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Dental Needs Unmet

Free Weekend Clinic Highlights Demand

By COLIN POITRAS, Courant Staff Writer

April 15, 2008

At least 1 million Connecticut residents, and possibly as many as 1.5 million — more than one-third of the state — lack dental insurance, according to the state dental association, and a new state medical plan for the uninsured, which includes tens of thousands of children, will not help.

Gov. M. Jodi Rell's Charter Oak Health Plan — a cornerstone in the state's effort to provide more affordable health care — will not include a direct dental health component when it launches July 1, although providers may offer dental insurance as a separate rider to those who can afford it.

More than 1,000 of those uninsured people braved driving rain, lightning and long lines in the pre-dawn chill this past weekend to take advantage of Connecticut's Mission of Mercy, the state's first large-scale free dental clinic that opened for two days in Tolland.

State Senate President Pro Tem Donald E. Williams Jr., a Brooklyn Democrat, walked among them. After two hours of listening to people's stories, Williams had heard and seen enough.

"It's overwhelming," said a stunned Williams as he stood in the crowded clinic about 7 a.m. "If there is any doubt in people's minds about the need for greater access to health care, people should come here and see this."

Those who got in to see one of the nearly 190 dentists volunteering their time at the old Tolland High School were lucky. The wait might be much longer for others.

Rell spokesman Rich Harris said that one of the primary goals of Charter Oak is affordability. Adding dental care would drive costs over the targeted $250 monthly premium, he said.

"It is something that will be looked at down the road," Harris said. "The most important thing at this point is to get the plan itself up and running before we go back and make any changes."

But one-time events such as the Mission of Mercy are not enough, officials said.

"Charity is not a health care system," said Carol Dingeldey, the state dental association's executive director. "Having a Mission of Mercy once or twice a year is not an answer. It is going to take a collaborative, thoughtful approach."

The legislature last year authorized an additional $20 million to increase reimbursement rates to dentists who take patients under HUSKY, the state-sponsored health plan for children and disabled adults. In some cases, reimbursement rates doubled.

Of the approximately 3,000 licensed dentists in the state, only about 400 take HUSKY clients. Of those, only about 100 take HUSKY patients as a large part of their business, Dingeldey said.

State reimbursement for adult patients is about 52 percent of the amount dentists receive to treat children. This makes it impractical for them to see a lot of needy adult clients and still keep their businesses solvent, said Marty Milkovic, executive director of the Connecticut Oral Health Initiative, a nonprofit advocacy group.

Studies have shown that dental care costs amount to only 4 percent to 5 percent of overall medical costs, so rolling them into the Charter Oak plan should not be insurmountable, Milkovic said.

The legislature last year also approved handing over the management of state-funded dental services to a single provider to streamline the system and make it more manageable for dentists and patients — something advocates said could increase the number of participating dentists.

But those kinds of initiatives won't help the working poor — individuals and families whose income is too high to qualify for HUSKY but who still don't receive affordable dental insurance through their employers.

"What we saw this past weekend were folks who we think have access to our health care system but who don't have access to dental care," said Williams, the only politician who arrived early enough Saturday to see the long lines in the dark and rain.

"These are folks who work hard for a living, but who are struggling to pay their bills at the end of the month," he said.

When it comes to a choice between dental care and keeping the lights on or putting food on the table, advocates say, dental care is usually the first to go.

The organizers behind this first Mission of Mercy said they already are planning another one for next year in New Haven. In the meantime, the University of Connecticut Health Center in Farmington offers a first-come, first-served emergency dental clinic for people with state insurance or no insurance Monday through Friday from 8 a.m. to 4 p.m.

Many community health centers also provide affordable and emergency dental care to people in need.