Legislation Addresses Oral Healthcare for Special Needs Patients

Dentistry Today
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The California Senate Committee on Health held a hearing on April 18 to discuss legislation introduced by Sen. Scott Wiener, SB 1464, that aims to increase access to critically needed oral healthcare for children and adults covered by Denti-Cal with chronic medical, mental, behavioral, or developmental conditions and disabilities.

Specifically, the legislation instructs the California Department of Health Care Services to provide additional funding to reimburse providers for extra time and resources necessary to treat beneficiaries with special needs.

“Access to oral healthcare has long been a challenge for Denti-Cal eligible patients, but the barrier to care can be even more significant for eligible patients with special needs, patients whose health needs and conditions can complicate their dental treatments,” said Shelly Lyford, president and CEO of the nonprofit Gary and Mary West Health Institute.

“The introduction of SB 1464 is a critical first step to ensuring all patients have access to high-quality and appropriate dental care,” Lyford said.

Dental patients with special needs frequently require additional time, multiple visits, and other modifications to their treatment plan compared to the delivery of routine dental care. However, Denti-Cal’s standardized policies and payments do not acknowledge additional costs of caring for patients with special needs.

“We see firsthand that it can take more than twice the amount of time to treat special needs patients,” said Karen Becerra, DDS, MPH, CEO and dental director of the nonprofit Gary and Mary West Senior Dental Center in San Diego during the hearing.

“For example, dentists may have to spend considerable time helping patients with psychological and cognitive conditions to understand and consent to treatment. Often, patients with physical disabilities and certain medical conditions have trouble remaining in the dental chair in the position or time required to complete treatment,” said Becerra.

“Patients with intellectual and developmental disabilities usually require increased assistance to receive treatment. It simply doesn’t make sense for Denti-Cal’s reimbursement policies to assume that it takes the same amount of time and resources to care for all patients,” said Becerra.

The West Health Institute is the leading organizational sponsor of SB 1464. Other supporters include Justice in Aging, the University of the Pacific School of Dentistry, Gatepath, the National Health Law Program, the Ravenswood Family Health Center, and the San Mateo County Board of Supervisors.

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