May 19, 2024

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California

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Priscilla Serrano did everything she could to keep her child’s teeth clean and healthy. She rubbed his gums twice a day with a finger brush when he was 3 months old. She brought him to the dentist before his first birthday. She weaned him off a bottle early, gave him healthful snacks, avoided juice, brushed his teeth twice a day, and even flossed for him.

But despite her best efforts, Daniel still developed two cavities before his 6th birthday.

“I was kind of devastated. You work so hard to prevent any of this, and then you see your child in pain,” said Serrano of Long Beach. “I was in denial at first. I was like, ‘No, I did a good job.’ But I finally accepted.”

At the time of year described by dentists as the scary season for teeth — a Halloween holiday laden with sticky, sugary treats — children’s dental care takes on a sense of renewed urgency. The stakes couldn’t be higher in California, where the health of little teeth is sobering.

A dental hygienist holds open the mouth of a stuffed animal so a young boy can learn good teeth brushing habits.

Dental hygienist Elizabeth Valdivia, right, holds a stuffed animal so that Armani Allen, 2, can learn good teeth brushing habits as he his held by his mother, Nicole Nelson, at the Children’s Dental Health Clinic in Long Beach.

(Allen J. Schaben / Los Angeles Times)

California ranks among the worst states when it comes to pediatric dental disease. A national survey from 2020-21 found that 14.8% of the state’s children ages 1 to 17 had decayed teeth or cavities in the past 12 months studied — ranking 47th out of 51 among all the states and the District of Columbia.

“We’re really pushing for prevention because we don’t want to go down the line of having cavities, oral pain, possible infection and spread of infection,” said Dr. Abrey Daniel, a dentist with the Oral Health Program at the Los Angeles County Department of Public Health. “Sometimes parents may just do a quick brush and not even notice that cavities are forming.”

Nationwide, more than half of children develop cavities by the age of 8, usually because of poor nutrition, bad hygiene habits or a lack of dental care. Other factors include drinking water without fluoride, inadequate saliva flow and genetics; even a child with good dental habits can develop cavities.

As with so many health issues, children from socioeconomically disadvantaged families are most at risk. The California Department of Public Health’s 2018-19 Smile Survey of third-graders found that children from communities of color and Spanish-speaking households are more likely to experience tooth decay. Latino children had the highest rates, with 72% having experienced some sort of tooth decay, compared with 40% of white children. Black children had the highest rate of untreated decay at 26% — almost twice the rate of white children.

Throughout the state, many low-income children have limited access to dental care, fresh fruits and vegetables, and fluoridated tap water, said Dr. Ryan Huang, the dental director at the South

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3 min read

The State Worker by The Sacramento Bee

Good Wednesday morning, and welcome to the Oct. 11 edition of the State Worker Newsletter.

Programming note: We’re still accepting title suggestions for the newsletter. If you’ve got one, send it to The Bee’s State Worker reporter Maya Miller at [email protected].

THIS WEEK’S BUZZ

State dental benefits haven’t increased in 40 years, retiree group says

Retired state workers are unsettled that California’s most comprehensive and popular dental plan only covers up to $2,000 worth of services each year.

That’s the same amount they were eligible for 40 years ago, according to the California State Retirees association. And, as one retiree points out, $2,000 barely covers half the cost of an average dental implant.

In the last eight months, retiree Geoff McLennan says he and his wife have undergone $12,500 worth of dental services. After a failed root canal, McLennan had to have an infected tooth surgically removed and replaced with an implant. His wife, Connie, had a rare form of tooth decay and needed a double extraction and surgical implants.

Only $3,500 of the couple’s costs were covered by their state dental plan, administered by Delta Dental of California.

“How can they call this a ‘benefit?’” McLennan said. “We’re having to use our retirement checks to pay for these high costs.”

The Rocklin resident was shocked when he learned from the California State Retirees that the maximum benefit hadn’t increased in nearly four decades. McLennan said he knew other retirees who were taking out loans and using credit cards to finance their dental work.

State workers and retirees who want a PPO plan — short for preferred provider organization, which generally provides the widest array of coverage — their only option is Delta Dental of California. The company’s three PPO plans max out after covering $2,000 worth of services ($1,500 for dependents).

