Improving oral health disparities and access to care: challenges and opportunities for the states.
States and their dental reimbursement, practice, and education policies and programs have done little to address oral health disparities. Particular state policies and programs are often cited as having an adverse impact on oral health access for vulnerable populations. These include poor Medicaid and State Children's Health Insurance Program reimbursement, an inadequate safety net, the ban on the corporate practice of dentistry, and a lack of funding to prepare the dental workforce to treat special needs populations and provide culturally competent care. (The State Children's Health Insurance Program, created by the Balanced Budget Act of 1997, enacted Title XXI of the Social Security Act and allocated about dollar 20 billion over five years to help states insure more children.) While state health officials have paid less attention to oral health disparities, there has been increased interest by state policymakers in addressing the special health care needs of the elderly, disabled, and children. These include state responses to the 1999 Olmstead Supreme Court decision and state pharmaceutical assistance programs for the elderly and disabled. (In rejecting the state of Georgia's appeal to enforce institutionalization of individuals with disabilities, the Supreme Court in 1999 affirmed the right of individuals with disabilities to live in their community in its 6-3 ruling against the state of Georgia in the case Olmstead v. L.C and E.W.) However, a few states have begun to develop solutions to explicitly address oral health access problems. States are considering or testing the following programs and policies pertaining to 1) improving workforce supply and distribution, 2) education reform and increased public accountability, 3) practice reform, and 4) increased data collection and research.
Henderson
Tim M
TM
D003695:Delivery of Health Care / Q000331:legislation & jurisprudence / Q000379:methods / Q000458:organization & administration; D006297:Health Services Accessibility / Q000331:legislation & jurisprudence / Q000458:organization & administration; D006304:Health Status; D006801:Humans; D009909:Oral Health; D014481:United States