforts by reaching special and specific population groups and emphasizing oral health, disease prevention, and oral health promotion. The workshop recommended that the following five goals be established:
In addition to the national workshop, seven regional workshops on the oral health of mothers and children were held between 1989 and 1991. The workshops focused on developing collaborative strategies and action plans to address oral health issues at state and local levels. The workshops also identified program successes and shortcomings.
Steffensen JEM, Brown JP. 1990. Equity and Access for Mothers and Children: Strategies from the Public Health Service Workshop on Oral Health of Mothers and Children. Rockville, MD: Maternal and Child Health Bureau.
Steffensen JEM. 1994. Maternal and Child Oral Health Regional Workshops: Summary Report. Arlington, VA: National Center for Education in Maternal and Child Health.
Steffensen JEM, Brown JP. 1989. Public Health Service Workshop on Oral Health of Mothers and Children: Background Issue Papers. Washington, DC: National Center for Education in Maternal and Child Health.
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