G-2402-20184

The mission of Pennsylvania Coalition for Oral Health (PCOH) is to improve oral health for all Pennsylvanians by uniting stakeholders to advance advocacy, policy, education and innovative approaches. CareQuest Institute funding has supported PCOH’s work with state departments to incorporate oral health in State Health Improvement Plans and maintain a steady drumbeat for restoration of Adult Dental Benefits in Medicaid, repealed in PA in 2011. Currently, PA’s Medicaid program covers only dental procedures that are deemed “medically necessary”.

Following years of advocacy and conversation, a bill (HB1417) to restore the benefits legislatively was introduced and received support from the PA Department of Human Services (DHS). The bill successfully passed through the House of Representatives in late 2023 and is a step toward full restoration of adult dental benefits from approximately 1.3 million Medicaid members in PA. According to the proposal, there is growing bipartisan support for the restoration of dental benefits that can be sustained in the next year.

In addition to increasing access to care through this bill, PCOH anticipates the restoration of benefits will increase provider enrollment, which could be significant with intentional advocacy around expanding scope of practice for oral health professionals, such as public health dental hygiene practitioners (PHDHPs), who currently cannot serve CHIP enrollees.

With this opportunity in mind, PCOH will continue to partner with oral health advocates, clinicians, community members, and coalition members to advocate for improved Medicaid benefits while also advancing oral health equity through expanded school-based oral health services and the increased utilization of PHDHPs and Certified School Dental Hygienists (CSDH). These priorities were developed based on input from more than 1,000 stakeholders and creatively seeks to address ongoing gaps in access with solutions that will strengthen students’ knowledge and ability to secure care as well as benefit from expanded benefits in the future. By advocating for dental benefits, direct access to providers, reimbursement, and billing, PCOH hopes to create sustainable methods for other oral health providers, like CSDHs, to provide preventive services and education that improve the oral health system in PA.

The grant funding request for this proposal is $98,000. Of the requested amount, half will support four staff members supporting project coordination, communication, and evaluation. Other expenses included in the proposal budget were related to communication and marketing for schools to be engaged in the work, office supplies, and various dues and subscriptions that support PCOH’s legislative research, tracking, and analysis. Finally, the budget outlines three additional funding areas including compensation for nurse survey/focus group participants, the PA School Nurses Association, and a Report Writer for the anticipated publication highlighting learnings and policy recommendations. The requested funds represent approximately 14% of the organization’s overall budget.