Working

Jan Blancett, RDH

Jan Blancett, RDH, is the dental program manager with Correctional Medical Services (CMS), a nationwide company that provides medical, dental and mental health care exclusively for jails and prisons.

She first got involved with this work in 1993. "The Arkansas State Dental Hygienists' Association (ASDHA) helped the Arkansas Department of Correction (ADC) pass legislation allowing hygienists to work under the general supervision of a dentists in their clinics," she said. "I wanted first-hand experience with this 'new,' less restrictive level of supervision, so I began working at one of the clinics part-time."

In 2001, after 28 years of private practice, Blancett accepted a full-time position as dental program manager for CMS. Her position is mainly administrative; however, she has the opportunity to fill in at the dental hygiene clinics when a position is open or a hygienist is out sick, on vacation, etc.

This line of work presents unique challenges for Blancett. For one, funding for the ADC comes from the state legislature. It is important for her to impress upon other health care team members and CMS managers the value and cost of the instruments they use. Another challenge Blancett faces is keeping the clinics fully staffed; it's hard enough to recruit dentists and dental hygienists for prison work, but there is also a geographical problem. Most prisons are located in rural area, while most dentists and dental hygienists live in urban areas. Finally, the degree of dental needs of the patients is much higher than that of the average patient. Many have had little or no dental care as children, and dentists and dental hygienists are dealing with gross decay (often from the use of methamphetamine and other drugs) and heavy calculus.

"The trade-off is their level of appreciation," said Blancett. "They simply cannot believe their teeth look and feel so good. It is instant gratification for us, as practitioners, to have patients who literally think we have worked miracles."

Blancett oversees 12 full-service dental clinics located inside the prison infirmaries. Blancett tries to maintain a "McDonald's" style of dentistry throughout the 12 clinics; that is, "the services provided at the Maximum Security Unit are the exact same services provided at the McPherson's women's unit or any other prison in Arkansas. Keeping all the dentists and hygienists on the same page, utilizing the same set of standards, the same charting criteria, et cetera, takes a lot of my time."

In addition to the written policies and procedures necessary to keep this standard in place, the state prisons are accountable to accreditation groups, such as the American Correctional Association and the National Commission on Correctional Health Care, whose guidelines they must follow. Blancett's part in this includes monthly and quarterly auditing of dental records and making sure that the Occupational Safety and Health Administration and Centers for Disease Control and Prevention guidelines are followed as well. She visits at least three clinics each month to conduct audits and discuss any problems with the staff.

Another important aspect of the job is the scheduling of patients with a community oral surgeon for needs that cannot be accommodated by the dentists on staff. Twice a month, CMS holds clinics with the oral surgeon who sees about 12 patients a day, who may come from all 12 different prisons with 12 different transportation officers. The schedule is made on a first-come-first-served basis, unless there is an emergent need. "Keeping the transportation officers scheduled and getting the right patient to the right clinic at the right time takes determination and organizational skills I never knew I possessed," said Blancett.

Blancett considers this a great job for any dental hygienist. "Hygienists make great administrators," she said. "It is in our nature to pay close attention to details, to be organized and to be wholly dedicated to succeeding at anything we do. I have grown so much as a person and a professional through my association with health care providers outside the dental field."

She continued, "I would encourage any hygienist who is interested in the correctional health care industry to contact CMS at www.correctionalmedicalservices.com to see if there are any clinical or administrative openings in their area.

"Other health care industries such as local and state Health and Human Services departments, insurance companies, juvenile detention centers, nursing homes and residential facilities for developmentally disabled children or adults are all places where dental services are needed, but there is usually no one with knowledge of the industry to oversee the programs. These would all be good avenues for hygienists interested in administrative positions to explore."

This edition of Working was prepared by Meghan Washington