Business Plan forExecutive Summary

History and Position to Date Good health is important to everyone. If an individual can not afford to pay for medical care right now, Medicaid can make it possible for he or she to get the care that they need so that they can get healthy and stay healthy. Medicaid is available only to certain low-income individuals and families who fit into an eligibility group that is recognized by federal and state law. Medicaid does not pay money to anyone; instead, it sends payments directly to their health care providers. Depending on state's rules, patient may also be asked to pay a small part of the cost (co-payment) for some medical services. Medicaid is a state administered program and each state sets its own guidelines regarding eligibility and services. Many groups of people are covered by Medicaid. Even within these groups, though, certain requirements must be met. These may include different information like: age, whether the patients are pregnant, disabled, blind, or aged; their income and resources (like bank accounts, real property, or other items that can be sold for cash); and whether if they are a U.S. citizen or a lawfully admitted immigrant. The rules for counting there income and resources vary from state to state and from group to group. There are special rules for those who live in nursing homes and for disabled children living at home. A child may be eligible for coverage if he or she is a U.S. citizen or a lawfully admitted immigrant, even if they are not (however, there is a 5-year limit that applies to lawful permanent residents). Eligibility for children is based on the child's status, not the parent's. When Eligibility Starts Coverage may start retroactive to any or all of the 3 months prior to application, if the individual would have been eligible during the retroactive period. Coverage generally stops at the end of the month in which a person's circumstances change. Most States have additional "State-only" programs to provide medical assistance for specified poor persons who do not qualify for the Medicaid program. No Federal funds are provided for State-only programs. The Medicaid managed care penetration rates and expansion enrollment by state charts are composed annually by the Finance, Systems and Budget Group (FSBG) of the Centers for Medicare & Medicaid Services (CMS).

Dental services under Title XIX of the Social Security Act, the Medicaid program, are an optional service for the adult population, individuals age 21 and older. However, dental services are a required service for most Medicaid-eligible individuals under the age of 21, as a required component of the Early and Periodic Screening, Diagnostic and Treatment (EPSDT) benefit. Individuals under Age 21 EPSDT is Medicaid's comprehensive child health program. The programs' focus is on prevention, early diagnosis and treatment of medical conditions. EPSDT is a mandatory service required to be provided under a state's Medicaid program. Dental services must be provided at intervals that meet reasonable standards of dental practice, as determined by the state after consultation with recognized dental organizations involved in child health, and at such other intervals, as indicated by medical necessity, to determine the existence of a suspected illness or condition. Services must include at a minimum, relief of pain and infections, restoration of teeth and maintenance of dental health. Dental services may not be limited to emergency services for EPSDT recipients. Oral screening may be part of a physical exam, but does not substitute for a dental examination performed by a dentist as a result of a direct referral to a dentist. A direct dental referral is required for every child in accordance with the periodicity schedule set by the state. The Centers for Medicare & Medicaid Services does not further define what specific dental services must be provided, however, EPSDT requires that all services coverable under the Medicaid program must be provided to EPSDT recipients if determined to be medically necessary. Under the Medicaid program, the state determines medical necessity. If a condition requiring treatment is discovered during a screening, the state must provide the necessary services to treat that condition, whether or not such services are included in the state's Medicaid plan.

Fluoridation Statistics 2002: Status of Water Fluoridation by State Data current as of 12/31/04. See also Statistics for the United States.

Percentage of state populations on public water systems receiving fluoridated water and sta rank, 2002

By State Rank Location United States DC Kentucky Illinois Minnesota Tennessee North Dakota Indiana Virginia Maryland Georgia West Virginia South Carolina Iowa Ohio Wisconsin Rhode Island Connecticut Michigan North Carolina Alabama Delaware Missouri South Dakota New Mexico Colorado Oklahoma Percent 67.3 100.0 99.6 99.1 98.4 96.0 95.6 95.5 93.8 93.7 93.0 91.5 91.4 91.3 90.6 89.4 89.2 87.6 86.2 84.6 82.0 80.9 80.9 78.0 76.6 75.4 74.6 1 2 3 4 5 6 7 8 9 10 11 11 13 14 15 16 17 18 19 20 21 22 23 24 25 State Rank

Alphabetical by State Location United States Alabama Alaska Arizona Arkansas California Colorado Connecticut DC Delaware Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Percent 65.8 82.0 57.3 55.4 62.1 27.6 75.4 87.6 100.0 80.9 67.4 93.0 8.6 47.5 99.1 95.5 91.3 62.1 99.6 45.9 74.4 93.7 60.7 86.2 98.4 46.1 20 30 9 49 40 2 6 11 33 1 42 26 8 34 17 3 41 19 36 38 32 45 24 16 State Rank

