ACCORDING TO THE 2011 Special Report on the "dental safety net" in Rhode Island, the number of providers serving the publicly insured or uninsured increased during the past five years but they are unable to fully meet their clients' needs. IMAGE SOURCE R.I. KIDS COUNT

By Kimberley Donoghue
PBN Web Editor
Twitter: @kydonoghue

5/18/11

PROVIDENCE - The number of people served by “dental safety net” providers in Rhode Island – serving those who are uninsured, have Medicaid/RIte Care coverage or are otherwise disenfranchised - more than doubled in 2010-2011 from 2005-2006.

These oral health care providers are public and private nonprofit organizations offering their services regardless of their clients’ insurance status or ability to pay.

According to the “Special Report: The Dental Safety Net in Rhode Island” released Wednesday, the number of patients served by hospital-based centers increased 106 percent between 2005-2006 and 2010-2011. The number of patients served by community health centers increased 51 percent. And the number of patients served by the CCRI dental hygiene clinic and school-based and community-based dental programs increased 22 percent in the five-year period.

“Dental safety net providers and dentists working in private practice are critical elements of the current and future health care delivery system in Rhode Island,” said Lt. Gov. Elizabeth H. Roberts. “As we work to get more Rhode Islanders covered by health insurance, we must ensure that coverage for, and access to, oral health services are part of those efforts.”

In Rhode Island, 27 percent of adults aged 18 to 64 years old did not have dental insurance; when looking at the above-65 age group, the number increased to 56 percent.

The 2011 report estimated that 20 percent of employer-sponsored insurance and 70 percent of individually purchased insurance in the U.S. does not include dental coverage.

“Access to dental care remains a major public health issue in Rhode Island. Even with safety net providers seeing more patients every year, only 52 percent of children and only 39 percent of adults enrolled in Medicaid last year were seen by a dentist,” said Jill Beckwith, co-chair of the Rhode Island Oral Health Commission and policy analyst at Rhode Island Kids Count.

The report also highlighted the insurance as a “strong predictor” of access to dental care. Those who had public insurance or no dental insurance were less likely to see a dentist than those with private insurance.

In the calendar year 2009, dental safety net providers saw 11,797 students in 90 elementary schools, 20 middle schools and three high schools in Rhode Island, a 24 percent increase from the 2005-2006 survey.

Most of the respondents in the survey noted that they were unable to meet all of their clients’ oral health needs. They identified three main barriers:

A lack of dental specialists willing to accept referrals for safety net clients, the limited types of dental services that safety net providers can provide (which require them to refer to other providers).
Inadequate reimbursement rates from Medical Assistance.
Insufficient space and insufficient funding.

The report also outlined eight recommendations for the providers, including the need to systemically collect and share utilization, staffing and financing data in order to measure success, improve programs, identify areas for improvement and inform policy change.

Among the seven recommendations for state agencies, public officials, foundations and charities, and oral health advocates, the report suggested increasing the age range of children who can qualify for RIte Smiles and increasing the pool of providers serving patients with Medicaid.

The 2011 report was released following the quarterly meeting of the Rhode Island Oral Health Commission in conjunction with the R.I. Department of Health, the Rhode Island Health Center Association, and Rhode Island Kids Count.