No bite to Husky coverage Dentists won't treat children on state plan

MATT O'ROURKE REPUBLICAN-AMERICAN
Many of the state's children aren't getting the dental care they need because most dentists won't treat kids on the HUSKY plan.
And, advocates say, the 16 community health clinics statewide can't serve all of the 350,000 kids on the state's Medicaid plan, better known as HUSKY.
Of the 2,500 dentists in the state, only about 100 will accept children on the HUSKY program because reimbursement rates are so low.
Marty Milkovic, director of the nonprofit advocacy group Connecticut Oral Health Initiative, said dentists lose money when they treat children on HUSKY.
"Fillings can cost around $125. HUSKY pays $38," Milkovic said. "Dentists are losing so much money, they've been forced to drop out."
Nancy Cardillo, officer manager at the Southbury Dental Center, agrees."I can't operate an office on $9 per patient," Cardillo said.She said that while her office may handle up to 20 pro bono cases per year, ranging from a cleaning to a full-mouth restoration, dentists in private practice don't like to be known as the "pro bono doctor."The shortage has left parents scrambling to make appointments.
When Kim Thompson moved to Waterbury from Bridgeport in 2004, she never thought it would take months to find her twin sons dentist appointments. She said she scheduled several appointments only to be turned away at the door when the office learned her kids are on HUSKY.
"It's like we've been bumming around. I can't find anyone who will take them," Thompson said.She finally brought Brandon and Brendon, 11, to Staywell Health Center, a community health clinic on South Main Street.
Brandon has a tooth growing into a space maintainer and Brendon has a tooth growing in sideways, on top of his baby teeth that won't come out."Being a single parent and having to work, how can you take them there? They're missing school just to get in here," Thompson said.
In February, a 12-year-old Maryland boy died after bacteria from a tooth abscess spread to his brain. His family had lost its Medicaid coverage. His death prompted states including Massachusetts and Virginia to re-examine their Medicaid programs and to begin implementing higher funds, Milkovic said.
While the Maryland death is an extreme case, poor dental health can lead to malnutrition, difficulty eating and self-esteem issues for children, he said.
Some states have raised their rates in recent years, including Tennessee and South Carolina in 2002. Connecticut last raised its rates 12 years ago.
In June, state legislators approved $20 million to be spent on raising the rates paid to dentists on top of the $17 million already in place.
However, that money has yet to spent, because of a lawsuit dating back to 2000 when Greater Hartford Legal Aid, a nonprofit legal services organization, filed a class-action lawsuit against the state's Department of Social Services for not providing enough support to families on Medicaid.
"The underlying problem was that the program was underfunded by the state," said Jamey Bell, an attorney at Legal Aid.
"The fee schedule which governs how much dental providers would be paid was much too low to attract enough providers to meet the needs of the children."
Earlier this year, the state entered settlement negotiations with Legal Aid.
Michael Starkowski, commissioner of the state Department of Social Services, said his department has been "frugal" with payments to managed care companies that pay dentists.
He said the settlement looks positive but the state's newly allocated funds will not be spent until the details of the settlement are worked out.
"We think the settlement is going in the right direction," he said. "I'm optimistic that this will result in better services to our clients."

Rochester, NY, is fluoridated:NYSCOF