TO: Senator Rodney C. Moen, Co-chair
Representative David Ward, Co-chair

FROM: Tim Size
DATE: Monday, September 25, 2000

SUBJECT: Special Committee on Dental Care Access.

Please accept this memo as input into the Special Committee on Dental Care Access on behalf of the Rural Wisconsin Health Cooperative in place of me being able to testifying in person at Tuesday’s hearing.

First, thank you both for addressing this particularly important issue. In rural health, we are accustomed to tracking many issues across a broad spectrum and I assure you that dental access in Wisconsin is a problem virtually without parallel--long neglected, doing real, preventable harm to Wisconsin’s rural and urban children and families.

I do not mean to minimize existing interventions, but intend to draw your focus to the unusually wide gap between those well served and those receiving few or no dental services. I have reviewed and support, as far as they go, the dental provisions in the Department of Health and Family Services 2001-2003 budget request. Particularly important is the proposal to redirect a portion of Marquette Dental School's State funding into a loan forgiveness and repayment program aimed at graduates who agree to practice in a Dental Health Professional Shortage Area. But to make a difference, the allocation needs to be significantly increased.

We hope your Committee will take the Department’s proposals as a good starting point and go further as a result of your hearing and deliberation process. For example, the Department of Commerce currently administers a multidisciplinary health care professions loan forgiveness and repayment program. That Department’s budget submission requests that the program be expanded to include dentists among the health professions covered. I suggest that the most cost effective approach, and one which could provide this incentive immediately, is to place the proposed funding and program administration in the Department of Commerce and requiring, as with all other beneficiaries of the program, that dentists provide services in Wisconsin to Medicaid recipients.

As a longstanding member of the State’s Rural Health Development Council (but not presuming to speak for it), I have had multiple opportunities to hear our state’s dental school on this issue. While this issue is certainly bigger than one school, we believe it has an important role to play.

At the risk of further antagonizing what, for better or worse, is an important state facility, I need to say that I have come to find the positions expressed by its representatives to be evasive and self-serving. I am convinced that we can no longer reasonably assume that the school will, on its own, take the necessary steps to maximize its part of a broader solution.

In particular, at one presentation by Marquette before the Rural Health Development Council, we were told that the school would work to substantially increase the portion of its graduates who are from Wisconsin (and who almost uniformly remain and practice in Wisconsin).

We were told that the school would request a substantially large state subsidy AND a change in the legislative language which would allow it to spread whatever subsidy is received from the State over a larger number of Wisconsin residents. It is our understanding that the former request has gone forward but that the latter has been "sidetracked."

In summary, we believe that a fundamental component of any solution to our state’s severe dental access problem requires a greater accountability re all State dollars given to the Marquette dental school.

That accountability needs to assure that there is:
(a) a much higher share of Marquette dental school students from Wisconsin, and

(b) that there is a more aggressive linkage between loans and scholarships with a service commitment to children and families currently going without proper dental care.

Thanks for listening to these concerns. If I can provide any assistance to your committee, please don’t hesitate to ask.


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