The CDA Foundation this week announced a new partnership with the state’s Office of Oral Health to administer the state’s Community-Based Clinical Education grant and pilot a new CDA Cares clinic model throughout the state. The new clinic model will prioritize the placement of patients into permanent dental homes to address their full oral health care needs and will provide new clinical opportunities for dental students working alongside practicing dentists serving the state’s most vulnerable populations.
The CDA Foundation was selected as the grant administrator of the Community-Based Clinical Education funds that CDA successfully advocated for in 2022. Seven California dental schools will be awarded $7 million to expand their CBCE rotation sites in underserved communities throughout the state. Sites will include Federally Qualified Health Centers, large private offices and neighborhood schools. The Foundation will also pilot grant-funded CDA Cares clinics at the awarded sites.
“California’s significant investment in the expansion of community-based clinical education is integral to expanding dental students’ experience and perspective on what it means to be a health care provider and serve communities in dire need of equitable access to oral health care,” states Nader Nadershahi, DDS, dean of the University of Pacific, Arthur A. Dugoni School of Dentistry. “We are excited to see our students return to these communities as licensed dentists, and we applaud the eventual expanded access to care at these new grant-funded sites. We are grateful for the strong partnership and leadership of the CDA Foundation.”
The new CDA Cares model offers several distinct advantages and opportunities for patients, care providers and dental students. CDA Cares clinics will evolve from one-time episodic care events to focus on placement of patients into permanent dental homes to meet their extensive and long-term care needs. With the new CBCE rotation sites operating at satellite dental school sites, dental students, working alongside dentist volunteers, will provide clinical care and gain experience with vulnerable populations including people with special health care needs.
Additionally, by hosting clinics at sites already equipped to provide oral health care, the new model of CDA Cares can be hosted more frequently and in more remote areas of the state, thereby increasing patient access to care and reducing patient travel time.
Since its inception in 2012, CDA Cares has provided relief and support in two ways: It provided care to over 30,000 Californians, particularly those who were ineligible to receive government assistance, and it illustrated to state policymakers why additional investment in the Medi-Cal Dental Program was necessary. CDA Cares has operated in a model that was reflective of the period of reduced capacity and deeply underfunded programs, when referrals to continued care often resulted in months-long waitlists or no care at all. While more progress is needed, dentists’ increased participation in Medi-Cal means an increased capacity for more dental homes.
CDA Cares clinics have successfully shown local communities the importance of oral health and revealed the unmet dental care needs. The clinics also contributed to state and local decision-makers' awareness of inequitable access, which helped advance improvements to the Medi-Cal Dental Program.
The Medi-Cal Dental Program was expanded to reinstate adult benefits, raise reimbursement rates and make other programmatic changes to help attain meaningful and sustained provider participation in the program. For example, in the past five years, the state has seen a 25% increase (2,400 providers) in Medi-Cal Dental Program providers, and that rate is consistently increasing each year. This expansion of providers has also allowed for an additional 115,000 annual dental visits and nearly 100,000 additional preventive services statewide from 2017-2019.
The evolving CDA Cares model will continue to demonstrate to policymakers the current equity and access challenges in the state. Among these challenges is a maldistribution of dentists, a dental team workforce shortage and continued rate reductions from major third-party dental benefit plans that dilute the value of patients’ dental coverage. Additionally, there are not sufficient care facilities and providers for patients with special needs. These factors undermine equity in access to care, especially for the state’s most vulnerable populations.
The expansion of CBCE sites and coordinated CDA Cares clinics into areas of the state that need additional dental care capacity not only alleviates immediate oral health care needs but will also expand the quantity of care provided over time through patient placement into dental homes.
“We are at an important juncture to evolve the Foundation’s clinic work and help address the system of care that has changed since the inception of Cares,” states Richard Graham, DDS, CDA Foundation Board chair. “We will serve and place patients into the emerging system of care that did not exist 10 years ago. We will also show how that system of care can be further expanded and improved while still maintaining a meaningful philanthropic outlet for a profession that is deeply committed to giving back to the community.”
CBCE site awards are expected to be decided in mid-2023 with the Foundation aiming to hold CDA Cares clinics at selected sites beginning in 2024. CDA members can stay up to date with additional developments on CBCE site awards, including volunteer opportunities at upcoming Cares events, in the newsroom.
In addition to CDA Cares events, CDA and the CDA Foundation will continue to prioritize expanding access to care for vulnerable populations through an expansive health equity lens with specific focus on populations with special health care needs and historically underrepresented and excluded communities. (Read the October 2022 issue of the CDA Journal on diversity, equity, inclusion and belonging in dentistry.)