Achieva Disability Healthcare Initiative (DHI) is a national and state-level leader in disability health equity and access to inclusive health care for people experiencing disabilities through education, public policy, and advocacy. The organization works to increase physical and programmatic access, medical workforce development, and education. Achieva works with many stakeholders, including individuals with disabilities and their families, medical professionals, hospital and health centers, government agencies, educators, insurance companies, foundations, and disability advocates, to develop viable solutions to increase access to physical health care and dental care for people with disabilities.
Since its creation in 2005, Achieva’s DHI has increased access to dental care, improved women’s health care, and focused on care transitions for youth with disabilities and chronic medical issues as they move to adult care systems. “The DHI recognizes that transition is not merely a matter of making lists of providers for families but also acknowledges the training gaps and limited numbers of providers who are able to provide care to those with developmental disabilities,” says Miya Asato, M.D., Vice-President of the Kennedy-Krieger Institute, and Professor of Neurology and Pediatrics at Johns Hopkins School of Medicine. “This initiative is powered by dedication, and its strong leadership sets a national care standard. Importantly, the DHI addresses a health care need in our community for an underserved population with many health problems.”
- In 2005, DHI began its work on access to healthcare for children and adults with disabilities. Access to dental care was the first issue undertaken by the DHI.
- In 2007, Achieva created the Advancing Oral Healthcare Project to identify barriers to accessing dental care for people with intellectual and developmental disabilities (I/DD) and to promote strategies and initiatives for systemic change, ensuring access to affordable, equitable services.
- In 2007, the Disability Healthcare Initiative published Access to Oral Health Care for Pennsylvanians with Disabilities: A Rising Public Health Issue which identified the issues that contributed to oral health care for people with disabilities being a serious public health problem.
- In 2009, DHI produced Access to Dental Care for People with Disabilities: Challenges and Solutions – A Report to Pennsylvania’s Legislators. DHI made seven recommendations to improve access to oral health care for those with disabilities. Several of these recommendations have come to fruition. For example, private insurance companies must now provide dental insurance payment for anesthesia for children under age five and people with disabilities.
- In 2012, the Disability Healthcare Initiative continued the nationally recognized work of the FISA Foundation on increasing access to health care for women with disabilities and wrote Access to Healthcare for Women and Girls with Disabilities: A Report to Pennsylvania Legislators.
- Also, in 2012, Achieva was selected by The Arc of the United States to be one of five pilot sites in the nation to implement HealthMeet®, which offered free health screenings to adults with disabilities while promoting health and wellness through webinars and information for people with disabilities, families and health professionals.
- On July 25, 2013, we delivered the Because Every Goddess Deserves Good Healthcare booklet, with the support of the Women and Girls Foundation, to all members of the General Assembly.
- In 2014, Senate Resolution 2013-61 directed the Legislative Budget and Finance Committee, a Joint Committee of the Pennsylvania General Assembly, to study and issue a report on the disparities found in dental care for Pennsylvanians with disabilities, both children and adults, and to make recommendations to preserve and improve such services. The finished report, Dental Services for People with Disabilities in Pennsylvania, was presented to the PA Legislature on February 24, 2015.
- In 2014 the Disability Healthcare Initiative researched and produced the report, Transition from Pediatrics to Adult Medical Systems for Young Adults with Disabilities or Special Health Care Needs.
- In 2014 DHI also received the Benjamin Rush Community Organization Award from the Allegheny County Medical Society (ACMS). Established in 1947, the award recognizes a company, institution, organization, or agency that is successfully addressing a community health issue.
- Since 2015, DHI has worked to reinstate the Adult Dental coverage under Medicaid, which was cut in 2011. DHI also works to eliminate access barriers present under the current Benefit Limit Exception process.
- During 2016 and 2017, with the support of the FISA Foundation, DHI has researched and explored enhancements for the University of Pittsburgh School of Medicine’s curriculum on disability to ensure that disability medicine becomes a component of the required four-year curriculum for all medical students. We also worked to eradicate dental disease in children by expanding programming for Cavity-Free Kids and From the First Tooth. In addition, we assisted in developing self-advocates to become oral health champions.
The DHI’s early success laid the foundation for its partnership with the national DentaQuest Foundation, a leading health equity philanthropic organization.
