California shares a solution that brings together private and non-profit organizations, universities, funders, and state and local governments for a more coordinated, comprehensive system of preventive oral health care.
The traditional system of dental care is not working for underserved patients, or dentists. Most dentists don’t accept Medicaid, leaving underserved people in Colorado – and nationwide – competing for a limited number of dentists, especially in remote, rural areas.
In California, more than half of people eligible for Medicaid dental benefits aren’t using them, due to the lack of dentists who will see them. Dentists that do want to participate in Denti-Cal, California’s Medicaid dental program, face administrative and billing issues of a broken government program.
Shedding light on the seemingly intractable challenge – and how to solve it – the Little Hoover Commission, an independent oversight agency of the California state government, released a new report: Fixing Denti-Cal. The report’s findings and recommendations support the main tenets of our own SMILES Dental Project.
Writes Pedro Nava – Chair of the Little Hoover Commission – in his opening letter to the California Governor and members of that state’s legislature:
“A silent, hidden epidemic of tooth decay and disease is ravaging California, endangering the overall health of millions of residents and overpowering the state administrative machinery assigned to contain it... Yet Denti-Cal, California’s Medicaid dental program, is widely viewed, historically, and currently, as broken, bureaucratically rigid and unable to deliver the quality of dental care most other Californians enjoy.
With dreadful reimbursement rates for dentists and slow, outdated paper-based administrative and billing processes that compare poorly with those of commercial insurers, Denti-Cal has thoroughly alienated its partners in the dental profession.”
In response, the Commission put forth 11 recommendations, including the following two recommendations that also inform the SMILES Dental Project in Colorado:
- Recommendation 7: the Legislature and Governor should fund a statewide expansion of teledentistry and the virtual dental home.
- Recommendation 8: state government, funders and non-profits should lead a sustained statewide “game changer” to reorient the oral health care system for Denti-Cal beneficiaries toward preventative care.
Across Colorado, grantees of the SMILES Dental Project are working hard to address similar workforce and systems-level challenges by bringing care directly to the places where people live and work (e.g., childcare centers and schools, long-term care facilities, etc.) via an innovative model of care that confronts the dysfunctional status quo.
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| SMILES dentists discuss the challenges and potential solutions of our current oral health care system. |
The Mountain Family Health Center team made tremendous strides building community partnerships and identifying locations and steps to implement a new delivery system.
Through its community outreach and awareness efforts, the Northeast Colorado Health Department lay the groundwork for regional buy-in and project implementation while collaborating with a local health clinic.
The High Plains team began outreach to school administration and leadership in Kiowa County to assess interest in receiving school-based SMILES services.
Summit Community Care Clinic (SCCC) has the support of community leaders and school partners, as well as the equipment, infrastructure and data capabilities for implementation.
Tri-County Health Network identified underserved schools in need of SMILES services, and they’re working to identify local dentist champions and oral health leaders.
We’re proud of our grantees’ planning progress toward achieving goals that parallel those set forth for California by the Little Hoover Commission. Across counties and beyond state lines, we’re learning from one another how to pilot and expand a new delivery model for oral health services, emphasizing preventive care and effective disease management for all.
