Calif. health chief vows changes to kids' dental program

California's health chief has vowed to change a failed children's dental program that was supposed to control costs and improve kids' ability to see a dentist.

Toby Douglas, director of the California Department of Health Care Services (DHCS), outlined steps he will take to ensure that some 110,000 Sacramento County children with Medi-Cal get "high-quality and timely" dental care, according to a Modesto Bee story.

In a letter to Senate President pro tempore Darrell Steinberg (D-Sacramento), Douglas vowed to resolve patient complaints more quickly and be tougher on dental plans that fail children, by either withholding payments or terminating their contracts, the paper reported.

Nearly two decades ago, the state made the county a testing ground for a new model intended to improve children's oral health. But new data show the county has consistently produced one of California's worst records for care, according to a California HealthCare Foundation Center for Health Reporting story that appeared in the Sacramento Bee.

Critics say the program forces many children to wait months or even years before receiving treatment, according to the story. Under the model, the state pays private dental plans a $12 monthly fee for each Medi-Cal child assigned to them regardless of whether the child sees a dentist.

In three out of the last four years, Sacramento's children's dental system was the lowest-performing system in the state. Between 2010 and 2011, approximately one-third of more than 110,000 Sacramento County children with Medi-Cal coverage saw a dentist. In comparison, nearly half of the state's Medi-Cal children received dental care, according to the Sacramento Bee.

According to the Modesto Bee, Douglas added in his letter that it would be "most expedient and effective" to keep Sacramento kids in the managed care program rather than shifting them into fee-for-service, because the state would have to alter agreements with the federal government, which provides some Medi-Cal funding.

Steinberg's office welcomes Douglas's letter, according to the paper, but remains cautious, expressing a desire to see more action. The director of the Sacramento District Dental Society echoed Steinberg's response and questions the lack of accountability for the program's lapses, the paper added.

Other critics noted that the plans are paid to see children from birth to age 3, but most do not. They also asked why Sacramento children on Medi-Cal must remain part of a mandatory managed care plan, instead of making it voluntary as it is in Los Angeles County.