Blog | March 12, 2018
2018 legislative session yields oral health care access gains

The conclusion of the 2018 legislative session marked another year of progress toward expanding oral health care access and reducing health disparities in Washington State. Oral Health Watch would like to thank the Legislature for its unanimous support of Substitute Senate Bill 6549 and its continued support of the Oral Health Connections pilot program. Targeted investments that promote greater access to care and health equity are not only smart policy; they also are the right thing to do.

Lawmakers fine-tuned the Oral Health Care Connections pilot program by selecting Spokane, Thurston and Cowlitz counties for its test sites. Last year, the Legislature directed the Health Care Authority to work with Arcora Foundation to determine whether expanding dental care access for expectant mothers and people managing diabetes would lead to better health outcomes, fewer complications, and shorter hospital stays. A robust evaluation is planned for the pilot.

Supporting efforts that provide access to essential oral health care for those who need it most is a wise investment – Jennifer Brackeen, CHOICE Regional Health Network

Using the Access to Baby and Child Dentistry (ABCD) model, pregnant moms and people with diabetes with Apple Health (Medicaid) coverage in pilot counties will be eligible for an enhanced dental benefit, outreach and education, and better coordinated care to address the whole patient’s needs. Lawmakers and health care advocates support the Oral Health Connections pilot because they believe it to be a smart, measured, and evidence-based approach that can improve health and spare people from needless suffering.

“A mouth free of infection is a necessary part of maintaining good overall health, and it is profoundly important for people who are managing chronic conditions,” said Jennifer Brackeen of CHOICE Regional Health Network. “Supporting efforts that provide access to essential oral health care for those who need it most is a wise investment.”

In addition to adjusting the pilot program for pregnant women and people with diabetes, lawmakers also expanded access for children with disabilities. SSB 6549 directs the state’s Health Care Authority, which manages Apple Health, to extend the ABCD program to Apple Health-covered children with developmental disabilities up to age 13. ABCD aims to set children on a healthy start in life by connecting eligible children age five and younger with ABCD-certified dental care providers in their communities, and SSB 6549 helps ensure that children with special health care needs receive continued care beyond the early years.

Supporters of SSB 6549 say expanding care to developmentally disabled children through their preteen years will help an at-risk population in need of particular attention and support. A report published in the Journal of the American Dental Association found that people with developmental disabilities experience disproportionate incidents of poor oral health, gum disease, and untreated cavities.

“Children with developmental disabilities are at greater risk of experiencing poor oral health,” said SSB 6549 champion and Tacoma-area pediatric dentist and the Washington State Academy of Pediatric Dentistry’s Public Policy Advocate, Dr. John Gibbons. “Expanding the ABCD program to care for some of our state’s most vulnerable kids helps ensure that children with special health care needs have access to preventive care and early treatment to live healthier and pain-free.”

For both SSB 6549 and Oral Health Connections, participating providers will receive specialized training and enhanced reimbursement rates for certain services. These higher reimbursement rates, combined with patient outreach and care coordination, make it easier for more providers to participate in the Apple Health program so patients can see dentists closer to home.

Oral Health Watch members also celebrated legislative gains in improving health equity for at-risk kids and underserved communities. Gov. Jay Inslee signed into law the Breakfast After the Bell program which will offer nutritious breakfasts at high-needs schools beginning in the 2019-2020 school year. Lawmakers also approved legislation that will grant COFA (Compact of Free Association) migrants access to affordable health care coverage on the state health benefit exchange.