Calif. hires dental director to resolve disparities

California legislators took the first step in resolving oral health disparities by hiring the state's first dental director, Jayanth Kumar, DDS, MPH. Dr. Kumar, who officially started the position on August 1, will create and implement a statewide oral health plan.

Dr. Kumar previously served as the director of the Bureau of Dental Health at the New York State Department of Health, where he worked for 25 years. However, the prospect of building a "strong" state oral health program drew him to his new position.

"A strong oral health program is critical to the state's health," Dr. Kuamr said in an interview with DrBicuspid.com. "So my goals are focused on public health functions -- assessment, assurance, and policy development."

Creating a statewide plan

Dr. Kumar is based out of the Center for Chronic Disease Prevention and Health Promotion at the California Department of Public Health (CDPH), and he will make $150,000 per year. His role focuses on developing a plan that addresses oral health disparities in the state.

Jayanth Kumar, DDS, MPH.

According to Dr. Kumar, the plan will take a "year or so" to build and begins by assessing the condition of oral health in California, which other assessments have shown are dismal. A 2014 audit of the California Department of Health Care Services (DHCS) noted that California was one of the worst-ranked states for children to receive dental care in 2013.

"One of the core public health functions is assessment. ... We're in the process of convening an advisory committee and bringing together partners and stakeholders," he said. "This is where we'll be identifying some of the issues and coming up with strategies to address the issues."

While part of the assessment will include feedback from organizations and individuals, it will also include a review of existing work that has already been done before Dr. Kumar's arrival. That assessment will be one of the most challenging aspects of getting the oral health plan in place, because identifying and tracking problems is difficult in a large, diverse state like California, Dr. Kumar noted.

Establishing prevention and access to care

In addition to assessing the state and building a plan, Dr. Kumar is responsible for collaborating with DHCS, the organization that houses the state's Medicaid dental program, Denti-Cal. The program has been highly criticized for its low reimbursement rates and time-consuming paperwork. The 2014 DHCS audit found that more than half of the 5.1 million children enrolled in Denti-Cal did not receive care in 2013 and that five California counties may not have access to any Denti-Cal providers.

"I'm aware of these problems, and I'm looking forward to working with the Department of Health Care Services," he said. "We want to see how we can collectively move forward in addressing these challenges and in strengthening the overall oral health program."

Dr. Kumar will also be organizing evidence-based prevention strategies, and specific strategies will be made as the oral health plan comes together. However, he did note that California has already made strides toward expanding the role of the dental team and that the state received a grant from the Health Resources Services Administration to grow the Virtual Dental Home program, where dentists, hygienists, and assistants collaborate to provide oral care to those in need.

Stakeholders are optimistic

Multiple organizations and individuals expressed enthusiasm after California governor Jerry Brown appointed Dr. Kumar in June, and many stakeholders are hoping for significant oral health improvements. The California Dental Association (CDA) in particular has been pressing the state to hire a dental director for years, and the association was pleased with the decision.

"CDA applauds Gov. Brown's appointment and looks forward to collaborating with Dr. Kumar," stated CDA President Walt Weber, DDS, in a press release. "Under Dr. Kumar's leadership, New York's oral health program experienced significant success and is recognized as one of the finest in the nation. We are excited to have his leadership and experience here in California."

Dr. Kumar is equally eager to work with stakeholders to improve Californians oral health, and he is excited for the opportunity to create a positive change.

"I want to emphasize that the disparities in oral health in income, race, education, and geographic location are profound. We have steady improvements in oral health in the last few decades, but not all populations have benefited equally," he concluded. "We want to collaborate with everyone to address disparities in oral health."