California School-Based Health Alliance & Children Now
If families are eligible for Medicaid or CHIP, it’s important to get their children enrolled. But a critical step for California policy makers is to “think teeth” and ensure that programs are in place for children to access the preventive services they need once they are enrolled in health coverage.
School-based health centers (SBHCs) can and do provide oral health care. They reach the state’s most vulnerable children who are most in need of oral health care by providing education, prevention, and treatment. Of the 231 SBHCs in California, 42% provide preventive dental services and 23% provide treatment services. However, SBHCs are only in 2% of all California schools – many more resources are needed to make sure oral health services are accessible to children and youth in schools.
A 2012 survey confirmed that many SBHCs see students who need, but are not getting, oral health care. Eighty-four percent of respondents indicated that the need for preventive dental services among school-aged children in their community had reached crisis proportions (with over 50% of school-aged children not getting preventive care). Similarly, 68% of respondents indicated that the need for restorative dental services among the same population was also critical (with over 50% of school-aged children not getting restorative care).
Further, as indicated by a recent audit of California’s Medicaid Dental Program, known as Denti-Cal, less than half of children enrolled received dental services. We, and many others, were disappointed that the Governor’s proposed budget does not restore funding to the evidence-based California Children’s Dental Disease Prevention Program (CCDDPP), the state’s school-based sealant program that was defunded in 2009. Restoring CCDDPP could help address several of the audit recommendations, including:
- Improving how we track children accessing care and providers participating in Denti-Cal;
- Fixing gaps in access to care and provider participation in Denti-Cal;
- Monitoring when families cannot access Denti-Cal and updating participating provider roles;
- Increasing referrals to Denti-Cal providers by screening families receiving benefits;
- Identifying barriers to access to care for families;
- Encouraging providers to participate in Denti-Cal;
- Ensuring students have access to dentists and seek follow-up care when oral health issues are identified at school.
These are goals that CCDDPP could support in partnership with Denti-Cal. Investing in CCDDPP would re-establish a system of care that ensures children access preventive services where they are – at schools – while also improving how Denti-Cal is run.
As we work to ensure CHIP is reauthorized, let’s make sure we also support preventive health programs in California schools that keep kids healthy and ready to learn.