The political back-and-forth over Sacramento County's failing Denti-Cal program is heating up.
Senate President Pro-Tem Darrell Steinberg, D-Sacramento, has called on the state's Medi-Cal chief to take immediate action to improve dental care for more than 110,000 Sacramento County children.
In a letter to Toby Douglas, director of the Department of Health Care Services, Steinberg said Sacramento County kids can't wait for the department to draw up new contracts with dental plans before they get better care.
"Immediate steps need to be taken now to improve access to dental care for children," Steinberg wrote.
This is the third letter that the two have exchanged over Sacramento County's Medi-Cal dental program in recent weeks. The county's "geographic managed care" model is unique in California, but has a poor record.
In fiscal 2010-2011, 30.6 percent of Sacramento County children with Medi-Cal saw a dentist, compared with nearly half of children on Medi-Cal statewide.
A CHCF Center for Health Reporting story, published Feb. 12 in The Bee, described the program's shortcomings, and gave examples of children who have waited months to receive treatment for painful, rotted or broken teeth.
Under the Sacramento County model, the state pays private dental plans a monthly fee currently about $12 for each Medi-Cal child assigned to them. The fee does not depend on whether the child actually sees a dentist.
Critics of the program say the model discourages dentists from seeing patients because they get paid either way.
In contrast, most other county Medi-Cal dental programs in the state are "fee-for-service," with dentists being paid for each visit they report.
In his letter to Steinberg last week, Douglas said his department is committed to improving dental care for Sacramento kids and promised quicker resolution to complaints from patients.
Douglas said it would be "most expedient and effective" to keep Sacramento kids in the managed care program rather than shifting them into fee-for-service, in part because the state would have to alter agreements with the federal government, which provides some Medi-Cal funding.
So, to improve the existing program, his department is reviewing existing contracts and preparing to beef up new contracts, which take effect between July 1 and Jan. 1, he said.
In his latest letter, Steinberg countered that Sacramento kids can't wait.
He urged Douglas to change the program immediately, giving Sacramento County families the choice between managed care or fee-for-service.