Elimination of Adult Denti-Cal affects Poor, Elder, Immigrant population

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San Francisco – 2.8 million adults in California will lose access to dental services on July 1, 2009 due to the Legislature’s February decision to eliminate Denti-Cal (Medi-Cal dental services benefits) for services for adults. A new health care report shows that while the program’s elimination would result in only a minor reduction in state outlays, it would cause the loss of $134.5 million of federal matching funds, substitute more expensive services for less expensive treatments and preventive services, and exacerbate the state’s problems with already overcrowded emergency rooms. The report also demonstrates that the elimination of adult Denti-Cal will have other significant ramifications, including lower participation by dentists in Denti-Cal, fewer children receiving oral health services and loss of jobs, wages and economic activities in California.

North East Medical Services (NEMS) is particularly concerned about their ability to maintain dental services to their patients. About 70% of their more than 22,000 dental encounters are provided to Denti-Cal patients, of which 60% services to adults. NEMS estimates that with the cuts, their Dental Department stands to lose nearly $1.9 million in program income, which not only covers the cost of dental services to Denti-Cal patients, but also enables NEMS to serve those without insurance or the ability to pay for care.

Dr. Cordelia Achuck, Dental Director at North East Medical Services in San Francisco, explains that these cuts particularly affect recently arrived immigrant. “Many of NEMS patients are monolingual Chinese speaking adults or recent immigrants from Asia. They come to NEMS because we speak their native language and provide quality service and affordable fees. Even with the discounted fees we offer, many of our Denti-Cal patients cannot afford to pay out of pocket for various dental procedures and as a result, they may extract teeth that could have been saved or seek “cheaper” oral health services in China or resort to local, unlicensed dentists that often provide poor quality services. This cut affects our Adult Denti-Cal patients and moreover our ability to provide dental services to uninsured and underserved patients. Since Denti-Cal is a substantial portion of our operations, NEMS plans to reduce the dental department budget by 20%.”

Asian Health Services (AHS) in Oakland stands to lose over $600,000 in revenues due to the cuts.

For AHS, the cuts will have a serious impact on their dental clinic as their patients are mostly elderly, with multiple medical problems. Dr. Huong Le, Dental Director at AHS explains that “Medi-Cal is the only dental coverage they have since Medicare does not cover dental. These patients will not be able to afford the dental treatment they need and therefore will wait until they are in dental crisis. Their dental deterioration can have significant consequences on their overall health.”

According to the AHS dental front office staff: “Within the last month, so many of our patients begged us to place them on waiting list for treatment because they know they will not have the benefits after June 30. We have no appointment time available! Some patients cried when they were told they would lose their benefits by June 30.”

The California Primary Care Association is planning a rally in Sacramento at the Capitol on June 30 to protest the elimination.

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