Oral Health Care Problems for Poor Children in Maryland.ppt.pptVIP

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Oral Health Care Problems for Poor Children in Maryland.ppt.ppt

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Oral Health Care Problems for Poor Children in Maryland.ppt

The Death of Deamonte Driver: Out of Tragedy, A Light to Shine on the Mouths of Maryland Children The Kaiser Commission on Medicaid and the Uninsured Alliance for Health Reform Briefing Washington, DC July 25, 2008 Dr. Harry Goodman, Director Office of Oral Health Maryland Department of Health and Mental Hygiene Deamonte Driver Grew up in Prince George’s County, Maryland, the 3rd of 5 boys From low-income family Children had medical and dental insurance through the Maryland HealthChoice (Medicaid) program contracted thru managed care organizations (MCO) Had long-standing tooth decay and abscess – but never complained Always received primary medical care through a pediatrician – a medical home But not a dental home – no primary care dentist Mother could not find a dentist willing to accept Medicaid despite the Medicaid MCO listing 27 dentists on their provider panel for that area All panel dentists could not see his brother Needed the Public Justice Center along with the help of others to finally find a dentist to treat his brother Deamonte Driver’s Maryland 1990’s – Ranked last by the ADA for Medicaid dental access No dental rate increases since the 1970’s Many dentists stopped participating in Medicaid for various reasons 1997 - HealthChoice – 7 MCOs with 3 dental subcontractors 1998: Office of Oral Health established in statute A major state legislative bill targeting Medicaid dental access passed 2000 - 52% Head Start children with untreated tooth decay 2005 - 31% schoolchildren with untreated tooth decay 2003 – Medicaid dental rates for 11 procedures increased 2006 (most recent data): 29% of Medicaid enrolled children had at least one dental visit 16% of all provided dental services were for restorative (fillings) care 19% of dentists participated in Medicaid 7% billed $10,000 or more Very few pediatric dentists Deamonte Driver’s Maryland By February 2007 (just prior to Deamonte’s death): Most Medicaid fees paid at below the ADA 25th percentile and ma