Allocation of Supplemental State Funding to Improve Denti-Cal under the Budget Act of 2017


June 29, 2017

Jennifer Kent, Director
California Department of Health Care Services
1501 Capitol Avenue, MS 4050

P.O. Box 997413
Sacramento, CA 95899-7413

Via Email to: Jennifer.kent@dhcs.ca.gov

RE: Allocation of Supplemental State Funding to Improve Denti-Cal under the Budget Act of 2017

Dear Director Kent:

How Proposition 56 revenues are allocated to Denti-Cal could mean the difference between a poor or great initial outcome for low-income seniors and other disadvantaged residents in the state of California.

As CEO and president of West Health, a non-profit based in San Diego that is focused on applied medical research, policy, and philanthropy, I write on behalf of the low-income seniors we see every day at the Gary and Mary West Senior Dental Center in downtown San Diego.

A large portion of our patients live with serious oral health issues, including pain, infection, and malnutrition, due to dental disease. Many have not seen a dentist in years – for others, it’s been decades, due to the costs associated with dental care. This, despite the fact that more than 85 percent of these patients are covered under the Denti-Cal program. What we’re seeing in San Diego is happening all across the state.

Denti-Cal’s shortcomings, including limitations on services covered and adequacy of reimbursement payment to dentists to ensure access, have been extensively documented. The additional $140 million in state funding for Denti-Cal only begins to address the significant unmet oral health needs among low-income Californians. That’s why it’s so important those funds be spent efficiently and effectively.

As you develop criteria for the allocation of these funds, we urge you to direct the funding to the services that will have the greatest impact. Specifically, we suggest concentrating the additional funding in two areas:

o   Increase payments for the most commonly-provided dental preventive services and basic treatments. We recommend allocating dollars to cover specific dental services versus spreading funds to cover all treatments. This would enable more beneficiaries to access care and may serve to reduce the incidence of future serious oral health issues and the costs associated with them.

o   Provide care for individuals with special circumstances and needs, such as people with disabilities and significant medical problems. These patients face even greater challenges in obtaining dental care. Appropriately caring for this population frequently requires additional time and/or visits, as well as modifications to the manner in which treatments are traditionally provided. These factors contribute to additional cost for dental practices and further limit access for these Denti-Cal beneficiaries.

Effectively allocating the additional funds from Proposition 56 revenues is a critical initial step toward making the Denti-Cal program the oral health safety net vulnerable Californians need and deserve. We appreciate your consideration of our on-the-ground experience and trust we share this important goal for low-income California seniors and other disadvantaged residents.