Andrew Zufall, DMD, one of 34 California dentists who in March was awarded a CalHealthCares Loan Repayment award, often tells people who are visiting Hill Country Community Clinic for the first time: “You can’t miss the clinic because it’s the largest building within 25 minutes in any direction!”
The clinic is in Round Mountain, a census-designated place in Northern California’s Shasta County with a population of just 160 people as of the most recent U.S. census data.
Dr. Zufall said some of the clinic’s patients travel from up to two hours away because they live in an area that does not provide services like dental and medical care. “Even their closest neighbor may be over a mile away,” he said.
Medi-Cal Dental patients make up about 80% of his patient population.
“By offering medical, dental and behavioral health services, we provide a wide range of care in an area with nearly no other health care options,” he added.
A return to rural Northern California with $500K in student debt
Zufall already had ties to rural Northern California before he moved to Southern California to attend dental school. He worked as a dental assistant at Hill Country Community Clinic for 2 ½ years, earning his RDA license along the way, and his father practices dentistry in Redding, the seat of Shasta County.
After graduating from the College of Dental Medicine at Western University of Health Sciences in 2022, Zufall quickly returned to Shasta County to practice dentistry — but this time he was carrying nearly $500,000 in student loan debt.
His CalHealthCares award of $300,000 will pay $60,000 toward his education debt each year for five years if he maintains a patient caseload of at least 30% Medi-Cal beneficiaries and within 10% of the caseload he proposed in his application.
Other requirements are also part of his agreement, but the primary goal of the CalHealthCares program is to increase access to care for Medi-Cal patients by expanding the number of dentists and physicians who are enrolled as Medi-Cal providers. Despite the strides made in the last five to 10 years with the help of CDA’s advocacy, Medi-Cal patients still represent one-third of California’s adults and half of the state’s children.
And even with an increase in Medi-Cal-enrolled dentists as a result of improved provider rates and simplified online enrollment, California still has a shortage of Medi-Cal dentists to meet the demand.
‘Peace of mind’ and ability to ‘help the patient population I care so much about’
“This award will allow me to continue seeing my Medi-Cal patient base even with a high student debt burden,” Zufall said while acknowledging that many of his classmates have sought more lucrative positions due to anxiety over monthly student loan payment reminders.
“Given that Hill Country Community Clinic is a nonprofit entity, and we are trying to stretch our budget as far as we can to help as many people as possible, the salary for dental providers isn’t as high as some other community clinics and private offices in Shasta County,” Zufall said. “This award more than makes up for that difference and allows me to have peace of mind that I’m being responsible with my student loan payments while still being able to help the patient population I care so much about.”
Access to dental care gets patients out of pain — and educates them
Abigail Aviles Manahan, DDS, a general dentist in Riverside County’s Moreno Valley, learned about the CalHealthCares Program last year on Instagram.
“The deadline was only about two or three weeks away when I saw another recipient’s Instagram story!” she said.
Dr. Aviles Manahan graduated from Loma Linda University School of Dentistry in 2021 and began working with the Medi-Cal population the same year. She described a high need for Medi-Cal Dental providers in the Inland Empire, especially in the cities of Moreno Valley and Perris.
“We get many patients traveling more than 30 minutes from surrounding cities with less access to pediatric dental care,” she said, adding that many patients visit the practice for their first ever dental exam due to pain.
“Having access to dental care not only gets them out of pain but also educates them and their parents on proper oral hygiene instructions. Ultimately, we hope this improves their overall oral health and prevents future pain. Early childhood caries is the most chronic disease of childhood, even though it is a preventable one,” she said.
As with Dr. Zufall in Shasta County, Aviles Manahan’s CalHealthCares award of $300K will be applied toward her dental school education debt as long as she maintains the minimum caseload of Medi-Cal patients for a minimum of five years.
Aviles Manahan’s proportion of Medi-Cal patients is already at 90%, and she anticipates being able to maintain that percentage or even increase it due to the high demand for care.
She said the award brings much relief along with continued opportunity.
“By receiving this award, I am able to have better work-life balance as a new mom and can comfortably pay down my student loans without worrying about burning out.”
Serving the Medi-Cal Dental pediatric population in Santa Clarita Valley
CalHealthCares award recipient Sederic Grant, DDS, sees many pediatric Medi-Cal Dental patients in the Santa Clarita Valley of Los Angeles County, which he said has a lack of pediatric dental specialists who accept Medi-Cal patients.
“General dentists typically are not comfortable seeing younger children with special needs, so through evidence-based care we help reduce the prevalence of caries in this population of children ages 6 months to 18 years,” he said.
Dr. Grant graduated with a DDS in 2020 from the University of California, San Franciso School of Dentistry, and went on to complete his pediatric dentistry residency at the Minnesota School of Dentistry in 2022. He received comprehensive training in the treatment of children with complex medical concerns that may require the use of sedation and the treatment of children in the operating room under general anesthesia.
He practices at two locations of Kidz Dental Care, where he already maintains a patient caseload of over 90% Medi-Cal patients and says he sees well over 100 patients per week.
Grant received a CalHealthCares award of just under $178,000 to cover his remaining student debt load.
“This award will allow me to continue to serve the underserved Medi-Cal population while not worrying about my student debt burden,” said Grant.
A look at the 34 dentists who received the CalHealthCares award
The CalHealthCares program, which is overseen by the California Department of Health Care Services and funded by Proposition 56 — the state tobacco tax co-sponsored by CDA and passed by voters in 2016 — awarded a total of $9.4 million to 32 dentists and two dental students in March 2024.
Key facts of this fifth CalHealthCares Awards cycle, known as cohort 5, include:
- Awardees practice in 22 California counties, from Del Norte on the far northern coast to Imperial in the inland south.
- 41% of awardees are female and 59% are male.
- Awardees reflect the greatest variability of specialties of all five years of the program: dental anesthesiology (1); endodontics (2); oral and maxillofacial surgery (1); orofacial pain (1); orthodontics (1); and pediatric dentistry (9).
- For the first time, an orofacial pain specialist received the award. (Orofacial pain was recognized as a specialty in March 2020.)
- 28% of awardees serve special-needs patients.
Altogether, CalHealthCares has awarded $48,876,864 in loan repayments to 187 dentists or dental students since the program launched in 2018-19. Physicians are eligible to apply for the award separately.
The recognition continues: We will spotlight additional CDA members who received the cohort-5 CalHealthCares Loan Repayment. Watch our social media channels and (for members) our weekly member newsletter, Inside California Dentistry, through June.
CDA also will keep members informed about potential future funding for the CalHealthCares loan repayment program and related application periods. Learn more about recent Medi-Cal Dental gains for dentists and patients, or sign up to become a provider.