Lawmakers: Oral health must be priority

The Assembly and Senate Republican caucuses called on Gov. Jerry Brown to make additional funding for Denti-Cal a top priority in this year's state budget. A letter to the governor from Republican leaders, Assemblymember Chad Mayes (Yucca Valley) and Senator Jean Fuller (Bakersfield), puts forward a plan to increase funding for Denti-Cal "in a meaningful and responsible way." Specifically, they are pursuing a commitment of an additional $200 million, which will also pull down federal matching funds. According to the proposal, the increased funding would go toward raising provider rates to the national average for the most common services to incentivize provider participation in the state's highly criticized dental program, which was recently described in a report from the Little Hoover Commission as one of the state government's "greatest deficiencies." The new funding would also be used to increase the emphasis on preventive care, case management services and bringing providers into the program. The proposal is encompassed in Assembly 1051 by Assemblymember Brian Maienschein (R-San Diego), vice chair of the Assembly Health Committee.

"While much work remains to be done to improve the state's Denti-Cal program, CDA greatly appreciates that the Republican caucuses in both houses are proactively taking on this issue," said CDA President Ken Wallis, DDS.

Numerous reports over the past several years have consistently highlighted the insufficiencies and dysfunction of the state's dental program, including reimbursement rates among the nation's lowest, an abundance of restrictive rules and reliance on outdated paper-based administrative processes.

The most recent report, released by the Little Hoover Commission in March, found that the program consistently falls short in its purpose to provide quality dental care for 13 million low-income Californians, including over 5 million children. The report reveals that "California's Medicaid dental program is widely viewed, historically, and currently, as broken, bureaucratically rigid and unable to deliver the quality of dental care most other Californians enjoy."

This report only reinforces the findings of the state's 2014 audit, which found more than half of the 5.1 million children enrolled in Denti-Cal in 2013 did not receive any dental care and that there is a lack of providers in a number of California counties, including five counties with at least 2,000 children in the program that may not have had any active dental providers.

Given these alarming reports, CDA appreciates the attention Denti-Cal is now receiving and the positive steps taken to address the program's deficiencies. Under an agreement the state negotiated at the end of 2015, through the 1115 Waiver, California will receive $740 million in new federal money for prevention, early treatment for children and innovative pilot projects. Additionally, legislation recently introduced — AB 2207 by Assemblymember Jim Wood, DDS — streamlines provider enrollment, increases monitoring and reporting requirements and improves care coordination and linkages with Medi-Cal managed care plans.

It is clear that fixing the Denti-Cal program will take a multifaceted approach and additional funding for provider rates must be a part of that solution. The type of funding proposed by California Republicans ultimately comes down to a negotiation with the governor and Democratic legislative leaders through the budget process. CDA will keep members informed through cda.org and the CDA Update as information becomes available.

Updated: 06/06/16