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Office Visit: Priceless... Benjamin Lund, Editor, Dentaltown Magazine

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CASS Dental Clinic for the Homeless is the largest facility in the nation to provide quality comprehensive dental care for homeless men, women and children – a huge step in helping them get back on their feet.

by Benjamin Lund, Editor, Dentaltown Magazine

Above, from left: Ting Ting Baumgardner, dental assistant; Annette Chunn, office manager; Ariel Collins, children’s clinic coordinator & volunteer liaison; Justin R. Fallers, dental coordinator; Kris Volcheck, DDS, MBA; Chris Chunn, dental assistant; and Robert Johnson, dental assistant.
A visit to the dentist isn’t usually something most people look forward to. But for the patients at Central Arizona Shelter Services (CASS) Dental Clinic for the Homeless – who are either homeless, addicted to drugs or may have been abused – a visit to the dentist means a new lease on life.

The CASS Dental Clinic, in Phoenix, Arizona, is the largest volunteer dental clinic in the United States, offering comprehensive dental care for the homeless. What began in a cramped trailer in 2001 is now a state-of-the-art facility, which operates solely on generous donations and selfless volunteers, and run by Kris Volcheck, DDS, MBA.

Volcheck, a tall, modest man with a magnetic smile and booming baritone laugh, is the reason CASS has a dental clinic in the first place. In 1985, Volcheck graduated from dental school at Emory University and began practicing in Globe, Arizona. But after 10 years of practice, Volcheck was done.

“I loved hanging out with my patients, but the actual dentistry? No thanks. I don’t like constructing things in small spaces,” he says. While he was still in practice, Volcheck earned his MBA at Arizona State University, and around the time he graduated, he met Mary Orton, founder and then director of CASS.

“Mary and I hit it off and she suggested I come down and volunteer at the shelter,” says Volcheck. So he did, volunteering part time – handing out clothing, feeding people and delivering packages to homeless people living under bridges. Everything he did had nothing to do with dentistry. Soon CASS hired him on as a social worker, which he did for six years.

CASS was able to help the homeless in many ways, but the largest need it was unable to meet was dentistry. Volcheck proposed a volunteer-based dentistry program and, logically, since he was a dentist he would spearhead the project. Because there was such a huge need for dentistry within the Phoenix-area homeless population, Volcheck realized he needed help, so he began asking local dental professionals to volunteer. “I am not good at many things,” says Volcheck. “I can be pretty disorganized, but I can get you to help the homeless.”

On January 1, 2001, the CASS Dental Clinic opened out of a trailer, which was donated by the Arizona Office of Oral Health, along with 20 dentist volunteers and 15 hygienist volunteers. More than eight years later and with much help, the clinic has its own eight-operatory facility and volunteers now number in the hundreds.

Operations
“We are 100 percent non-profit,” says Volcheck. “CASS is the largest clinic of it’s kind for homeless in the nation. Things we do, like implants, cosmetics and dentures are unheard of in the homeless setting. The reason why we do it is because it is absolutely necessary. Because it’s necessary, we do everything that every other nonprofit does like fundraisers and donations from companies like Henry Schein. We get things in bulk from Oral Health Relief, but even with all of that it is still extremely expensive to run this facility.” The clinic’s operating budget is about $700,000, and its production runs several million dollars, but every single person operating on the patient is a volunteer and everything is free for each patient.

Standing in the middle of the clinic, you don’t get a feeling that all of the patients are being treated for free. From the equipment used to the restorations for every single patient to the roof over their heads – all of it is donated. When the clinic moved out of the trailer, Gordon Osterhaus of Valley Dental Consulting helped design and build the new dental facility. All eight of the operatories are equipped by generous donations from Pelton & Crane, A-dec and KaVo. The clinic treats the operatories as a showroom (after all, more than 300 dentists come through to volunteer their time each year), and because of that, all of the equipment is fairly high-end. Becker-Parkin filled the entire clinic with supplies, instruments and cassettes for free. Totaltek, a local IT company, wired the facility so it could operate digitally and completely paperless.

