2007
- Alliance for Information on Maternal and Child Health program established
AIM grantee American Academy of Pediatrics hosted Oral Health in the 21st Century: Something to Smile About—Your Role in Oral Health, October 10, 2008, Boston, MA. Reproduced with permission from the American Academy of Pediatrics
Background
The Maternal and Child Health Bureau (MCHB) established the Alliance for Information on Maternal and Child Health grant program to help members of 16 national organizations make well-informed decisions, formulate effective public health policies, and implement programs for women, children, and families.
Impact
The American Academy of Pediatrics (AAP) and the American Academy of Pediatric Dentistry (AAPD) each received an AIM grant to support oral-health-related activities. AAP’s Oral Health Initiative aimed to promote improved child oral health by offering pediatricians and other child health professionals tools and support to provide community-based, collaborative care. AAPD’s Improving Perinatal Oral Health project aimed to (1) expand the availability of perinatal oral health care by disseminating resources to health professionals, health educators, and consumers and by promoting policies to expand access to perinatal oral health services; (2) expand the number of general dentists and pediatric dentists who see infants by age 1 and promote the availability of Medicaid and State Children’s Health Insurance Program coverage for infant oral health visits; and (3) raise public awareness about oral health care for pregnant women and infants through public-health-awareness campaigns.
Source
Working in Partnership: Maternal and Child Health Bureau’s Oral Health Programmatic Activities [manuscript].
- Death of Deamonte Driver from a brain infection caused by tooth decay
Deamonte Driver. Reproduced with permission from the Community Foundation for the National Capital Region.
Background
In February 2007, 12-year-old Deamonte Driver of Prince George’s County, MD, died from a brain infection resulting from an untreated tooth abscess. Although Deamonte was entitled to oral health care from his Medicaid managed care organization, his family had found it difficult to locate a dentist in their neighborhood who would provide care to Medicaid beneficiaries. By the time Deamonte received care for his tooth, bacteria from the abscess had spread to his brain. After two surgeries and more than 6 weeks of hospital care, Deamonte died.
Impact
Before this incident occurred, concerns had arisen about the adequacy of oral health care for children from families with low incomes. The widely publicized case of Deamonte Driver focused yet more attention on the subject. As a result, the Government Accountability Office was asked to examine the extent to which children participating in Medicaid experience oral disease, the extent to which they receive oral health care, and how these two things have changed over time. The finding were issued in a report, Medicaid: Extent of Dental Disease in Children Has Not Decreased, and Millions Are Estimated to Have Untreated Tooth Decay, that presents information from national health surveys on key indicators of the oral health status of children participating in Medicaid. Specifically, the report examines rates of oral disease, children’s receipt of oral health care, and changes in these indicators over time.
In May 2007, a hearing was held before the Subcommittee on Domestic Policy of the Committee on Oversight and Government Reform in the House of Representatives to take a closer look at the circumstances that led to the death of Deamonte Driver. This hearing focused on the adequacy of oversight of pediatric oral health care and Medicaid. It was noted that Deamonte’s death demonstrated both the importance of oral health to children’s welfare and the sometimes fatal and often costly consequences of inadequate oral health care.
In 2008, in response to the Congressional hearing and federal studies on access to oral health care, the Centers for Medicare and Medicaid (CMS) conducted on-site reviews of children’s oral health services in 16 states with dental utilization rates for children of less than 30 percent based on data from the Early and Periodic Screening, Diagnostic, and Treatment Program CMS 416 annual report. These reviews were performed to determine what efforts states have made to improve children’s dental utilization in their state, to make recommendations on additional actions states can take to increase utilization rates, and to ensure compliance with federal Medicaid regulations.
CMS published a summary of those state reviews and identified several opportunities for improving oral health care for children eligible for Medicaid. CMS convened a town hall forum in April 2009 to discuss steps to address lack of access to oral health services for children eligible for Medicaid and to improve the delivery of services to this population.
Between December 2009 and March 2010, to identify best practices and opportunities for improving children’s Medicaid dental programs, CMS conducted eight state Medicaid dental program reviews focused on practices and program innovations designed to increase dental utilization in these states. The eight states reviewed were Alabama, Arizona, Maryland, Nebraska, North Carolina, Rhode Island, Texas, and Virginia. The states were selected based on a CMS review of state data and external partners’ identification of Medicaid dental programs with promising initiatives. Following the reviews, CMS published the findings.
Sources
Centers for Medicare & Medicaid Services. 2009. Centers for Medicare & Medicaid Services—2008 National Dental Summary. Baltimore, MD: Centers for Medicare & Medicaid Services.
Centers for Medicare & Medicaid Services. 2011. Innovative State Practices for Improving the Provision of Medicaid Dental Services: Summary of Eight State Reports: Alabama, Arizona, Maryland, Nebraska, North Carolina, Rhode Island, Texas, and Virginia. Baltimore, MD: Centers for Medicare & Medicaid Services.
Centers for Medicare & Medicaid Services. 2009. National Medicaid Dental Town Hall Forum Discussion Points. Baltimore, MD: Centers for Medicare & Medicaid Services.
Government Accountability Office. 2008. Medicaid: Extent of Dental Disease in Children Has Not Decreased, and Millions Are Estimated to Have Untreated Tooth Decay. Washington, DC: Government Accountability Office.
Government Printing Office. January 23, 2009. Medicaid Program; Town Hall Forum on Access to Dental Care for Medicaid-Eligible Children; April 6, 2009. Federal Register 74(14):4205.
Health Resources and Services Administration [transcript]. CMS National Medicaid Dental Town Hall Forum (presentation).
Otto M. February 28, 2007. For want of a dentist. Washington Post.
Otto M. March 3, 2007. Boy’s death fuels drives to fund dental aid to poor. Washington Post.
Subcommittee on Domestic Policy, Committee on Oversight and Government Reform, House of Representatives. 2007. Evaluating Pediatric Dental Care Under Medicaid. Washington, DC: U.S. Government Printing Office.
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