Adult dental services are limited by the Medicaid state plan to medically necessary oral surgery and associated diagnostic services, such as X-rays and surgical extractions. Preventive, restorative, endodontic, and prosthetic services ( e.g. cleanings, fillings, root canals and dentures) are not covered for adults. The recent cut of public health dentists from services provided by VDH only served to exacerbate the lack of regional access, resulting in inadequate dental services for all Virginians without dental insurance coverage, including individuals with DD.
In response, the OIH developed the fixed rate dental program that began as a pilot and has since been rolled out in several regions. This program replaced the segregated dental clinics located at NVTC and SVTC by offering a single fixed rate for the provision of basic dental services over the course of one year. Using established community dental practices and clinics that serve everyone in a community (free clinics, FQHCs ), the program has expanded its reach to not only individuals who were served at the Training Center's but those in the community with DD who have never received dental services. The program looks to meet two needs, meeting the dental needs of the broader DD adult community, and demonstrating a cost effective and reasonable payment structure.
The HSN capitalized on the sedation dental program for individuals with DD observed in the Tidewater area of Virginia. This innovative model utilizes a Certified Registered Nurse Anesthetist (CRNA) and certified moderation sedation dentist to provide a wider variety of services within the community setting, omitting the need for additional medical professionals or the need for hospitalization for services. This program is designed to supplement not replace Medicaid, and is available for individuals with fears, and behavioral or physical issues, that make a standard dental visit difficult. Because of the specific nature of this pilot requiring sedation certified dentists, and a CRNA, and the expectation that examinations and treatment were carried out on sight, program implementation has been challenging. An initial attempt was made in Northern Virginia between October 2016 and March 2017. The contract however did not yield the intended results and had to be terminated. Alternative arrangements for temporary care have been made until the new contract is fully implemented this summer.
Our Dental Team
Casey Tupea, RDH
Registered Dental Hygienist
Lori S. Wilson, DDS, MPH, FACD
Tamika Clark, DA, BS
Mobile Dental Assistant