One of the most challenging aspects of providing community-based care is sustainability. Grant funding can be pursued for start-up expenses; however, it is much more difficult to secure grant funding to pay for overhead and salaries. Large corporations and community health centers will most likely have a billing system in place. When professionals are starting a new community-based care model, the dental team must examine the payment systems that are in place. The individual/organization that can bill for services varies from state-to-state depending on the dental practice act. Public policies and payment systems may not be coordinated and this will need to be addressed. This influences the development of metropolitan and rural communities in terms of livability, working, operating a business, growth, and preserving heritage.30,59
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