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Improving Access to Oral Health Care in Washington State


Improving Access to Oral Health Care in Washington State Christina Peters Health Policy Director, Children s Alliance January 23, 2015 Families USA – PowerPoint PPT presentation

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Title: Improving Access to Oral Health Care in Washington State

Improving Access to Oral Health Care in
Washington State
  • Christina Peters
  • Health Policy Director,
  • Childrens Alliance
  • January 23, 2015
  • Families USA

Dental care is out of reach in Washington
  • Snohomish Co 2010 low-income needs assessment
    dental care identified as 1 unmet need
  • Chelan/Douglas Co 2010 community needs assessment
    quoted a local nurse that compared dental care
    access for adults to that of a third world
  • A 2012 assessment, homeless veterans
    self-identified dental care as the 1 unmet need

Dental Care Shortage Areas in WA
  • Oct 23-26 in downtown Seattle at the Seattle
    Center, 3386 patients received care at a Remote
    Area Medical event which provides charity care
    to individuals who need it.
  • 87 of patients came from the central Puget sound
  • 75 reported incomes below 200 FPL and 40
    reported being uninsured.
  • 92 of patients reported not having dental
  • People camped out overnight to gain access to the
    free clinic

  • 1714 patents received dental care which amounted
    to 1.24 million in dental services.
  • 76 of dental patients require follow up
  • 30 of dental providers (and 40 of supporting
    providers) agreed with the statement I
    discovered many conditions I couldnt treat on

Dentists Participation in Medicaid
    FY 2009 FY 2010 FY 2011 FY 2012
Number of licensed dentists 5,923 6,072 6,155 6,080
Number of dentists that serve Medicaid-enrollees Based off claims payment data and age grouped 0-20 1,226 1,353 1,214 1,165
21 22 20 19
Number of dentists that serve Medicaid-enrollees Based off claims payment data and age grouped 21 1,111 1,210 997 626
19 20 16 10
WA State Department of Health WA State Health
Care Authority
Increasing Access to Coverage
  • Embedded Pediatric Dental Benefits offered in
    QHPs in the Exchange
  • Oral Health Coverage and the Medicaid Expansion

Embedded Pediatric Dental Benefits
  • Dental benefits offered in the exchange must be
    offered and priced separately to assure
    transparency for consumers

Embedded Pediatric Dental Benefits
  • In 2014 we ran a bi-partisan bill with a very
    broad coalition of supporters The Healthy
    Washington Coalition, Dentists, Big health plans
    like Premera and Regence
  • The dental insurers led by Delta Dental were the
    main (and only) opposition to the bill
  • The bill did not pass the senate

Embedded Pediatric Dental Benefits
  • Consumer Choice
  • Equal Markets
  • Lower Costs

Medicaid Eligible January 1, 2014
Restoration of Adult Dental in Medicaid
  • The Alliance of Dental Hygiene Practitioners
  • Childrens Alliance
  • Washington Dental Service Foundation
  • Statewide Poverty Action Network
  • UW School of Dentistry
  • Washington State Dental Hygiene Association
  • Washington Denturists Association
  • Solid Ground
  • Washington Association of Community and Migrant
    Health Centers
  • Washington Senior Citizen Lobby
  • SEIU Healthcare 775 NW
  • Washington State Dental Association
  • Eldercare Alliance
  • Northwest Health Law Advocates
  • Washington Association of Area Agencies on Aging
  • Washington Dental Access Campaign
  • Broad coalition including
  • Providers
  • Childrens Advocates
  • Seniors Advocates
  • Poverty Advocates
  • Labor Unions
  • Oral Health Advocates

Medicaid eligible adults receiving at least one
dental service in FY 2013
Increasing Access to Care
  • Dental Therapists
  • A Community Workforce Solution to Improve Oral
    Health Access to Quality Dental Care For Rural,
    Tribal Underserved Washington

Why Dental Therapists?
  • Dental Therapist provide high quality, community
    based, culturally competent care

40,000 more Alaskans now receiving routine and
preventative care because of dental therapists.
Theyll get actually more training than a
dentist does within a small scope of practice.
I think a dental therapist model could be
utilized in any dental office anywhere in the
United States. Dr. Mary Williard, DDS
Dental therapists address cost and access issues
  • Dental Therapists make the dental team more
  • On average, Dental Therapists cost only 30 cents
    for every dollar of revenue they generate. This
    allows dentists to see more Medicaid patients at
    existing reimbursement rates
  • Preventive care offered by Dental Therapists can
    prevent costly emergency room visits for
    dental-related health problems.
  • A solo-practice dentist in rural Minnesota is now
    taking 38 percent more patients after hiring a
    dental therapist. The practice increased the
    number of Medicaid patients served by 73 percent.
  • Dental Therapists free up dentists to do more
  • complicated procedures.

What were seeing on the ground is that not only
is this an effective dental workforce provider,
but its also well accepted by patients and by
dentists when they have actual exposure to it.
Sara Wovcha, Director of Childrens Dental
Services, the first clinic to employ Dental
Therapists in Minnesota.
Dental Therapists support strong families and
healthy communities
Dental Therapists strengthen communities by
creating family wage jobs
  • Dental Therapists bring jobs to their
    communities for the dental team, as well as for
    office secretaries and even the landlord
    collecting rent from a once-empty storefront.
  • Dental Therapist create an accessible rung on the
    health professional career ladder for communities
    underrepresented in the heath professions.
  • In Alaska and Minnesota Dental Therapists are
    active members of their communities promoting
    good oral health in schools and other community
    settings .
  • Dental Therapists provide culturally competent
    community based care
  • Dental Therapists in Alaska and Minnesota are on
    the front lines of wiping out decay and improving
    overall health in underserved communities.

Whats the hold up?
Supporters of Dental Therapy
  • AARP of WashingtonAffiliated Tribes of Northwest
    IndiansAlliance for a Just SocietyAmerican
    Friends Service CommitteeAmerican Indian Health
    Commission of WashingtonAsian Pacific Americans
    for Civic Empowerment (APACE)Center for
    MultiCultural HealthChildrens AllianceEastern
    Washington UniversityEastern Washington
    VotersElder Care AllianceEquity in Education
    CoalitionFaith Action NetworkHealth Coalition
    for Children and Youth (HCCY)Healthy King County
    CoalitionLatinos for Community
    TransformationLGBTQ AllyshipNational
    Association of Social WorkersWashingtonNational
    Dental AssociationNorthwest Portland Area Indian
    Health BoardOlympia Coalition for a Fair
    BudgetOneAmericaPara Los Niños

Opposition to Dental Therapy
Puget Sound Advocates for Retirement ActionReal
ChangeResident Councils of WashingtonSchool
Nurse Organization of WashingtonSea Mar
Community Health CentersSeattle Central
Community CollegeSeattle King County Public
HealthSeattle NAACPSEIU Healthcare 775NWSenior
ServicesSolid GroundStatewide Poverty Action
NetworkUFCW Local 21Washington Adult Day
Services AssociationWashington Community Action
NetworkWashington Low Income Housing
AllianceWashington Rural Health
AssociationWashington State Dental Hygienists
AssociationWashington State Hospital
AssociationWashington State Labor Council,
AFL-CIOWA State Long-Term Care Ombudsman
ProgramWashington State Senior Citizen's Lobby
  • Washington State Dental Association
  • American Dental Association