Running Head: BUSINESS PLAN

Access to Dental Care for Cognitive and Physically Impaired Individuals Business Plan Rochelle Betton-Ford Siena Heights University LDR 609 Health Systems Management Dr. Fick October 29, 2013

BUSINESS PLAN Business Plan I. Executive Summary The purpose of this business plan is to secure a business loan from your organization for Special Smiles, PC Dentistry. With assistance of your loan Special Smiles

Dentistry, PC will establish a general dental practice in Detroit, Michigan specifically for the cognitive and physically impaired populations in Southeast Michigan. Mission: We are committed to provide superior dental services to individuals with Intellectually, Physical and Mentally Ill challenges, with Compassion, Respect and Dignity. Vision: Realize access to quality dental services for intellectually, physically and mentally ill challenged individuals in the state of Michigan, and advocate for access to adequate dental care nationwide. Access to dental care remains a problem for the special needs population government agencies state and local levels should not only consider change in the way dental care is provided for persons with mental and physical challenges, it is crucial to implement change for the long term. Dental caregivers have waited too long, for the government to implement change, it is time to act now. That is the decision that must be made, and will our proposal seeking funding for our capital funding becomes a reality. This proposal has been recommended by the Chief Financial Officer of Special Smiles Dentistry, PC regarding the capital and operating budgets.

II.

Project Description

BUSINESS PLAN A. Access to dental services for cognitive and physically were mandated and provided for individuals residing in institutionalized facilities (Burtner, Dicks, 1994). . Since the closing of many of these facilities, patients are facing barriers to adequate dental

care. There are several reasons for this disparity, Patient to provider ratio, school, and non-exposure of the special needs population to the public (Fisher, K, 2012). B. Written description of the service/program General dental services provided to persons with cognitively, physically and mentally ill individuals. Services include, preventive general cleanings to full scaling and root planning, fluoride treatments, dental radiographs, restorative procedures amalgam and composite and bonding, endodontic treatment pulpotomy and root canal therapy, crowns, extractions simple and limited oral surgery, crowns, partials and dentures, and relief of dental emergencies. C. Objectives and description of how it contributes to the mission and vision 1. To establish a general dental practice specifically for cognitively, physically and mentally ill patients, making access to dental care for this population possible 2. To increase the number of patients by 50% per year by providing quality dental services and referrals from caregivers, teachers, and healthcare providers. 3. To become a leader in the field of dentistry, creating unique methods to provide dental services to patients with special needs 4. Eventually establish a rotation agreement with dental schools, providing requirements for dental students and hygienist to work and treat the special needs population.

D. Strategies, tactics and outcomes of the service/program

BUSINESS PLAN Special Smiles will employ full time staff to operate our practice, we will also utilize dental student offering on site experience to enhance their educations objectives: 1. Two Dentists 2. Two Hygienist, 3. Three Dental Assistants, 4. 5. Receptionist, Certified Medical Assistant,

6. Insurance biller. 7. Dental Students; Hygienist and Dentist (students) from University Detroit Mercy and Wayne County Community College District, Extern dental both clinical and administrative students from Kaplan, Everest and Ross while completing educational requirements for serving patients with special needs. III. Documentation of Need A. Demographics There are 6.5 million people in the United States with cognitively impairments (Intellectual disability, 2005), according to CDC (n.d.) 1 in every six child have one or more developmental disabilities this number does not include persons with mental illness and physical disabilities. Our organizations initial target area is those persons in midtown Detroit, Michigan; however we will accommodate individuals with disabilities from any area seeking dental services. B. Demand/Usage The demand for dental services has remained overwhelming for individuals with cognitively and physical disabilities. There is a 1- 5 ratio (dentist/patient).

BUSINESS PLAN The number of students applying to dental school remains low and an inadequate

reimbursement rate from Medicaid may be the blame for barriers to access dental care for this population. C. Competitor Analysis There are a small percentage of practices in Wayne and Oakland County presently accepting or treating patients with cognitive impairment and disabilities. D. SWOT (Swayne, Duncan & Ginter, 2009) Strengths of competitors 1. Existing location/practice

2. Established patient base 3. Established financial resources

Weakness of competitors 1. Long waiting list for patients requesting dental services, 2. Limited appointment days and hours 3. Limited handicapped facilities 4. Restrictions to age and cognitive severity for some practices

Opportunities for Special Smiles 1. Completely handicapped accessible facility 2. Open provide five days a week and including one Saturday each month

3. Same day availability for emergency patients, appointments available within 1- 3 weeks upon contact 4. Providing services for all patients regardless of cognitive limitations, and age.

