Instead, the reader bought into a discount network and saved about $800 after purchasing an individual membership for $100 a year. The waiting period before her benefits kicked in? Three days.

It’s called a discount dental plan and it’s similar to buying a membership at Costco or Sam’s Club. For the price of your annual membership, you get the benefit of paying lower prices on the products or services offered.

The dentists who participate in the program agree to accept a discounted fee from the plan as payment in full for their services. For example, a white filling is typically $173, but discount plan members pay $51 to $116, depending on the plan. A crown is typically $1,200, but members pay $473 to $1,000.

Annual membership fees range from $80 to $160 for an individual and $130 to $200 for a family.

One of the best ways to shop for a plan is at www.dentalplans.com. It has aggregated plans from more than 30 companies, including Aetna and Cigna. After putting in a ZIP code, you can find dentists in your area who accept the plans and what the discounted rates are for fillings, crowns, root canals and dentures.

Most people have never heard of the discount plans, probably because nearly 70 percent of Minnesotans have dental insurance, said Loren Hanson, director of marketplace activities at the Minnesota Dental Association in Minneapolis.

But even those with insurance might want to consider a dental plan if they have some unexpected big bills. Dental insurance typically has a maximum benefit per year of $1,000 to $1,200. Anyone who has already met the annual maximum and develops a new toothache is unlikely to wait until January to get it fixed.

Hanson said the MDA has had few complaints about the discount dental plans but says many patients will find that their dentist doesn’t offer the discounts. About 10 percent of dentists in the Twin Cities offer them, he said.

Dental plans have a 30-day cancellation policy and no waiting periods, deductibles or maximums. Orthodontia and cosmetic procedures are included in some plans. DentalPlans.com is offering a 10 percent discount with the code “July10,” but when I called several months ago I was offered a 20 percent discount after I balked about joining. Call 1-888-632-5353 or visit the website.

Even the recession couldn’t vanquish vanity; steady consumer demand for teeth bleaching, tooth-colored fillings, implants and other cosmetic procedures has kept dentists smiling through today’s tough economic times. It’s also helped keep dental benefits popular and prompted some leading dental insurers to broaden plan coverage to include cosmetic services.

“More and more dentists see cosmetic procedures as a way to increase their revenue,” says Dr. Roma Virani, second vice president, Dental Cost & Utilization at Assurant Employee Benefits. For example, “most practices are doing tooth-colored fillings. It used to be that only a third of the fillings on back teeth were composites. Now that is reversed.

“While some people are concerned about the safety of amalgams,” she continues, “the switch is primarily driven by aesthetics. You get equally good results, so one type is not better than the other. However, people want their fillings to be tooth-colored so they are not as visible.”

Whitening leads the way

By far the most popular cosmetic procedure is teeth whitening. Dental magazines report that the most common conversation dentists have with their patients is about bleaching. Bradley Dykstra, DDS, wrote about the trend in Dental Economics magazine in April.

“The quest of baby boomers to stay forever young and society’s expectations to look our best drives this demand,” he says. “It is important to understand that patients, both male and female, want whiter teeth – period.”

Until a few years ago, bleaching was not covered by dental benefit plans. This changed when a handful of dental plan providers heeded requests from brokers and employers for voluntary insurance products that would offset the cost of cosmetic dental procedures for employees.

“All insurers in this industry are always looking for something new and different for brokers to sell,” says Kevin Martin, dental product development leader at Sun Life Financial. “Cosmetic was something the industry shied away from because it was not necessary care. Sun Life came up with the thought that since people want nice, shiny teeth, wouldn’t it be nice to offer a benefit that covers some, but not all, of the cost. I guess covering cosmetic was our iPod.”

Sun Life offers two cosmetic dental riders to its insurance plan. One covers teeth whitening done in the dental office or at home with products provided by the dentist. The other includes veneers as well as whitening.

The cost of the riders is based on the annual maximum selected and adds 3% to 6% to the standard dental insurance premium.

“It’s all about the smile,” maintains Paul Sherman, vice president and national sales director for American General Benefits Solutions, which began covering cosmetic procedures under its voluntary “Smile Maker” benefit plan two years ago.

Smile Maker currently covers teeth whitening and implants and will soon be expanded to include implants and composite fillings, according to dental product manager Sadia Zoppi. “It works like a lifetime orthodontia benefit for each family member,” she says. “About 2% of our business has this feature, but we anticipate that it will increase as more plan sponsors ask employees to contribute to the cost of their dental plan.”

