A hui of more than a dozen isle- and mainland- based dentists wants to create a system to ensure that $26 million in state funds to restore dental coverage to as many as 280,000 indigent patients gets deployed efficiently in January.
Adult patients in Hawaii who are eligible for Medicaid — known as Med-QUEST in Hawaii — lost their dental benefits in 2009 during the economic crisis that prompted budget cutbacks, including “Furlough Fridays” for public workers to save costs.
In the past legislative session, lawmakers enjoyed higher-than-expected budget revenues as Hawaii’s economy bounced back from the COVID-19 economic downturn ahead of all forecasts, enabling restoration of cuts to programs and, in some cases, record levels of funding.
But there is no overall, uniform plan to connect the newly restored money to the dental care that patients need across the state, especially in low-income rural areas.
During a visit about three months ago to residents at the Pu‘uhonua o Wai‘anae tiny-house community of formerly homeless people who had been living illegally next to the Waianae Small Boat Harbor, Dr. Russell Kim said a community leader asked about 40 residents how many of them were afraid of dentists. Nearly every hand went up, said Kim, who runs a private dental practice in Kaneohe, serves on the board that oversees Adventist Health Castle Medical Center and volunteers at Pu‘uhonua o Wai‘anae.
Perhaps more shocking was that the residents were then asked how many had extracted their own teeth, and again nearly every hand was raised, Kim told Lt. Gov. Josh Green in a meeting with the hui this week.
The local group included representatives of diverse organizations such as Darrah Kauhane, executive director of the nonprofit Project Vision Hawai‘i & Hawaiian Eye Foundation, which wants to spread the word about the restored funding and expand its services into low-income dental care; Patrick Donnelly, program manager of the Hawaii Oral Health Coalition; and Kanoa Switzer, a Native Hawaiian healer and practitioner of hooponopono and laau kahea.
They were joined remotely in their hourlong meeting by the former public health dental director for Iowa, the former public health director for Massachusetts and the president of the national American Mobile and Teledentristry Alliance.
If he’s elected governor on Nov. 8, the hui asked Green to let it work with his administration to create a commission to ensure that low-income adults receive the dental care they have not gotten in 13 years. He asked that everyone at Thursday’s meeting then participate in a formal commission to reform delivery of dental care services that could involve overhauling state departments so that public dental services are not focused solely in the Health Department while Medicaid/Med-QUEST programs are run through the state Department of Human Services.
The group also suggested that the next state health director have a background in oral health care.
Green, a Kona emergency room physician who treats low-income rural patients, told the group that he sees quality dental care as part of his ongoing efforts to create more permanent housing for homeless people.
He said he understands how poor dental care can shape a person’s life, and shared the story of his grandfather Samuel, a Polish immigrant who arrived in the United States at the age of 10 in 1920 and “lost most of his teeth.” Green said his grandfather gave up an opportunity in 1928 to attend Carnegie Tech, now known as Carnegie Melon, because of not having dentures. “He missed college because of that … because of the sense of shame that he didn’t have good oral health,” Green said. “I see all these things connected.”
Outgoing House Finance Chair Sylvia Luke helped shepherd the restored Med-QUEST funding through the Legislature and called it “a long time coming.”
Federally qualified health centers across the state have pediatric dentists treating juvenile Med-QUEST patients, so the centers are already set up to treat low-income patients, Luke said. In addition, some private-practice dentists also treat homeless and formerly addicted meth patients for free, she said.
But Luke, Green’s lieutenant governor running mate, said she is especially encouraged that dentists and organizations are offering to help the state create a new system “that works” to turn the funding into badly needed dental care.
“I think that’s terrific,” Luke said. “We want to make sure that we maximize the funds.”
