Public health care delivery system is the second main way to access U.S. dental services. It provides urgent and basic oral health care for millions of Americans who face barriers in accessing the private system. Choosing between the two systems often depends on the person’s employment status, insurance coverage or ability to pay. People deciding to access the public health system often have more unmet oral needs and may come from various underserved groups. The main component of this safety net is a network of community health centers that offer services at reduced or no cost.

Federally Qualified Health Centers: FQHCs enhance the provision of primary care services in underserved urban and rural communities. These clinics are located in high need areas and are open to all residents regardless of insurance status. They focus on providing comprehensive primary care services to low income populations in a culturally appropriate manner. In Nebraska, there are now seven FQHCs that serve over 60,000 patients and all centers offer dental services which represents about 28% of their patients. These clinics produced four times as much preventive care as restorative, emergency and other dental services. The value of this care was nearly 8.5 million in 2015. The annual activities of these Health Centers are reported through the Health Center Association of Nebraska.

Medicaid-CHIP: Medicaid-CHIP public subsidized health care plan through the government. The goal of these plans is to increase access to care for low income people, especially children. There are different types of programs under this type of insurance: Medicare, Medicaid and the Children’s Health Insurance Program. Nebraska is one of the few states to cover limited dental services for adults up to a $1,000 dollar limit per year to include exams, prevention, restorations and extractions.¹ Assisting eligible patients to enroll into these existing programs and to utilize these important dental benefits, will allow more of our underserved population in Nebraska to access the private or public dental care systems in the future. All children enrolled in Medicaid up to age 21 are entitled to the comprehensive set of health care services known as Early and Periodic Screening, Diagnostic and Treatment (EPSDT) aimed at low income infants, children and adolescents. These children receive age-appropriate screening, diagnostic and treatment services, including dental services, that are medically necessary to correct any identified conditions.

Safety Net System: Despite financial assistance programs efforts to increase access to care to dental homes through the private and public dental health systems, there are still thousands of Nebraskans who lack the resources to receive dental care on a regular basis. Many safety net components exist to help people who fall into these care gaps and may include: public or charity clinics, university clinics, individual dental professionals and organizations/companies that sponsor charitable events located throughout the state. Some of the largest safety net providers are the UNMC College of Dentistry and Creighton University School of Dentistry. Together they have a large professional workforce of hundreds of faculty and students that annually provide millions of dollars’ worth of free and reduced dental services to underserved populations.

Examples:

Mission of Mercy (MOM)-The Mission of Mercy (MOM) is a non-profit organization started in 2000 that works in partnership with the American Dental Association to address the needs of low income and uninsured dental patients.² Using volunteer dental personnel and donated equipment and materials, they have treated more than 170,000 patients and provided approximately $100 million worth of care.³ In 2005, MOM and the Nebraska Dental Association started in Norfolk and it has moved to a different location each year since. Field Clinics are set up in large community outreach settings with dozens of portable dental units and hundreds of volunteers that provide free exams, X-rays, cleanings, fillings, extractions and even dentures to the needy.

Source: Nebraska Department of Health and Human Service, Office of Oral Health and Dentistry; 2014.

Peoples City Mission Lincoln- The Peoples City Mission Medical Clinic opened in 2008 and provides health care to thousands of Lancaster County residents who are homeless or low income. Its primary purpose is to fill gaps in the existing medical network. Care is provided through group of volunteer doctors, dentists, students and other health professionals who work days, evenings and weekends to treat patients and provide referrals. In 2013, they had over 17,000 patient visits which made them one of the largest free clinics in the U.S. They also performed over 3,000 dental visits and provided more than $1 million worth of dental services.³ The clinic operates entirely on donations and does not accept cash, private or public insurance payments.

Sources:

1. Nebraska Department of Health and Human Service. Nebraska Medicaid Program Client Information. Retrieved Date: 03/12/2015. Available at: http://dhhs.ne.gov/medicaid/Pages/med_clientbook.a....

2. Missouri Mission of Mercy. Webpage. Retrieved Date: 03/18/2015. Available at: http://www.momom.org/.

3. Nebraska Department of Health and Human Service. Office of Oral Health and Dentistry; 2014.