Christina Peters
Health Policy Director,
Children’s Alliance
January 23, 2015
Families USA

Dental care is out of reach in
Washington
• Snohomish Co 2010 low-income needs assessment: dental care identified as
#1 unmet need
• Chelan/Douglas Co 2010 community needs assessment quoted a local nurse that compared dental care access for adults “to that of a third world country”
• A 2012 assessment, homeless veteran’s self-identified dental care as the #1 unmet need

Dental Care Shortage Areas in WA

• Oct 23-26 in downtown Seattle at the Seattle
Center, 3386 patients received care at a
“Remote Area Medical” event which provides charity care to individuals who need it.
• 87% of patients came from the central Puget sound area
• 75% reported incomes below 200% FPL and
40% reported being uninsured.
• 92% of patients reported not having dental insurance
• People camped out overnight to gain access to the free clinic

• 1714 patents received dental care which amounted to $1.24 million in dental services.
• 76% of dental patients require follow up
• 30% of dental providers (and 40% of supporting providers) agreed with the statement: “I discovered many conditions I couldn’t treat on site”

Dentists’ Participation in
Medicaid
FY 2009 FY 2010 FY 2011 FY 2012
Number of licensed dentists*
Number of dentists that serve
Medicaid-enrollees**
Based off claims payment data and age grouped 0-20
5,923 6,072
1,226 1,353
6,155 6,080
1,214 1,165
21% 22% 20% 19%
Number of dentists that serve
Medicaid-enrollees **
Based off claims payment data and age grouped 21 +
*WA State Department of Health
1,111
19%
**WA State Health Care Authority
1,210
20%
997 626
16% 10%

• Embedded Pediatric Dental Benefits offered in QHPs in the Exchange
• Oral Health Coverage and the Medicaid
Expansion

Dental benefits offered in the exchange must be offered and priced separately to assure transparency for consumers

• In 2014 we ran a bi-partisan bill with a very broad coalition of supporters – The
Healthy Washington Coalition, Dentists,
Big health plans like Premera and
Regence
• The dental insurers led by Delta Dental were the main (and only) opposition to the bill
• The bill did not pass the senate

• Consumer Choice
• Equal Markets
• Lower Costs

* E s t i m a t e
Medicaid Eligible
January 1, 2014
Reinstatement of
Medicaid Adult Dental
4 5 0 , 0 0 0
Newly Eligible
Adults up to
133% FPL
2 8 0 , 0 0 0 +
O v e r
7 0 0 , 0 0 0
*

• The Alliance of Dental Hygiene Practitioners
• Children’s Alliance
• Washington Dental Service Foundation
• Statewide Poverty Action Network
• UW School of Dentistry
• Washington State Dental Hygiene
Association
• Washington Denturists Association
• Solid Ground
• Washington Association of Community and
Migrant Health Centers
Broad coalition including:
• Providers
• Children’s Advocates
• Senior’s Advocates
• Washington Senior Citizen Lobby
• SEIU Healthcare 775 NW
• Washington State Dental Association
• Poverty Advocates
• Labor Unions
• Eldercare Alliance
• Northwest Health Law Advocates
• Washington Association of Area Agencies on Aging
• Washington Dental Access Campaign
• Oral Health Advocates

Medicaid eligible adults receiving at least one dental service in FY 2013

A Community Workforce Solution to Improve
Oral Health & Access to Quality Dental Care
For Rural, Tribal & Underserved Washington

“They’ll get actually more training than a dentist does [within] a small scope of practice. I think a dental therapist model could be utilized in any dental office anywhere in the United States.”
—Dr. Mary Williard, DDS
40,000 more Alaskans now receiving routine and preventative care because of dental therapists.

Dental Therapists make the dental team more efficient
• On average, Dental Therapists cost only 30 cents for every dollar of revenue they generate. This allows dentists to see more Medicaid patients at existing reimbursement rates
• Preventive care offered by Dental Therapists can prevent costly emergency room visits for dental-related health problems.
• A solo-practice dentist in rural Minnesota is now taking 38 percent more patients after hiring a dental therapist. The practice increased the number of Medicaid patients served by 73 percent.
• Dental Therapists free up dentists to do more complicated procedures.
“What we’re seeing on the ground is that not only is this an effective dental workforce provider, but it’s also well accepted by patients and by dentists when they have actual exposure to it.”
—Sara Wovcha, Director of Children’s Dental Services, the first clinic to employ Dental Therapists in Minnesota .

Dental Therapists strengthen communities by creating family wage jobs
• Dental Therapists bring jobs to their communities: for the dental team, as well as for office secretaries and even the landlord collecting rent from a once-empty storefront.
• Dental Therapist create an accessible rung on the health professional career ladder for communities underrepresented in the heath professions.
• In Alaska and Minnesota Dental Therapists are active members of their communities promoting good oral health in schools and other community settings .
• Dental Therapists provide culturally competent community based care
• Dental Therapists in Alaska and Minnesota are on the front lines of wiping out decay and improving overall health in underserved communities.

Supporters of
Dental Therapy
AARP of Washington
Affiliated Tribes of Northwest Indians
Alliance for a Just Society
American Friends Service Committee
American Indian Health Commission of
Washington
Asian Pacific Americans for Civic Empowerment
(APACE)
Center for MultiCultural Health
Children’s Alliance
Eastern Washington University
Eastern Washington Voters
Elder Care Alliance
Equity in Education Coalition
Faith Action Network
Health Coalition for Children and Youth (HCCY)
Healthy King County Coalition
Latinos for Community Transformation
LGBTQ Allyship
National Association of Social Workers —
Washington
National Dental Association
Northwest Portland Area Indian Health Board
Olympia Coalition for a Fair Budget
OneAmerica
Para Los Niños
Puget Sound Advocates for Retirement Action
Real Change
Resident Councils of Washington
School Nurse Organization of Washington
Sea Mar Community Health Centers
Seattle Central Community College
Seattle & King County Public Health
Seattle NAACP
SEIU Healthcare 775NW
Senior Services
Solid Ground
Statewide Poverty Action Network
UFCW Local 21
Washington Adult Day Services Association
Washington Community Action Network
Washington Low Income Housing Alliance
Washington Rural Health Association
Washington State Dental Hygienists’ Association
Washington State Hospital Association
Washington State Labor Council, AFL-CIO
WA State Long-Term Care Ombudsman
Program
Washington State Senior Citizen's Lobby
Opposition to
Dental Therapy
Washington State Dental Association
American Dental Association