2019 Policy Priorities

Issue: Increase access to culturally and linguistically appropriate oral health care services

California’s diversity is something to be proud of. At least 220 languages are spoken in California, and almost half of our residents speak a language other than English at home. Therefore, having access to linguistically and culturally appropriate services is essential. Yet, we continue to hear barriers within diverse communities. For example, our partner the South East Asia Resource Center (SEARAC) explains how members of the Hmong community in Butte County (refugee of wars) continue to go without needed care due to a lack of cultural and linguistic competent services.

Solution:

This year, we have prioritized creating a strong oral health system to provide better care to all of California’s residents. Advocates have been working with the Department of Health Care Services to offer recommendations on improving accessibility for limited English proficient (LEP) Medi-Cal enrollees. Additionally, we are in support of legislation AB 318 (Chu) co-sponsored by the California Pan Ethnic Health Network, and the Western Center on Law and Poverty, which seeks to improve readability of important Medi-Cal documents. Ensuring consumers attain the most out of their coverage.

Action and Updates:

This year, CA-OPEN prioritized creating a strong oral health system to provide better care to all of California’s residents. Advocates are working with the Department of Health Care Services to improve accessibility for limited English proficient (LEP) Medi-Cal enrollees. On June 10, 2019, advocates from 28 statewide organizations submitted a joint letter to the Department of Health Care Services regarding language access within DHCS Medi-Cal Dental Division. Since submission of the letter, DHCS has undertaken additional efforts to make substantial improvements in response to the concerns raised in the advocates’ letter. At the request of stakeholders, DHCS has also launched a Medi-Cal Language Access Workgroup. You can read DHCS’s response hereFor more information, please contact Carolina Valle at cvalle@cpehn.org

CA-OPEN also supported legislation AB 318 (Chu), co-sponsored by the California Pan Ethnic Health Network, and the Western Center on Law and Poverty, which sought to improve readability of important Medi-Cal documents. In October 2019, Governor Newsom vetoed legislation AB 318. Moving forward, advocates remain committed to language access for millions of Medi-Cal beneficiaries. For more information, please contact Marques Castrejon at mcastrejon@cpehn.org.


 

Issue: Increase awareness of the harmful effects of sugar-sweetened beverages on oral health

The single leading source of added sugars to the American diet is consumption of sugary drinks. In California, like many other areas around the state, we are seeing increasing rates of chronic health conditions, including diabetes, obesity, and oral health diseases, which are caused or further exacerbated by sugary drinks. Daily consumption doubles the risk of tooth decay and increases the risk of obesity by 55% and diabetes by 26%. Not all communities experience these conditions equally. Some communities are targeted by soda or other industries, while also facing limited access to affordable, clean water and healthy foods. Over 74% of African Americans, adolescents, and 73% of Latinos drink at least one sugar-sweetened beverage each day, compared to 63% of Asians and 56% whites.

Solution:

We support ways to increase awareness and understanding of the negative impacts sugar-sweetened beverages have on oral health. CA-OPEN 2019 policy agenda includes legislation that warns consumers about the impacts of sugar sweet beverages – including impacts on tooth decay. SB 347 (Monning) Sugar-Sweetened Beverages Safety Warning.

Action and Updates:

This year, CA-OPEN continued to find ways to support greater awareness and understanding of the negative impacts sugar-sweetened beverages have on oral health. Advocates supported legislation SB 347 (Monning), co-sponsored by the Latino Coalition for a Healthy California, Public Health Advocates, and the California Black Health Network,which sought to increase awareness about the impact of sugary sweetened beverages on oral and overall health. SB 347 will now span the twoyear legislative session. For more information, please contact Abigail Ramirez at aramirez@lchc.org. 


 

Issue: Expand oral health access through virtual dental homes

Over 30% of Californians, including 11 million children and adults, are not getting their oral health needs met through the traditional dental care system. Virtual Dental Homes offer a way to meet the diverse needs of underserved children where they are at: Head Start Centers and schools, residential care facilities and nursing homes, and other communities based settings that meet rural families’ needs. To date, the program has been very successful. In 2019, over 30 Federal Qualified Health Centers and Rural Health Clinics are participating in projects to implement Virtual Dental Homes. However, a recent rule change at DHCS would limit the accessibility of Virtual Dental Homes.