BUSINESS PLAN 5. Staff is knowledgeable with regards to various aspects of the special needs population Threats for Special Smiles 1. Established financial resources of competitors 2. New to the market List of competitors 1. Childrens Hospital - Detroit, Michigan patients age 2- 25 years of age Long waiting list approximately 3-6 months (Childrens Hospital, n.d.) 2. Childrens Center Clinic Detroit, Michigan Provides hospital dentistry and comprehensive pediatric care, sedation, cleft palate/lip correction

3. University Michigan Hospital in Ann Arbor - provides dental services to patients with cognitive and physical impairments; appointments may be three to four months away Lack of transportation is a deterrent for persons living in Wayne, and parts of Oakland counties. Hours of operation poses a problem for many of the caregivers of these individuals E. Trends Individuals with cognitively and physical disabilities are routinely referred to hospitals, or physicians for relief from dental pain. Due to poor oral hygiene, and a lack of early preventive care many of these patients may eventually lose all dentition. For persons with sever cognitive impairment, dentures and partials are impossible for patients to wear, resulting in poor mastication, digestive health problems, malnutrition.

BUSINESS PLAN IV. Marketing Plan Marketing is the activity and processes for creating, delivering, communicating and exchanging offerings that have value for customers, partners, and society at large (AMA, 2013). Our marketing strategy is unique as we are offering dental services both preventive and restorative to the cognitively and physically challenge populations including those with mental illness. Caregivers and healthcare providers will prove to be an excellent mode of marketing and word of mouth. By developing visibility among parents, caregivers, associations related with the special needs populations and utilizing a network of referral from physicians other healthcare providers. Extensive marketing campaign, ensuring visibility for the organizations target market. Market strategies;

Network with teachers, doctors, nurses, workshops and recreation facilities for special needs individuals, counselors, social workers, department of social services, legal system- court- (guardianship) attend parent-teacher meetings, seminars, group homes, shelters, rehabilitations facilities, develop an online website and place the companys name and contact information, hospitals, word-of-mouth and the yellow papers,

Network and attain membership to professional associations example; Michigan Dental Hygienist Association, Wolverine Dental Hygienist association, Wolverine Dental Association.

BUSINESS PLAN

Another marketing strategy of Special Smiles Dentistry will provide dental screenings in schools for our target population, and churches, senior citizen dwellings and nursing homes. Special Smiles will create pamphlets detailing updates of our of our organizations process to the various networks we have established. V. Facility Planning Legal description of the business is Special Smiles Dentistry, P.C. At this time there is no obvious external or internal or conditions that will negatively affect the survival and growth strategies. Schematic facility master plan, we are in the process of leasing a previously full functional dental and medical office to our specifications Description of the facility Front entrance Waiting room 2- Lavatories (patients) inside waiting room Receptionist office Administrative office Joined Dentist office 2 - lavatories (staff) 1st Dental operatory/ 2nd Dental operatory 3rd room with 3rd and 4th operatory 4th room with 5th and 6th operatory Dental supply and stock area

BUSINESS PLAN Laboratory and Sterilization area Two additional lavatories Staff lounge/Conference room Locker area Compressor, Furnace, utility room Side and Back door entrance and exits Back entrance

This facility was previously utilized as a dental and medical office, single 3400 sq. foot, with available parking in the back of the building, including handicapped access ramps to each entrance of the building. With our SBA for women, we have made the necessary improvements to our facility. Special Smiles Dentistry owned dental supplies and major equipment from their previous mobile dental business. However it is necessary to purchase additional supplies, medications and disposable and paper products and a few other important pieces of equipment. We are presently waiting for re- assessment of zoning, regulations and approval from the department of zoning and regulations and necessary permits. Special Smiles and team members are committed to our objective, we realize that our quest will be face with many challenges, however we are prepared to reach our goals, we understand the initial sacrifices that must be met to succeed. Our efforts will be rewarded.

VI.

