CDA Cares a temporary fix for broken Denti-Cal program

Marquita has a job that requires her to be on the phone a lot, which wouldn’t be an issue if she didn’t have trouble speaking. But she does — because of pain from the poor condition of her oral health.

With frequent migraines and discomfort from simply opening and closing her mouth, Marquita had known she needed dental care for quite some time, two years in fact. Specifically, she needed extractions, but her Denti-Cal coverage landed her on a dentist’s waiting list for months.

This is a story that many Californians share because of the broken Denti-Cal program, which fails to provide access to care due to glaring oversight issues and extremely low reimbursement rates. A recent state audit of Denti-Cal showed that in 2013 fewer than half of the children enrolled in Denti-Cal received care. Further compounding the problem is that Denti-Cal reimbursement rates have not increased since 2000-2001.

As a result, Marquita took matters into her own hands after hearing on the news about dentist volunteers helping people like her at CDA Cares Sacramento. She knew it was her chance to get needed treatment to relieve pain.

“There is not enough Tylenol or ibuprofen in the world to make the pain go away,” she said. “I start getting fevers. I just felt horrible all day, it hurts to open my mouth, close my mouth – chewing is a no go. So I just need to get it done.”

She got in line at 3 a.m. on March 28. By 11 a.m., Marquita said she had received more dental care in just a few hours than in the last two years.

Marquita had two extractions.

“Thank you, this is a great help to a lot of people,” she said.

Marquita is one of the 2,080 people who received charitable dental services at no charge at CDA Cares, which was hosted by the CDA Foundation and CDA on March 27-28.

In addition to providing dental services and oral health education, CDA Cares educates the public and policymakers about the importance of good oral health and the need for an adequately funded dental safety net, which includes a well-functioning Denti-Cal program.

“These events have had a tremendous impact across the state,” said CDA President Walt Weber, DDS. “Dentists are committed to providing oral health care to Californians in need, but the state needs to step up. We can’t do it alone.”

Lines at each of the seven CDA Cares clinics held throughout the state since 2012 demonstrate how Denti-Cal fails to provide access to care. CDA is advocating for immediate improvements to the program, and CDA members testified at two joint oversight hearings of the Senate Health Committee, Assembly Health Committee and the Joint Legislative Audit Committee in March. The point was made at both hearings that the state must do better than having a Medicaid program that ranks at the bottom of the nation.

At these hearings, CDA advocated for the state to establish criteria that allows for a legitimately accurate assessment of true access to timely care and substantially increase Denti-Cal reimbursement rates starting this year.

In 2014, the state budget included funding that partially restored adult Denti-Cal benefits with a proposed annual cost of $77 million. The coverage includes preventive care, restorations and full dentures, but that funding covers a mere fraction of the need.

That fact was evident for the 16 state elected officials and staff members who toured the CDA Cares event. Sen. Richard Pan, MD, MPH, (D-Sacramento), a pediatrician and U.C. Davis educator, was one of those who toured the clinic and acknowledged that dentists cannot solve the tremendous amount of need for oral health care on their own.

“We need to do more at the state to make sure more people have access to dental care. Our Denti-Cal program has unfortunately not stood up to the test,” Pan said. “The state auditor examined the Denti-Cal program and pointed out access problems where payment was so low that there are counties where there are no dentists accepting new patients, and it is often cheaper for them to see these patients as charity care patients than to accept Denti-Cal — it is unacceptable that our state has to depend on charity care.”

During the two-day CDA Cares charity event, dentists and dental professionals provided nearly 14,000 dental procedures, including fillings, extractions, cleanings and oral health education. In addition, dentists worked with volunteer technicians in the clinic’s dental lab area to provide 377 complete and partial dentures and repairs. The event was reported by TV, newspaper and radio stations – nearly 90 stories over seven days carried positive news about the clinic as well as CDA’s message about the need to fix the Denti-Cal program.

“From setup to breakdown, the entire CDA Cares experience is so rewarding,” said CDA Foundation Chair Don Rollofson, DMD. “People are leaving here with relief from pain and infection, improved opportunities for employment and a better understanding of the importance of maintaining their oral health.”

A CDA Cares patient named Doug is another Californian who has Denti-Cal, which paid for the dental exams and cleanings he had done recently, but didn’t help relieve the pain from a cracked tooth. Doug, who cleans houses for a living, has dealt with pain since last year and has to cut his food up finely in order to eat. But he had plans for that to change after he decided to line up at CDA Cares at 5:15 a.m.

“I’d like to thank them for what they are doing, this is a heck of a community service,” Doug said. “There are a lot of people here who need help.”

Nearly 1,800 volunteers donated their time and services to help patients like Doug at the event, including 1,015 health professionals – dentists, dental hygienists, dental assistants, nurses and lab technicians – as well as hundreds of community volunteers who assisted with registration, translation, data entry and escorting patients.

As for Marquita, she will be able to perform her job without pain thanks to the volunteers who took the time to fill the gap in dental coverage Californians face.

“It shouldn’t have to come down to everybody being outside all hours of the night waiting in line. You should be able to take care of this with your Medi-Cal — this is what Medi-Cal is for,” she said.

The CDA Foundation is planning another CDA Cares event in Fresno Oct. 2-3. To register to volunteer, visit cdafoundation.org.