DAYTON — Half of Columbia County’s adults haven’t had a dental checkup in over a year, but leaders are working to change that for this rural community.
Columbia County Health System is planning to build a dental lab, attached to Dayton’s Columbia Family Clinic, that will provide dental services to Medicaid patients by the end of this year.
The lab will see patients from Waitsburg, Dayton, Prescott and other nearby communities and is targeted for 100% Medicaid beneficiaries.
“The model that we have started with and have looked at so far anticipates having 2,100 visits throughout the year,” said Shane McGuire, CEO of Columbia County Health System, the hospital district that also includes Dayton General Hospital and the Waitsburg Clinic.
The construction project to add dental operatories, or rooms, to the medical clinic is expected to cost around $250,000 and is supported by the governor’s budget, he said.
“We are covering the equipment ourselves and, of course, operations,” McGuire said.
The lab will need $130,000 in dental equipment, and McGuire’s team will search for grants to assist with these costs, he said. The agency will also hire a dental aid, a dental hygienist and a dentist.
Columbia County has just one other dental office, Dayton Dental Care, the practice of Dr. Michael Strang. He does provide care for Medicaid patients, but residents used to have more options.
Before Dr. Norm Passmore retired several years ago, he also provided dental care for a portion of the county’s Medicaid patients.
Walla Walla’s Alder Family Dental, which purchased Passmore’s practice in downtown Dayton in 2015, discontinued services to Medicaid patients and closed the Dayton office after the dentist operating out of the rural office left the business.
“Currently dental clinics are challenged to provide care to Medicaid beneficiaries because of very low reimbursements that often do not cover costs,” McGuire said.
Facilities designated as rural health clinics, such as the Columbia Family Clinic, can perform dental care and receive a rate that is based on costs, not volumes or fee for service, he said.
“The problem with a lot of the for-profit dental offices is that they actually lose money on Medicaid beneficiaries,” McGuire said. “If they filled their practice with Medicaid beneficiaries, they’d likely go out of business.”
Rep. Skyler Rude, R- Walla Walla, said Wednesday at a local legislative forum that dentists such as Strang who accept Medicaid patients struggle to handle the patient load.
“Medicaid rates are below market,” Rude said. “It’s not practical for a private dental office to deal with 100% Medicaid patients, basically, and they’d go under in two seconds.”
Federally qualified health centers and rural health clinics and community health centers can be reimbursed by Washington state Medicaid.
“They have special services that allow us to provide dental services to Medicaid recipients, and we get reimbursed at a higher rate then dentists do,” McGuire said. “It’s not a profit center for us, but at least covers the cost of providing that service.”
Several offices in Walla Walla can be reimbursed by Washington state Medicaid and will see Medicaid patients for dental services. The wait times are fairly long and transportation is always a hurdle for people living in Columbia County, he said.
Looking for a solution, the Washington State Hospital Association mentioned that the governor’s budget includes projects for expanding dental care in rural areas, McGuire said.
“We reached out to Rep. Rude and asked him if he would be willing to help us with an ask, and he said he would,” McGuire said.
Because of the way the funding works from the federal government, it is financially viable for the Columbia County Health System to provide dental services to Medicaid patients, Rude said.
“They need facility space, so that’s something that I did, along with my colleagues, to make sure we’re serving that population in a rural community,” he said.
The project is still in need of a construction firm that would be interested in the project, McGuire said.