As reported by the Connecticut Post, March 5, 2007.

HUSKY Care Boost Urged in Hartford

By Gail Brown

HARTFORD — The little boy's face was so swollen his left eye was sealed shut.

He sat in Dr. Andrea Beltzner's dental chair at the Connecticut Children's Medical Center, terrified to open his mouth.

Beltzner, in testimony before the General Assembly's Public Health Committee Monday, said that when the 3-year-old finally allowed her to pry his mouth open and examine his teeth, she could see three crater-sized cavities. He had not one, but several others so large that the roots of his baby teeth were infected.

"I knew he would return" to the dental center's emergency room, Beltzner said. "And the saddest thing is that this boy's parents knew he had cavities, but couldn't find a dentist who would take their HUSKY insurance."

Beltzner was one of a cadre of Connecticut dentists to urge legislators to hike what the state pays dentists who treat youngsters on HUSKY, a joint federal and state Medicaid program that provides medical coverage to 267,000 of the state's poorest children.

Beltzner said the Connecticut Children's Medical Center, a safety net facility in Hartford, is so inundated with dental emergencies it rarely has time to provide routine dental care to new pediatric patients. The last time the Legislature gave dentists who treat indigent kids on HUSKY a raise was 1993. It set the reimbursement rates to a level that was acceptable, at that time, to 80 percent of dentists.

However, reimbursements have stayed frozen at that level for 14 years, falling out of step with inflation and dental-care costs. HUSKY rates are now in the 10th percentile: what 10 percent of dentists would consider acceptable.

The Connecticut State Dental Association, the Connecticut Oral Health Initiative, the Greater Hartford Legal Assistance, the University of Connecticut School of Dentistry and advocates for the poor testified that the state should raise its reimbursement rate to the 70th percentile.

They said the state also should adjust reimbursement rates to reflect cost-of-living increases, to keep pace with inflation.

Connecticut pays $22 a month to provide dental coverage for each state employee.

By comparison it allocates only about $8 per month for kids covered by the HUSKY dental plan.

If the General Assembly approves the oral-health access bill, now in the Public Health Committee, the state's Department of Social Service would pay about $14 per HUSKY enrollee.

Nearly doubling what it now pays dentists would entice about 400 more of the state's 3,000 dentists to accept HUSKY patients, according to the Connecticut Oral Health Initiative and the Connecticut State Dental Association, which surveyed dentists.

According to the Connecticut Oral Health Initiative, if each of those dentists saw just one HUSKY patient per week, an additional 20,000 Connecticut youngsters who have not received regular dental care would get treatment.

"I'm a pediatric dentist in private practice, together with my partners we see over 700 HUSKY patients" each year, said Dr. Fred Thal, of New Britain. "We find it necessary to limit the number because the fees are so low they don't even cover our overhead."

Dr. Arvind Shaw, executive director of Generations Health Care Center in Windham County, railed at the legislators.

"There's a lack of priority. By not paying its fair share, the state is taking a page from the Wal-Mart manual. It's like our state's policy is to turn its back on its kids," Shaw said. "Do we not have a moral obligation to provide for these kids?"

In a state Department of Social Services investigation, undercover officials called hospitals and dentists last November, seeking appointments for HUSKY patients. Seventy-five percent of the time, they were turned down.

"They were refused care in the state of Connecticut," said Senate President Pro Tempore Donald Williams Jr. "That's outrageous, that's unacceptable and we have to change that around.

"For dental care for children, it's even worse," Williams said. "Only 4 percent of the dentists in Connecticut accept HUSKY patients."

Summing up the dentists' argument, Dr. Jeanne Strathearn, of Hartford, said that for every HUSKY patient she and her colleagues treat, they lose 30 to 90 cents on the dollar, depending on the service they provide.

"No business can sell its product below cost very long," Strathearn said.

Capitol reporter Ken Dixon contributed to this report.