State pushed to restore dental aid

Groups petition Lansing that canceling Medicaid benefit is health risk for the poor

Kim Kozlowski / The Detroit News

Advocates for the disabled, poor and elderly say the state needs to restore Medicaid dental benefits before more people suffer or another person dies.

"We've got to start to thinking about these policy decisions and how they affect real lives, not just what they represent in budget numbers," said Sharon Parks, president and CEO of the Michigan League for Human Services.

Gov. Jennifer Granholm eliminated dental benefits to adults in July to help shore up the $1.3 billion deficit in last year's budget. They weren't restored in this year's budget, so only emergency dental work is now paid for by Michigan's Medicaid program, even though advocates argue that dental care is essential to good health. Before the cut, the program paid for routine exams and fillings. Research has shown that dental services are essential to good health.

Since the governor's cut, a disabled woman died, and another disabled woman filed a class-action lawsuit, demanding that the state restore the services.

This week, the Michigan League for Human Services plans to send a letter of outrage to lawmakers that is signed by more than 30 advocacy groups.

Gov. Jennifer Granholm was pained by the cuts, but "we simply are not going to be able to fund everything that we have funded in the past," said Liz Boyd, the governor's spokeswoman.

Granholm will continue to fight for benefits for the state's neediest citizens, Boyd said. But she added that Michigan's state revenues are the lowest in more than 40 years, when adjusted for inflation.

Death tied to aid cut

This is the second time that a state budget crunch has led to a cut in dental benefits for adults on Medicaid, one of the largest state programs and fastest growing. In 2003, adult dental benefits were eliminated but they were restored in 2005.In 2003, the Medicaid caseload was 1 million and has reached about 1.7 million. The number of people who need Medicaid dental benefits is expected to grow.

"People's incomes are dropping, they are becoming uninsured, and they are qualifying," said Janet Olszewski, director of the Michigan Department of Community Health. "It's a real statement about what's going on in this state with the economy."

State revenues have dropped, leading to billion-dollar state budget deficits. Reducing dental services for adults saved Michigan $1.4 million last year and $5.2 million this year.

But some advocates say the savings came at a steep price.

They point to the October death of Blanche LaVire, a mentally disabled woman who lived in a northern Michigan group home near Alpena and needed dental surgery because of advanced gum disease. She was scheduled to have the surgery in a hospital before Medicaid dental benefits were cut, said Thomas Veryser, executive director of Michigan Community Dental Clinics, which serves Medicaid patients in public health clinics, including one where LaVire got care. But the surgery was canceled after LaVire, 76, contracted pneumonia.

When she was well enough, dental benefits were cut. By the time documents were assembled to show state Medicaid officials that the surgery was a medical emergency, she had died.

"It should have never happened in this time and day and age," said Lillie Young, LaVire's younger sister.

But James McCurtis, spokesman for the Michigan Department of Community Health, said Medicaid officials weren't contacted to pay for services after the benefit was cut.

LaVire also may have had underlying health problems that contributed to her death, McCurtis said.

Even so, care should have been rendered and payment sought later, he said.

"If you are a health care provider, you treat a patient first and ask questions later," he said. "You don't try and get all this approval."

But advocates say the dentists were going to donate their services to the woman, but she needed to get the work done in a hospital, which had to get Medicaid to authorize her stay before she was admitted.

They also counter that dental benefits should not have been cut.

"For many in the population covered by Medicaid, dental disease is on a continuum of relatively being controlled," Veryser said. "Without access to preventive and restorative services, the dental health of this population deteriorates precipitously, resulting in unnecessary pain, suffering and even death."

Poor oral health has risks

The state can cut the benefits because Medicaid dental care for adults is optional under federal rules.

But when that rule was made 40 years ago, it was unknown that people could die from dental infections, Veryser said. It was also unknown that poor oral health can lead to other health problems such as cardiovascular disease, difficulty in controlling diabetes and low infant birth and infant death.

Research has shown that bacteria from gum disease can travel throughout the body, which reacts by producing chemicals that creates or exacerbates diseases, said George Taylor, a dental professor at the University of Michigan.

"Dental care helps to prevent and treat cavities," Taylor said. "But good oral health contributes to better overall health."

The state shouldn't be able to cut dental benefits for those who need Medicaid for their health care, said Anita Schrader, a Manistee woman who suffers from multiple sclerosis. She filed a lawsuit last month that she hopes will become class-action suit, demanding the Medicaid dental benefits for adults be restored.

Schrader, 50, needs to see a dentist to repair chipped teeth, loose cavities and other dental problems.

But since she has been battling breast cancer, she was unable to see a dentist before the benefit was cut.

"I am hoping and praying they get it put back because if I run into a toothache or maybe a tooth needing to be pulled, I really don't know what to do," Schrader said. "We can't do without something like that."

kkozlowski@detnews.com (313) 222-2024