Open Smiles Adult Mobile Dental Program

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Executive Summary

Open Smiles Adult Mobile Dental Program is a nonprofit in North Carolina that brings a fully equipped mobile dental clinic to adults who have little access to care. A licensed dentist, hygienist and assistant provide exams, cleanings, fillings and simple extractions at community sites, a navigator helps patients enroll in coverage and patients who need more are referred to dental homes.

Many adults go without dental care for years, and untreated disease causes pain, infection and missed work. Medicare does not cover most routine dental care, few dentists accept Medicaid and many people simply cannot reach an office.

With this grant we will serve about 400 patients in Year 1 at 1 regular set of community stops. Care is provided only by licensed professionals under state rules, and we call 911 in any medical emergency. We do not promise any health outcome. We promise safe care, honest limits and respect for every patient.

Our Year 1 budget is about $350,000, growing to about $563,500 by Year 5 as we add sites, coaches and participants. Each year's budget is planned to balance, with a small surplus each year. We have 6 staff in Year 1 (an Executive Director, a Clinic Coordinator, a part-time dentist, a hygienist and a dental assistant) and 10 by Year 5.

We are asking the Carolina Oral Health Foundation for $90,000 for a dental hygienist, a dental assistant and dental supplies. Our other income and startup support cover the rest. These numbers are estimates based on the assumptions listed at the end of this proposal, and we do not promise any result beyond what we describe.

Company Description

Open Smiles Adult Mobile Dental Program is a nonprofit organization in North Carolina. We are a registered charity with a volunteer board of directors, a written conflict-of-interest policy and a yearly budget the board reviews.

Our mission. Everyone deserves a healthy mouth, and no adult should live with dental pain because they cannot afford or reach care.

What we do.
- Bring a fully equipped mobile dental clinic to community sites where adults have little access to care.
- Provide exams, cleanings, fillings, simple extractions and referrals for adults without dental coverage.
- Offer same-day care for dental pain and infection when possible.
- Teach oral health and connect patients to ongoing dental homes.
- Help patients enroll in Medicaid or other coverage.
- Provide care in English and Spanish.

Our values. Respect for every participant, honesty with families and partners, safety first and a place for everyone who wants to belong.

What we do not do. We follow all state dental practice and infection control rules. Care is provided only by licensed dentists, hygienists and assistants. We are not an emergency room and we call 911 for any medical emergency. We do not promise treatment beyond what we can provide on the van, and we refer patients who need more. We do not promise any health outcome. We follow the rules of our partner sites and our insurer.

How we got here. A group of dentists, hygienists and community leaders began offering free dental screening days at a church and a food pantry. Long lines formed and many people had urgent needs. We kept simple records of who we saw and what they needed. This proposal asks for support to move from screening days to a steady program with paid, trained staff and the materials to match.

Problem & Opportunity

Many adults go without dental care for years, and untreated dental disease causes pain, infection, missed work and trouble eating, speaking and finding a job.

Cost. Dental care can cost hundreds of dollars a visit, Medicare does not cover most routine dental care and many adults have no coverage at all.

Access. Few dentists accept Medicaid or offer sliding fees, and the nearest office may be far away.

Safety and trust. Patients and funders want to know that care is provided by licensed professionals and follows infection control rules.

Missed benefits. Adults with untreated dental problems may end up in emergency rooms, which cost far more and rarely fix the underlying problem.

What we hear.
- A man says he has had a broken tooth for two years and chews on one side.
- A nurse says she sees patients in the emergency room with infections that began as cavities.
- A woman says she has not smiled in photographs in a decade.
- A dentist says half of her volunteer patients have never had a cleaning.

We do not claim that a program can solve every challenge. We believe that bringing licensed dental care to where adults already are can relieve pain, prevent infection and restore confidence.

Products & Services

Open Smiles Adult Mobile Dental Program gives adults without access to dental care a safe, welcoming place to get safe dental care close to home.

How the program works.
1. Stops. The mobile clinic visits community sites on a regular schedule, such as health centers, churches and food pantries.
2. Booking. Patients book by phone or walk in, and priority goes to those in pain.
3. Care. A licensed dentist, hygienist and assistant provide exams, cleanings, fillings and simple extractions.
4. Education. Each patient receives oral health teaching and a plan for follow-up.
5. Referrals. Patients who need more care are referred to dental homes, oral surgeons and community clinics.
6. Coverage help. A navigator helps patients sign up for Medicaid or other coverage when eligible.
7. Follow-up. We check in with patients after treatment and invite them back for regular care.

