Medi-Cal needs to move on helping kids

Perhaps the bureaucrats who run the state’s Medi-Cal dental program would move more quickly to improve dental service for Sacramento kids if it were their own children waiting for months for their cavities, broken teeth and abscessed molars to be treated.

Senate President Pro Tem Darrell Steinberg is insisting justifiably that Medi-Cal officials act without delay to get taxpayer-funded dental services to kids who need them and are entitled to them. Under a pilot managed care program established 18 years ago, Medi-Cal pays dentists $12 per month per patient to treat poor children. Dentists get paid whether they treat the children or not. Studies have shown that dentists routinely turn away eligible kids, even those with the most serious and painful dental conditions.

The state has promised to modify future managed care dental contracts to ensure that they can stop payment to those providers who fail to see covered children. It’s incomprehensible and, frankly appalling, that such basic protection – not just for kids but for taxpayers – is not included in existing contracts.

But it will take months for amended contracts to be put in place. Kids suffering from toothaches should not have to wait that long. While waiting for changes, Steinberg, First 5 Sacramento and the Sacramento District Dental Society, representing some 1,600 private dentists in five counties, are urging Medi-Cal officials to permit Sacramento families to voluntarily enroll in the same kind of fee-for-service dental programs that serve other poor children in California.

The state has said such a switch would require a costly and time-consuming federal waiver. However, First 5 Sacramento officials dispute that. They say other counties allow for managed care patients to switch to fee-for-service on a voluntary basis without the need for a federal waiver. And where it is allowed, utilization rates for children’s dental services have soared.

There have been horror stories about kids unable to access dental care under the managed care program since it began in 1994. In 2010 data was collected documenting poor performance. Only 31 percent of kids eligible to be seen in Sacramento were seen last year, according to a Feb. 12 report in The Bee by the California HealthCare Foundation Center for Health Reporting, one of the poorest Medi-Cal dental utilization rates in the state.

Poor kids in Sacramento should not have to put up with abysmal service, and taxpayers ought not to pay for something that is not being delivered. Neither should have to wait a year for amended contracts to fix the problem.

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