Furthering progress for children’s dental health in California

By the CDHP team

CDHP relies on the work of our state partners and their in-depth knowledge and advocacy. The following blog post is by Mayra E. Alvarez, President of The Children’s Partnership. The Children’s Partnership has long been an advocate for expanding access and improving the quality of dental care in California. Dental has become a visible priority of policymakers in the state, bringing significant opportunities to improve the oral health of children at highest risk for tooth decay.

With a little over six years since the Affordable Care Act (ACA) was signed into law, remarkable progress has been made for the health and well-being of children in California and across the nation. California, in particular, has been a leader in taking full advantage of the provisions in the ACA and leveraging the momentum to advance additional opportunities to improve the health of children.

The Children’s Partnership’s new report, The Affordable Care Act and Children’s Coverage in California: Our Progress and Our Future, details the tremendous progress California has made in health care reform and identifies future actions that are necessary to continue to support a healthy future for all California children. Children’s dental health coverage and care are key pieces to such progress.

California is making it easy for families to purchase dental coverage for children through its health insurance marketplace. In many states’ marketplaces, children’s dental coverage is sold separately from medical coverage, subjecting families to additional costs and bureaucracy to enroll children in important dental coverage. Initially, this was also the case in California. As a result, only 30 percent of children who enrolled in medical coverage through Covered California (the state’s ACA marketplace) also enrolled in dental coverage during the first year of open enrollment in Covered California.

Our hope is that the DTI pilots demonstrate what it really takes to improve the oral health of kids.

The Children’s Partnership joined other advocates to spearhead the case for a commonsense solution­: integrating pediatric dental plans into Covered California health plans. By the second open enrollment period, all children enrolled in medical coverage through Covered California automatically received dental benefits, without an additional cost or extra enrollment step.

Meanwhile, there was mounting evidence that children enrolled in Medi-Cal, the state’s Medicaid program, were not getting needed dental care. A December 2014 State Auditor’s report revealed that over half of all children in Medi-Cal did not see a dentist in 2013. With such disappointing evidence, advocates worked with the State to include a Dental Transformation Initiative (DTI) in California’s federal Medicaid waiver aimed at transforming the delivery of care for those enrolled in Medi-Cal.

The DTI leverages an unprecedented amount of new federal support to reward dental providers for providing preventive dental care to children enrolled in Medi-Cal. The DTI also sets aside millions of dollars for local pilot programs, offering an opportunity to deploy innovative ways to bring dental care to chil­dren in community settings. These initiatives hold promise in helping our most vulnerable children get critical preventive dental care.

As technology transforms our health care system, there is great potential to use telehealth to bring dental care to children at schools and Head Start sites.

Our hope is that the DTI pilots demonstrate what it really takes to improve the oral health of kids. For example, we know that many children face barriers to getting care. Children and families are more likely to get the preventive dental care, education and support they need if that care is brought to them in schools, Head Start sites, and even at home through home visitation models. We also know a dentist is not the only provider who can deliver needed care to children and families. Community health workers, promotores, home visitors and other community-based providers play a critical role in providing linguistically and culturally appropriate education, care coordination and other support to help improve the oral health of the whole family.

Finally, as technology transforms our health care system, there is great potential to use telehealth to bring dental care to children at schools and Head Start sites through programs such as the Virtual Dental Home. DTI pilots can further explore these opportunities and more to better reach children and improve oral health.

As tooth decay remains the number one chronic disease among children in California and nationally, the time is now to do more to improve the health of children. Building on the success of the ACA would ensure that the 5.7 million children in our state enrolled in Medi-Cal or Covered California health plans get the critical dental care they need. With a new state dental director in place and the attention of policymakers and stakeholders from multiple and diverse sectors, California can continue its leadership in advancing real solutions to address the dental care gap too many of our children face.

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Did you know?

44% }
of U.S. children will have at least one cavity by kindergarten.
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