What a typical session looks like. Participants arrive and check in with a staff member, settle in together, work on the day's activity in small groups and finish with a short talk about what went well. Staff praise effort, correct mistakes kindly and make sure no one is left out.

Staff. Our dentist, hygienists and assistants hold current licenses, pass a background check, complete our training and are paid for their time.

Access and fairness. Programs are free. Services are free or sliding scale, with no one turned away for inability to pay. We welcome every adult and offer care in English and Spanish.

Market Analysis

Who we serve. Adults ages 18 and older in our service area with no dental coverage, with limited coverage or with trouble reaching a dentist. Eligibility is based on need and where a person lives, and no adult is turned away for lack of insurance or money.

How we estimate need. We cannot count every young person who could benefit, so we plan from what we can see. In our screening days we saw more patients than we could treat and kept a waiting list. Community health centers told us that many more adults need care than their clinics can offer. For Year 1 we plan to serve about 400 participants at 1 community stops. By Year 5, with more staff and sites, we plan to serve about 1000.

Where participants come from.
- Community health centers and clinics.
- Food pantries and social service agencies.
- Churches and community groups.
- Patients who tell a friend.

Who else benefits. Families gain relief and the ability to work. Hospitals gain fewer dental emergency visits. Dentists gain a way to give back.

What the numbers mean. Every number here is a patient who could chew again. We keep our early counts modest and honest so we can do the work well.

Competitive Landscape

What young people can find today, and how we are different.

1. Private dental offices. Provide excellent care with costs and limited Medicaid participation. We serve those they cannot.

2. Community health center dental clinics. Strong and often have long waits. We add capacity and reach.

3. Dental schools. Offer lower costs and distance. We bring care closer.

4. Emergency rooms. Treat pain and infection and cannot fix teeth. We provide dental care.

5. Volunteer dental days. Valuable and occasional. We offer a regular schedule.

What makes us different.
- Care comes to the community.
- Sliding scale or free, with no one turned away.
- Licensed dental professionals and a navigator.
- Same-day care for pain when possible.
- A regular schedule of stops.

Why this gap matters. Existing programs do good work, and most serve people who can already pay or who live close to them. The people we serve are the ones left over: they live in the wrong neighborhood, have the wrong schedule or have no one to ask. We are built to reach them.

We have spoken with community health centers, dental schools, hospitals and other dental programs to make sure we are filling a gap and not duplicating services. Their letters of support are in the attachments.

Marketing & Sales Strategy

How young people and partners will find us.

Reaching young people.
- Health centers and clinics. We will share a referral form and a named contact.
- Food pantries and agencies. We will post the van schedule and give out flyers.
- Churches and community groups. We will talk with leaders who know families.
- Local media. We will share the schedule.
- Word of mouth. Patients tell friends.
- A simple website and a phone line with a text option.

Reaching staff and sponsors.
- Recruit dental professionals through dental associations, schools and community clinics.
- Offer an orientation, a background check and training in safety, privacy and respectful practice.
- Give partners a short report each quarter with counts of participants and what they said.

How we decide who joins. We use a simple sign-up form and enroll participants in the order received, with priority for those with the greatest need and for people new to the program. We keep a waiting list when the program is full.

What we watch. Sign-ups, attendance, patients seen, procedures completed and how many participants return for a second season.

Operations Plan

How the program will be carried out.

Timeline for Year 1:
- Months 1 and 2 (July and August): Hire the staff, buy equipment and materials, finalize the waiver, consent form and privacy policy with our attorney and sign site agreements.
- Month 3 (September): Acquire and outfit the mobile unit and begin the first stops.
- Months 4 to 10: Operate regular stops, provide care and refer patients for follow-up.
- Months 11 and 12: Survey patients and partners, report to funders and plan Year 2.

Space. The mobile clinic parks at partner sites with permission, and the team works from a small office.

Safety and privacy.
- The clinic follows state infection control rules, sterilizes instruments after every patient and keeps required records.
- Staff follow a written plan for medical emergencies that names 911.
- Every staff member and volunteer passes a background check and completes safety training.
- Staff work in pairs or in view of others whenever participants are minors or in a vulnerable situation.
- We keep an emergency plan at every site, and participants complete an emergency contact form.
- We keep records private, share them only with a participant's permission or as the law requires and follow a written policy.

Equipment. We buy about $140,000 of equipment once at the start: used mobile dental unit with dental equipment ($110,000), sterilization equipment and portable instruments ($15,000), digital x-ray and computer system ($10,000), generator and power system ($5,000). Later years replace or add a few items.

