The political opposition to Sacramento County's managed care dental program for poor children is mounting.
State government officials promised new accountability after elected representatives, county supervisors and advocates demanded better care for the more than 110,000 Sacramento County children who receive dental coverage through Medi-Cal, the state's insurance program for low-income residents.
The county operates the state's only mandatory managed care model, and government data show it has one of the state's worst records of care. In fiscal year 2010-2011, fewer than one-third of Sacramento children with Medi-Cal saw a dentist, compared with nearly half of children on Medi-Cal statewide.
The political tug of war is intensifying.
Brent Barnhart, director of the Department of Managed Health Care, told members of a Senate budget subcommittee that his department will review the five dental plans that participate in Sacramento's managed care program to address access to care, quality of care and other issues.
In a letter dated March 7, Department of Health Care Services Director Toby Douglas wrote Senate President Pro Tem Darrell Steinberg, D-Sacramento, that he has compiled a list of actions he expects dental plans to take to improve children's access to care. DHCS has enforcement authority over the dental plans because it contracts with them directly to provide services.
At a press conference at an Oak Park clinic, Assemblyman Richard Pan, D-Sacramento, and other local leaders called on DHCS to give Sacramento families on Medi-Cal the temporary option to leave managed care for a fee-for-service option. On Thursday he will chair a special hearing at the Capitol focusing on Sacramento's Denti-Cal program.
The Sacramento County Board of Supervisors will discuss the dental program on Tuesday and hear recommendations from the county's Public Health Advisory Board on how to improve access and care.
Some advocates are losing patience with promises for change, including Cathy Levering, executive director of the Sacramento District Dental Society.
"This is all great, and they're answering now because the pressure is on them. But why has this gone on for 18 years?" she asked.
She and others also point out that this isn't just about Sacramento. The state is embarking on a statewide expansion of managed medical care under Medi-Cal.