The Smile Maker add-on is $8 per month for an individual and $32 per month for a family. “That can be a substantial increase in cost on a lower-priced dental plan that’s, say, $50,” notes Zoppi.

These products are expensive in nature, says so you’d expect this, says Zoppi. “But they are still very attractive, and they are meeting a need. There is a growing demand for these services.”

According to AACD, the mean amount spent by the average patient in 2006, the last year for which data is available, was $5,640 and the median was $3,860. At the high end, 3% of practices indicated an average amount spent per patient of $20,000 or more.

At the other extreme, 2% of practices reported average patient costs of less than $500. The most often indicated categories were $5,000-$9,999 (23%) and $2,500-$4,999 (22%).

Assurant Employee Benefits also was one of the first to cover teeth bleaching. Some of its plans also include posterior composites and porcelain crowns on posterior teeth, which it considers restorative rather than cosmetic.

“Going along with these trends, Assurant has come out with products that will take employees’ benefits farther,” says Virani. “We have Family Share Max and Preventive Max Waiver products that give more benefit dollars to plan members for these services. With the Preventive Max Waiver, preventive work does not count toward the annual maximum, so more dollars are available for non-preventive services.

“This supports our belief that if patients are getting preventive work done, they’ll need less restorative work in the future.”

Guardian broke new ground in 2004 when it extended coverage to implants. The company also offers coverage for whitening, posterior composites, porcelain inlays and onlays, and porcelain crowns and veneers.

“We take a lot of pride in customizing our plan designs to meet brokers’ and plan holders’ price points,” says Dr. Richard Goren, second vice president of Guardian’s group dental unit.

“There are hundreds of options. No one offers everything that we do.”

Brighter smiles, better health

Dentists view cosmetic dentistry not only as a means to increase revenue, but also as an important way to improve Americans’ oral health.

“If I want to whiten my smile, the dentist is going to talk about restorative needs before doing cosmetic work,” says Goren. “The motivation for a bright smile and white teeth is coming from the individual patients, and the drive for overall care is coming from the dentists.”

Like bleaching and tooth-colored fillings, implants improve patients’ appearance and promote self-esteem. But they also can help prevent problems down the road, Goren notes. “Bridge work involves shaving the tooth and cementing the bridge on top of it. When that happens, the tooth is never as good as when it was healthy. With an implant, no one is contributing to a tooth’s demise.”

Dermal filler next?

Dermal filler therapy may be a natural progression of where the cosmetic dental industry is heading, according to Goren. “With proper training, these procedures are easy for dentists to accomplish. Patients are motivated to accept these therapies and excited about having them done under local dental anesthesia, making dentists the health care professionals of choice to deliver these procedures.”

Whether dental plan providers will push the cosmetic coverage envelope to cover dermal filler therapy remains to be seen. Meanwhile, however, a new national movement is underway among dentists that could spark discussions about including cosmetic procedures as part of basic dental plans.

The dental industry has been lobbying across the country for states to prohibit insurers from negotiating discounts on services that are not covered.

Because there is a great deal of discounting on cosmetic procedures, this trend is significant, according to Evelyn Ireland, executive director of the National Association of Dental Plans in Dallas.

“The dentists feel that they are in an unequal, negative position,” she says. “Their position is if a carrier won’t pay toward a service, they shouldn’t be required to discount it.”

“The no-discounts on non-covered services legislation is not very consumer friendly,” says Virani. “If a service that is cosmetic in nature is not covered, the dentist will have better luck convincing the patient to have it done if it can be provided at a discount. Discounts are the cornerstone of PPO products, so this is changing things quite a bit.”

“Carriers aren’t happy [with these regulations] because employees are losing out on discounts,” agrees Martin. “It is possible that we’ll see a resurgence of requests for coverage for cosmetic services because then we could offer a discounted fee if that’s requested.”

Discounted or not, there’s no doubt that patients will continue to request cosmetic procedures and dentists will continue to expand the scope of these services.

“It’s a nice time to be a dentist when you have patients who are smiling, looking good and you know they have a healthy mouth,” says Guardian’s Goren. “It’s a stark contrast to getting feedback that it hurts and they don’t like anything you can do for them.”

