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CDA secures historic state budget wins for dentistry, oral health access

Budget includes staff training investments and $50M sought by CDA for clinics serving patients with special needs

June 30, 2022 2540

Quick Summary:

The California 2022-23 state budget signed by Gov. Gavin Newsom includes all of CDA’s priority asks, making significant gains for dentistry and oral health with major investments in health care workforce development; $50 million to build and expand facilities and infrastructure to provide care for dental patients with special health care needs; and $10 million for grants to develop dental student clinical rotations.

The California 2022-23 state budget signed today by Gov. Gavin Newsom includes all of CDA’s priority asks, making significant gains for dentistry and oral health with:

  • Major investments in health care workforce development. 
  • $50 million to build and expand facilities and infrastructure to provide care for dental patients with special health care needs.
  • $10 million for grants to develop dental student clinical rotations. 

Elsewhere the budget continues to support CDA’s years-long advocacy to improve the Medi-Cal Dental program through expanded benefits, supplemental provider payments and continuation of the CalHealthCares student loan repayment and practice support grant.

$1.7B for health care workforce, staff recruitment and training

With dental practices across the state experiencing staffing shortages, CDA has been advocating tirelessly for targeted investments to improve dental pipeline opportunities and expand apprenticeship programs.

Expanding and diversifying the health care workforce was a top priority in this budget with hundreds of millions invested in a wide range of health care provider scholarship, loan and grant programs that many dentists and dental team members are eligible to apply for. Among other things, funding will support the work of the Health Workforce Education and Training Council, which aims to build a diverse, culturally competent health care workforce, as well as the Multilingual Health Initiatives to expand scholarship and loan repayment for multilingual applicants.

CDA is particularly supportive of two new investments: 

  • $45 million to develop and expand the High Road Training Partnerships for health and human services.  
  • $175 million over three years to the Apprenticeship Innovation Program with a focus on nontraditional apprenticeships, including in health care.

The High Road Training Partnerships is a public-private partnership initiative of the California Workforce Development Board to provide training and career-ladder opportunities, including in dental assisting. The new budget investment builds on the HRTP funding of $75 million in last year’s budget, and CDA is in the process of applying for HRTP funding to expand the association’s own dental assisting pilot training program, Smile Crew CA.

Expanding the trainings to more regions across California would not only help to alleviate dental staffing shortages exacerbated by the COVID-19 pandemic but also create new job opportunities for workers who were displaced by the pandemic.

The Apprentice Innovation Program provides another major opportunity for CDA to help resolve dental workforce shortages. The program provides grants, reimbursements or other funding to support an apprenticeship program or train apprentices. Training funds could be used for course development, classroom instruction and other eligible activities. 

CDA is already beginning to work with the Newsom administration on opportunities to establish dental assisting apprenticeships. The three-year investment includes an additional $60 million for the program in fiscal years 2023-24 and 2024-25. This program is an effort to fulfill Gov. Newsom’s stated goal of creating 500,000 apprenticeships across the state by 2029.

$50M investment will expedite care for patients with special needs

Lack of access to dental care for patients with special needs is a decades-long crisis, even as the state has made strides to increase access in the Medi-Cal dental program. Few settings can provide dental care for patients with special needs. Most, including dental schools, are backlogged with exceptionally long wait times, sometimes a year or more, and which have been exacerbated by the pandemic. Many patients and their families travel hours to clinics to receive routine dental care, and some wait for years to receive that care, as highlighted in a CalMatters article published in May.

An approved one-time investment of $50 million will help to alleviate the long wait times for these patients. The investment, advocated by CDA and a coalition of special needs advocates, provider groups and dental schools, will fund grants to build a network of new specialty dental clinics or expand settings that serve individuals with physical, developmental or cognitive disabilities. 

Entities will be able to apply for up to $5 million in grant funding and need to be Medi-Cal providers as well as agree to serve the special needs population for at least 10 years upon completion of the construction.

The additional care settings will significantly expand access to dental care for individuals who are unable to undergo dental procedures in traditional dental offices either due to special health care needs or the complexity of the care needed ― sometimes requiring special accommodations for mobility issues, stabilization or deep sedation.

$10M for grants to develop dental student clinical rotations 

Also approved was CDA’s budget ask for a one-time allocation of $10 million to create new and enhanced community-based clinical education rotations for dental students to improve the oral health of underserved population groups in California. A newly developed consortia of California dental schools will be responsible for creating these rotations.

The new rotations will address two goals: to improve access to quality health care services and to foster a health care workforce that is able to address current and emerging needs.

CDA’s ask was spurred by findings of the 2018-2028 California Oral Health Plan advisory committee, which indicated “insufficient infrastructure to promote culturally sensitive community-based oral health programs” was a key reason for the high prevalence of dental caries and untreated dental caries among grade three children.

The committee also recommended increased collaboration between various health care, academic and public health organizations to provide dental care to underserved Californians.

The new, self-sustaining clinical rotations model will give trainees real-world experiences in various dental practice models, including federally qualified health centers, private offices and mobile dentistry to enhance learning in patient engagement, practice management and team-based care delivery.

Crown benefit expanded, supplemental Medi-Cal provider payments backfilled

Improvements to the Medi-Cal Dental benefits, rates and initiatives will also see a big boost in the 2022-23 budget. These successes build on wins CDA has achieved through advocacy in past years, such as installment of California’s first state dental director and the passage of the Proposition 56 tobacco tax, which helps fund medical and oral health care programs.

New support through the budget includes:

  • Expanded adult crown benefit. Expands the adult crown benefit in Medi-Cal to include laboratory-processed crowns. This benefit will reflect July 1, 2022, coverage of evidence-based dental practices consistent with the American Dental Association and allow dentists to save the tooth by placing a long-lasting customized crown that will avoid costly procedures such as root canals. Also provides Medi-Cal dental coverage of laboratory-processed crowns on posterior teeth for persons ages 21 or older when medically necessary to restore a posterior tooth to normal function.
  • Extension and funding of the CalHealthCares Student Loan Repayment Program. The budget extends this program permanently and provides additional ongoing funds. Approximately 120 dentists have already received the award as of the program’s third year. This technical change and ongoing funding source will allow the program to continue expanding access to care by supporting new dentists serving the Medi-Cal population.
  • Backfills the $31.7 million deficit in the Dental Transformation Initiative for preventive services for children. Dentists who provided services under DTI Domains Nos. 1 and 3 in 2021 will receive the full incentive payments they were expecting for services already rendered.
  • Backfills Proposition 56 revenues. Proposition 56 revenues have dropped due to reductions in smoking, which is a goal of the tax. The 2022-23 budget supports the Proposition 56 rates with general fund dollars, and CDA strongly supports the use of general funds to maintain supplemental provider payments, which have led to a 25% increase in dental providers enrolling in the program since the tobacco tax took effect. The use of general fund dollars to maintain these funding levels aligns with the will of the voters and will provide much-needed long-term stability for the program.

Watch for updates in the CDA newsroom, including about dental apprenticeship opportunities through the Apprenticeship Innovation Program and new ways to recruit and retain qualified dental staff.