Rep. Marcus Riccelli: House efforts would expand access to dental care, training

Prior to beginning my first session as a state legislator, I met with a group of concerned citizens in Spokane’s lower South Hill. We discussed a number of social and economic justice issues, among them the lack of access to affordable dental care. That was where I first heard Aaron Robert Kathman talk about his bouts in the emergency room because he could not afford dental care. He implored me to do something about it.

Since then, I have served on the House Health Care Committee, including three years as vice chair. What repeatedly came up in this committee, and what I’ve consistently heard from constituents in Spokane and across our state, is the need for more affordable, accessible, quality dental care.

Good overall health begins with good oral health. As a state, we need to do a better job in this regard.

Over the past year, I convened and chaired a legislative work group focused on expanding statewide dental access. We collaborated on an agenda to significantly improve access and care for thousands of Washingtonians. Working with community stakeholders, our Democratic and Republican budget leads on the House Capital Budget Committee and other legislators, I’ve focused intensely on expanding infrastructure to increase our state’s dental safety net.

Here in Spokane County, the adult dental Medicaid utilization rate is only 23 percent because of lack of access. That means of the nearly 95,000 adults enrolled in Medicaid, only slightly more than 22,000 are using their dental benefits.

That’s why I’m thrilled the proposed House capital budget funds the dental infrastructure initiative, proposing more than $15 million to build our community health clinics to serve more than 60,000 people and increase dental visits by more than 150,000.

This budget also invests in two dental residency programs, one in Spokane. It will leverage state resources, private investment and partnerships here in our community. The Spokane Dental Residency would increase access by providing treatment to 12,000 patients per year, a majority of them Medicaid- eligible.

Medically fragile adults in Eastern Washington have difficulty obtaining dental care because of the complexity in managing their care and the lack of availability outside Seattle. As a result, lifesaving hospital procedures are often delayed. By funding six chairs at a clinic on Providence Sacred Heart’s campus and 20 chairs at a new community clinic near Holy Family, the proposed budget takes a major step in addressing this problem.

Additionally, the residency program will train six residents a year with the intent to retain these providers in Eastern Washington, where they are sorely needed.

The House operating budget proposal also includes some targeted investments, including a pilot initiative to provide enhanced dental benefits for Medicaid-insured adults with diabetes and pregnant women. These vulnerable populations would receive increased periodontal visits, up to four per year. This is critical because mothers can transmit oral diseases to their babies before and after delivery. Tooth decay is the most common childhood disease, yet it is totally preventable.

The budget prioritizes investing in the Regional Initiatives in Dental Education, coordinated between the University of Washington and Eastern Washington University. Rep. Jeff Holy, R-Spokane, and I advocated for funding in the House budget to add a second year of dental curriculum to this program, doubling the amount of time RIDE students would stay in Spokane. This sets the stage to expand the capacity of the program from eight to 30 students per cohort with a phased-in approach.

Ultimately, all of this helps more people get the critical dental care they need.

Many knew Aaron Kathman as a champion for our marginalized communities. He opened my eyes to how serious a problem lack of dental access is for people in our state. Sadly, Aaron passed away two years ago at age 39 from heart complications. Although he had an underlying health condition, we know dental issues like an abscessed tooth can cause serious, even life-threatening health problems for people. This may or may not have been the case with Aaron, but we know these problems are preventable.

It’s too late for Aaron, but his message persists. It’s not too late for others to get the dental care they need. Funding these initiatives, in the capital and operating budgets, can make a tremendous difference for kids and adults. I ask our community, our state and my fellow legislators to join me in ensuring these critical investments in oral health are in the final capital and operating budgets this year.