KAJX

As local Medicaid load grows, problems around dental access increase

Feb 12, 2015

Now that adults with Medicaid in Colorado have dental benefits, there's a growing need for providers who will serve them. Right now, just one clinic in our region is caring for them.
Credit Creative Commons/Flickr/Wonderlane

If you’re an adult with Medicaid in the Roaring Fork Valley, there’s just a handful of dental offices that will accept your health insurance. This lack of access is a problem as the number of Medicaid patients increase under the Affordable Care Act. Colorado expanded Medicaid a year ago and in Pitkin County alone, the number of people using Medicaid nearly tripled. Aspen Public Radio’s Marci Krivonen has more.

It’s a busy Tuesday at Mountain Family Health Center in Rifle. Doctor Garry Millard is one of two dentists who regularly handles several patients a day. The clinic is typically booked five months out.

"This last week I saw 21 patients and that was the first time I had seen over 20 patients. It’s hard to maintain sanity with that many patients," he says.

The patient load is heavy because few dentists in the region take Medicaid patients. The reimbursement is dismal, so many can’t afford it. Comfort Dental in Glenwood Springs takes adult Medicaid patients. Mountain Family operates at a loss but is reimbursed by the federal government.

Mountain Family Health Center in Rifle is currently the only dental clinic that will see adult Medicaid patients in our area. Patients travel there from as far away as Aspen.
Credit Marci Krivonen

Millard says many patients travel from the far reaches of the Roaring Fork Valley.

"It’s not just Rifle, Silt and New Castle. That was the case when we first opened, but now that we’re the only clinic serving adult Medicaid, I imagine we’ll see a lot more patients from Carbondale, Basalt, El Jebel and Aspen."

Before 2013, only children with Medicaid got dental benefits. Now, adults receive up $1000 a year in dental services. The Affordable Care Act’s Medicaid expansion combined with new dental benefits for adults, has resulted in a glut of new patients.

"The issue is that we don’t have providers," says Nan Sundeen, Pitkin County Health and Human Services Director.

At a Pitkin County Commissioners meeting Tuesday, Sundeen brought up the problem.

"If you want dental, you have to go all the way to Rifle. I think we have a serious access issue here."

Last year Pitkin County’s Medicaid enrollment jumped to 1400, from 500 the year before. Most are adults. Sundeen suggested a meeting around access for physical and dental health. Commissioner Rachel Richards said Aspen Valley Hospital should be included.

"It continues to be frustrating to me that as an Aspen resident and in the (hospital) district, I’m paying property taxes to support a first-rate quality facility and yet many of our residents are priced out of it based on the providers."

Right now, low income kids in the Valley have more dental options than adults. Some private providers take kids with Medicaid and a non profit called the Aspen to Parachute Dental Alliance provides a dental hygiene and sealant program. Cristina Gair directs the Alliance.

"So we go into schools and we provide those services for kids who sign up. This past year we served 1200 kids and it was the most kids served ever with our program. We served 17 schools in Garfield, Eagle and Pitkin Counties."

Even with these services, there’s still a lack of access for kids in need. And, some families don’t prioritize dental care. Haidith Ramirez directs the Roaring Fork School Health Centers, which provides care to 430 kids in Basalt.

"When we’re talking about families that are really living paycheck to paycheck and are always in crisis mode, unless they see an infection in the mouth of the kid, they won’t prioritize dental care," she says.

Basalt is in the running to become part of a pilot program that provides tele-dentistry in rural areas where there’s limited access. The statewide program would use computers to link dentists with kids for assessment and treatment planning.

Back at Mountain Family Health Center in Rifle, the staff continues to see patients. Doctor Garry Millard says a lack of access isn’t isolated to our region.

"Here in Western Colorado there are a large number of counties that don’t have a single dentist. And, if they do have a dentist, most of them do not accept Medicaid patients."

For now, his office will continue to take anyone who walks through their door, whether they’re using Medicaid or not.