By the numbers

In 2007, the American Academy of Cosmetic Dentistry put the market for cosmetic dental procedures at $2.75 billion, based on a 2006 survey of its members. Of that, $138.8 million was for bleaching and whitening, $383 million was for posterior composites, or rear fillings, and $144.3 million was for implants. The total number of patients seeking cosmetic services was estimated at 2.69 million, which represented a 12.8% increase over 2005. Furthermore, the survey respondents expected another 11% increase in patients and revenue in 2007.

Credit: By Lynn Gresham

Baby teeth are vulnerable to tooth decay from their very first appearance, on average between the ages of six and 12 months. Pediatric dentists specialize in caring for these tiny teeth, imperative for proper speech development and nutrition. The specialized care offered by a pediatric dentist includes unique strategies for working with children that alleviate fear and anxiety through the use of positive reinforcement and behavior guidance. Pediatric dentists monitor babies’ growth and development and provide essential dentistry services including tooth cleaning, polishing and fluoride treatment.

For healthy smiles, dental care must be established in – and out – of the pediatric dentist’s chair. The AAPD recommends the following at-home methods for infant oral health care:

Clean infant mouths and gums regularly with a soft infant toothbrush or cloth and water.

Children older than six months need fluoride supplements if their drinking water does not contain enough fluoride. Fluoride supplementation in infants has been shown to reduce tooth decay by as much as 50 percent. Check with your pediatric dentist first.

Babies should be weaned from the bottle by 12-14 months of age and at will breast-feeding should be discouraged.

Baby teeth should be brushed at least twice a day with a toothbrush made for small children using a “smear” of fluoridated toothpaste.

Visit www.aapd.org for more information or to locate a pediatric dentist.

The American Academy of Pediatric Dentistry

Founded in 1947, the AAPD is a not-for-profit membership organization representing the specialty of pediatric dentistry. AAPD’s 7,600 members are predominately pediatric dentists and primary care providers who deliver comprehensive specialty treatments for infants, children, adolescents and individuals with special health care needs. As advocates for children’s oral health, the AAPD aims to promote the use of evidence-based policies and guidelines, foster research concerning pediatric oral health, and educate health care providers and the public to improve children’s oral health. For further information, please visit the AAPD Web site at http://www.aapd.org.

“However, to what extent schools are able to do this is unclear. The aim of this study was therefore to investigate opportunities and challenges to promoting oral health in primary schools. A purposive sample of 20 primary schools from socially and economically disadvantaged areas of Cardiff, UK were selected to participate in this qualitative study. Data were collected through semi-structured interviews conducted with head teachers or their nominated deputies. General awareness of health and oral health was good, with all schools promoting the consumption of fruit, water and milk and discouraging products such as carbonated drinks and confectionaries. Health promotion schemes were implemented primarily to improve the health of the children, although schools felt they also offered the potential to improve classroom behaviour and attendance. However, oral health was viewed as a separate entity to general health and perceived to be inadequately promoted. Successful health promotion schemes were also influenced by the attitudes of headteachers. Most schools had no or limited links with local dental services and, or oral health educators, although such input, when it occurred, was welcomed and highly valued. Knowledge of how to handle dental emergencies was limited and only two schools operated toothbrushing schemes, although all expressed an interest in such programmes. This study identified a positive predisposition to promoting health in primary schools. The challenge for the dental team, however, is to promote and integrate oral health into mainstream health promotion activities in schools,” wrote P. Gill and colleagues, University of Glamorgan.

The School-Based Oral Health Program, used in 10 local school districts from 2006 to 2009, was designed to bring the number of kids with cavities closer to 42 percent — a health benchmark set by the federal government.

But despite the school program, the percentage of Pierce County youngsters with cavities remained high: 56 percent overall and 65 percent for low income children.

There was “no evidence” the program reduced cavities in the total population of children, the Health Department’s internal assessment of the program concluded.

In the program, Health Department staff members examined the teeth of nearly 75,000 second- and third-graders, said David Vance, a Health Department division director. Children without cavities were offered a fluoride varnish or a dental sealant, Vance said. Those with decay were referred to low-cost dental providers.

Several factors contributed to the disappointing results, examiners said. Among them:

–Administrative problems. Only 18 percent of children who qualified for dental treatment received it.

–Failed sealant. Only about half of sealed molars remained fully sealed a year later.

