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Table 1 Key items on the Proactive Responsible Party's Dental Checklist.

From: Economic models for prevention: making a system work for patients

Proactive Responsible Party's Dental Checklist

□ I'm motivated to take the lead on behalf of an aging or disabled vulnerable adult. Obtaining routine dental care is a high priority to me, whether or not my ward has obvious dental problems.

□ I am willing and able to find a dental office near myself and also near the nursing facility or group home that meets these requirements:

□ The dental office accepts new Medicaid patients

□ The dentist is skilled at treating medically, behaviorally, and dentally complex vulnerable adults

□ The parking lot, building and dental office chairs are all wheelchair accessible and the dentist's staff are skilled in safe patient handling

□ My employer is willing to approve time off so that I can accompany a vulnerable adult for dental appointments. This is in addition to approving time off for my own dental appointments several times each year, as needed.

□ I have my own personal funds to pay for my own automobile or for public transportation so that I can travel from home or work, to a group home or nursing facility and also travel to a nearby dental office, and of course, back again, several times each year, as needed.

□ I have been formally designated as the “responsible party” and I have the clear authority to act on behalf of the patient for medical care and financial decision-making. I feel comfortable carrying out this role, and I understand that it includes being responsible for regular dental care.

□ I will direct nursing facility staff members to coordinate and schedule medical transportation services for dental visits as needed.

□ I will authorize the nursing facility staff to release medical, nursing and financial information as requested by the dental practice.

□ I will assure the dental practice that a nursing staff member will accompany the vulnerable adult during transportation to and from each periodic dental appointment, and will assist during dental care if necessary.

□ I will participate actively during the dental evaluations on behalf of the vulnerable adult, considering all treatment options and the limitations of Medicaid dental coverage, and I will authorize appropriate and necessary dental care, even if I have to find an alternative way to pay for services not covered by Medicaid.

□ Because regular dental care is so important to me, I am willing to repeat this process twice a year for checkups, plus one or two additional visits for treatment that may be necessary.