Denti-Cal ‘Remains a Seriously Troubled Program’, Commission Report Finds

Updated Oct. 3, 3:39 p.m.

The latest report on California’s low-income dental program finds it’s still plagued by cost and accessibility issues, making it tough for patients to find care.

The Little Hoover Commission, an independent watchdog group led by state legislators, found that policy changes to Denti-Cal in recent years haven’t translated to major improvements.

“California’s promise of quality dental coverage for millions of low-income children and adults who are eligible for Denti-Cal has not been adequately fulfilled,” report authors wrote.

Half of all children and one-third of all adults in the state are enrolled in the dental arm of Medi-Cal, according to the California Dental Association. The program has a history of long wait times that negatively affect patient health.

Adults and caregivers aren’t receiving enough education about Denti-Cal services, the process of finding care is too tedious, and funding for the program is not sustainable, according to the commission.

They also point out a lack of data transparency and clear communication from the Department of Health Care Services, which administers the program.

“It is a general feeling among providers that sometimes the rules are not clear,” said Dr. Paul Glassman, director of community oral health at the University of the Pacific’s Arthur A. Dugoni School of Dentistry.

He said the department sometimes agrees to pay for a service, but when a dentist submits the requested paperwork, DHCS denies the request, calling the explanations unsatisfactory.

Major legislative efforts in recent years have sought to improve the situation by incentivizing more providers to accept Denti-Cal. The program recently began receiving funding from the Proposition 56 tobacco tax, which allowed for the full restoration of adult dental benefits and better provider reimbursement rates. New laws over the past three years have aimed to increase patient utilization and reduce bureaucratic red tape.

DHCS has made its own changes, including simplifying the paper application process for providers, creating a digital application and releasing a handbook describing Denti-Cal policies, procedures and billing instructions.

The department is also launching a statewide education campaign to inform Denti-Cal enrollees about available services and reduce fear around visiting the dentist.

“The Medi-Cal Dental Program is moving in the right direction,” department representatives said in a statement. “Improvement efforts must continue in the years ahead.”

Still, dentists and families who gave testimony for the report say it’s a broken system.

“Unfortunately the basic structure of the program still remains the same, and makes it unattractive for providers who have a choice, who don’t need to be a part of it,” Glassman said.

He said the more promising answer lies in rethinking the way dental care is delivered and focusing on prevention efforts that could reduce the amount of oral disease statewide.

Editor’s Note: We updated this story to include comment from the Department of Healthcare Services provided after publication.