The state of California has contracted with the company since October 1984 and “actively monitors plan utilization and engages with Delta Dental annually” to ensure competitive coverage options, according to CalHR spokesperson Camille Travis. McClennan questioned why the state wouldn’t choose to solicit more competitive bids from other providers.

Only about 5% of people enrolled in the state’s dental plan hit their $2,000 plan year maximum, Travis said, and more than half of enrollees use less than $400 worth of coverage. The $2,000 maximum is consistent with industry standards, Travis wrote, and 80% of Delta Dental of California’s portfolio offers less than that per year, according to CalHR.

Still, Larry Woodson, former health benefits chair of the California State Retirees, questions why the state isn’t able to offer a separate plan — with higher premiums — for people who know they’ll need more dental coverage.

Woodson met with representatives from CalHR in February to discuss the possibility of expanding coverage, but he hasn’t received a follow-up meeting since June. Woodson just recently retired from his position as health benefits chair.

“They were very cordial in meeting with us, and we appreciated that,” Woodson said of the retirees’

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Two California counties have issued new influenza and COVID-19 vaccination orders that incorporate dental offices and will consider outcome Nov. 1, as CDA first reported in the Oct. 6 member publication.

Regional wellbeing officers issued the orders to minimize the risk of infection and transmission of the flu, COVID-19 and RSV, notably to vulnerable men and women, for the duration of peak respiratory virus time. The new orders be a part of other people that are already in area in 6 counties and a few towns.

As component of the orders, businesses are demanded to build or carry out a compliant masking or vaccination policy for the place of work.

A on a regular basis updated CDA useful resource lists all flu- and COVID-similar community health and fitness office orders.

San Luis Obispo and Yolo counties problem vaccination orders

Helpful Nov. 1, workers in dental offices and other health treatment facilities in San Luis Obispo and Yolo counties are required to be vaccinated as follows:

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  • Yolo County: Influenza vaccination buy productive by April 30, 2024.
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  • San Luis Obispo County: Influenza and COVID-19 vaccination buy helpful through April 30, 2024, and every single flu period thereafter until finally purchase is rescinded.
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The two new vaccination orders be part of present orders for possibly flu or the two flu and COVID-19 in the metropolitan areas of Berkeley and Pasadena, moreover San Francisco (metropolis and county) and the counties of Alameda, Madera, San Joaquin and Santa Clara.

Placer County’s get is related to the condition regulation requiring that staff in accredited well being treatment facilities either be vaccinated versus the flu or dress in masks in patient treatment settings.

Like the new San Luis Obispo order, a lot of vaccination orders are effective every calendar year all through flu time, and some neighborhood health and fitness departments outline influenza time in another way. For illustration, Madera County’s vaccination get is powerful annually from Nov. 1 to March 31.

Other towns and counties may well issue identical vaccination orders this fall, and counties with current orders might revise or extend them at any time.

Dentists should really familiarize on their own with local wellbeing office orders issued on their metropolis or county website. 

Latest county masking orders do not incorporate dental workplaces

CDA confirmed this week that masking orders issued by San Mateo and Sonoma counties do not consist of dental place of work personnel as was incorrectly mentioned in CDA’s Oct. 6 member newsletter.

CDA also confirmed before this thirty day period that masking orders issued by Alameda and Contra Costa do not contain dental office environment staff.

Nevertheless, as with nearby vaccination orders, employer-dentists need to be aware that counties may possibly amend their orders at any time, although other counties might issue new orders, as a San Francisco Chronicle write-up notes.

See CDA’s resource Nearby General public Health and fitness Office Orders Related to COVID-19, Flu for links to all present-day orders. Relatedly, read “Flu season starts: In

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3 min read

Right after federal funds are factored in, the condition will be ready to spend north of $35 billion, explained Jennifer Kent, a previous administration formal who helped the coalition suggest a composition for the tax.

It would be the premier-ever financial commitment in Medi-Cal, California’s Medicaid program.

“We’re attempting to provide a Medi-Cal plan that is the sizing of some states’ total populace,” stated Linnea Koopmans, CEO of the Local Wellness Designs of California, who was aspect of the coalition. “It requires an financial investment of this magnitude to have a significant impression.”

