State faulted for lax oversight of dental program

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SACRAMENTO, Calif. (AP) — Millions of children enrolled in California's health care program for low-income residents did not get dental check-ups last year in part because low payments deterred many dentists from participating in the program, according to a new state audit.

The agency that administers Medi-Cal has failed to adequately monitor the program's dental component and that its "shortcomings and ineffective actions are putting child beneficiaries at higher risk of dental disease," State Auditor Elaine Howle said in a report sent to the governor and Legislature on Thursday.

Nearly 56 percent of the 5.1 million children who get their health care through Medi-Cal did not visit a dentist in fiscal year 2013, Howle said, noting that the program had similarly low participation in 2012 and 2011. She attributed the problem in part to a shortage of dentists willing to see Medi-Cal patients due to reimbursement rates that have not increased since 2000.

"Although California as a whole appeared to have an adequate number of active providers to meet child beneficiaries' dental needs as of January 2014, five counties may lack active providers," Howle said. "In addition, 11 counties had no providers willing to accept new Medi-Cal patients while 16 other counties appear to have an insufficient number of providers."

She also faulted the California Department of Health Care Services for not monitoring a large contractor to make sure it was providing mobile dental services in underserved rural areas.

Health Care Services Director Toby Douglas said he agreed with most of the audit's findings and recommendations. Douglas, who is leaving his post next month, said the department already has plans for correcting the problems.

Jenny Kattlove, director of strategic health initiatives for the Children's Partnership, an advocacy group that lobbied lawmakers to request the audit, told the San Francisco Chronicle ( ) that demand for dentists to treat low-income patients is expected to increase now that more California residents qualify as part of the federal Affordable Care Act.

"While the state has taken some steps to increase the number of children in Medi-Cal who get needed dental care, more needs to be done, and this audit clearly demonstrates that," Kattlove said.

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