Soapbox

Poor kids should get dental care

Jesus Rojas Jimenez, 4, has X-rays at the Effort Inc. Oak Park dental clinic, where a vast majority of patients are on Denti-Cal.
Jesus Rojas Jimenez, 4, has X-rays at the Effort Inc. Oak Park dental clinic, where a vast majority of patients are on Denti-Cal. Sacramento Bee file

As the father of three children and chairman of the Assembly Committee on Health, one of my top priorities is protecting the basic health needs of all California children, especially when it comes to dental care.

A state audit last December was alarming, revealing that nearly 56 percent of the 5.1 million children enrolled in Denti-Cal the prior year did not receive care. The audit also reported a severe lack of providers in many counties.

It’s unacceptable that poor children in California don’t have adequate access to dental care. We must immediately consider a wide range of potential solutions.

With my colleagues in the Senate and the Assembly, I have been closely reviewing the audit recommendations to determine how to correct these problems going forward. In March, we held a joint oversight hearing and discussed a number of ways to improve the program.

A significant obstacle to participation is low reimbursement rates for Denti-Cal providers, which are well below national and regional averages. Rates for the most common dental procedures averaged 65 percent less than the national average. For some providers, reimbursements don’t cover the administrative costs of participating in the program.

In addition to rates, we need to take a serious look at the structure of the program itself. Even the California Department of Health Care Services’ leadership has acknowledged that changes are needed to reduce red tape.

Updating archaic administrative processes will help ensure that patients can get care when and where they need it most. For instance, California and other states have experimented with mobile dental services and school-based dental programs. Initiatives like these should be encouraged.

The audit also cited the absence of outreach, particularly in rural areas, about healthy habits and dental care access. These are basic components of successful programs and should be addressed immediately.

California can take additional steps to set us up for long-term success. Our state should ensure we are getting the optimal value for our investment and top care for its citizens by implementing best practices from other states. We should develop incentives for increased access and improved quality. And we should streamline administrative processes and enhance access in rural and urban communities alike.

For a system that serves more than 5 million children in as geographically, culturally and economically diverse a state as California, this can seem like an insurmountable task. But with 30 percent of Californians encountering barriers to dental care, half of all kids in California enrolled in Denti-Cal and California ranking 47th nationally in oral health, these are issues we cannot ignore.

A solution is not impossible. Other states have recently undergone similar transformations with remarkable results. In Illinois, provider participation in the Medicaid dental program has increased by 250 percent and the number of children receiving service has increased by 155 percent. These remarkable improvements occurred by using technology to streamline administration and by boosting patient education. Maryland, in just six years, moved from 29th to seventh in the country in the number of children successfully receiving dental services through Medicaid.

Now is the time to expand the conversation and fundamentally transform the Denti-Cal system so we can serve those who need it most. Let’s ensure that all children have the early care they need to achieve optimal oral health.

Assemblyman Rob Bonta, D-Alameda, represents the 18th Assembly District.

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