Medi-Cal Dental Cuts Put Mission Health Center at Risk

By Rigoberto Hernandez

The Native American Health Center is the only place in the Mission where Leonor Verde can get her lateral incisor extracted. If that doesn’t sound like much fun at least it’s free.

“I have no food, no money, no medicine, “ Verde said. “ I normally don’t come to doctors but they are so good they keep me coming back.”

But not for long.  As of July 1,  dental care for Medi-Cal recipients ends—a move that will affect patients as well as  federally qualified health centers like the non-profit Native American Health Center. 
The Center at 160 Capp St. is the only federally qualified center clinic in the Mission District that offers dental care to Medi-Cal patients.

Some 50 percent of its revenue comes from Medi-Cal dental reimbursements, according to Sherie Jalipa, an administrative assistant at the Native American Health Center.

Yoladia Velasco, the director of projects at the center, said that unlike private practitioners, federally qualified clinics are designated to serve the poor. As a result, the clinics have higher reimbursement rates than private clinics and are therefore more dependent on public money.

Dick Hodgson, the vice president of policy and planning at the San Francisco Community Clinic Consortium, agreed that these cuts are going to severely affect clinics like the Native American Center, which is part of the consortium.

“The dental cuts are going to affect federally qualified health centers, the dental programs might have to close because it is a major source of revenue,” he said.

The dental cuts will only apply to adults but it would also affect children,  said Hodgson.

“If the funding is not there they won’t be able to better help children, “ Hogson said. “In the case of smaller clinics this {budget cuts} can affect the entire clinic.”

Jalipa said,  “We are still going to run, I don’t know what we are going to cut, but we are going to run.”

The center employs five dentist at present for the 1,300 dental patients it sees each year.  They are trying to keep the doors open through voluntary furloughs.. 

“Everyone is pitching in,” Jalipa said, who has taken two one-day furloughs already. “It’s very familial here, we don’t want anyone to loose their jobs.”

She added: “The worst thing is that they are doing this when more people need our services.”

Brenda Storey, the executive director of the Mission Neighborhood Health Center, said that when dental services end, other clinics like hers will start to see patients for oral absesses and other emergencies.  What they really need is a dentist, she said, but they’ll end up here or in an emergency room.

The dental cuts are only one that threaten the Native American Center’s future.  This week, the state legislature and the governor begin work on a final budget. At present two proposals exist: one Governor Arnold Schwarzenegger has proposed and one the legislature’s conference committee hammered out last week.

The legislature rejected many of the extreme cuts to health care, according to an analysis by the California Budget Committee, but agreed to reduce  state funding for specific programs including a $1.5 million cut for the Indian health program.

“It is uncertain right now,” said Hodgson. “The Native American Center is working with that, there is some questions whether it applies to urban or rural reservation programs.”

Private practitioners abound in the mission but few accept Medi-Cal dental patients.

Marco M. Chavez’ s office is one that does.  He said Medi-Cal patients represent about 20 percent of the people who walk into his office , but the reimbursements account for only 10 percent of his revenue. 

“I don’t get much from it {Medi-Cal}, but it’s the right thing to do,” Chavez said explaining why he accepted the patients.

He gave the example of charges for fillings.  With a Medi-Cal patient he receives a $60 reimbursement compared to the $120 from a patient without insurance.

Lady Sarmiento, the receptionist for the South Van Ness Dental Group, said their patients are unaware of the Medi-Cal cuts and won’t take kindly to the news.

“They think we are trying to get rid of them,” she said.

Related Stories:

The Vanishing Stimulus, June 13, 2009

Ouch, the Needy Brace For more Cuts, March 25, 2009