Category Archives: Dental Health

Mental Health: The Next ‘Inconvenient Truth’

Picture1000words(177x160)

Could be a friend, relative, or another shooting. Might be hereditary, or from disease, substance abuse, head trauma, PTSD, or some other cause. Regardless of the who and the why, mental health care can no longer be pushed aside. [It reminds me of the debates around the impact of second hand smoke and dental health.]

The financial impact is huge, requiring both new facilities and staffing, so the need to legislate mental health treatment is not a surprise. The #Affordable Care Act was instrumental in legislating insurance coverage. State laws are inconsistent, but most have three forms of court-ordered treatment: (CLICK HERE for state specific info):

    1. Emergency hospitalization for evaluation (aka “psychiatric hold” or “pick-up”)
    2. Civil commitment – inpatient
    3. Civil commitment – outpatient

#Healthcare employment is already stretched thin from decreasing supply (retiring professionals) and increasing demand (aging population). Adding Mental Health positions will exacerbate the problem as employers seek #Registered Nurses, psychologists and clinicians specializing in psychiatric, mental health, behavioral health, chemical dependency, and addiction, as well as counselors, social workers, chaplains and parish nurses. Proving once again that healthcare is #1 for people seeking a long term career with growth opportunities and variety.

To learn more, check out these national professional associations (and Washington State chapters):

To see current job openings in Washington state:

 

The solution to ‘Dental Deserts’ is not complicated.

Dental health is a critical component of medical health. That debate is over. Community Health Centers (CHCs) have understood this sooner than others and intentionally offer dental services alongside the traditional medical services.

Our federal Critical Access Hospital (CAH) program’s sole purpose is to ensure our rural communities have access to medical care. [CAHs are reimbursed by Medicare, on a reasonable cost basis, for applicable patients and services.] Why doesn’t the CAH program include dental health? It’s a stroke-of-the-pen solution to our Dental Deserts!

In 2013 the Minnesota Legislature changed their Critical Access Dental Payment Program (CADPP) to include criteria to designate two additional eligible dental practice types. In 2011 the Kansas Legislature passed a law allowing rural hospitals to employ dentists and provide dental services to their population, and launched a financial impact study of serving their Dental Deserts. State-by-state solutions shouldn’t be needed.

One might hope the ACA will fix this since, after all, it’s really only an insurance/reimbursement problem, right? The ACA solution could provide ~8.7 million more children with some dental benefits, but the adult population would need to be on Medicaid to receive any dental benefits.

Even if the ACA won’t mandate dental care, the CAH program could still encourage ($) CAHs to offer dental health services similar to the CHCs. I don’t see an argument against providing dental health services at critical access hospitals. Isn’t preventative medicine fundamental in the Patient Centered Medical Home?