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Federal Report: Children In Medi-Cal Getting Inadequate Dental Care

Children in California receiving Medi-Cal benefits are getting inadequate dental care, according to a federal report issued yesterday detailing the dental utilization rates in four states across the country.

According to the CMS report:

  • About 29% of California’s Medi-Cal children received no dental care at all in the past year, and a total of 78% of kids did not receive all required dental services;
  • That compares to 31% receiving no dental care in Indiana, 26% for Louisiana and 23% for Maryland; and
  • The overall number of children who received less than the required dental services in the last year also are similar to California’s numbers: 78% in Indiana, 81% in Louisiana and 73% in Maryland.

“It’s not a surprise at all, it’s just one more indication that California needs to do more to make sure kids get required services,” said Jenny Kattlove, senior director of programs for The Children’s Partnership, a children’s health advocacy group based in Santa Monica.

Given the methodology of the CMS report, Kattlove said, which looked at children who received benefits for two years, the low estimate of dental utilization in those four states is most likely even lower.

“Most people move on and off Medi-Cal, they’re not on it for two years,” Kattlove said, “so the situation is probably worse than that.”

In fact, a 2013 California State Auditor’s report estimated that 56% of Medi-Cal children did not receive any dental services in the past year, based on methodology that included all Medi-Cal children, not just the ones who had been beneficiaries for two years.

Since that audit came out, the state has initiated a number of possible remedies, including reversal of a 10% provider rate cut for dentists, a new law to establish dental homes in California, more effort put toward teledentistry, creation of the state’s Dental Director position  — and most recently, inclusion of dental reform in the 2020 Medi-Cal waiver.

The director of the Department of Health Care Services, Jennifer Kent, has said improving dental access and services in California is one of her top priorities.

“They’ve taken a lot of steps,” Kattlove said, “but, yes, more needs to be done.”

The CMS report highlighted the telehealth component of increasing dental access, and that’s especially important in rural areas without many dentists, Kattlove said.

“But the report doesn’t go into ways that we need to bring more care to underserved kids,” she said, ideas that go beyond raising provider rates, which still rank among the lowest in the nation.

“We need to look at creative and innovative ways of reaching these kids, such as Head Start sites and schools,” Kattlove said.

Change on this scale, however, is always incremental, she said. “Improving access to dental care through the waiver, that’s great, it’s the first time we’ve seen such a robust focus on children. There has been movement,” she said. “It’s going to take time.”

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