Washtenaw County considers dental clinic for Medicaid patients
Stephanie Paraian of Westland gets dental work done in 2011 at Ypsilanti's Hope Clinic, which serves patients with no insurance. Washtenaw County leaders are considering starting a new dental clinic to help people on Medicaid.
AnnArbor.com file photo
“We have met people who are ashamed to smile, and that’s embarrassing. Their self-worth is lowered. Their ability to interact with people is diminished, and their ability to apply for a job is diminished,” said Dick Fleece, director of Washtenaw County Public Health.
Less than one percent of the 300 dentists in Washtenaw County accept Medicaid patients because the reimbursement rate for dental care through the program is “dismally low,” Fleece said.
There are various free clinics in existence now -- including Hope Clinic and the University of Michigan School of Dentistry's Community Dental Clinic -- but there is a greater need for a clinic to provide dental services, Fleece said.
Verna McDaniel
AnnArbor.com file photo
Fleece and his staff in Washtenaw County Public Health, as well as staff from the University of Michigan’s Dental Clinic, made the case for a dental clinic to county leaders at a working session of the Board of Commissioners April 2.
Three out of the nine county commissioners attended the meeting: Felicia Brabec, D-Pittsfield Township; Andy LaBarre, D-Ann Arbor and Yousef Rabhi, D-Ann Arbor.
The reimbursement rate to dentists for care provided to Medicaid patients is much lower than the reimbursement rate for care for patients covered by private insurance - which often deters dentists from accepting Medicaid patients, Fleece said.
“It’s a real unmet need in this community,” Fleece said.
The Hope Clinic serves about 1,400 patients per year, and only sees patients without insurance.
The UM Dental School sees less than 1,000 patients per year and has a limited range of services that it can provide to patients, as its primary function is education.
About 20,000 Washtenaw County residents are on Medicaid with a dental benefit and have difficulty accessing services, Fleece said. Additionally, there are 43,000 residents that don’t have dental insurance.
Fleece said he had little experience with running a dental clinic, and proposed to county leaders that a separate organization run it: Michigan Community Dental Clinics Inc. -- a non-profit company that runs dental clinics for 22 health departments in the state.
Fleece invited the executive director of Michigan Community Dental Clinics, Dr. Tom Veryser, to speak before the county commissioners at the April 2 meeting.
Patients coming in to Medicaid clinics have more severe dental problems than those that go to private practitioners and require extensive treatment, Veryser said.
Fleece said he didn’t think that there would be enough “benevolent funders” to support the construction and start-up costs of the clinic, and that it would likely require the full faith and credit of the county to make it happen.
“It would be wonderful if we had a benevolent donor,” LaBarre said. “I think this is a worthy endeavor to consider bonding for.”
The county’s initial investment would be about $1 million to build the clinic, which could be paid back over 10 to 20 years, Fleece said, floating the idea of building a 12-bed-capacity building and initially only filling it with eight beds.
The clinic would need to be associated with the local health department to be eligible for a higher reimbursement rate for dental services through the Medicaid program.
“If we could get the support of the board and get financing and find a spot, we could have it open … before the end of 2014,” Fleece said.
After the presentation by Fleece, Administrator McDaniel directed her staff to form a task force to further pursue the logistics to creating a dental clinic.
Amy Biolchini covers Washtenaw County, health and environmental issues for AnnArbor.com. Reach her at (734) 623-2552, amybiolchini@annarbor.com or on Twitter.
Comments
Jeremy Engdahl-Johnson
Thu, Apr 11, 2013 : 3:59 p.m.
Could more access to pediatric dental care increase health exchange premiums? http://www.healthcaretownhall.com/?p=6477
Jack Gladney
Wed, Apr 10, 2013 : 10:31 p.m.
Less than three percent of Washtenaw County's dentists accept Medicaid? How does this compare with other communities? What percentage received federal or state aid to get through college and dental school?
Linda Peck
Wed, Apr 10, 2013 : 9:02 p.m.
This is such a needed service. Healthy teeth are important for the health of the body. This is a great idea, long overdue.
Westfringe
Wed, Apr 10, 2013 : 3:48 p.m.
Is it just me or does Washtenaw county seem to care more for "low-income" people and building entitlements than it does for providing basic services to tax-payers?
Robert E.
Thu, Apr 11, 2013 : 2:36 a.m.
I see what you are saying WestF...however due to the county govt in Wash Co. and A2 generally being more progressive, there are things done here and allowances made that may understandably not appeal to some...I do know that part of the reason leaf pickup was eliminated was due to sewer drains becoming clogged and issues with people parking in the street during the sweeps...I realize its inconvenient(my yard is covered completely in the fall and raking and bagging is a huge hassle)...there are tradeoffs to be made no doubt...I simply feel its a valid consideration for the county to consider helping those who are less financially fortunate than myself to have access to affordable dental care and services...
Westfringe
Wed, Apr 10, 2013 : 8:38 p.m.
