Virginia Oral Health Coalition Update

January 2017

In This Issue
Join Us - Northern Virginia Oral Health Steering Committee 

Last week over 50 northern Virginia stakeholders gathered in Fairfax for the Northern Virginia Oral Health Forum. Participants used the 2016 Virginia Oral Health Report Card as a framework to examine regional data and health inequities; identify information and resource gaps; and propose policy and programmatic strategies to improve the oral health of Northern Virginia's most vulnerable citizens. 

Their work will inform the efforts of the newly created Northern Virginia Oral Health Steering Committee which will begin convening this spring to build on the priorities identified at the forum, leverage resources, and coordinate action. If you live or work in northern Virginia, please consider sharing your expertise as a member of the steering committee. 

To get involved, or to learn more about convenings in other regions of the state, please fill out a partnership form online.   

The Forum was supported by the Northern Virginia Health Foundation, the Potomac Health Foundation, DentaQuest, LLC and Smile Virginia.

Upcoming Events

February 9: Community Conversations: Oral Health Care Access for Individuals with Special Health Care Needs (Virginia Beach)  
February 10-11: Practical Guide to Treating Patients with Special Health Care Needs (Virginia Beach)


February 28: Early Dental Home Committee Meeting (Richmond) 


March 23: Oral Health & Pregnancy Training (Richmond)

Details to come

March 28: Statewide Report Card Workgroup Meeting (Richmond)


November 2: 2017 Virginia Oral Health Summit (Richmond)

Save the date 

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Virginia Oral Health Coalition

4200 Innslake Drive

Glen Allen, Virginia 23060


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Federal Health Policy - What's at stake in Virginia?

The Trump administration has made repeal of the Affordable Care Act (ACA) a priority. This, coupled with expiration of funding for FAMIS (known federally as CHIP) and the likelihood of significant changes to Medicaid, will have substantial bearing on Virginia's health care system and the health of Virginians.

VaOHC staff is staying up-to-date on health policy changes and is steadfast in its mission to increase access to affordable, comprehensive health care that is inclusive of oral health - this includes protecting our recent gains in coverage and access. 

FAMIS Funding 
FAMIS (Family Access to Medical Insurance Security - known as Child Health Insurance Program, or CHIP federally) provides over 105,000 Virginia children and pregnant women with quality, affordable, comprehensive medical and dental coverage. FAMIS is currently authorized through 2019, however funding expires in September 2017; Congressional action is necessary to ensure the program continues. Historically FAMIS has enjoyed bipartisan support; however, given the current environment, this funding cannot be taken for granted. 

ACA Repeal
In January, Congress approved a budget reconciliation resolution which instructed members to draft budget reconciliation legislation to repeal the ACA. If the ACA is repealed without a replacement, the Urban Institute estimates that over 100,000 children in Virginia will lose medical and dental coverage. When the entire population is considered, this number could grow to over 600,000. In addition, repeal of the individual mandate could lead to much higher premium costs in the individual market, and repeal of taxes and revenues associated with the ACA will make financing a replacement plan difficult. 

ACA Replacement
Congressional Republicans have not coalesced around a replacement package; however, two past proposals (notably from Congressman Tom Price, President Trump's candidate for Secretary of Health, and Speaker of the House Paul Ryan), and recently-proposed Senate legislation provide a framework for what a replacement plan might look like.  Each handles Medicaid differently, and the recent Senate legislation creates an additional mechanism to provide premium relief to consumers. This table provides a side-by-side comparison of the legislation.

Medicaid Changes
Currently, over 600,000 Virginia children and pregnant women have medical and dental coverage through Medicaid and FAMIS. An additional 400,000 low-income Virginia patients, seniors and people with disabilities have a limited dental benefit in addition to medical coverage. As Congress wrestles with what an ACA replacement plan should look like, there is a significant discussion about changing the Medicaid program into a block grant or a per capita cap for states. Under a block grant, states will receive a set amount of funding, based on an established baseline year, for its Medicaid program; no additional funds are available for increased enrollment or other issues. Per capita caps also use a baseline year to determine funding, but states receive set dollar amounts per person enrolled, often with a ceiling of allowable funds. While both scenarios portend to provide states with more flexibility, they are designed to save the federal government money, not to improve health. The amount of money state Medicaid programs receive will be reduced, leaving the states to determine how to administer the program with less money. 

If these changes are enacted, what might this mean for Virginia? Virginia policymakers may have to wrestle with extremely difficult choices because our program is already much less generous than that of other states. In such a drastic scenario, there are only a few levers to pull to cut costs, including: 
  • Reduce reimbursement rates to providers. 
  • Reduce the level/type of services covered. 
  • Reduce eligibility requirements so that fewer individuals are covered. 
Of note, Virginia legislators on both sides of the aisle have indicated they have reservations about changing Medicaid to a block grant program.

Virginia Activity
Currently, the Virginia legislature is considering legislation to create several bipartisan committees to draft policy recommendations related to proposed federal health care changes and to promote efficient and effective health care delivery and coverage in Virginia.

Stay tuned for future updates.

February is Children's Dental Health Month

Children who receive early dental care are more likely to have better oral health as they grow. In February, we join the ADA, ADA Foundation and many state organizations to celebrate national Children's Dental Health Month (CDHM). This year's theme is "Choose Tap Water for a Sparkling Smile." Community water fluoridation is safe and effective, and reduces tooth decay about 25 percent over a person's lifetime. 

View and download ADA's CDHM resources, including posters, sample newsletter articles, and fun activity sheets for kids.

Of Interest
Oral Health and Overall Health

Oral health and overall health are fundamentally intertwined. The following articles present current information on how oral health is connected to overall health and well-being. 

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Strategies for Integrating Oral Health and Primary Care 

Hand shake A recent article from Health Affairs entitled "Bridging the Dental Divide: Overcoming Barriers to Integrating Oral Health and Primary Care" 
presents a few straightforward strategies for ways primary care and dental providers can work together, including interprofessional education and cross training, financial alignment, and supportive information technology. 

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Federal Legislation Proposes to Expand Medicare to Include Dental, Hearing and Vision 

The "Seniors Have Eyes, Ears and Teeth Act" (HR 508) would expand Medicare coverage to include dental, hearing and vision benefits. Medicare currently has no dental benefits. The CDC reports that over a third (37%) of adults over 65 did not have an annual dental visit in the past year.  Read the full press release from Rep. Roybal-Allard.

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2017 MATRC Telehealth Summit

Registration is open for the 2017 MATRC Telehealth Summit, April 2-4 in Leesburg, Virginia. This event will explore "Quality and Innovation in Telehealth" and offer a forum to network with colleagues and new partners. Register here by Friday, March 10.

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2016 CAMBRA Conference - Online

The 2016 CAMBRA conference presentations are now available online.  View the video on the Medical Management of Caries website.

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Virginia Oral Health Coalition | 4200 Innslake Drive | Suite 103 | Glen Allen | VA | 23060