A decision by Gov. Mike Dunleavy to eliminate $27 million in Medicaid dental benefits for adults will end up costing the state more in the long run and is a bad deal for those who truly need those services, says a spokesman for Alaska’s licensed dentists.
Dr. David Logan, executive director of the Alaska Dental Society, said Dunleavy’s decision to end Medicaid dental services to the poor is shortsighted.
“We understand where he’s coming from, but this will result in that care shifting to hospital emergency rooms,” Logan said, in interviews with The Cordova Times.
“Eliminating these services for people with no alternative, who also have related medical issues, such as diabetes, can complicate care of other medical problems,” Logan said. “There are a lot of things at play, all of them bad.”
The Alaska Dental Society had met with state Medicaid officials before the final operating budget cuts were announced, to voice their concerns regarding cuts in dental services for adults.
“The bottom line was they came in predestined with the idea of cutting that money from the budget and were not interested in alternatives,” Logan said. “They simply looked at a budget number and saw it as optional low hanging fruit.”
The governor never asked, and he didn’t listen to advice from the dental society, Logan said.
“He had a plan and he wasn’t interested,” he said.
Dunleavy’s office did not respond to a request for comment.
Most of Alaska’s some 500 dentists do a little to a lot of work with Medicaid patients, with Medicaid paying about 50 to 60 percent of the actual bill, he said. Under the program just eliminated, Medicaid annually paid up to $1,150 a year for preventive care, such as exams and cleanings, for Alaskans 21 and older who were eligible for Medicaid services. The veto cuts another $27 million hole in the Alaska economy, Logan said.
State officials had initially announced that preventive care benefits ended July 1, but on Friday, Aug. 23, the Department of Health and Social Services said those benefits were now extended until the end of September. As veteran journalist Dermot Cole noted in his “Reporting From Alaska” column on Aug. 23, the Dunleavy administration had failed to follow regulations that require a 10-day advance notice of termination to beneficiaries, which may explain why the program now continues until the end of September, according to a document posted by the Office of Management and Budget on its website.
Emergency dental benefits, including the need for tooth extraction, will continue unabated.
Logan posted a note on the Alaska Dental Society’s Facebook page on Monday, Aug. 26, confirming to members of the society that prior pre-authorizations for Medicaid dental work are being honored, and that recipients will have $1,150 in new year’s benefits to use.
The problem, he said, is that all these preventative benefits have to be authorized and Conduit, the subcontractor for the program, was not yet comfortable authorizing those benefits. Meanwhile, dentists would be in contact with their Medicaid patients who have treatments pending or seeking new treatments.
Hold on free dental clinics
Several times in past years the Alaska Dental Society has organized large free dental clinics in Anchorage and Fairbanks to treat a variety of dental needs for those with no insurance and no other means to pay for such services, Logan said. Such efforts require the volunteer services of numerous dentists, dental technicians and others, as well as the added costs of renting space and equipment.
About $100,000 is needed to hold such an event in Anchorage, including rental of space and equipment, he said. When the event is held at the Dena’ina Convention Center, most of that money goes to rent space, which requires a mandatory catering fee just to provide food and beverages for volunteers. In the past, Northrim Bank, oil companies and others, including TOTE Maritime Alaska, have contributed money and services, but these days there are fewer folks available to donate, he said.
No events are planned for 2019 because of the prohibitive cost, he said.
Logan also commented on the state’s Aug. 20 online posting, the day after the vetoes were announced, for a part-time dentist to develop oral health program priorities and identify gaps in oral health services to Alaska’s most vulnerable populations.
The contract, to run from Oct. 15, 2019 through Aug. 31, 2020, plus two renewals to be exercised at the discretion of the state, requires the dentist to work about 20 hours a month,
That works out to about $300 an hour, but given the extensive requirements, there are currently no applicants.
The post has been vacant since the long-standing director retired several years ago, and one potential applicant said he thought he would actually lose money on the deal, Logan said.
The extensive requirements are outlined in the 46-page request for proposals, posted online on Aug. 20, the day after Medicaid adult dental services were cut, at aws.state.ak.us/OnlinePublicNotices/Notices/Attachment.aspx?id=118776.