A new national study found Florida still ranks dead last when it comes to dental care access for children on Medicaid.
Five-year old Jocelyn, who goes to Naples Pediatric Dental Center to get her teeth cleaned, is among a small percentage of children from low-income families in Florida who actually gets her teeth cleaned regularly.
That’s because Florida has dismal access to dental care for people on Medicaid—and that includes children.
According to a new report from the Pew Research Center, in 2011, 76 percent of children on Medicaid did not receive any dental care that year. That’s the highest percentage in the country.
This problem is fueled by the dwindling number of dentists in Florida who serve Medicaid patients. According to the Pew report, in 2010, only 15 percent of dentists in Florida even accepted Medicaid patients and experts say that number continues to plummet.
Frank Catalanotto, who chairs the Department of Community Dentistry and Behavioral Science at the University of Florida, said state lawmakers are to blame.
“Florida has some of the lowest Medicaid reimbursement rates in the country to dentists in the United States,” she said. “I don’t blame the dentists for this. It’s no wonder that only 8 to 10 percent of Florida dentists participate in the Medicaid program, which makes the access issue even more difficult for these patients.”
Catalanotto said this lack of access costs the state millions. He said 115,000 adults and children visited emergency rooms in 2010 for preventable dental pain and infection.
“It cost the state, either Medicaid or private insurers or self-pay, $88 million,” he said. “That’s crazy. That’s just absolutely crazy.”
The Naples pediatric dental clinic where Jocelyn goes has a patient roster that is 95 percent Medicaid enrollees. The clinic was created to provide care to the many underserved indigent and low-income families in the South Naples area. However, Chance Powell, one of its many dentists, says because so much of the state is underserved, his clinic is serving children from all over.
“You know, initially the incentive was to take care of the needs of kids in Collier County, but it has definitely expanded over the years,” Powell said. Kids are traveling more than 2 hours sometimes for dental treatment one way.”
Powell said he, and 9 other residents in the clinic, see up to 24 patients a day. Still, many of the complicated dental procedures provided in the clinic require a lengthy wait.
“The operating room, for example to take kids that have three or more quadrants of dentistry that need to get taken care of, that waiting list is 6 to 8 months right now,” he said. “The waiting list for any type of oral sedation is a year. And they are on the brink of having abscesses and infections.”
Powell said he thinks it’s about to get worse. This year, Florida officials turned its Medicaid program over to for-profit managed care plans.
State Sen. Alan Hays, R-Umatilla, who is also a retired dentist, said managed care companies will probably cause even more dentists to stop seeing Medicaid patients.
“The preauthorization process is onerous,” he said. “I am hearing the denial of treatment is insulting and I can assure you that managed care is not best for the patient. And it’s not best for the doctor either. But it’s best for the politicians who think ‘oh we are now off-loading that responsibility to the managed care companies.’”
Hays disagrees with Catalanotto who said managed care programs actually improved access in other states and could improve Florida’s situation. Hays also said Catalanotto is also wrong in blaming the legislature. He said the problem is bigger than how much the state spends on dental care for Medicaid patients.
A few years ago, Hays helped raise dental Medicaid reimbursement rates by 48 percent, but even with the increase, Florida’s rates still lag behind the rest of the country.