–Economic recession: Tough times might have canceled out improvements

–High mobility: Only 28 percent of students assessed the first year were present for assessment two years later.

The Health Department will continue to explore strategies to prevent cavities in Pierce County children, Vance said.

Officials want to expand the sealant program to more children, find better ways to obtain parental approval and figure out a better way to apply sealants so they stay on molars longer.

Next year, Vance said, local dentists and their staffs will visit the schools instead of Health Department employees.

“We’ve reached out to private providers,” he said. “Rather than having Health Department staff go into the schools, we’ll be the ones coordinating the care. We’ll act as a clearinghouse. We think that will be a much more effective role for us.”

A “Smile Survey,” conducted by the Health Department in 2005, concluded the severity of dental decay was worse in Pierce County than the rest of the state.

In that survey, 37 percent of second and third graders had a history of decay in seven or more teeth (“rampant decay”), compared with 21 percent in all of Washington.

Among low-income preschool children, 39 percent had a history of decay in their upper front teeth, compared with 18 percent in the whole state.

A 2010 Smile Survey has just been finished and the results will be released later this month.

“That should give us a much better idea of where we are with the oral health of kids in Pierce County,” Vance said.

Rob Carson: 253-597-8693 rob.carson@thenewstribune.com

2010 JUN 6 – ( NewsRx.com) — Two community dental clinics that provide much-needed services to low-income people who lack access to care will receive a $10,000 grant from Delta Dental of Pennsylvania (see also Managed Care).

The grant will directly reimburse clinic dentists for their services to patients who have unmet dental needs and who are unable to pay on their own for those services.

The first grant installment of $5,000 was presented Thursday to the James W. Barner Community Dental Clinics of the Partnership for a Healthy Community, which provides oral health care services for those with limited access to care due to medical conditions, disability or limited financial resources. The two clinics collectively serve about 7,500 patients a year, including more than 4,000 children.

The Partnership was created by and operates as an affiliate of Altoona Regional Health System. The children’s clinic is located in and operated in partnership with the Greater Altoona Career and Technology Center.

Although about half of the clinics’ patients are beneficiaries under dental Medicaid or Medicaid Managed Care, many lack any financial resources to help pay for care. The clinic provides these patients approximately $100,000 per year in services such as dental screenings, restorations and emergency care.

“Our clinics are a great story of good people coming together to help neighbors in need,” said Jerry Murray, president and CEO of Altoona Regional Health System. “We have been blessed by the hard work of devoted and community-minded individuals who turned a dream into reality.

“Generous partners such as Delta Dental help us keep the dream alive. And we thank Dr. Donald Betar, clinical director, who was instrumental in securing this grant.”

The clinics serve an eight-county area (Blair, Centre, Huntingdon, Fulton, Bedford, Cambria, Clearfield, and Clinton). They are the area’s largest provider of oral health care services to patients with limited resources.

“These two clinics routinely absorb the cost of urgent and emergency care for the dentally underserved,” said Gary D. Radine, Delta Dental president and CEO. “We’re pleased that this grant will go directly toward paying for this care. The grant is consistent with our mission to expand access to care for as many people as possible.” About Delta Dental of Pennsylvania Delta Dental of Pennsylvania (www.deltadentalins.com) is part of a holding company system whose affiliated companies, along with Delta Dental of New York, provide dental benefits to nearly 25 million people in 15 states, the District of Columbia and Puerto Rico. They are all part of the Delta Dental Plans Association (DDPA), based in Oak Brook, Ill. DDPA consists of 39 Delta Dental member companies licensed in all 50 states. The association collectively covers nearly 54 million of the 176 million people nationwide with private dental insurance, making it by far the largest national system of dental plans. About the Altoona Regional Partnership and the James W. Barner Community Dental Clinics The Altoona Regional Partnership for a Healthy Community (www.altoonaregional.org) is a 501(c)(3) nonprofit corporation for the Altoona area, which is demarcated as an underserved rural area. In 1999, the Partnership and the Greater Altoona Career and Technology Center opened the dental clinics – one for pediatrics and one for adults. Directed by Dr. Donald Betar, the clinics offer free dental screenings, restorations and emergency care for dental Medicaid and Medicaid Managed Care beneficiaries as well as uninsured children and adults and Medical Assistance recipients in Blair, Centre, Huntingdon, Fulton, Bedford, Cambria, Clearfield, and Clinton counties. The clinics serve 7,500 patients a year, including more than 4,000 children.

