Oral Health
Increasing Access to Oral Health in Connecticut
It became apparent in the 1990s that Connecticut had a major oral health crisis. The Connecticut Health Foundation played a role in bringing providers together to begin tackling this challenge—making increased access to oral health a priority for all dental providers and the state of Connecticut.
There were two issues—first, not enough providers would treat Medicaid patients. Even if patients did seek treatment, they had a hard time receiving care. Only an estimated 100 of the 3,000 dentists in Connecticut regularly participated in HUSKY, the state’s Medicaid program for children. Medicaid reimbursements were so low, accepting Medicaid patients was not financially viable for many private providers. Second, all types of dental providers were not focused on creating solutions to this widespread problem.
The Connecticut Health Foundation played a role in bringing providers together to begin tackling this challenge—increasing access to oral health a priority for all dental providers and the state of Connecticut. We set out to bring a change to the existing oral health system, which took time, work, and team-building, and a number of different tactics:
- In 2001, CT Health provided start-up funding for the Connecticut Oral Health Initiative, a coalition of health professionals and community and business leaders working to resolve the state’s oral health issues. The foundation provided hundreds of thousands of dollars of support to this advocacy organization to promote sound oral health policies and changes in the system.
- In 2002, CT Health commissioned a landmark oral health study by Drs. James Crall and Burton Edelstein. The study laid out five strategies that became a strategic framework for improving oral health in the state—including working to increase reimbursement to dentists for providing care to children on Medicaid.
- When attorneys filed a class-action suit against the Connecticut Department of Social Services, challenging the lack of access to oral care for Medicaid recipients and demanding increased reimbursement to private dentists, CT Health made a key general support grant to Greater Hartford Legal Aid. A settlement in 2008 increased reimbursement to private dental providers to make it financially viable for them to treat lower-income children.
Since then, the number of providers treating Medicaid patients has risen significantly—more than 33 percent between 2009 and 2010 alone.
Lessons Learned
Buy-in from all stakeholders is essential
With everyone coming together, CT Health was able to build a common vision and buy-in about the importance of working together to improve oral health care of low-income children throughout the state. The Foundation provided advocates and dental health professionals with a place to strategize, and access to leading experts and solid research. That collaboration and momentum helped build a framework for changing the oral health system in Connecticut.
No one tactic works on its own
It wasn’t just grant-making that raised the profile of oral health in Connecticut. Or advocacy. Or research. It was a combination of these things and others that moved the dial. Strategies for successful change must be flexible to adapt to changing circumstances.
Short term and long term initiatives are equally crucial
Lawsuits don’t settle overnight. While aiding legal efforts, the foundation also worked with our partners in the short term to advance the state of oral health for low-income children and families. It brought together community members to talk about the issue, and financed local initiatives with the goal of increasing access to care. So while the lawsuit was a slower, long-term process, progress in the advancement of oral health could continue forward.