Financial Analysis Operating expenses: Salaries

BUSINESS PLAN Dentist (2) CEO Hygienist (2) Assistants (3) Receptionist CMA Monthly salary Health Insurance Liability Insurance Equipment Insurance Radiograph products Building Insurance Disability Insurance Telephone/Internet Disposable Paper products Disposable Hygiene products Disinfectant/products Miscellaneous front (Desk supplies) Custodial services Subtotal $ 400.00 $7925. + $ 41,400 $350.00 $250.00 $50.00 $3,600.00 $1750.00 $2400.00 $1,560.00 $520.00 $520.00 $10,350.00 x 4 = $ 41,400.00 $3000.00 $375.00 $400.00 $250.00 $600.00 $600.00 $1,000.00 $1,000.00

10

BUSINESS PLAN Total Operating Cost $ 49,325.00

11

BUSINESS PLAN Capital Budget This budget is based on monthly set fees Lease (Building) New Compressor Digital X-ray Machine New Chemiclave Desktop Computers (3) Laptop computers (5) Printers (2) Dental Chairs (3) Easy Dental program Including EMR system Total Capital Budget expenses $3,200.00 $6,950.00 $ 2,500.00 $ 200. $ 200.00 $ 75.00 $150.00 $200.00 $100.00 $125.00

12

BUSINESS PLAN VII. Business Risk Analysis

13

We expect a modest growth in new patients by the end of the year, due to our word of mouth and professional network of referrals. Our target population will finally have a viable option for quality dental care. Our initial start-up fee is substantial, we are requesting, $800,000.00 bank loan, with a 10% interest fixed fee over and another $100,000.00 from a SBA loan. We have $200,000.00 in current assets; we strongly believe this will place Special Smiles Dentistry, PC on solid foundation to sustain and grow for years to come. We realize that we cannot sustain our organization on Medicaid reimbursements; therefore we are reviewing possible incentives under the Affordable Care Act. We are participating with several insurance companies and working out polices to accept patients that have cognitively and physically challenges. The consequences of our business plan being rejected will only prolong access to dental care for our targeted population. VIII. Recommendations After approval from the inspectors Special Smiles will began operating in two months. Prior to opening our doors for business we will make certain all staff is certified in CPR, Medical emergencies, OSHA and continuing education requirements are in place, necessary vaccinations are up to date, HIPAA reviewed and requirements are in order. Once again attend continuing education seminars on communication, and sensitivity and empathy classes. Dr. A will serve as manger over the clinical team members and Dr. B over the administrative team members. I believe this will prove satisfactory as Dr. B. has a MBA in organization management. We are

BUSINESS PLAN

14

fortunate to have an experience insurance biller knowledgeable in dental terminology, as well as medical insurance biller experience. All personnel of Special Smiles will attend training sessions for EMRs, as we are making a transition to EMR. We understand that implementation is only the beginning of the business plan; we will continue to monitor (Longest, Darr, 2008) and make necessary improvements and changes to our plan in order for its survival.

BUSINESS PLAN

15

References American Marketing Association Definition of Marketing (2013). Retrieved October 21, 2013 from http://www.marketinngpower.com/AbouAMA/Pages/DefinitionofMarketing. aspx. Burtner, A.P., Dicks, J. L. (1994). Providing oral health care to individuals with severe disabilities residing in the community: Alternative care delivery systems. Special Care in Dentistry, 14(5) Retrieved October 09, 2013 from http:// www.plaza.ufl.edu. /burtner/provide.pdf CDC for Disease Control and Prevention- Facts About Developmental Disabilities Retrieved October 23, 2013 from http://www.cdc.gov/ncbddd/developmentaldisabilities/facts.html Childrens Hospital: Developmental Dentistry Specialist Dentist in Detroit. Retrieved October 13, 2013 from http://www.wellness.com/dir/2224536/dentist/mi/detroit/developmentaldentistry-speciali Fisher, K. (2012). Is there anything to smile about? A review of oral care for individuals with intellectual and developmental disabilities. Nursing Research and Practice, 2012 Retrieved October 11, 2013 from doi:10.1155/2012/860692 Longest, B. B., Darr, K. (2008). Managing health services organizations and systems. (5th ed.). Baltimore, Maryland: Health Professions Press. National Center on Birth Defects and Developmental Disabilities. (2005). Intellectual disability Retrieved October 23, 2013 from http://www.cdc.gov/ncbddd/actearly/pdf/parents_pdfs /IntellectualDisability.pdf Swayne, L. E., Duncan, W.J., Ginter, P.M. (2009). Strategic management of health care

BUSINESS PLAN organizations. (6th ed.). West Sussex, England: John Wiley & Sons, Ltd.

16

BUSINESS PLAN

17