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Center
for Policy Alternatives (CPA). State of the States: Overview of 1999 State
Legislation on Access to Oral Health. Washington D.C.; 1999. Available
at: http://www.stateaction.org.
Washington
Initiatives/Projects
Dentists who participate in the Medicaid program and provide care to children
under age five receive enhanced payments. (NCSL)
The ABCD project - Access to Baby and Child Dentistry - is a demonstration
project that: (1) provides dental prevention services to young, at-risk
children from birth through age 5 and (2) trains dentists on recent developments
in pediatric dentistry. Initiated in 1995, the project established a coalition
of pediatric dentists from the University of Washington dental school,
local dentists, and State Medicaid and dental public health staff. The
project:
-- screens and treats children, provides family oral health education,
calculates the direct costs and cost savings derived from the preventive
program,
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studies factors that determine children's utilization of dental services,
-- determines if improved access changes parents attitudes so that they
will visit dentists more frequently,
-- and assesses the cost effectiveness of a new technique to provide fluoride
varnish.
Pediatric dentists from the dental school will train participating dentists
in recent pediatric dental techniques. According to project staff, training
is needed because most general practitioners lack pediatric dental knowledge.
The Washington Department of Health Services will pay participating dentists
higher fees than dentists get for similar services in the rest of the
state. An outreach program notifies eligible families of the availability
of services, encourages early childhood visits to the dentist, and works
to minimize adverse personal behaviors, such as appointment failures.
This program also trains pediatricians to deliver preventive dental services
and it ties fluoride treatments to immunizations. A child enrolled in
the program was 7.2 times as likely to have at least one dental visit
than a child not enrolled. According to Dr. Peter Milgrom, private dentists
will step forward to solve the problems that states have with dental care
in Medicaid if the state (and other interested parties) helps them break
the problem down into manageable pieces and if the dentists are treated
fairly with respect to reimbursement rates. Although the project will
cost the State an estimated $3 million, project staff hope to demonstrate
significant cost benefits. The project has submitted an application to
the National Institute of Dental Research to fund a 4-year cost benefit
and utilization study. (NCSL)
References
Center for Policy Alternatives (CPA). State of the States: Overview of
1999 State Legislation on Access to Oral Health. Washington D.C.; 1999.
Available at: http://www.stateaction.org.
Children's Dental Health Project (CDHP). State Surveys of Oral Health
Needs and Dental Care Access for Children. Available: http://www.childent.org/StateSurveys/statesurveys.htm.
National Conference of State Legislatures (NCSL). SCHIP: Dental Care for
Kids; 1999. Available at: http://www.ncsl.org/programs/health/CHIPDENT.htm
Children's Alliance. Info available at:
http://www.childrensalliance.org/kidsteeth.htm
Washington Dental Service Foundation. Available at:
http://www.findarticles.com/m4PRN/1998_Dec_28/53468637/p1/article.jhtml
Office of Inspector General (OIG). Children's Dental Services Under Medicaid:
Access and Utilization. Washington D.C.: United States Department of Health
and Human Services; 1996.
NEWS
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