Even during downtime the clinic is bustling, but there is very little chaos, thanks in most part to Dr. Gretchen Henson a volunteer dentist who runs her own practice in Ahwatukee, Arizona. “Dr. Henson is the reason this clinic is so well organized and runs the way it does,” says Volcheck. “She volunteers here twice a week and is sort of my assistant director. She is why we are paperless, why all our systems are in place, why our OSHA is in place. She brought her systems from her office – patient flow, routing forms, check-in and checkout of patients, how dental students present to the faculty, etc. She brought all of her for-profit knowledge from her office into CASS.”

CASS Dental Clinic is the only dental clinic in the state of Arizona that serves the homeless, and because of this every single patient is scheduled. The clinic takes in emergencies, most of which are seen within an hour. Because there is a fair amount of unreliability in patients keeping schedules, scheduled patients arrive and are seen on a first-come, first-served basis. The morning session begins at 9 a.m. and the afternoon session starts at 1 p.m. Most of the patients arrive from the CASS campus, but some arrive from the 30 other small homeless shelters across the Phoenix metropolitan area. Every shelter that refers into CASS Dental Clinic funnels through one entity that presents the patients to CASS in a priority list. When the front desk at CASS gets the list, patients are scheduled depending on which dentists are volunteering.

“We have had patients come in from Flagstaff and Tucson,” says Volcheck. “Most of our population comes from Phoenix, but when it gets extreme, people from other areas head here. We do every area of dentistry – every specialty. We do implants and cosmetic cases every week. We even have a couple plastic surgeons on staff because a high percentage of the women who are homeless are victims of domestic violence. They have mangled teeth or broken oral structures, so the plastic surgeons will work with the dentist to do the cosmetic repair and plastic surgery as well. Some of the most touching cases we work on have to do with domestic violence victims. When they get a new smile, they are overwhelmed. They get their smiles back, which they never thought they ever would.”

Aside from drafting volunteers and because of his work history as a social worker, Volcheck has the unique role at CASS to make sure all treatment plans are appropriate for the homeless patients.

“I still do no dentistry,” says Volcheck. “But because volunteers can’t really treatment plan for the homeless, I have to make sure the treatment plans are appropriate. Say for example, the patient is a paranoid schizophrenic, well partials and dentures won’t last in their mouths for a day. If they are not stable with their home lives, then there are only certain things that I can do with them. I have to decide if they are stable enough to get fillings and once they move into a home and can take care of their hygiene then maybe they can move up to crown and bridge or cosmetic work, but I can’t teach dentists how to determine that.”

The clinic sees everything from people still living on the street who require emergency care to formerly homeless people who might now be working at Macy’s for whom big resources are reserved such as implants or veneers. Those people get full cosmetic treatment because they are stable and can take care of their hygiene.

Patient recovery presents another dilemma, but even though the clinic has to walk a fine line in some cases, CASS manages its patients’ health well, which has taught Volcheck a thing or two about the dental profession.

“With an addict, you don’t want to give them something that is going to get them hooked again, like Vicodin or Percocet, but if you cause them too much pain they might go out and self medicate,” says Volcheck. “I will tell you that with most of the cases we do, high doses of ibuprofen work. This place has confirmed to me that dentists overmedicate their patients. Now, if we’re doing alveoplasty, we will give them something, but those are typically patients who are more stable. Typically, the patients who are on crack or drugs come in for emergency care and extractions – they’re not here for comprehensive care.”

Still Much More to Do
The day-to-day operation of CASS keeps Volcheck and his staff pretty busy, as you can imagine, but their work is compounded by the help they offer to other metropolitan areas around the world in developing programs like this.

