California's recent budget agreement may not bode well for all government-sponsored health programs, but the outlook for oral health is not entirely grim.
Thanks to Proposition 10 and the windfall to counties produced by tobacco tax revenues, thousands of children stand poised to gain access to low-cost dental coverage across more than half a dozen counties where those revenues are earmarked for oral health, among other services.
San Bernardino, San Joaquin, and San Mateo counties are among the latest to launch or expand dental benefit programs for the children of low to middle-income families. Similar programs are already in place and growing in Alameda, Riverside, Santa Clara and San Francisco counties.
On August 1, a program called Inland Empire Healthy Kids, which over the past year provided low-cost dental insurance to some 3,700 children in Riverside County, was expanded to reach another 3,000 children in adjacent San Bernardino County. The program, similar to those in several other counties, targets the children of families who are ineligible for the state's Healthy Families and/or Medi-Cal (Denti-Cal) dental programs.
Later this year, San Joaquin County will launch a similar program for some 1,750 children, called San Joaquin Healthy Kids. San Mateo County, meanwhile, launched a children's dental program called San Mateo Healthy Kids last February that already serves 2,700 children, a number expected to reach 3,500 by year's end.
"California counties are showing a renewed interest and commitment in the fight against dental disease, thanks to Proposition 10 and what appears to be a growing awareness about the importance of dental health," said Gary D. Radine, president and chief executive officer for Delta Dental Plan of California, the state's largest dental health plan. "These communities and the local health plans that serve them deserve acknowledgement for their efforts, and for the creative public-private collaborations they have pulled together to address the unmet oral health needs of their youngest residents."
Newly emerging county-sponsored health, dental and vision insurance programs with low monthly premiums for the working poor owe much of their existence to the passage nearly three years ago of Proposition 10, the California tobacco tax measure. Since then, several local commissions created by Proposition 10 have disbursed tens of millions of dollars at the urging of several local health coalitions already addressing the unmet health needs of county residents to provide dental and other health coverage. Such coalitions often partner with local health plans, philanthropies, foundations and community-based organizations to increase the scope of the programs.
San Mateo County's Healthy Kids program, for instance, is funded by a coalition that includes the county's First Five Commission using Proposition 10 monies, the County of San Mateo, the Sequoia and Peninsula Health Care Districts, the David and Lucille Packard Foundation and the Peninsula Community Foundation.
Meanwhile, Healthy Kids programs established earlier are entering their second and third years of operations in counties like Santa Clara (Santa Clara Health Plan's Healthy Kids), San Francisco (San Francisco Health Plan's Healthy Kids), and Alameda (Alameda Alliance for Health). All of these county-based programs and the local health plans behind them are expanding enrollment and creating refinements to improve the quality of care provided within each of their respective communities.
Santa Clara Family Health Plan in Santa Clara County -- the first county to declare that every child in the county should have access to comprehensive health care -- recently modified its Healthy Kids dental program from an HMO-style program to fee-for-service, thereby increasing the number of participating dentists providing care. Santa Clara now boasts enrollment of nearly 13,000 children, and like many of the other county-based programs, derives its financial support from Proposition 10 along with substantial support from tobacco settlement funds from Santa Clara County and the City of San Jose, and private foundations, corporations and individual donors.
The Alameda Alliance for Health, another one of the longest running county-based programs, today provides dental coverage to 8,000 children, drawing chiefly upon state and federal funds earmarked for health care. County health officials there have simultaneously procured grants for related projects that deliver both health and dental services to the county's indigent and working poor families.
"Awareness is growing of the unacceptably high level of untreated dental need among California children, but less is said of the many constructive efforts now underway by counties to fulfill those needs," said Marilynn Belek, DMD, Delta Dental's chief dental officer. "Our extensive experience with the many community-based efforts underway suggests that while we may have a long way to go, there are also a lot of unheralded heroes out there succeeding in their efforts to improve oral health."
San Francisco-based Delta Dental Plan of California is California's largest dental health plan, covering nearly 15 million Californians. The company recently launched a $100,000 initiative to assist local dental clinics serving California children and parents of the working poor.