Staffing. In Year 1 I serve as Executive Director. The Clinic Coordinator, paid $44,000 a year, manages the schedule and partners. A part-time dentist works about 40 percent time at a full-time pay of $160,000, a dental hygienist is paid $48,000 and a dental assistant is paid $36,000. We add staff as we add stops.

Management & Organization

Dr. Michael Tran, Executive Director. I lead the organization, report to the board and am responsible for budgets, partnerships and reporting. I came to this work as a dentist who volunteered at pop-up clinics and saw the lines. I will complete the training we require of our staff so I understand the program from the inside. (Replace this paragraph with your own background.)

Staff. The Clinic Coordinator manages the schedule and partners, and the dentist, hygienists and assistants provide care. Each holds the required license and passes a background check. These positions are part of our grant request.

Board of directors. Our volunteer board includes a dentist, a hygienist, a patient, a banker who serves as treasurer, an attorney and a community health center director. The board meets every other month, approves our budget and reviews our safety plan. No board member is paid, and members with a conflict of interest step out of related decisions.

Advisory partners. A public health dentist, a nurse and a community health worker give guidance twice a year.

Staffing and pay in this plan: Executive Director, paid $56,000 a year; clinic Coordinator, paid $44,000 a year; dental Hygienist, paid $48,000 a year; dental Assistant, paid $36,000 a year; dentist (part-time), paid $160,000 a year.

Milestones Narrative

Our goals, how we will measure them and when we plan to reach them.

Year 1 outcomes (July 2027 through June 2028):
- Serve about 400 participants at 1 community stops.
- Run at least two full seasons and a summer session.
- Have at least 85 percent of participants attend most sessions.
- Have at least 80 percent of participants return for a second season.
- Receive positive feedback from at least 90 percent of families who answer our short survey.

What we count and how.
- Participants enrolled, sessions and games attended, from our records.
- Skills learned and goals met, from the coach's checklist.
- Equipment issued and returned, from our log.
- Participant and family feedback, from a short, confidential form.
We report what we find, including what did not work, and use it to improve.

Growth over five years.
- Year 2: About 550 participants at 1 community stops.
- Year 3: About 700 participants at 2 community stops.
- Year 4: About 850 participants at 2 community stops.
- Year 5: About 1000 participants at 3 community stops.

Learning along the way. At the end of each quarter, the director and the board review the numbers and decide whether we are on track. If we are behind, we will adjust our outreach, our sites or our schedule before asking for more money.

After the grant. By Year 5, grants make up about 65 percent of our budget, down from about 71 percent in Year 1, as partners and donors give more. We will keep building those relationships every year.

Funding Request

What we are asking for, and how the money will be used. Our request: $90,000 from the Carolina Oral Health Foundation for a dental hygienist, a dental assistant and dental supplies, for July 2027 through June 2028.

The request is spread across these budget lines:
- Personnel: Dental hygienist salary, $48,000.
- Personnel: Dental assistant salary, $36,000.
- Supplies: Dental supplies for patient care, $6,000.

Other money in the program. This request is about 36% of our Year 1 grant income. Other grants and the income lines below pay for everything it does not cover.

Year 1 budget: about $350,000, planned to balance with a small surplus (about $14,000 after the yearly wear on equipment). Year 1 money coming in: Grant Revenue $248,000; state Oral Health Funding $60,000; hospital and Health Partners $30,000; individual Donors $12,000. Year 1 costs: executive Director $56,000; clinic Coordinator $44,000; dental Hygienist $48,000; dental Assistant $36,000; dentist (part-time) $160,000; dental Supplies and Lab about $18,000; vehicle Fuel, Insurance and Maintenance about $14,000; sterilization and Compliance about $6,000; malpractice and General Liability Insurance about $8,000; outreach about $4,000; administration and Insurance about $10,000; about $34,400 a year for the wear on equipment.

One-time startup costs. Startup costs of $158,000 are paid once from startup money, not from the yearly budget: $110,000 for used mobile dental unit with dental equipment; $15,000 for sterilization equipment and portable instruments; $10,000 for digital x-ray and computer system; $5,000 for generator and power system; $4,000 for attorney review of the patient consent form, privacy policy and facility agreements; $2,500 for banners, flyers and a simple website; $3,500 for staff licensing checks, training and background checks; $8,000 for first insurance payment and vehicle registration.

