Placer County no longer to pay for permanent fillings for needy

By: Gus Thomson, Journal Staff Writer
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Placer County is eliminating many of the dental services it has provided to some of its most needy residents, including free permanent fillings. With warnings that providing only temporary fillings and subsequent tooth extractions for indigent patients will save money now but cost the county in the future, supervisors have approved a plan that also closes the Placer North Auburn dental clinic Jan. 1. Future dental services will outsourced to the nearby Chapa-De Indian Health Program’s Auburn clinic. Jim Gandley, Health and Human Services Department assistant director, said reducing dental service levels and relocating services would save the county about $273,000 annually. The county’s move follows a state reduction of its allowed scope of services for its Denti-Cal program and the new levels correspond with federal standards for prevention of serious illness or disabilities. Herb Whitaker, managing attorney for Auburn’s Legal Services of Northern California office, said the reduced level of services are mainly in the areas of preventive care and procedures such as amalgam fillings. That could backfire when future costs increase because of more expensive procedures, he said. The savings from reducing service, including eliminating permanent fillings, is $162,000. “Except for temporary fillings, that leaves county dental services with very little in the area of options but extractions,” Whitaker said. The vote was 5-0 at Tuesday’s board meeting in favor of the austerity measures and the move to Chapa-De’s Atwood Road clinic from quarters in the county’s government center. Gandley, a dentist, told supervisors that offering services to the indigent that don’t include permanent fillings is consistent with the scope of Denti-Cal practices as well as those of other states to prevent infection and serious disability. The decision was based on both a caring and fiscally prudent perspective, he said. Plans are to keep the county’s other dental clinic in the Tahoe area open. The current scope of services – including permanent fillings – has been in place in Placer County for 16 years. But the state reduced the scope of services for its Denti-Cal program. In all, dental services are provided to about 175 Medical Care Services Program patients a month. About a third of the 2,100 annual visits would no longer be provided for under the new scope of services, Gandley said. Gregory Uskus, a 38-year Placer County resident, said he has been actively seeking work in a dwindling economy and appreciates having dental care – including permanent fillings – available through the county when if he needs them. “If you have a pothole, it’s better to use asphalt than it is to use gravel,” Uskus said. “People should be able to get a filling to avoid further complications.”