Solution:

Advocates have been working administratively for the full-implementation of the VDH program. Additionally, there is legislation that would help clarify the rule, allowing providers to continue offer their services in the community.

Action and Updates:

This year advocates attempted to clarify policies that allow providers to establish dental patients through tele-dentistry. AB 74 and SB 74 both included clarifying language on this issue; however, this efforts was not included in the bills. CA-OPEN is committed to continuing to support Virtual Dental Homes. For more information on VDH contact Dr. Paul Glassman at pglassman@pacific.edu.


 

Issue: Improve access to oral health care

In California, over 40% of Californians living below 200% of the federal poverty level have not seen a dental provider within the last 5 years. As Californians age, dental benefits become critical for overall health. In 2009, at the height of the recession, California eliminated dental benefits for adults, as they are considered “optional”. In 2014, some services were restored. In 2017-18, California fully restored adult dental benefits in Medi-Cal. While this is great news, many beneficiaries continue to face barriers accessing services. It is critical that we continue to increase funding for treatment, public health, and education efforts to ensure adults, children and families are utilizing their services.

Solution:

We support ways that aide beneficiaries in obtaining access to health care including oral health services. Advocates have been working administratively to ensure beneficiaries know their rights. CA-OPEN stays committed in monitoring utilization for Medi-Cal dental services and ensuring these services are more accessible by improving the Treatment Authorization Requests (TARS) beneficiaries go through. As the new administration signs the 2019-2020 budget, we will continue to monitor and advocate for Proposition 56 funding (tobacco tax) to fund needed oral health services for our communities.

Actions and Updates:

This year, CA-OPEN continued to monitor the impact of restoration on adult dental benefits. In 2017-18, California fully restored adult dental benefits in Medi-Cal. Following the restoration of adult dental benefitsadvocates found that deep cleanings became one of the most commonly utilized dental benefits among adults. You can read more about the impact of the restoration on access to periodontal treatment here. While the restoration is great news, many beneficiaries continue to face barriers accessing services. Advocates from Asian Americans Advancing Justice-Los Angeles, California Pan Ethnic Health Network and Justice in Aging have produced a “Know your Benefits” pamphlet to ensure Medi-Cal’s diverse consumers understand their benefits. You can download the pamphlet here. For more information, please contact Carolina Valle at cvalle@cpehn.org.   


 

Issue: Increase access to oral health through expanded health care services

One of the most important ways to improve access to oral health is to expand health care services. California has a strong commitment to our immigrant communities, including undocumented immigrants, play an integral role in our state. For example, undocumented immigrants contribute over $3 billion in state and local taxes each year. They are close to 10% of the state’s workforce and are parents to 1 out of 6 of our California children. California needs to protect the health including the oral health of ALL undocumented Californians, which are about 1.5 million people.

Solution:

In 2019, CA-OPEN champion’s legislation aimed at including all low-income undocumented Californian’s into full-scope Medi-Cal to allow access to all services including dental so no Californian goes without healthcare services due to their citizenship status. SB 29 (Durazo) and AB 4 (Bonta, Chiu, Santiago) Health4All Adults: SB 29/AB 4 would provide full-scope Medi-Cal coverage to income-eligible adults by removing immigration status as an eligibility exclusion. These bills can ensure that no Californian goes without life-saving health coverage.

Actions and Updates:

In 2019, CA-OPEN members supported legislation SB 29 (Durazo) and AB 4 (Bonta, Chiu, Santiago), whichaimed to remove immigration status as a basis for exclusion from Medi-Cal. The Final State Budget Act of 2019 included $86 million for health care coverage for income eligible, undocumented youth and young adults under the age of 26. In September 2019, Senator Maria Elena Durazo announced an agreement with the California Governor to continue to work toward extending health care to undocumented adults age 65 and over next year. You can read more about the announcement here. For more information, please contact the Health4All Coalition.