- In 2017, DHI worked with our partners and the Office of Medical Assistance Programs (OMAP) and the Pennsylvania Coalition for Oral Health (PCOH), to streamline the Benefit Limit Exception pre-authorization process by eliminating physician’s letter requirement, standardization of the BLE application forms, and making the forms available online. We worked with our partners at the Pennsylvania Health Access Network to educate people needing oral healthcare about the availability of the Benefit Limit Exceptions. We developed a training guide to assist Navigators in raising consumer awareness, assisting with BLE applications, and tracking BLE application data. We also deepened our outreach to state legislators to advocate reinstating the adult oral health benefits, which were cut from public insurance in 2011. We educated dental diseases as a serious public health matter and focused on legislators on the Appropriations and Human Services Committees to support budget appropriations for oral health.
- In 2018, DHI collaborated with Senator Lisa Baker and our partners to draft legislation restoring the Adult Dental Benefit in Pennsylvania’s Medicaid program. DHI worked with the University of Pittsburgh School of Dental Medicine to determine how the deep cuts to Medicaid’s adult dental coverage negatively affected dental education and resources. We also worked with PCOH and the American Dental Association’s Health Policy Institute to illustrate the links between the increase in Hospital Emergency Department use for non-traumatic dental diseases and the adult dental coverage cuts from 2011. In addition, we collaborated with PHAN to host community meetings and collect personal stories to share and build support for reinstating adult dental coverage in public insurance. DHI also educated dental professionals about the American Dental Association’s changes to their Code of Professional Conduct and Ethics requirement that dental professionals provide treatments to patients with disabilities or refer them to another dental professional with the requisite skill. DHI also became part of a four-year grant from the Health Resources and Services Administration and the PA Department of Health to develop a short film webinar to encourage more dental professionals to build their knowledge, skills, and attitudes about inclusive dentistry.
- In 2019, DHI continued its partnership with the DentaQuest Foundation (now the CareQuest Institute) to improve health equity for people experiencing disabilities. DHI collaborated with PCOH to draft HR 799, a bipartisan resolution introduced in the PA House directing the Legislative Budget and Finance Committee (LBFC) to commission a study about increases in Emergency Room use for non-traumatic dental diseases since the 2011 adult dental coverage cuts. DHI also advocated reinstating adult dental coverage and improvements to the BLE process under the Pennsylvania Medical Assistance program.
We met with the governor's Policy Director, SWPA Regional Director, Budget Director, and an Inter-Agency Liaison. We also met with the Lieutenant Governor’s Western PA Director, Bipartisan General Assembly Caucuses, and Oral Health Champions in the General Assembly.
We also partnered with the Center for Medicare Advocacy to present Deputy Secretary Kozak of OMAP with research on evidence-based chronic conditions worsened by oral diseases. DHI and PCOH were instrumental in persuading OMAP to pre-authorize dental treatment for patients with a history of some of the listed chronic conditions. As a result of DHI’s work and collaboration with partners, OMAP added adult dental visit data and tracking to all Managed Care contracts with the Commonwealth.
- In 2020, DHI and our bipartisan bill sponsors connected with members of the PA General Assembly and persuaded 50 House of Representatives to co-sponsor HR 799. DHI also began work on obtaining a Medically Underserved Population designation for Pennsylvanians with disabilities. Nancy Murray, Achieva Senior Vice President and President, The Arc of Greater Pittsburgh, also leveraged her seat on the Medical Assistance Advisory Committee (MAAC) to advocate for Medicaid reimbursement increases and a simplified Benefit Limit Exception application process.
DHI and PCOH also organized seven Virtual Listening Sessions across the state to get feedback and hear concerns about the availability of inclusive dental care in Pennsylvania. DHI worked with Untitled to produce a film short that encourages dental professionals to consider offering inclusive care in their practices. We also collaborated with the Oral Health Progress and Equity Network (OPEN) to organize a nationwide Twitter Storm to elevate the need for improved access to inclusive dental care.
- In 2021, DHI intensified its efforts to promote the designation of people with disabilities as a Medically Underserved Population. To advance this work, DHI built partnerships with:
- The National Council on Disability,
- The American Academy of Developmental Medicine and Dentistry,
- Harvard Law’s Disability Law Project,
- Stakeholders who served on the 2010 HRSA Negotiated Rule-Making Committee that was charged with updating the Medically Underserved Population designation process,
- University of Pittsburgh School of Dental Medicine,
- University of Pennsylvania School of Dental Medicine and Dr. Mark Wolff,
- Special Olympics PA,
- The LEND Center,
- Dr. Steve Perlman, Boston University, Goldman School of Dentistry,
- Dr. Paul Glassman, California North State University, and
- Community Catalyst.
DHI also developed three oral health training modules for Direct Support Professionals. DHI’s work centers on promoting equitable and inclusive healthcare for all people with disabilities throughout their lifespan.
For information about Achieva’s Disability Healthcare Initiative, please contact Vanessa Rastovic, Esq., at 412.995.5000 x569