HB 105-MEDICAID FOR ADULT DENTAL SERVICES 4:18:52 PM CHAIR WILSON announced that the next order of business would be HOUSE BILL NO. 105, "An Act relating to coverage for adult dental services under Medicaid; and providing for an effective date." REPRESENTATIVE ANDERSON moved to adopt CSHB 105, Version 24- GH1081\G, Mischel, 2/7/05, as the working document. There being no objection, Version G was before the committee. 4:19:20 PM CHAIR WILSON asked if any of the committee members had comments or questions. There were none. 4:19:52 PM DELISA CULPEPPER, Chief Operating Officer, Alaska Mental Health Trust Authority (AMHTA), testified in support of HB 105. She noted that the AMHTA is helping to fund the fiscal note for this. She commented: Dental services have been [an] issue for all four of our beneficiary groups for many years. We do fund some dental services through what we call mini-grants already, and we're noticing a trend over the years that the mini-grants are going more and more to provide basic dental services because there's no other funding for people who ... [are] Medicaid-eligible or lower income and aren't on Medicaid. But our funding for mini-grants isn't available in a timely manner the way people that have a dental emergency or are trying to prevent one would need. And so we've been very supportive of the department's proposal to invest in a more preventive action, realizing that it takes a little time up front to get people to a point where they aren't having these emergencies, but [in the] long term we think that it can eventually save us money and be a much more humane way to provide some of our beneficiaries with the treatment they need when they don't have access to other insurance for dental. 4:21:39 PM PAMELA HAWEK, Anchorage Neighborhood Health Center, testified in support of HB 105. She pointed out that there are two health center clinics, and a large population of the patients are underserved and underinsured, many of who are Medicaid-eligible. There's a huge gap in the dental care of the adults that are Medicaid-eligible, she commented. Currently approximately 30 adults a week are seen at the clinic, and because they are only eligible for emergency care, she said, "we're pulling a lot of teeth. We're doing very little restorative treatment." HB 105 would allow these patients to make appointments, have exams, and work on restorative dental treatment as well as preventative care. She offered to collect more information for the committee if the members would like. 4:24:07 PM DIANE DISANTO, Special Assistant to Mayor Mark Begich, Municipality of Anchorage, stated that the Municipality of Anchorage was in total support of this bill. She commented that this bill would expand Medicaid coverage to include preventative and restorative care. She noted that if dental care is not taken care of, it can lead to infection and chronic disease, so in the long run, this bill will save money. AMHTA has recognized access to dental service as a priority issue and are willing to commit funding, she said, and the Medicaid matching funds would apply as well, so the impact to the general fund wouldn't be too much. She said, "The city is working on other ways to look at helping the uninsured, and there's over 100 doctors that are now signed up to do pro bono work, and hopefully in the future we will have dentists." 4:26:13 PM RICHARD GREEN, Major, Salvation Army, testified in support of HB 105. He pointed out that the Salvation Army has operated a free dental clinic for the last 15 years to the uninsured working poor. Last year the clinic saw about 1,300 clients and provided 450 in-chair appointments. He noted that about 90 percent of the clients have no insurance at all. The Salvation Army dental clinic does not bill Medicare or Medicaid, he said, so "we're probably not going to receive any funds from this, but we see the bill as [meeting] a tremendous need for people who are in need of medical care and yet have no ability to pay for that." 4:27:50 PM GEORGE BIRD, M.D., Tanana Chiefs Conference (TCC), stated that TCC supports HB 105. He commented that the current Medicaid program has deficiencies in the way that it funds adult dental services; people need routine preventive dental care, not just emergency care. DENA SUMMER PEDEBONE, Tanana Chiefs Conference (TCC) reiterated that HB 105 would provide a valuable service to those in need. 4:29:55 PM TOM BORENSTEIN, D.D.S., Director of Dental Services, Southeast Alaska Regional Health Consortium (SEARHC), stated that access to dentistry in Southeast Alaska is limited for the underinsured and the uninsured. He pointed out that SEARHC currently delivers services through a federal grant to the uninsured in Haines and on Prince of Wales Island; the demand for those services is pretty large, he noted. SEARHC opened a clinic in downtown Juneau last year that provides dental services to homeless people where "we were oversubscribed the day we opened and we've applied for an expansion to that grant that provides those services," he said. He remarked that about four years ago, SEARHC began a children's dental health program in conjunction with the Denali Kid Care program, which has been able to bring pediatric dental specialists to a numbers of Southeast Alaska communities. Expanding these services to adults, he said, would be of benefit. 4:33:05 PM MARIE DARLIN, AARP Capital City Task Force, commented that the committee already had a letter from her in support of HB 105. She said, "[HB 105] is really definitely needed. It's a preventive aspect that we really need to look at, and saves money down the road." SUSAN PHIPPS, National Alliance for the Mentally Ill (NAMI), stated that she serves on the NAMI statewide board. The NAMI supports HB 105, she said. She mentioned that anxiety disorders cause people to grind their teeth, which can be harmful particularly when combined with certain medications. 4:35:51 PM CHAIR WILSON commented that, though this bill will add a lot to the Department of Health and Social Services budget, it will prevent other issues in the long run. She pointed out that there is a cap included in the bill. 4:37:15 PM REPRESENTATIVE ANDERSON disclosed a possible conflict of interest; he is on the fundraising committee for the Anchorage Neighborhood Health Center. REPRESENTATIVE ANDERSON moved to report CSHB 105, Version 24- GH1081\G, Mischel, 2/7/05, out of committee with individual recommendations and the accompanying fiscal note. 4:38:44 PM There being no objection, CSHB 105(HES) was moved from the House Health, Education and Social Services Standing Committee.