Twenty years ago, Kris Volcheck, D.D.S., started volunteering to work with homeless people in his Phoenix community. He began as a case manager, handing out food and clothing and helping out with transportation, while continuing his day job as a private practice dentist. But he soon realized that he wanted to turn his volunteer work into a full time job at Central Arizona Shelter Services (CASS). “I loved being with the homeless population and I had gotten to know the people here,” he says. He also noticed that there was a huge gap in the hodgepodge of services CASS offered to the homeless: They did not receive dental care.
RWJF Community Health All-Stars
Robert Wood Johnson Foundation scholars, fellows and grantees, along with the Community Health Leader award winners, address the health needs of the nation in unique and innovative ways. Whether they are creating healthier environments, bringing needed health resources to underserved communities, diversifying the local health care workforce or generating grassroots programs—they make a difference. This series tells their stories.
At the end of 1999, Volcheck began work on what would become the CASS Dental Clinic, which offers full-service, free care to the homeless. At the beginning of 2001, Volcheck and 20 volunteers opened a two-chair clinic in a trailer which led to a permanent, state-of-the-art clinic that opened in 2005. Over the course of a year, more than 300 people volunteer their time and skills at the clinic.
Last year, Volcheck extended those free services to include the Murphy School District in an impoverished Phoenix neighborhood, by creating a portable dental clinic called the CASS Children’s Dental Clinic at Murphy—a module that can be moved from school to school. Volcheck was also named a Robert Wood Johnson Foundation (RWJF) Community Health Leader in 2010. RWJF funding also helped provide equipment and staff for this clinic the now serves four different schools.
The Underappreciated Role of Oral Health
“Whether people are homeless or not, oral health [care] is often separated from the [health of the] rest of the body,” Volcheck says. Though individuals who are homeless can qualify for health care through government programs, in most states dental care is not included. As a result, millions of Americans do not have access to affordable dental care, and as many as two thirds of low-income adults go without regular dental checkups, according to the 2005 Kaiser Family Foundation survey, Low-Income Coverage and Access.
Poor oral health is often coupled with chronic diseases such as diabetes. “A person’s ability to get proper nutrition without healthy teeth is absolutely hindered by their not being able to chew properly,” Volcheck adds. Pregnant women with infected gums also run the risk of giving birth to premature or underweight babies. Missing teeth and poor dental health negatively affect self-esteem and prevent otherwise capable people from getting a job.
For these reasons, Volcheck was determined to help the children in his community—whether homeless or poor—avoid a lifetime of poor dental health.
Overcoming Challenges to Help Kids
At first Volcheck and his team considered transporting students to the CASS clinic for treatment, but they soon realized that the chaperones and resources needed for transport would be expensive. In addition, taking students out of class could have devastating consequences for these cash-strapped schools that meet funding requirements based on attendance. So Volcheck’s group designed a portable clinic that can be set up in a classroom at each school. The team stays at each of the four schools for a month during the fall and comes back again in the spring. As a result, students can be scheduled for cleanings and fluoride treatments during gym class, but remain in class during academic time blocks for reading and math.
In the first year of the CASS Dental Clinic at Murphy, the clinic served 1,000 students, about 50 percent of the students in this four-school Murphy school district. “We have seen kids with a full mouth of black and rotting teeth,” Volcheck says. Part of the problem is education: parents haven’t always been told that kids should not receive bottles of milk or juice at night. So Volcheck and his colleagues are coupling their work providing cleanings, fluoride, sealants and treating decay with a strong focus on educating parents about how to protect their children’s teeth.
The students in the Murphy School District are 90 percent Hispanic, a mixture of documented and undocumented children, some of whom have health coverage. “Whether the children have health coverage or are documented is irrelevant to us. We treat everyone in a comprehensive manner and it is done for free,” Volcheck says.
Immigration fears also can lead parents to only give consent for the treatment of documented children. Volcheck recounts a poignant case of one such family. When a 10-year-old girl saw what dental care did for her, she told the team that her younger brother had problems with his mouth. After the team talked with the mother, they convinced her to bring in her 3-year-old son. “His teeth were infected and he was in great pain, but the mom was so worried that she couldn’t pay, she wasn’t covered by Medicaid and that they might be reported for being illegal, that she had been afraid to bring the child in,” Volcheck says.
The current portable dental clinic has three chairs for treating kids and a hired staff. Grants from RWJF and the Bruce T. Halle Family Foundation have supported staffing costs, portable dental equipment and laptops for keeping and updating dental records. In the next year, Volcheck and his team plan to expand the clinic to accommodate six chairs. At that point, they’ll be able to bring in volunteers to support the work. Eventually they hope to expand this model of portable dentistry to other surrounding schools.
The RWJF award and grant came at a critical point for the dental clinics last year, helping to bring media attention and greater credibility. “The Robert Wood Johnson Foundation award seemed to give us a big push in the community,” Volcheck says.
Each year, the Robert Wood Johnson Foundation selects 10 Community Health Leaders to receive an award. The winners are outstanding and otherwise unrecognized individuals who overcome daunting odds to expand access to health care and social services to underserved populations in communities across the United States. The program aims to elevate the work of these unsung heroes through enhanced recognition, technical assistance and leadership development opportunities.