Keywords: Dentistry, Health Policy, Managed Care, Medicaid, Delta Dental of Pennsylvania.

“The color looked a little different on one of the front teeth,” Garcia said. “I started looking to see what was wrong with that tooth.”

Tuesday morning, the Garcia family decided to take Daniel to the Wilson County Health Department to see what was wrong with the tooth.

Turns out little Daniel has a cavity on the back of that front tooth, said Valerie Brock, child public health nurse, after examining him.

The Wilson County Health Department has a new dental screening and fluoride varnishing program called “Into the Mouths of Babes,” which allows parents to bring in children as young as 6 months old to have a dental screening and fluoride varnish applied to the teeth.

The program, which is funded by the state, is for children up to 3 1/2 years of age and the treatments are suggested to be given every six months. The program started March 8.

“Getting the varnish is just like having a fluoride treatment at the dentist,” said Kay Long, child health coordinator. “We just put a very small amount of the varnish on the teeth and it sticks to the teeth until parents brush it off the next day.”

Long said the varnish tastes like bubble gum and the procedure doesn’t hurt the child.

“Children do make a fuss,” Brock said. “But it’s only because they don’t want you to go into their mouth.”

Brock said Daniel cried because he didn’t understand what she was doing.

“His father held him and comforted him,” she said.

Long said the sooner parents bring their children get the varnish, the fewer cavities they will probably have. She said studies show children receiving the procedure have fewer cavity-related treatments in a dental office than children who do not receive the treatment.

Brock said it also helps children to continue into adulthood with dental care when they start early.

Health department officials are trying to get more parents educated about why it is important for children to have regular dental check-ups.

“You would be surprised to know how many children don’t see the dentist,” Long said. “Statistics say 40 percent of children who start kindergarten have cavities.”

Long said many times children come to the health department for their well child check-ups needed to enter school and she finds their teeth and gums are in bad shape.

One reason very young children get cavities is because parents put babies to bed with a bottle.

“Milk has sugars in it and when a baby falls asleep with milk in his mouth, the sugar from the milk sits on the teeth,” Long said. “Toddlers also have sugary drinks in their sippy cups. All of those things cause cavities.”

Access to dental care for some parents is out of reach, Long said.

“There are not many pediatric dentists and only 25 percent of North Carolina dentists participate in Medicaid,” Long said. “So many children don’t get to see the dentist.”

It is not necessary for a child to receive any other health department services to get the dental screening services.

But the parent or guardian of the child must be present when the child gets the varnish.

“It is important that the person who cares for the child be here so they can learn first-hand about cavity prevention and what they can do,” Long said.

Appointments are not necessary. Walk-ins are welcome.

“The color looked a little different on one of the front teeth,” Garcia said. “I started looking to see what was wrong with that tooth.”

Tuesday morning, the Garcia family decided to take Daniel to the Wilson County Health Department to see what was wrong with the tooth.

Turns out little Daniel has a cavity on the back of that front tooth, said Valerie Brock, child public health nurse, after examining him.

The Wilson County Health Department has a new dental screening and fluoride varnishing program called “Into the Mouths of Babes,” which allows parents to bring in children as young as 6 months old to have a dental screening and fluoride varnish applied to the teeth.

The program, which is funded by the state, is for children up to 3 1/2 years of age and the treatments are suggested to be given every six months. The program started March 8.

“Getting the varnish is just like having a fluoride treatment at the dentist,” said Kay Long, child health coordinator. “We just put a very small amount of the varnish on the teeth and it sticks to the teeth until parents brush it off the next day.”

Long said the varnish tastes like bubble gum and the procedure doesn’t hurt the child.

“Children do make a fuss,” Brock said. “But it’s only because they don’t want you to go into their mouth.”

Brock said Daniel cried because he didn’t understand what she was doing.

“His father held him and comforted him,” she said.

Long said the sooner parents bring their children get the varnish, the fewer cavities they will probably have. She said studies show children receiving the procedure have fewer cavity-related treatments in a dental office than children who do not receive the treatment.

Brock said it also helps children to continue into adulthood with dental care when they start early.

Health department officials are trying to get more parents educated about why it is important for children to have regular dental check-ups.