To pull it off, physicians and overall health programs, hospitals and arranged labor, unexpected emergency providers providers, safety net clinics and Prepared Parenthood all experienced to get driving a single proposal although balancing the governor’s need to have to place money in the point out coffers and the Legislature’s motivation to devote on constituent priorities like holding hospitals open up.

They did it by meeting for two hrs each and every 7 days due to the fact November, debating spending information at the headquarters of the California Healthcare Association over lunch, where by they stuffed the convention area whiteboards with calculations. Dustin Corcoran, the CEO of the clinical association who chairs the coalition, stated he’s even had goals about the tax.

“There was a ton of sausage producing,” Corcoran said. “It’s not often pleasant or enjoyment, but we landed in a location we can be actually proud of.”

Wellness designs will be taxed dependent on how quite a few men and women they deal with, and that revenue is utilised to leverage billions far more from the federal governing administration, all when passing practically no expenditures on to people. Traditionally, these taxes on managed treatment ideas — the MCO tax — have been swept into the state’s general fund, employed to stability the budget anytime situations obtained challenging.

But this year, just about each and every well being treatment advocate and elected formal in the point out was demanding the revenue keep in the health and fitness treatment program. California has included thousands and thousands extra people today to Medicaid in current decades, and is including additional benefits as the condition overhauls the plan. But there are not more than enough physicians to see all individuals new customers. The coalition pushed tricky for the condition to stage in and elevate reimbursement prices so that extra physicians will deal with Medi-Cal people.

There require to be medical professionals to see individuals just before they get to the unexpected emergency area, Corcoran explained.

“The MCO tax in and of itself is not likely to be a panacea for all of the shortcomings of Medi-Cal program,” Corcoran stated. “But it can go a extended way in addressing these historic inequities.”

At a single stage, the Newsom administration needed the bulk of the income to go into the standard price range to fund present priorities in Medi-Cal, like increasing the application to suitable undocumented immigrants. In May possibly, he outlined a

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Knowledge: County Health and fitness Rankings Map: Kavya Beheraj/Axios

Nearly all Bay Region counties earned a “optimum” rating in an once-a-year position by the College of Wisconsin Populace Health and fitness Institute.

  • Marin County ranked most effective in California in general and San Francisco County seventh.

Why it issues: The data is so rich that even large-scoring communities can come across weak spots to tackle, usually by resolving difficulties that may not straight away appear related to health these as inadequate housing, long solo commutes and even small voter turnout.

  • It really is made to be a resource to assist determine in which to invest resources.

How it performs: The yearly rankings crunch “wellbeing results” facts — these types of as premature loss of life, small birthweight and self-reported psychological and actual physical well-remaining — together with “health variables” — many inputs that correlate to overall health results.

  • Some elements are right connected to health and fitness, these kinds of as the range of dentists in a group or the charge of sexually transmitted infections. But some others are indirectly tied to bodily wellbeing, these as social ties, economic health and the physical environment.
  • More healthy counties are inclined to have far better access to information and facts, by issues like very good broadband, libraries and nearby information outlets, as nicely as properly-funded universities and parks.

What they’re indicating: “The place you will find an opportunity for modify is in all those overall health aspects,” Ericka Burroughs-Girardi, investigate software coordinator for the project — referred to as County Wellness Rankings & Roadmaps — tells Axios. When wellbeing aspects go up, health and fitness rankings tend to observe.”

  • The investigation includes information-backed approaches to deal with precise challenges, like little one care subsidies to aid shut revenue gaps, or supporting group gardens to promote physical exercise and much healthier having.

Zoom in: San Francisco experienced two-thirds much less liquor-connected driving fatalities than Marin, San Mateo or Alameda counties, but a great deal greater fees of sexually transmitted ailments.

  • San Francisco also has a far better provider-to-men and women ratio of most important care medical professionals, psychological wellness vendors and dentists, in comparison to people three counties.

Zoom out: California’s lowest rated counties for wellbeing are Trinity, Siskiyou and Lake.

The intrigue: Great wellness can influence the alternatives folks have, irrespective of whether to earn a living or do factors that support them experience very well. “It can be a comments loop,” Christine Muganda, details and analytics staff direct for the research, tells Axios.

  • “If we want healthier communities to turn out to be the default, we need to have to imagine about removing limitations,” she explained.
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