“We have helped a lot of cities do this model,” says Volcheck. “We’ve helped San Antonio, San Francisco and Pittsburgh, and we’ve had about 15 other cities come in to learn our model and our program. Right now, we are working with Bangalore, India. The thing is, I wouldn’t have been able to do this kind of program in Pittsburgh or New York. Phoenix is such a dynamic place. This type of clinic was easier to build here than in more entrenched cities.”

Things are about to get even busier as CASS is opening a second facility on 35th and Buckeye in Phoenix. CASS is opening a dental clinic for the Murphy Elementary School District – an extremely impoverished district that works very closely with CASS. “An innovative superintendent, Paul Moore, has a new medical, educational, childcare facility over there. But they couldn’t do dental because they didn’t have the expertise or the knowledge, so I met him and said, ‘Let’s go.’”

The second facility is currently being built out, but the program is already in operation – in a very familiar trailer.

If you would like to get involved or if you’d like more information about CASS Dental Clinic
for the Homeless, please visit www.cassdentalclinic.com, e-mail kvolcheck@cass-az.org,
or call 602-256-6945.
The Lab Component
When the CASS Dental Clinic opened, a local Phoenix TV station ran a public service story in which Dr. Kris Volcheck implored local dental professionals to help the program any way they could. In the broadcast, Volcheck said he needed dentists and hygienists, but Genny Bolles, who was watching the report over lunch thought, “What about lab technicians?” Bolles, a longtime dental lab technician and owner and operator of Vitech Dental Lab in Phoenix, called the phone number provided in the news story and spoke to Volcheck personally.

“What about lab technicians?” she asked Volcheck.

“I honestly didn’t think we could get any labs involved,” Volcheck replied. But lab involvement turned into one of the most crucial elements of operating the CASS Dental Clinic. Bolles reached out to her lab connections and convinced them to donate cases to CASS.

“I told them the more labs we can get to do this, the fewer cases we’ll all have to do,” says Bolles. Between 20 and 30 labs got involved and pledged to help CASS as much as they could. Some labs will do a couple cases each year, but others, like Gold Dust Dental Lab in Tempe, Arizona, will do several units a month.

“We really believe in their mission of serving the underserved,” says Jenn Robertson, COO of Gold Dust Dental Lab. “There is no greater cause locally that has the ability to get so many people’s lives back on track. There’s a community spirit there that’s just awesome. We couldn’t not contribute our services to CASS.”

“Labs like Gold Dust will do 10 units a month for us and I have other labs that will do one unit a year. That is the beauty of labs; when I am vacationing and I can stop in labs and ask, ‘Can you help me out in Phoenix once a year?’ and they say, ‘Sure I can do once a year,’ but they end up doing two or three a year – that’s great! We have labs in 15 states, but we can really use more lab involvement at CASS,” says Volcheck.

Bolles, who got the ball rolling all those years ago, still volunteers her services to CASS whenever she can. She likes that she’s able to keep working – and for a good cause. “I don’t make a lot of money,” says Bolles. “So since I can’t donate to charity, I can work for charity.”

Contributing Businesses
  • A-dec
  • Becker-Parkin
  • Brasseler
  • Computer Cable Specialists
  • Consult-Pro
  • Dentsply
  • Desert Dental Staffing
  • Guidance Endodontics
  • Hu-Friedy
  • KaVo
  • Kay C Carl, RN, BS, CIC
  • Money Doctors LLC, Accounts Receivable Expert and Front Office, Hygiene Systems Specialists
  • Nobel Biocare USA
  • Officite
  • Osteogenics Biomedical, Inc.
  • Pelton & Crane
  • Practice Strategies
  • Steelcase
  • Sure-Way Systems, Inc.
  • Sybron
  • Team One Consulting, Inc.
  • Tigerview
  • Totaltek Computer Services
  • Velscope
  • XDR Digital Radiography Cyber Medical Imaging, Inc
Dentaltown Magazine
April 2024
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