Proposed Dental Reform Would Come at a Cost to State

By ANDY ZIEMINSKI, Capital News Service

ANNAPOLIS (Sept. 13, 2007) - The state should spend at least $60 million to extend dental coverage to all Maryland children, according to a special committee report presented to the state health department this week.

The money would be used to increase reimbursements for Medicaid dentists, reach out to parents and minority families, and boost access to care through schools and local health clinics, among other things.

Maryland Health Secretary John M. Colmers conceded that some of the seven recommendations from the Dental Action Committee have "serious budget implications," but he said they are all going to get "full consideration."

"Clearly there are many things that we can be doing to improve dental care to the Medicaid and low-income population in Maryland," said Colmers, who received the report Tuesday afternoon.

The Dental Action Committee was formed after Deamonte Driver, a 12-year-old from Prince George's County, died in February from an untreated tooth infection that spread to his brain. Driver's mother said she could not find a dentist to treat her son who accepted Medicaid.

"The cost of not doing anything is very high, and Deamonte Driver is an excellent example of that," said Leigh Stevenson Cobb, a committee member and the health policy adviser for Advocates for Children and Youth.

The committee's most expensive suggestion was to spend an additional $40 million to make Medicaid rates for Maryland dentists comparable to other states in the region. For example, Maryland repays dentists $9 per sealant, whereas the District gives its dentists $38 and Pennsylvania $25.

"It's horrible. It's just embarrassing," Cobb said.

With repayment rates so low, only 19 percent of Maryland dentists see Medicaid children, according to the report. "With so few dentists providing these services, families have limited choices for dental care," the report said.

Delegate James W. Hubbard, D-Prince George's, said now is "a good time to put these numbers on the table" so that health officials and legislators can weigh them in light of the state's projected $1.5 billion structural deficit.

"If we don't find the money for it now, that $40 million will turn into $120 million three years or four years down the road," when children develop serious conditions that require more expensive care, Hubbard said.

Another key recommendation, which does not come with a cost estimate, is to consolidate Medicaid dental services through a single vendor, said Jane Casper, a dental hygienist and chair of the committee.

The state currently uses several vendors, which is "very confusing for everyone" and makes dentists "shy about participating in the program," Casper said.

The committee of 25 health advocates and dental professionals also called for incorporating dental screenings and exams with the vision and hearing checks that children now get in school.

"It would be too cost-prohibitive to do screenings every year," Casper said. "But hopefully we would catch the worst cases, the cases most in need of treatment the first time around."

At a cost of at least $20 million, committee members also recommended the state "maintain and enhance the dental public health infrastructure," by funding oral health services at local health clinics.

While committee members said their recommendations will save money in the long run, some outside experts could only see the immediate price tag.

"While any social service can be improved, there are other services that have a higher claim on the public purse," said George W. Liebmann of the Calvert Institute for Policy Research, who pointed to the "huge, looming deficit" for retired state employee pensions.

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