Dental care access and use for children ineligible for SCHIP and Medicaid

Overview: This research reviews dental care access and use among children enrolled in a public insurance program in San Mateo County, California called “Healthy Kids.” This paper analyzes data from 3 years of a 5-year evaluation of the Healthy Kids Program, including: responses to a parent survey of children enrolled in Healthy Kids, site visit interviews, focus groups, and dental claims/encounter data. The study population is children aged 0-18 years who are enrolled in the Healthy Kids program. These children are predominantly low-income, Latino, undocumented immigrants who are not eligible for Medicaid or SCHIP. Findings: While 72.3% of parents of Healthy Kids children reported their child has a usual source of dental care, only 56.9% of 13-18 years, 69.5% of 6-12 years olds, and 61.7% of 0-5 year olds had any dental service in a 12-month period. By way of comparison, for uninsured, Latino, 2-5 year olds in California, 55.4% had been to the dentist in the last year (CHIS, 2005). Of Healthy Kids children using dental services, 47.4% had more than 3 visits in a year suggesting they required more than preventive care. 12% of parents said there had been an occasion when their child needed dental care but did not go; however, for most, cost of care was not a barrier to going. Focus groups revealed parents find dental care access more of a problem than medical care access. Aligning and streamlining reimbursement procedures among public insurance programs may improve access to dental services for Healthy Kids participants.