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About Street roots. (Portland, OR) 1998-current | View Entire Issue (Oct. 25, 2013)
4 street roots Oct. 25, 2013 A health care expansion worth smiling about Oregon’s new health networks are partnering with dental programs to bring better oral care to low-income,families BY JASMINE ROCKOW S T A F F W R IT E R espite the controversy and questions surrounding the new health care law, one concrete benefit is giving many of Oregon’s most vulnerable people cause to celebrate. Homeless and low-income Oregonians are about to gain access to dental health care as part of their Medicaid benefits administered through the Oregon Health Plan. Those who already have OHP will see an expansion of dental services offered, and with the income limit increased by 38 percent, many more will be able to join. The deadline for Coordinated Care Organizations to start providing care is July 1, but many people will be able to access dental services as soon as January. The expansion is part of Oregon’s new approach to health care, a holistic model that includes physical, dental, and mental health care. Those working with the homeless, the mentally ill and people living with addiction say the dental benefit could not come sooner. Poor oral health is an important but often overlooked part of the cycle that keeps people living in poverty. Besides the stigma and embarrassment, missing teeth or having visible problems with them can be a barrier to employment. Gum disease is a treatable and entirely preventable form of chronic infection, but left untreated it can spread to the bloodstream and quickly become life-threatening. Same goes for an abscessed tooth. And there are a whole host of other problems. Oral health affects a person’s ability to absorb nutrients and their ability to sleep, not to mention the psychological effects of living in chronic pain. Today, OHP is a tiered system. Members of OHP Plus already receive basic dental services like cleanings, fillings and extractions in addition to emergency dental care. But members of the Standard plan - mainly poor adults without children — only have access to the so-called “extraction benefit.” Even if the tooth is salvageable, Standard members unable to afford, for example, a root canal, are often forced to choose the less costly option of having the teeth removed. While such treatment may alleviate the immediate problem, it can also introduce a host of new dental problems like reduced chewing ability and shifting teeth. By July 1st, the division between OHP Plus and Standard dental benefits will disappear and all members will have access to preventative care, emergency dental services and some restorative care. But it’s still unclear which restorative services will be covered and which D M irador COMMUNITY STORE 8® ones will not. Either way, the quantity and quality of dental services available to low-income Oregon residents are about to expand significantly. Health Share is one of two coordinated care organizations serving Multnomah and Clackamas counties. They have eight dental plans preparing to provide service to Medicaid patients on January 1st, well ahead of the July deadline. In addition to the 20,000 Standard members poised to receive their expanded benefit package, they anticipate an additional 45,000 new enrollees over the next qualify three years. for. CCC has begun to help their clients fill out “We’re interested in not destabilizing the paper applications, and Cover Oregon staff are system of care” says Health Share CEO Janet now processing them manually. Meyer. “So when we bring these people in, our Many people receiving food stamp benefits goal is to have a Y2K event: Nothing happens.” through the Supplemental Nutrition Assistance Meyer expects most of those new enrollees to Program, or SNAP, have already been seek services within the first year and she’s determined eligible for OHP. The Oregon Health working diligently with dental plans to make sure Authority has been mailing letters to those their capacity measures are accurate. Care qualified since the end of September. All they Oregon and Central City Concern both provide have to do is fill out the enclosed form and send Medicaid services under the Health Share it in — they are automatically enrolled and able to umbrella and they optimistically echo her start using their benefits in January. concerns about capacity. But there is one caveat. Enrolling through “Having concerns about capacity are relevant,” SNAP forfeits a person’s ability to choose a says Mike Plunkett, Dental Director for Care provider. CCC has already run into problems Oregon. “But when you get down to the granular you can isolate your partners-who arc focusfid---- -referring patients to the Billi Odegaard clinic and have a common mission and are willing to because their health plan has assigned them address it. Those people exist. It’s just a matter elsewhere. Patients can try to get re-assigned but of priority.” it hasn’t been the most user-friendly process, Central City Concern (CCC) is one such particularly for people struggling to navigate the partner. Last year they helped fund Multnomah complex system. Armitage says CCC will offer County’s Billi Odegaard Dental Clinic, housed in help to those wanting to make a change but she’s their downtown location above the Old Town not yet sure exactly what that process will look Clinic. Since then CCC has referred hundreds, if like. She’s hoping things will go more smoothly not thousands of people, but there’s still room than expected. for more. They are far from reaching capacity Of course, people have to know about the and eager to serve more of the people who are services that are available before they can begin so desperately in need of care. E.V. Armitage, to use them. Those with mental illness or an Executive Coordinator at CCC, says the Medicaid addiction, or those without a home are often expansion will have a positive impact on the living off the grid. If they don’t have an address, communities they serve. they are unlikely to receive a letter. If they can’t “Just like any safety net clinic, you can’t take afford a cell phone, a call from the Oregon everyone who’s uninsured, only a certain Health Authority is useless. capacity.” she says. “This will greatly expand our “People may have to be willing to advocate for ability to refer here because there won’t be this themselves to get the kind of care that they question of whether or not you are uninsured.” want,” says Armitage. Until dental coverage becomes available in The hope is that an integrated system of care January, CCC and other low-income providers will make these difficult to reach populations have more immediate problems to solve. The more accessible to groups like CCC, so that Cover Oregon website has suffered a rash of those who cannot advocate for themselves can problems and is expected to take weeks to fully find an ally. But for now, the biggest hurdle is bring back online. 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