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