You don't find the things I listed worthwhile or necessary? They seem pretty standard to me. A large portion of A2 residents are not homeowners and do not pay taxes for the services they use. We foot the bill. Is it too much to ask that we get some consideration sometimes? It's not that I am against spending on things such as this clinic but I think we need to cover the basics first.
walker101
Wed, Apr 10, 2013 : 8:28 p.m.
Get used to it, this is the Big picture of things to come, the less you earn the more your entitled to, just make sure you don't earn too much because then the government will make sure they get a bigger cut to give to those who make less. Eventually everyone will stop contributing and we'll all be broke and this is called socialism.
Robert E.
Wed, Apr 10, 2013 : 8:07 p.m.
It all depends on how you look at it WestF...and what a resident of A2 decides is worthwhile...my experience has been the exact opposite of yours and I believe the general consensus is that Ann Arbor provides excellent services...you're making a political point based upon your personal belief system, not one based on fact...
treetowncartel
Wed, Apr 10, 2013 : 5:45 p.m.
Well, you can always vote with your feet and move.
Westfringe
Wed, Apr 10, 2013 : 4:59 p.m.
Robert E., That is not true. Every city I have ever lived in (with lower taxes rates might I add) provided much more for the tax-payer. A2 has under staffed police and fire depts, horrible road services, no large garbage, leaf or Christmas tree pick-up just to name a few. I don't ever see my taxes go to anything but services for people who don't live in the city, support for "low-income" people, and pet-projects of the mayor.
Robert E.
Wed, Apr 10, 2013 : 4:30 p.m.
Good Lord its called human decency and Ann Arbor provides more services to its residents than the vast majority of other comparable cities...
mhirzel
Wed, Apr 10, 2013 : 3:39 p.m.
Filling the heads of children and pregnant women - and anyone else! - with neurotoxic mercury is not a charitable gift.
mhirzel
Thu, Apr 11, 2013 : 1:50 a.m.
5 votes down = 5 votes up for mercury toxicity. Ann Arbor right on track!
slave2work
Wed, Apr 10, 2013 : 2:17 p.m.
Goodluck trying to get into a program.I've been trying for 3 years.
Carrie Rheingans
Wed, Apr 10, 2013 : 3:53 p.m.
I think this is part of the problem they're trying to address, s2w. If you have Medicaid, there are so few dentists who will take it that you end up having long waits to be seen, even for basic preventive measures. This clinic would allow folks with Medicaid to be seen in a more timely manner, and the dentists providing the services would get reimbursed more than those at their own private practices, because of a deal that health departments has with the state.
clownfish
Wed, Apr 10, 2013 : 1:34 p.m.
Well, if we are going to use Scripture to set public policy, say for gay marriage or adoption or if we are One Nation Under God... ""Then the King will say to those on his right, 'Come, you who are blessed by my Father; take your inheritance, the kingdom prepared for you since the creation of the world. For I was hungry and you gave me something to eat, I was thirsty and you gave me something to drink, I was a stranger and you invited me in, I needed clothes and you clothed me, I was sick and you looked after me, I was in prison and you came to visit me.' "Then the righteous will answer him, 'Lord, when did we see you hungry and feed you, or thirsty and give you something to drink? When did we see you a stranger and invite you in, or needing clothes and clothe you? When did we see you sick or in prison and go to visit you?' "The King will reply, 'Truly I tell you, whatever you did for one of the least of these brothers and sisters of mine, you did for me.' Or not.
walker101
Wed, Apr 10, 2013 : 8:24 p.m.
OK then give it up.
countrycat
Wed, Apr 10, 2013 : 11:11 a.m.
Wouldn't it be a lot cheaper for the county to pay for dental insurance for these people than to invest in a large dental office, full staffing, and overhead? And how are these people to get to this one dental clinic; there's private dental offices conveinently located for anyone?
Amy Biolchini
Wed, Apr 10, 2013 : 1:31 p.m.
countrycat, the issue here is that there's a population of people on Medicaid with a dental insurance benefit that too often don't receive dental care. Private dentists often don't accept Medicaid patients because of the extremely low reimbursement rate for services that comes from Medicaid patients vs. those on private insurance plans. The billing system for Medicaid is also more complicated, and Medicaid only covers a set spectrum of services, according to the local health department. Additionally, less than four dentists in the county accept Medicaid patients. A location has yet to be determined for this dental clinic. The east side of the county was mentioned in preliminary discussions at the meeting for a location because it would be closer to the area where the clinic would be in the highest demand.
clownfish
Wed, Apr 10, 2013 : 1:30 p.m.
NOPC, Did you notice that it is the COUNTY, and not Ann Arbor, proposing this idea?
NoPC
Wed, Apr 10, 2013 : 12:54 p.m.
That would go against Central Planning Committee of the People's Republic of Ann Arbor! Besides, that's too obvious and logical to implement...
outdoor6709
Wed, Apr 10, 2013 : 11:47 a.m.
You do not get the point of government. It is not about cost effecient services, it is about getting reelected.
missmisery
Wed, Apr 10, 2013 : 10:53 a.m.
Thank you to Dick Fleece and the staff from the U of M Dental clinic who made the proposal to the Board of Commissioners. I hope the rest of the Commissioners follow Ms. McDaniels lead and support this.