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NRHA and CareQuest Institute have partnered since 2015 to elevate rural oral health care as part of primary care through the National Rural Oral Health Initiative (NROHI). In line with NRHA’s four-tiered approach – policy, communications, education, and research – work in previous years of partnership have included advocacy for integration-focused policy efforts, communication, and dissemination of information to NRHA’s base of rural oral health stakeholders, education through national and local conferences, and publishing of research pieces around rural oral health best practices. A National Rural Oral Health Initiative Taskforce has been convened to oversee and drive the work under the initiative. Notably in 2021, NRHA staff became increasingly engaged with the Oral Health Progress and Equity Network (OPEN) and have played a leadership role in OPEN’s Rural Network Response Team and Health Equity Network Response Team.

In 2022, NRHA’s grant work focused on pursuing new opportunities to advance oral health integration within the National Rural Oral Health Initiative, while maintaining the four-tiered approach. NRHA continued to convene its NROHI Taskforce to establish a policy blueprint for the initiative, respond to and provide leadership on emerging regulatory and legislative opportunities, and convene a Rural Oral Health Interest Group. NRHA also maintained a consistent flow of information about rural oral health research, policy efforts, best practices, and resources to their membership and to policy makers.

NRHA also provided oral health educational opportunities and technical assistance to rural providers and State Rural Health Associations. More broadly, NRHA hosted an Oral Health Research Webinar Series, highlighting oral health subject matter experts, OPEN members, and NRHA policy staff, developed three topic papers with the direction of rural oral health subject matter experts, and developed blog posts and opinion editorials.

For 2024-25, NRHA proposes to build upon the following NROHI activities:
(1) NRHA state-specific oral health policy pilot – For the first time, NRHA state will work directly with state partners, in two states, Pennsylvania and Nebraska, to elevate state specific policies, regulations, and legislation to ensure greater access to quality oral health.
(2) Expand the Rural Seminar programs – One seminar will be held at a dental school within a majority rural state. Additionally, resources will be provided to seminar participants who indicated an interest in rural practice, with a goal of capturing data of how many of those students practiced or are currently practicing in rural locations.
(3) Compile a 2025 Compendium of Rural Oral Health Best Practices – comprised of the six topic papers created in cycles four and five of CareQuest Institute funding with NRHA.
(4) Build upon the Community Health Worker (CHW) trainings – Provide an in-person training to include primary care clinicians to improve care coordination for the rural community and enhance the relationship between the two groups. Per the request of previous NRHA CHW training attendees, an advocacy component will be added to this training.

Additionally, NRHA will work in partnership with CareQuest Institute to provide capacity building support through technical assistance, peer learning, and resources sharing to grantees working to improve oral health in rural areas. NRHA will also continue to provide support to OPEN, adding context to rural health equity.

The original budget for this proposal was $300,000. The recommendation was made during proposal review to reduce the grant budget to $250,000 or less. Through a collaborative process with NRHA, several adjustments were made to the budget that resulted in the requested amount of $245,000. Reductions include a decrease in the number of people to be supported to attend training, removal of AV equipment and room rental, and a decrease in the indirect funds. Funding will support staffing, in-person meetings, state rural oral health education and policy support, rural oral health CHW training, and several other smaller deliverables. The recommended funding amount represents slightly less than 3% of the overall operating budget.