State to pay $10.5M in stu­dent debt for Medi-Cal den­tists

The Fresno Bee (Sunday) - - News - BY CATHIE AN­DER­SON can­der­[email protected]

The state of Cal­i­for­nia is pay­ing off $10.5 mil­lion in stu­dent loans for 40 den­tists who agree to en­sure that 30 per­cent of their pa­tient caseload is made up of Medi-Cal pa­tients – among the state’s poor­est and frailest res­i­dents.

“Den­tists with sig­nif­i­cant stu­dent loan debt may find it more dif­fi­cult fi­nan­cially to com­mit to care for the Medi-Cal pop­u­la­tion,” said Jen­nifer Kent, di­rec­tor of the Cal­i­for­nia De­part­ment of Health Care Ser­vices, the agency that ad­min­is­ters the pro­gram. “Help­ing them to pay off their debt will make that com­mit­ment pos­si­ble.”

The Amer­i­can Den­tal Ed­u­ca­tion As­so­ci­a­tion es­ti­mates that 2018 den­tal school stu­dents owed $285,184 in ed­u­ca­tional loans, on av­er­age, if they grad­u­ated from a pub­lic school and $326,133 if they grad­u­ated from pri­vate schools.

Only about one-third of Cal­i­for­nia’s li­censed den­tists take some Medi-Cal den­tal pa­tients in their prac­tice, ac­cord­ing to DHCS statis­tics. Roughly 13.4 mil­lion Cal­i­for­ni­ans are el­i­gi­ble for den­tal care un­der Medi-Cal, a pro­gram known as Denti-Cal.

Denti-Cal has come un­der fire from the Lit­tle Hoover Com­mis­sion, an in­de­pen­dent state over­sight agency. It cas­ti­gated DHCS in 2016, 2017 and 2018 in re­ports to leg­isla­tive lead­ers and then-Gov. Jerry Brown, say­ing that, among other things, the agency is ig­nor­ing the Leg­is­la­ture’s di­rec­tion that it meet a goal of 60 per­cent uti­liza­tion for chil­dren cov­ered by Med­i­Cal. The com­mis­sion noted that half of Cal­i­for­nia’s chil­dren are sup­posed to be get­ting den­tal care through this pro­gram.

While Ethan Rar­ick, the ex­ec­u­tive di­rec­tor of the Lit­tle Hoover Com­mis­sion, re­mains con­cerned that Denti-Cal is not serv­ing enough el­i­gi­ble ben­e­fi­cia­ries, he said the CalHealthC­ares loan re­pay­ment pro­gram does align with a com­mis­sion rec­om­men­da­tion .

“This pro­gram clearly ad­vances the com­mis­sion’s gen­eral goal of in­creas­ing ac­cess to Den­tiCal,” Rar­ick said. “The most re­cent let­ter that we did in 2018 is to make ac­cess to Denti-Cal eas­ier and more seam­less.”

Be­cause pay­ments from Medi-Cal of­ten do not cover the cost of med­i­cal ser­vices pro­vided, the ben­e­fi­cia­ries of­ten strug­gle to find den­tists and doc­tors who will ac­cept them as pa­tients. State lead­ers say they ex­pect the fi­nan­cial awards will pro­vide an eco­nomic in­cen­tive for med­i­cal providers to im­prove ac­cess to care for low-in­come pa­tients. DHCS an­nounced ear­lier this month that 247 physi­cians would be awarded $58.6 mil­lion in stu­dent debt re­lief.

“Ex­pand­ing ac­cess to care will en­sure Cal­i­for­nia’s most vul­ner­a­ble res­i­dents re­ceive oral health care, which is es­sen­tial to over­all health,” said Dr. Del Brunner, pres­i­dent of the Cal­i­for­nia Den­tal As­so­ci­a­tion, in a pre­pared news re­lease. “We know stu­dent loan debt is one of the big­gest fi­nan­cial hur­dles a den­tist may face and this pro­gram will al­low prac­ti­tion­ers to fol­low their pas­sion of pro­vid­ing care for the un­der­served.”

In­creas­ingly, stud­ies have pointed out that poor den­tal hy­giene can in­crease the risk of se­ri­ous health prob­lems such as poorly con­trolled di­a­betes, heart at­tacks, stroke and other prob­lems. The Amer­i­can Academy of Pe­di­atric Den­tistry has noted that, among chil­dren from dis­ad­van­taged back­grounds, a rapid form of tooth de­cay has reached epi­demic pro­por­tions.

The CalHealthC­ares loan re­pay­ment pro­gram is funded from an al­lo­ca­tion in the re­vised 201920 bud­get and a $2 in­crease in to­bacco taxes that went into ef­fect July 1, 2017. That tax in­crease was part of Propo­si­tion 56, ap­proved by Cal­i­for­nia vot­ers in Novem­ber 2016.

Al­to­gether, DHCS has $340 mil­lion to put to­ward the loan re­pay­ment pro­gram, and agency lead­ers said in a news re­lease that they plan at least five rounds of the loan re­pay­ment pro­gram. It is run by Physi­cians for a Healthy Cal­i­for­nia, the char­i­ta­ble arm of the Cal­i­for­nia Med­i­cal As­so­ci­a­tion.

Al­most 240 den­tists ap­plied for CalHealthC­ares. The 40 awardees – nine spe­cial­ists and 31 gen­eral den­tists will serve Medi-Cal pa­tients in 20 coun­ties in com­mu­nity clin­ics, fed­er­ally qual­i­fied health cen­ters, aca­demic set­tings, group prac­tices and pri­vate prac­tices.

The debt re­lief pro­gram will cover up to $300,000 of the cost of den­tal school, a den­tal or physi­cian res­i­dency pro­gram, and any fel­low­ship com­pleted within the last five years. Those who ac­cept the awards agree to en­sure that Medi-Cal pa­tients rep­re­sent 30 per­cent of their caseload for five years.

AR­DEN BARNES as­[email protected]

Gov. Gavin New­som con­grat­u­lates By­ron Ruiz, DDS, dur­ing his visit at the Sacra­mento Na­tive Amer­i­can Health Cen­ter on Tues­day. Ruiz learned ear­lier that he was ap­proved for Cal­i­for­nia’s loan for­give­ness pro­gram for his ed­u­ca­tion.

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