Grant Project Title
Increasing Access to Dental Care through Medicaid Advocacy
Grantee Address

Pennsylvania Coalition for Oral Health
PO Box 242
Delmont, PA
United States

The Pennsylvania Coalition for Oral Health (PCOH) is a diverse group of leaders from across the state from schools of public health, philanthropic organizations, businesses, dental organizations, health insurance firms, advocacy organizations, state agencies and other champions. This request was submitted under the Strengthen Community Voice and State Advocacy subprogram within the Advancing Equity through Oral Health fund.

PCOH serves as the leading voice to improve oral health across the state. The organization's mission, led by oral health advocates and professionals, is to unite stakeholders to advance advocacy, policy, education, and innovative approaches for the improved oral health of all Pennsylvanians. The organization has served as a key participant in oral health policy development and advocacy within PA since 2017 and continues to increase its visibility and role as a leader on oral health issues. Among its several priorities, PCOH expresses deep commitments to supporting workforce development opportunities and improving access and care delivery for the state's most vulnerable populations.

The work proposed aims to improve oral health outcomes through policy change and community outreach. First, PCOH plans to work with its existing and new partners, as well as an identified legislator, to educate local policymakers about the impact of repealed Medicaid coverage with the hope of introducing a bill to repeal PA's 2011 Medicaid coverage cuts in the latter part of 2022. The COVID pandemic, with its financial and stress burdens, led to a rush of dental retirements and dropped participation in Medicaid plans for dentists, and this has exacerbated the Medicaid issues even more. A significant consequence of these cuts to coverage has been the increased emergency department use for preventable oral health issues and, to this end, the organization will work to engage community-based organizations and consumers to collaboratively identify key oral health barriers and collect stories about the challenges to accessing oral health care. Among their partners are organizations such as Put People First! PA (PPF-PA) and the PA Health Access Network. These partners will support by coordinating patient story collection and ultimately hosting an Oral Health Advocacy Day at the state capital to raise awareness of the opportunities around a Medicaid Adult Dental Benefit before the end of this calendar year. In early 2022, PCOH continued its engagement with state legislators and discovered a renewed interest among them in relation to dental reform that the organization and its network plan to capitalize on through educational efforts with policymakers and policy development in partnership with consumers and community-based organizations.

Additionally, with upcoming changes to the HealthChoices network, which is the Medicaid Managed Care Organization (MCO) system in PA (set to take effect on July 1, 2022), PCOH will be developing and distributing one-page briefs that summarize these changes and their impact for Medicaid-beneficiaries throughout the state who may be affected. In Pennsylvania, there will be a shift from combination of one statewide MCO and regionally focused MCOs, to four statewide MCOs (the original state-wide MCO will be eliminated). This transition will affect a significant number of MCO members and providers. As the MCOs are introduced to rural areas of PA, PCOH will address a lack of patient awareness that could result in barriers to care and increased costs as patients and providers may not be able to continue their typical care routines/schedules. PCOH will be a key entity in developing clear and organized language and materials that will support a smoother transition process.

Much of this work is currently underway and PCOH has set clear data collection goals to supplement future efforts to repeal the Medicaid cuts and institute a renewed Medicaid Dental Benefit. PCOH is working with the Legislative Policy and Research Officer (LPRO) to review draft legislation and make informed recommendations using data that include emergency department use for dental issues. The organization will also leverage the existing network adequacy maps and providers lists provided by the PA Department of Human Services (DHS) as well as annual Medicaid claims utilization rates by code and county to inform and guide their outreach to different areas of the state. PCOH has strong relationships with the state dental association and primary care association that will also support the dissemination of their one-pager summaries and their development of a policy advocacy approach to Medicaid through the end of the year. Finally, the work around community awareness building will focus primarily on outreach to providers and patients at Federally Qualified Health Centers and Community Health Workers who work most closely with historically marginalized individuals and families in the state.

Outside of the specific grant activities proposed, PCOH will also be engaged with a broad set of state and community-based partners to learn more about the specific barriers impacting access to quality oral health care for unique marginalized populations. There is a Pennsylvania Medicaid Dental Benefit Workgroup in place that will conduct on-site surveys of consumers at both a Mission of Mercy event in Pittsburgh and through more targeted surveys afterward. Additionally, as part of a separate project funded through HRSA, PCOH will be publishing a white paper and holding several webinars to address the current oral health workforce crisis in PA. The plan moving forward is to use this data to assess the strength of provider networks across PA and to promote Medicaid participation among providers.

Most of the budget of $48,300 would go toward staff salaries with the remaining funds being applied to the communication and marketing costs, meeting expenses, a subgrant to PPF-PA and incentives for survey participants. Overall, this funding at this level would constitute 7% of the organization's budget.

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