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Project Samples

Below is a sampling of projects where AFL helped our clients achieve their goals and bring their projects to life!

SMILES Dental Project
 Spanning Miles in Linking Everyone to Services


Happy Kids with Books

In 2015, AFL was contracted by Caring for Colorado Foundation and Colorado Health Foundation to implement The SMILES Dental Project  in Colorado. The Project was created using teledentistry and the concept of the Virtual Dental Home.  Over a three-year period, SMILES sites have provided 11,000 patient visits to populations that were not accessing the dental delivery system.  AFL and our partners also successfully championed legislation to expand the scope of dental hygienists in Colorado. 


AFL worked with SMILES Partner Organizations to sustain their Virtual Dental Home programs after the project ended - as these organizations had success in using the model to deliver ITR and SDF to manage the caries disease process at community sites for those patients who might otherwise receive no services.


National Network for Oral Health Access
Sealants Improvement Collaborative
NNOHA Sealants

As a subcontractor to NNOHA, AFL Enterprises, LLC served as the Quality Improvement Learning Collaborative Director for the HRSA National Training and Technical Assistance Oral Health Cooperative Agreement with the National Network for Oral Health Access (NNOHA). NNOHA is the Health Resources and Services Administration (HRSA) National Cooperative Agreement grantee for training and technical assistance on the HRSA UDS Sealants Measure.  

From 2015 through 2020, we worked to implement the NNOHA Sealants Breakthrough Series Collaborative designed to support health centers in monitoring, reporting and improving on the Health Center Dashboard measures.  Using the Institute for Healthcare Improvement Breakthrough Series Collaborative methodology to train health center oral health programs in the Model for Improvement, creating the foundation for monitoring, reporting and improving on a specific set of dashboard measures that includes the HRSA sealant measure. 

AFL also provided expertise and guidance in the development of the Collaborative including review of materials, assisting in convening faculty and reviewing and negotiating contracts, planning event logistics, and supporting expert panel convenings, facilitating discussions at learning sessions and providing feedback to teams.


Our fifth cohort of the series focused on improving HRSA UDS sealant rates.  To date, 122 health centers have participated in the Collaboratives, with more than 500,000 dental patients impacted by this care.


Collaboratives Successes:

  • Supported more than 100 health centers in delivering evidence-based, patient-centered dental care. 

  • Deployed early detection, prevention and management of dental caries across the country.

  • Participating health centers were able to report on Caries Risk Assessment (CRA) monthly and the median number of patients receiving CRA for all health centers increased by the end of the Collaborative. 

  • Most of the health centers reported CRA levels at or above 95%. And the rest substantially increased CRA levels from baseline period. 

  • Health centers were able to report on the Sealants for 6-9 year olds measure weekly. 

  • Participating health centers showed signals of improvement over initial levels for all collaborative measure. 

  • Past participants report reduction in caries at recall from above 50% to below 20%. 

  • Data clearly demonstrate improved performance on preventive members, increased access to dental services (growth in utilization) with no increase in cost per visit. 

NNOHA Risk Assessment.png
San Francisco Department of Public Health’s, Local Dental Pilot Project, Dental Transformation Initiative, Dental Access Collaborative
Kids Running

The San Francisco Department of Public Health’s, Local Dental Pilot Project, Dental Transformation Initiative, Dental Access Collaborative is a multi-year initiative with the goal to strengthen participating dental practices’ skills and processes for providing evidence-based, culturally-informed, preventive dental care that directly benefits California’s Medi-Cal Dental beneficiaries age 0-5 years.


Through the initiative, AFL has conducted Breakthrough Series Learning Collaboratives with Federally Qualified Health Centers (FQHCs) and private practices within the City and County of San Francisco.  AFL’s work includes the development of a Collaborative Workplan, convening of an expert team to research and create a change package and other associated technical content including establishing improvement metrics; and management of participant recruitment, subcontractor recruitment, and the planning and leading of three in-person Learning Sessions. 

National Network for Oral Health Access Dental Dashboard
NNOHA Dashboard
Dentist Chairs

AFL Enterprises, in partnership with Delta Dental of Colorado Foundation, Arcora Foundation (formerly known as the Washington Dental Service Foundation) and NNOHA, led an initiative to create the Health Center Dental Dashboard. This was the first-ever set of dental quality improvement measures and was developed in close collaboration with health center dental directors. The Health Center Dental Dashboard serves as a resource for what to measure to monitor performance in a dental setting, and a user guide that shows how to effectively monitor and measure quality and drive performance within dental programs.

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