Despite budget surplus and evidence that lack of access to dental care results in costly emergency room utilization, Governor Brown deepens cuts to Medi-Cal dental care benefits and perpetuates Arnold Schwarzenegger’s legacy of neglect of the state’s oral health.

Yesterday, Governor Jerry Brown announced his May Revision of the California State Budget, declaring for the first time in decades a multi-year balanced budget. In his brief remarks unveiling the proposal, the Governor highlighted the work to implement the Patient Protection and Affordable Care Act (ACA). But he continues to deny dental care for millions of Californians.

In 2009, budget deficits prompted California lawmakers to eliminate adult Denti-Cal benefits to reduce public spending by nearly $109 million. However for next fiscal year California  is expecting a $3 billion surplus. Despite the surplus, Governor Brown’s revision of the State Budget continues cuts to Medi-Cal funds for dental care and worsens Medi-Cal provider rates, which would make it harder for nearly 3 million low-income Californians that rely on Medi-Cal to get the care they need.

To the eyes of many, over the past three years, California has taken a leading role in implementing ACA. Under the ACA, millions of Californians will gain access to affordable coverage beginning in January 2014 through a new health insurance marketplace called Covered California. In addition, more than 1 million low-income Californians will be newly eligible for Medi-Cal under a program expansion that state policymakers have said they will adopt. The federal government will pay 100 percent of the cost of this expansion from 2014 to 2016, gradually reducing the federal share to a still-high 90 percent of the cost by 2020. But Governor Brown’s inaction regarding dental benefits will prevent the State from bringing in the one-to-one federal matching dollars authorized by ACA. Furthermore, his lack of understanding of oral health may result in increased utilization of costly emergency room services for dental care denied to Californians. By continuing the neglect to the oral health federal funding will not come into our state, not helping families get the care they need, not improving our health system, and dampening California’s economic recovery.

The Budget includes provider rate reductions enacted through Chapter 3, Statutes of 2011 (AB 97). These reductions will result in General Fund cuts of $488.4 million in 2013‑14. It also includes decreases for MRMIB (a cut of $143.9 million General Fund from the Budget Act of 2012). This significant decrease is primarily due to the transition of Healthy Families Program beneficiaries to Medi‑Cal.

The expectation is that the California Legislature will pass an adjusted budget on time, by June 15. Thus, the next four weeks are crucial for the implementation of the Affordable Care Act, the future of the Medi-Cal program, the state's commitment to the remaining uninsured, and more.

The Center for Oral Health will continue to provide updates on this topic in the upcoming weeks.

The Center for Oral Health is pleased to announce the release of a new guidebook: Guidelines for Providing Dental Services in Skilled Nursing Facilities.

This guide, adapted by Susan McLearan, RDHAP from an existing COH publication¹, was compiled to assist skilled nursing facilities contemplating the use of a dental provider with mobile/portable dental care equipment. It includes information and guidance on the procedures that should be considered before entering into a contract and/or memorandum of understanding with a provider, as well as in the continuous evaluation of providers.

Addressing the oral health of this needy population will help prevent systemic disease, reduce health care costs, and improve the quality of life by addressing the oral hygiene of long‐term care facility residents.

¹Integrating Oral Health into School Health Programs

PRESS RELEASE

March 15, 2013, 4:29 p.m. EDT

WesternU's College of Dental Medicine to Receive $8.4 Million From First 5 LA

POMONA, CA, Mar 15, 2013 (MARKETWIRE via COMTEX) -- Western University of Health Sciences College of Dental Medicine will receive $8.4 million from First 5 LA to provide dental care to uninsured and underserved children.

The First 5 LA Commission approved the initial 19-month contract for $3.1 million with WesternU, part of a five-year, $38 million project in cooperation with UCLA and USC. The total awarded to WesternU through the full five-year implementation of the program is anticipated to be $8.4 million.

The program will emphasize getting children into the oral health care delivery system, or dental homes, by age 1, said Timothy Martinez, DMD, College of Dental Medicine Associate Dean for Community Partnerships and Access to Care.

College of Dental Medicine faculty and students will assess patients and provide dental care and preventative and educational services. The College will work with the San Gabriel Valley Foundation for Dental Health, WesternU's Patient Care Center, and the Center for Oral Health, which is now housed on WesternU's Pomona campus. It also plans to work collaboratively to establish four school-based dental oral health centers.

"We want to track the patients, make sure they're getting into dental care, make sure their treatment plans are being completed, and make sure they're put on preventative maintenance," Martinez said. "That's how you take care of a population and keep them healthy."

WesternU is working with school districts that have high Medicaid enrollment, and one goal is to create sustainability.

"We're trying to integrate oral health services with established school-based health centers, and we're going to develop processes to help support those programs," Martinez said. "The goal is to demonstrate how dentists can be successful providing services at these schools. We also have interprofessional training, teaching nurse practitioners and physician assistants about anticipatory guidance, which is how to prevent caries (cavities), talking to mothers, and how to apply fluoride varnish."

This program will introduce College of Dental Medicine students to caring for very young patients early in their education, which does not typically happen in dental schools, said College of Dental Medicine Dean Steven W. Friedrichsen, DDS.

"While providing essential dental services, the project will also help prepare the next generation of dentists to understand the importance of a dental home, a first dental visit by their first birthday, and early intervention and treatment for these children," he said.

First 5 LA is a unique child-advocacy organization created by California voters to invest tobacco tax revenues in programs aimed at improving the lives of children in Los Angeles County, from prenatal through age 5.

Since 1998, the program has allocated more than $1.5 billion toward grants, programs and operations that improve the well-being of young children and families in Los Angeles County, according to First 5 LA's 2011-12 Annual Financial Report.

The Center for Oral Health now has an online store! Our new and existing customers of fluoride varnish and educational materials are encouraged to try the online store as a convenient alternative to fax and phone ordering.

Click the "Store" link in the top menu bar, or click here to visit the store.

This report is an evaluation of COH's "School Health Policy: An Avenue to Community Collaboration" project, based on regular check-ins and project-end interviews with key subjects. It was prepared by Dana Hughes, DrPH & Anya Gutman, MPH, of the Philip R. Lee Institute for Health Policy Studies, UCSF.

You may download the report here, or find it and other documents like it on our Publications page.