title: Shaking up the dental safety-net: elimination of optional adult dental Medicaid benefits in California.
abstract: In July 2009, California eliminated funding for most adult non-emergency Medicaid dental benefits (Denti-Cal). This paper presents the findings from a qualitative assessment of the impacts of the Denti-Cal cuts on California's oral health safety-net. Interviews were conducted with dental safety-net providers throughout the state, including public health departments, community health centers, dental schools, Native American health clinics, and private providers, and were coded thematically using Atlas.ti. Safety-net providers reported decreased utilization by Denti-Cal-eligible adults, who now primarily seek emergency dental services, and reported shifting to focus on pediatric and privately-insured patients. Significant changes were reported in safety-net clinic finances, operations, and ability to refer. The impact of the Denti-Cal cuts has been distributed unevenly across the safety-net, with private providers and County Health Departments bearing the highest burden.
authors.forename: Cynthia
authors.initials: C
authors.lastname: Wides
authors.forename: Sonia Rab
authors.initials: SR
authors.lastname: Alam
authors.forename: Elizabeth
authors.initials: E
authors.lastname: Mertz
mesh_terms: D000328:Adult; D002140:California; D003149:Community Dentistry / Q000191:economics* / Q000331:legislation & jurisprudence*; D003729:Dental Care / Q000191:economics* / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D006801:Humans; D007347:Insurance, Dental / Q000191:economics* / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D008484:Medicaid / Q000458:organization & administration; D064876:Safety-net Providers / Q000191:economics / Q000331:legislation & jurisprudence* / Q000706:statistics & numerical data; D014481:United States