Maine New York Nebraska Nevada Florida Texas Arkansas Kansas Massachusetts Washington Alaska Vermont Arizona Pennsylvania Idaho Mississippi Louisiana New Hampshire Wyoming California Montana New Jersey Oregon Hawaii Utah

74.4 72.9 69.5 69.4 67.4 65.7 62.1 62.1 60.7 58.9 57.3 55.7 55.4 54.0 47.5 46.1 45.9 42.7 36.7 27.6 23.8 20.8 19.4 8.6 2.2

26 27 28 29 30 31 32 33 34 35 36 37 38 38 40 41 42 43 44 45 46 47 48 49 50

Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming

80.9 23.8 69.5 69.4 42.7 20.8 76.6 72.9 84.6 95.6 90.6 74.6 19.4 54.0 89.2 91.4 78.0 96.0 65.7 2.2 55.7 93.8 58.9 91.5 89.4 36.7

21 46 28 29 43 47 23 27 18 5 13 25 48 38 15 11 22 4 31 50 37 7 35 10 14 44

Data Source:

2002 Water Fluoridation Reporting System (WFRS)

Date last reviewed: December 3, 2007 Date last updated: December 31,2004

Content source: Division of Oral Health, National Center for Chronic Disease Prevention and Healt Promotion Oral Health Problems: Painful, Costly, and Preventable

Mouth and throat diseases, which range from cavities to cancer, cause pain and disability for millio Americans each year. This fact is disturbing because almost all oral diseases are largely preventab

For children, cavities are a common problem that begins at an early age. Tooth decay affects more one-fourth of U.S. children aged 25 and half of those aged 1215. Low-income children are harde about two-thirds of those aged 1219 have had decay. Untreated cavities can cause pain, dysfunc absence from school, and poor appearanceproblems that can greatly affect a childs quality of lif

Tooth decay is also a problem for U.S. adults, especially for the increasing number of older adults w have retained most of their teeth. Despite this increase in tooth retention, tooth loss remains a prob among older adults. One-fourth of adults over age 65 have lost all of their teethprimarily because decay, which affects more than 90% of adults over age 40, and advanced gum disease, which affe 11% of adults. Tooth loss can affect self-esteem, and it may contribute to nutrition problems by limi types of food that a person can eat.

In addition, oral cancers pose a threat to the health of U.S. adults. In 2007, an estimated 34,000 pe learn that they have mouth or throat cancer, and more than 7,550 will die of these diseases.

In 2007, Americans made about 500 million visits to dentists, and an estimated $98.6 billion was sp dental services. Yet many children and adults still go without measures that have been proven effe preventing oral diseases and reducing dental care costs. For example, over 100 million Americans not have access to water that contains enough fluoride to protect their teeth, even though the per c cost of water fluoridation over a persons lifetime is less than the cost of one dental filling.

The most cost-effective way to deliver the benefits of fluoride to all residents of a community is through water fluoridationthat is, adjusting the fluoride in the public water supply to the right level for decay prevention. A peer-reviewed CDC study found that, in communities with more than 20,000 residents, every $1 that is invested in community water fluoridation yields about $38 in savings each year from fewer cavities treated. fluoride include the following:

Issuing Recommendations for Using Fluoride to Prevent and Control Dental Caries in the United States. Providing fluoridation training to state drinking water system engineers, dental directors, and other public health staff members. Managing a Web-based system that helps states monitor the quality of fluoridated water systems.

Educating people throughout the country on the appropriate use of fluoride products.

Promoting Use of Dental Sealants Dental sealantsa plastic coating applied to the chewing surfaces of the back teethare a safe, effective way to prevent cavities among schoolchildren. In some cases, sealants can even stop tooth decay that has already started. Sealants significantly reduce a childs risk for having cavities. Although progress has been made toward the national Healthy People 2010 objective, which calls for half of all U.S. children to have dental sealants, only about one-third of children aged 619 do. Children in some racial and ethnic groups and who live in low-income households are less likely to have sealants. For example, fewer than 1 in 4 African American and Mexican American children have sealants. The Task Force on Community Preventive Services strongly recommends school-based or school-linked sealant programs as an effective way to prevent and control cavities.

Introduction to Your Business

Mission Statement

Business Structure Management Team

Products and Services

Market Research Customers

Product Features

Customer Sensitivities Competitors

Business Strategy Pricing Policy

Advertising and Promotion

Location

Operations Sales and Sales Management

Manufacturing/Supply

Staffing Issues

Forecasting

Financial Statements

Sensitivity Analysis

Financing Requirements

Business Controls