Letter to Governor Brown and Legislature on Denti-Cal Update

Dentical web

Report #243, September 2018


Since the Commission’s first review in 2016, lawmakers have poured money into California’s Medicaid dental program, Denti-Cal, in order to attract dentists and improve access to dental care for millions of low-income children and adults. Yet, data from the Department of Health Care Services (DHCS) continue to show a decrease in provider enrollment.

For parents or caregivers of children eligible for oral health care through Denti-Cal, limited access to providers can mean long waits in dental offices or lengthy commutes to find enrolled providers. At worst, delaying or forgoing treatment can lead to childhood tooth decay that results in discomfort and pain, poor self-esteem, and irregular school attendance.

Despite the attention and investment from lawmakers, the Commission found the DHCS continues to experience challenges administering the Denti-Cal program, but opportunities for improvement remain. As the next Administration sets its agenda, the Commission offers the following prospects for improved access and administration of the important program:

  1. Caregivers of Denti-Cal eligible children lack basic education about the importance of regular, preventative oral health care. Low-income caregivers and adults must be better educated about dental health and Denti-Cal;
  2. Parents and caregivers rely on help to navigate the Denti-Cal system and find dentists who will treat their child, schedule appointments, and offer other assistance as needed. Access to dental care must be expanded and made easier and more seamless;
  3. The continued disconnect between Denti-Cal providers and DHCS is a serious problem that undercuts the effectiveness of the program. Enhanced communication between DHCS and Denti-Cal providers is required;
  4. Swings in program funding, though now at a high, negatively impact Denti-Cal providers. Consistent and sustainable Denti-Cal funding is imperative; and
  5. DHCS is required to publicly report on their website data related to Denti-Cal. Yet despite improvements, more could be done. DHCS must continue to improve data access that is timely, complete, and transparent and in compliance with law.

The Little Hoover Commission is an independent state agency charged with recommending ways to improve the efficiency and effectiveness of state programs. The Commission’s recommendations are submitted to the Governor and the Legislature for their consideration and action.

Previous Studies

Letter to Governor Brown and Legislature: Denti-Cal Program Still Broken
(Report #241, November 2017)

Fixing Denti-Cal
(Report #230, April 2016)