How we got our startup number. The Funding Need Calculator in this plan adds the startup costs ($158,000), the cash the program uses before it balances (about $0) and a cash cushion of about $77,000, which is about three months of Year 1 costs. In all, that comes to $235,000. We start with $20,000 from our founding board and $217,000 in startup support from a health foundation and a hospital partner, $237,000 in all, which covers that amount with room to spare.

The next five years. Our budget grows from about $350,000 in Year 1 to about $563,500 in Year 5. Grants are planned at $248,000, $246,500, $333,000, $349,000 and $365,500 in Years 1 to 5. Other income grows: state Oral Health Funding from $60,000 to $100,000; hospital and Health Partners from $30,000 to $70,000; individual Donors from $12,000 to $28,000. Our surplus is planned at about $14,000 in Year 1, about $16,100 in Year 2, about $21,700 in Year 3, about $24,500 in Year 4 and about $27,300 in Year 5. We grow from 1 community stops to 3 by Year 5, adding a part-time coach for each new site.

Savings. We plan to keep several months of costs in savings. The lowest year-end balance in the plan is about $125,000, at the end of Year 1. Some grant payments and partner payments arrive after we bill, so we plan for about $14,000 owed to us at the end of Year 1.

Cost per patient. In Year 1, our total costs are about $840 per patient served, which includes setting up the program. By Year 5, with more patient served and a trained team in place, that falls to about $536 per patient.

After the grant. State oral health funding, corporate sponsors and individual donors grow every year, so grants become a smaller share of our budget. Participants and families share their stories, and businesses can sponsor a team or a season by name. We will look for partnerships with schools and the city that want a safe, free mobile dental care option for every child.

Risks and how we will handle them:
- An injury. Certified coaches, proper equipment, groups matched by age and skill, a written emergency plan and insurance.
- A site is no longer available. We keep agreements with more than one site and a plan for bad weather.
- A coach leaves. We keep a list of trained backup coaches and share lesson plans.
- Low attendance. We adjust sites, times and rides based on family feedback.
- A privacy problem. We follow a written policy, use secure systems and train every staff member and volunteer.
- A grant ends. We keep savings and grow partner and donor support each year.

If you are just starting. A new organization can begin before it has its own 501(c)(3) status through a fiscal sponsor: an established nonprofit that receives grants for you and passes them to your program, usually for a fee (commonly around 5% to 10% of the grant, sometimes more; ask before you agree). Another way is to start smaller: one neighborhood, a handful of patients and a small team, tracked carefully. Strong results from a small start make larger grants easier to win.

Appendix Notes

Documents to attach with this proposal:

- Your IRS 501(c)(3) determination letter, or your fiscal sponsor agreement.
- Your most recent financial statements and your current year budget.
- A list of your board members and what each one does.
- Signed letters of support from partner schools, agencies and sites.
- Your site agreements and your insurance certificate.
- Your consent, waiver and privacy policy.
- Your safety plan and background check policy.
- Your program outline and schedule.
- Quotes for equipment and materials.
- Resumes for your Executive Director and key staff.
If you don't have any of this yet, no worries - let's continue.

The assumptions behind our numbers (change them in the Financials section to match your own):
- Grant Revenue: $248,000 in Year 1, growing to $365,500 in Year 5.
- State Oral Health Funding: $60,000 in Year 1, growing to $100,000 in Year 5.
- Hospital and Health Partners: $30,000 in Year 1, growing to $70,000 in Year 5.
- Individual Donors: $12,000 in Year 1, growing to $28,000 in Year 5.
- Pay (a full year, per person, including payroll taxes and workers' compensation): executive Director $56,000; clinic Coordinator $44,000; dental Hygienist $48,000; dental Assistant $36,000; dentist (part-time) $160,000.
- Other yearly costs in Year 1: dental Supplies and Lab $18,000; vehicle Fuel, Insurance and Maintenance $14,000; sterilization and Compliance $6,000; malpractice and General Liability Insurance $8,000; outreach $4,000; administration and Insurance $10,000. These grow between 4% and 6% a year.
- Equipment: $140,000 at the start, then $6,000 to $10,000 a year.
- Startup costs: $158,000, paid once from $237,000 in startup money.
- Participants served: about 400 in Year 1, growing to about 1000 in Year 5. Sites: 1 in Year 1, growing to 3 by Year 5. The mobile clinic operates year-round on a regular schedule of community stops.
- About 4% of each year's income is still owed to us at year end.
- Tax: none, as a nonprofit.
- Every dollar amount is an estimate. Replace them with your own quotes and real budget.

Startup Costs