February marked nine years since the death of 12-year-old Marylander Deamonte Driver. His death made national headlines because he was a child who died of a toothache. And he died of a toothache because his family was poor, in and out of homelessness and uninsured, and could not access dental care.
Health Care for the Homeless Dental Director Tom Stack recalled Deamonte’s story while recently testifying before the Maryland Senate Finance Committee on the importance of access to dental care. It was the anniversary of Deamonte’s death—February 25—and Stack noted that the outcome for Deamonte today would likely be no different; it just wouldn’t make national news because he would no longer be a child. Despite improved access to dental care for young people under Medicaid expansion, very little in the way of adult dental care is covered by insurance today in Maryland.
That dental care is largely uncovered by insurance is a huge barrier to overall health and health care for vulnerable individuals and families like Deamonte.
The dental programs at our Downtown and West Baltimore clinics are currently the only two dental operatories in Maryland that provide care exclusively to people experiencing homelessness. And for most of the people we see, this care is not reimbursable through insurance. We provide the care “because we have prioritized[it] for our patients as an agency,” Stack told legislators. But the demand is much greater than our ability to meet it, and we raise significant private dollars to help fund it.
“In 2015 our dental clinic saw 977 unique patients, and 559 of those patients were enrolled in Medicaid. Our total costs to the agency were $627,000, and our total reimbursement through Medicaid was $56,000. We operated at a $440,000 loss,” Stack testified. “This is what it looks like financially to truly provide care to all, regardless of insurance status or ability to pay. And even with this investment, we are only able to provide comprehensive dental care to about 10% of our total patient population.”
Dental care at Health Care for the Homeless is funded primarily by public and private grants and the support of our compassionate community. But without adult dental coverage under Medicaid in Maryland, access to this lifesaving resource will remain out of reach for so many like Deamonte Driver.
“Dental care is health care,” Stack told the lawmakers in the room. And he got a lot of nods. Now we just have to turn those nods into action. The legislation he testified on was to create a task force to study access to dental care in Maryland. Maybe we could skip the study and get straight to work at getting dental care covered under Medicaid in Maryland. To give our Dr. Stack the last word:
“We can do better.”