“You would be surprised to know how many children don’t see the dentist,” Long said. “Statistics say 40 percent of children who start kindergarten have cavities.”

Long said many times children come to the health department for their well child check-ups needed to enter school and she finds their teeth and gums are in bad shape.

One reason very young children get cavities is because parents put babies to bed with a bottle.

“Milk has sugars in it and when a baby falls asleep with milk in his mouth, the sugar from the milk sits on the teeth,” Long said. “Toddlers also have sugary drinks in their sippy cups. All of those things cause cavities.”

Access to dental care for some parents is out of reach, Long said.

“There are not many pediatric dentists and only 25 percent of North Carolina dentists participate in Medicaid,” Long said. “So many children don’t get to see the dentist.”

It is not necessary for a child to receive any other health department services to get the dental screening services.

But the parent or guardian of the child must be present when the child gets the varnish.

“It is important that the person who cares for the child be here so they can learn first-hand about cavity prevention and what they can do,” Long said.

Appointments are not necessary. Walk-ins are welcome.

But the children, selected through the school district by referral from nurses, will get additional treatment, said Aiken dentist Dr. Charlie Wyont, who has coordinated the Aiken County effort in the national program that provides the pro bono services.

Originally, dentists volunteering with the program went ahead and treated kids with cavities and other needs on the “Give Kids a Smile” day. But that time frame allowed only partial treatment, Wyont said. Last year, dental hygienists began a procedure of providing the children with a thorough cleaning, followed by screening from the dentists.

“Now the child gets a complete treatment in our offices,” said Wyont. “We aren’t seeing the same number of kids now. The first year, we had over 100 children, and it’s gone down each year. As this program has gone on, the dentists have visited schools for screenings, and nurses can also refer for abscesses or tooth decay. We’re getting feedback from the dentists that we’re seeing less problems in the schools. The system is working.”

ATC’s dental assisting program has hosted Give Kids a Smile since its start in Aiken County.

“I love having them here,” said the program director, Amy Johnson. “It’s a great learning experience for our kids and a good networking experience, too. It meets the needs of an underserved group of kids in the community. I wish we had the ability to do this more than once a year.”

Johnson’s students provided assistance as needed and observed the hygienists and dentists. A group of health science students from the Aiken County Career and Technology Center also coordinated games and other activities for children while they waited to see a hygienist and a dentist. One health science student, Elizabeth Hernandez, had a different assignment, serving as a translator for some of the kids. A native of California, Hernandez’s parents are from El Salvador.

“This has been great,” she said. “I look forward to doing it again. My hope of wanting to be a nurse has grown. So far the kids have been really excited. I think they felt more comfortable knowing I was there.”

Most recently, the Senate version of health reform represents a high water mark for oral health legislation, with more than two dozen important provisions aimed at improving oral health care, which include:

– Expanding insurance coverage for pediatric oral health services and

eligibility for preventive oral health services without co-payments.

– Launching new dental disease prevention initiatives including public

education, school- based sealant programs in all 50 states, and research

grants for dental caries management.

– Addressing critical dental care workforce issues and the cultural

competence and diversity of the provider teams through expanded training

programs and education resources for general, pediatric and public

health dentists and for the exploration of new solutions for dental

professionals to reach rural and underserved areas.

Access issues are particularly severe in many rural and urban communities, and particularly impact children and families of color. The rate of untreated decay in American Indian and Alaska Native children is more than 3 times higher than that of all children in the United States. It is known that those who lack affordable health insurance are at increased risk for unmet dental needs, and together with children from poor and/or minority families, these two categories amount to 52 percent of children in this country.

Untreated dental disease many times leads to serious, life-threatening medical situations. For too long, oral health has long been separated from the rest of the body in most health policy conversations, even though oral health is essential to overall health.

We are pleased that Congress is bringing oral health into the conversation to improve our nation’s overall health. These issues have historically received broad bi-partisan support, and we look forward to continued progress.

The W.K. Kellogg Foundation supports children, families, and communities as they strengthen and create conditions that propel vulnerable children to achieve success as individuals and as contributors to the larger community and society. Improving oral health for children and families is an important component of our work to improve overall health, eliminate racial disparities in health, and provide needed health care to those who are underserved.

SOURCE W.K. Kellogg Foundation

Credit: W.K. Kellogg Foundation