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Arizona Association Urges Legislature to Restore Dental Services for At-Risk Populations

April 2, 2014

A coalition led by the Arizona Dental Association is lobbying the state legislature to restore funding for dental services for the special needs and elderly disabled population and reinstate adult emergency dental benefits under Medicaid.

Adults with special needs received full dental benefits under the Arizona Long Term Care System (ALTCS) until 2007, according to Kevin Earle, executive director of the state dental association. The program also provided benefits for seniors with disabilities who reside in long-term care facilities.

The Arizona Legislature is considering appropriating $2.1 million to the Arizona Health Care Cost Containment System (AHCCCS) for emergency dental care services for eligible adults. Budget negotiations between the House and the Senate were in progress as of April 1.

The state’s Medicaid agency historically has not provided preventive dental coverage to low-income adults, but offered emergency dental services limited to extractions and root canals on the twelve anterior teeth for adults already receiving basic medical coverage under Medicaid. The state cut the benefit in 2009 because of budget constraints.

After the state cut funding, the Arizona Dental Association began noticing a worrying trend: visits to emergency rooms for non-emergency dental problems began spiking, said Mr. Earle.

According to the Arizona Department of Health Services’ hospital data, emergency room dental visits increased 29 percent between 2009 and 2011, and charges for those visits increased 69 percent during that same time. Hospital admissions for dental pain and infection also spiked.

“We started raising the issue with legislators, letting them know that the elimination of this benefit didn’t make good business sense, that if you were going to take away the benefit and shift the cost to the emergency side without resolving the patient’s condition, then it was a misuse of state funds,” said Mr. Earle.

Reinstating the stripped benefits could lower emergency room and hospital admission costs and save the state millions of dollars since these services are largely being billed to the Medicaid program as medical expenses, said Mr. Earle. He also noted how the 2013 vote on Medicaid expansion in Arizona became contentious among some conservative politicians who might now view restoration of these services as a partisan issue.

“We were dealing with a delicate political situation,” he said.

In response, the Arizona Dental Association amplified the call for restoration of the dental programs by forming the Adult Benefit Coalition for Dental Care, a group of 25 stakeholder organizations that represent the special needs population and the elderly, as well as other mainstream healthcare organizations.

“This is sad thing to see folks whose underlying health [is] severely compromised, and the lack of attention to routine dental care was leading to very severe consequences,” said Mr. Earle. “That’s why we thought that partnering with folks who are being affected by this would be most powerful. When you have opportunities to engage with a broad spectrum of organization to get behind one specific initiative, you can do amazing things.”

NOTE: The Arizona House and Senate on April 7 reached a compromise on the state budget, which did not include funding for emergency dental care. Arizona Dental Association Executive Director Kevin Earle said the coalition partners plan to lobby again for reinstated funding in 2015.