Grant Project Title
Advancing Oral Health Equity for Older Adults Through Federal Policy
Grantee Address

Justice in Aging
1444 Eye St. N.W.
Washington, DC
United States

Justice in Aging is a national non-profit legal advocacy organization that fights senior poverty through law. The organization provides training and free resources to professional advocates and legal aid attorneys representing older adults. Additionally, Justice in Aging elevates issues raised by a disability and aging network by advocating at the local, state, and federal level to fix those issues.

Justice in Aging has been a funded partner of CareQuest Institute since 2018, working alongside other partners such as Families USA, Community Catalyst, and Center for Medicare Advocacy to advance dental benefits in Medicare. Justice in Aging brings a unique perspective to this work due to its engagement not only with advocates for the aging community but also the disability population. As a result of the organization’s commitment to diversity, equity and inclusion, Justice in Aging has implemented a Strategic Initiative to Advance Equity, which aims to center its advocacy strategies and projects on issues that directly address systemic inequities faced by older adults of color, older women, LGBTQ older adults, older adults with disabilities and older adults who are immigrants or have limited English proficiency. In 2021, Justice in Aging was key partner in bringing national attention to the need for a comprehensive dental benefit in Medicare Part B, and used its tools and expertise to both advocate and educate state and local advocates about the impact and importance of a benefit.

In 2022, Justice in Aging’s grant will continue the existing advocacy work around Medicare and partnership building, as well as embark on a new body of work to expand available oral health services through Medicaid Home and Community-Based Services (HCBS) Waivers.

In order to maintain a steady drumbeat of support for the addition of dental benefits to Medicare, Justice in Aging will educate federal policy makers, national partners, and the aging and disability network about Medicare and the most effective ways to achieve comprehensive, equitable dental benefits. Justice in Aging will develop and disseminate written resources regarding Medicare policies and adding comprehensive dental benefits to Medicare Part B and will develop and conduct one online training for advocates around older adults and oral health. Justice in Aging will also participate in and provide expertise to the Medically Necessary Oral Health Coalition and Medicare Oral Health Coalition related to policy efforts.

Justice in Aging will also continue its efforts to engage aging and disability advocates in oral health work. This will include bringing oral health policy issues to the table in national conversations with the Leadership Council of Aging Organizations, Coalition for Constituents with Disabilities, and the Disability and Aging Collaborative.

New in 2022, Justice in Aging will explore and develop strategies to expand access to oral health services through Medicaid Home and Community-Based Services (HCBS) Waivers. HCBS Waivers are broadly defined and allow states to create programs and provide services to target groups who are at risk of institutionalization. Populations served under these waivers can be defined as eligible by age or by a particular diagnosis. States can offer a variety of unlimited services to a specific population through an HCBS Waiver program. Commonly covered under these waivers are case management, home health aides, and adult day health services. Justice in Aging has provided technical assistance to states in developing their HCBS Waivers, but have not yet explored the addition of dental services to these waivers.

With this grant, Justice in Aging will work with consumer-facing organizations within OPEN to develop template language that state oral health advocates can present for addition into state HCBS Waivers. This language could include covered benefits beyond those in the Medicaid state plan (e.g. additional cleaning, periodontal treatment, silver diamine fluoride, etc.), that needed anesthesia services could be billed as oral health services, enhanced reimbursement to providers who serve populations in waivers to account for extra time it takes to serve the population, and increased coordination between aging providers, dental providers, and health providers.

The total request for this proposal was $120,000. The majority of the budget for this request, $100,000, is allocated toward staff and administrative time for the project. Other line items include travel expenses and communications expenses. This request represents about 3% of the organization’s overall budget.

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