Speech

Speech to New Mexico State legislature, prepared for ACC Consultants

ACC/Mira Legislative Finance Committee Speech

(Introductions)

We’re here for two reasons today. One is to tell you about our program, which we will do shortly. The other, though, is to thank you -- Thank you for enabling us to improve the oral health of several thousands of children and elderly adults in your communities and elsewhere in New Mexico during the past six years.

Thanks to our state legislators, ACC Consultants and Mira Consulting have been able to improve and protect the oral health of indigent populations in 28 communities throughout New Mexico. Our mobile dental units deliver much-needed care to underserved children and elderly adults alike, most of whom have nowhere else to go for care. New Mexico can be proud of these accomplishments.

To fully appreciate the impact of ACC and Mira on the oral health status of New Mexico, it’s important to understand the extent of oral disease, particularly among the poor.

Children of poverty have nearly five times more dental decay than children with adequate resources, and yet they receive only a fraction of the care. Aggravating the problem here in New Mexico is the state’s extreme poverty levels, which are the highest in the nation. More than one-fourth of all New Mexico children live in poverty, and more are uninsured -- two out of every three -- than anywhere else in the nation.

Half of all children in this country now reach adulthood without ever having a single cavity. And yet, according to a recent survey, two out of every three children in New Mexico have experienced dental decay. More than one-third of them had active decay at the time of the survey. One in ten had never even been to a dentist. Ever. And one in twenty needed dental treatment immediately.

Older New Mexicans in poverty are particularly vulnerable. For every adult without medical insurance, there are three without dental insurance. And yet dental disease is among the most common of all afflictions.

The inability to pay for dental care factors prominently in these statistics. Compounding the problem are the shortage of public health providers, the lack of transportation, and an inadequate understanding about the importance of preventive and routine oral health care.

Why is oral health so important? Quite simply, oral health is essential to one’s general health and well being. It means freedom from dental pain and disfigurement, keeping one’s natural teeth throughout life, and avoiding infection that can compromise overall health. It’s the ability to chew adequately and to speak properly. And it’s the desire to smile.

Oral health results from the wise investment in preventive dental services and early treatment, to avoid the costlier consequences of neglect. Investing in good oral health is our goal.

As Medicaid providers, ACC and Mira deliver preventive and restorative dental treatment to the people who need it the most: New Mexico’s indigent children and the impoverished elderly in rural areas. And we do so in an efficient, convenient and cost-effective manner -- through the use of mobile dental equipment.

ACC has been serving New Mexico since 1995, and Mira, since 1996. We deliver care in [#] facilities in 28 communities. These include nursing homes, assisted living and adult day care programs, adolescent treatment centers, correctional facilities, and schools.

Within the 78 nursing homes we serve, nearly 5000 geriatric patients receive oral health care from one to four times per year. Biannually, more than 8000 children receive dental procedures through more than 200 school-based programs in five school districts.

In all of our programs, preventive care is a vital component. Prevention saves time, money, and teeth. Through routine dental examinations, we detect oral disease in its early stages, when treatment requirements are modest and relatively inexpensive. We apply topical fluorides to strengthen tooth enamel to help prevent decay. We provide periodontal evaluations and dental cleanings to protect the integrity of the supporting tissues, so that the natural teeth may be retained. And we conduct oral cancer screenings to detect premalignant and cancerous lesions earlier than they might otherwise be discovered. This allows prompt treatment and a much more promising prognosis.

Among our most effective and cost-saving preventive procedures are the dental sealants we apply to children’s teeth. This material coats the teeth before they can decay. Even fifteen years after the proper application of sealants, 100% of the tooth surfaces remain decay-free. Still, children who need sealants the most are the least likely to get them. And their unsealed teeth are eight times more likely to decay.

As a result of our preventive services, thousands of New Mexicans have been spared the anguish of dental decay, severe infections, immeasurable pain, dental disfigurement and tooth loss.

ACC and Mira provide comprehensive treatment, as well. Children and geriatric adults alike receive dental fillings and extractions in a timely manner. Many adults also receive dentures, partial dentures, and biopsies of suspicious lesions. Edentulous patients are given oral cancer screenings, as well as denture cleanings and labeling.

Beyond direct care services, ACC and Mira coordinate emergency care as needed. If we can’t locate a local provider to deliver emergency treatment, we send one of our providers to respond. We coordinate with other Medicaid providers throughout the state to assist us, as needed. And we refer patients to specialists, whenever necessary.

How important are our services? Just consider our patients without them. Imagine an impoverished child, suffering from an abscessed tooth or rampant decay, his face swollen with infection. Or an elderly resident in urgent need of extractions, perhaps dentures, just to be able to chew. What if these individuals, and others like them, were in excruciating dental pain, but had nowhere to go. Without your support, thousands of New Mexicans would suffer the consequences of untreated disease and continued neglect.

In most of the communities served by ACC and Mira, there are no other dental Medicaid providers -- no options for our Medicaid patients in need of dental treatment. And without preventive services, their conditions can only worsen. For thousands of school children and geriatric adults alike, ACC and Mira are their only source of dental services. They have nowhere else to go.

Beyond having access to care, people with limited mobility find our on-site services to be far gentler, convenient and efficient. Severely disabled patients would otherwise require transport via ambulance for needed dental treatment elsewhere. This is an extremely costly and inefficient approach. Off-site care would further compromise patients’ health and delay treatment.

With our mobile dental equipment, access to care among our young beneficiaries is simple and efficient, as well. Treating them at their schools ensures that they receive timely care and with only minimal disruption to their educational activities.

Uniquely suited to mobile dentistry, # adolescent treatment centers and correctional facilities also benefit from ACC [and Mira?]. Imagine the challenge to the State if it had to arrange off-site care to these populations. Security issues would only compound the difficulty -- along with the expense -- of providing routine and emergency treatment to these incarcerated populations.

We deliver this wide range of services to all of these populations at a remarkably low cost. For only $88 per child per year, we provide dental services ranging from preventive procedures only to comprehensive care, depending on the school district. Our dental sealant program alone saves XX dollars for every dollar spent. This program translates into a major savings of Medicaid dollars.

For adults, the cost per capita for comprehensive care is approximately $350-$400 per year. Compare that to your typical dental bill, and you’ll appreciate that we can provide a patient with complete preventive and restorative treatment at a cost that would barely cover that of a single dental

Money is saved in other ways, too, by treating these patients on site and on schedule. The routine care our patients receive through ACC and Mira helps prevent disease from progressing into far more serious, complex and costlier conditions. This greatly reduces the need for emergency transportation of patients for dental treatment in the private sector. The savings of Medicaid-funded travel expenses by ambulance alone are immense.

ACC and Mira operate on a tight budget to minimize expense and maximize productivity. And, of course, our programs return money to the State in the form of gross receipt and payroll taxes.

Another advantage of the ACC and Mira programs involves dental manpower. Despite the severe and worsening dental provider shortage, we recruit and maintain a dedicated staff of highly qualified professionals. We employ more than [70 – increase due to Mira staff?] dentists, hygienists, assistants and support staff.

Furthermore, both Mira and ACC have temporary staffing agencies that contract with the New Mexico Department of Health, to supply dentists, hygienists and assistants to the state-operated programs.

Come see what New Mexico does to improve and protect the oral health of its citizens in need. We invite you to join us when we visit the facilities in your communities. And read what your communities say about us in this report.

Please maintain ACC and Mira’s level of funding so that we can continue to serve these beneficiaries – the children and the elderly with nowhere else to turn. You can be proud of your decision to continue to support this vital program.

Thank you.