King County Dental Access Program

Grantee: Project Access Northwest
Timeframe: July 2014 – June 2017 | Total Amount: $389,246

Year 1: July 2014 – June 2015. Amount: $125,246
Year 2: July 2015 – June 2016. Amount: $132,000
Year 3: July 2016 – June 2017. Amount: $132,000

Low income patients with complex oral health needs have very limited options even with the return of dental services to Adult Medicaid. With care in the Private Market being reimbursed at an average of $196 – 245 (WSDA – Adult Dental Medicaid reimbursement Rates in 2014; Dental Codes for Preventive Care, Emergent Care and Restorative Care visits), the $55 that Medicaid reimburses is not sufficient for general practitioners to treat Medicaid patients. The dentists in the community health centers and free clinics do an amazing job serving low income adults but need an additional resource for complex extractions that are beyond their training or scope. Currently, these dentists refer over 100 patients per month to PANW for complex extractions. Oral pain and infection is one of the top 5 reasons why low income uninsured patients use an emergency room. The dental treatment available in the Emergency Room is for pain and infection. Without definitive treatment, the patient is on a non-ending cycle of infection and pain; antibiotics treat the symptoms but not the cause. The average Emergency Room visit is $1500, dental pain is an expensive and inappropriate use of the Emergency room.

In partnership with Swedish Medical Center, the Seattle Specialty Dentistry Clinic and Seattle King County Dental Society, Project Access NW will provide case management services (enrollment, eligibility verification, appointing, improving health literacy, reminder phone calls, assuring a low no-show rate) for the free dental clinic on Swedish First Hill Campus. The patients will be referred by dentists in the community health centers, free clinics and the Swedish emergency departments. In addition to the safety net patients, the low income NW Kidney Centers dialysis patients who need an oral clearance as part of being placed in on the Kidney Transplant list will be included. For this limited number of patients, once infection is managed, we case manage the patients into private dental practices for other dental care needs. All patients live in King County.