Healthy Choices

Many Sacramento children on Medi-Cal going without dental care

Low-income Sacramento children aren’t going to the dentist as much as they should, according to a report released this week. That’s despite a five-year effort to bring more dentists into Medi-Cal managed care plans, expand community clinics and educate families about the importance of dental care.

In Sacramento County, only 40 percent of children on Medi-Cal managed care plans use the dental services they’re eligible for, compared to 52.5 percent statewide.

Efforts by state health officials have helped double the percentage of Sacramento region children using dental services since 2010, but there’s still room for improvement, said the report’s lead author, Barbara Aved. Dental health advocates will present the results to the Sacramento County Board of Supervisors next week.

Sacramento is the only county in California where Medi-Cal consumers are required to enroll in a managed care plan for dental services. About 140,000 children in the county are eligible for dental care from a network of local providers and community clinics. Still, two-thirds of them didn’t receive any preventive dental care services in 2014, the report found.

The Medi-Cal Dental Advisory Committee requested the report as an update to a 2010 study that found multiple failures and shortfalls in pediatric dental care in Sacramento County. The new report, released by the Sacramento health consulting firm Barbara Aved Associates, aims to use the county as a case study for policy changes at the state level.

A 2014 study cited in the report found that nearly a quarter of Sacramento County children in preschool to sixth grade had early-stage oral disease, and 7 percent of them required immediate treatment.

Many families receiving Medi-Cal in the county aren’t aware of the importance of dental care, Aved said. That could be addressed through more education in low-income neighborhoods and more caseworkers to help families make and keep appointments, she said.

But there aren’t enough providers in the Medi-Cal managed care network to meet the region’s dental needs, Aved said. Dentists are reluctant to join the network because of low reimbursement rates, excessive paperwork and a tendency among Medi-Cal patients to not show up for appointments.

“(Sacramento) is supposed to be really great, because these kids all have a dental home,” she said. “The problem, on some level, is with the providers, but the patients bear a responsibility as well.”

On a positive note, five children’s dental clinics covered by Medi-Cal have been built in Sacramento County with support from the child health nonprofit group First 5 Sacramento. Aved called the expansion “one of the best things to happen in Sacramento in the last five years.”

“Where those exist, it’s going to be easy for families to get into care, especially the clinics that typically have night hours and Saturday hours,” she said.

The study makes several recommendations to the state health department, including streamlining the Denti-Cal application process and making dental work requiring general anesthesia more affordable. It also recommends raising reimbursement rates and continuing to expand community dental clinics.

Sammy Caiola: 916-321-1636, @SammyCaiola