When the state cut Medicaid assistance for dental coverage two years ago, thousands of low-income adults were left without reliable access to dental care.
Use of emergency rooms for dental issues shot up, and local clinics struggled to respond to the need.
Help is still available for low-income kids up to age 19, pregnant women and the disabled. But for adults without dental insurance, resources are often hard to come by.
To help remedy the problem, the Union Gospel Mission has developed its own volunteer-led dental clinic to provide service for those without insurance and who can’t afford the fees anywhere else. It’s set to open to patients Feb. 6.
“Our market will really be a group of people that are not being reached by anyone else in town,” said Dr. Mike Buehler, who started the Chalet Dental Clinic about 40 years ago and retired in 2011.
The mission has had a small medical and dental clinic for several years, operating out of a tiny former conference room at its compound on North First Street. Surrounded by donated supplies, doctors cram into two exam rooms to provide physical therapy, podiatry, chiropractic and dental care, while moving equipment in and out as needed. On Saturdays, Pacific Northwest University medical students set up shop in two even smaller exam rooms, shielded by white shower curtains.
“We’re doing everything but cutting hair in here; I won’t let them cut hair,” said Buehler, who volunteers each week with dental patients.
Twelve years ago, he said, the clinic was intended as a temporary space.
The new clinic has been under construction in the mission’s back parking lot since September, and the dental equipment will be installed next week. The 2,000-square-foot space will include four fully equipped exam rooms, along with storage space, a room for X-rays and a waiting room.
The entire $850,000 cost came from donations, including $250,000 by the Washington Dental Service Foundation and discounts from the contractors who built the facility.
Buehler has recruited 40 dentists from around the Yakima Valley, both active and retired, to each volunteer a few days a year at the clinic. Residents from the Yakima Valley Farm Workers Clinic’s Northwest Dental Residency also will provide services. It will be open from 8 a.m. to 5 p.m. four days a week, and the only paid staff member will be an office manager.
Buehler anticipates 1,500 patients in the first year.
By serving only people without insurance, Buehler said, he avoids the hassle of filing insurance claims. Instead, patients will pay out of pocket on an income-based sliding fee scale that starts at about 80 percent of the total fee they would pay at a private dental practice in town.
For those at the federal poverty level or below — about $23,000 a year for a family of four — the service will not cost anything.
But there’s a twist: Buehler and the mission are not interested in handouts. Those who cannot afford the fee will be offered volunteer opportunities to work off the cost in hours served. The Red Cross, Habitat for Humanity, the Salvation Army and the mission itself have already put systems in place for that.
It’s both to empower the patient and to ensure accountability, Buehler says.
“As soon as you have to start paying for it yourself or participate in it, you have a vested interest,” he said. In his private practice, he often saw poor patient cooperation among those who weren’t paying for their own health care.
Director Rick Phillips said that standard applies to everything at the mission.
“If people are coming here with an entitlement attitude ... that doesn’t fly here,” he said. “Everybody participates here.”
It’s a big shift from the government-subsidized community health centers in town.
Yakima Neighborhood Health Services and Farm Workers both offer dental services at several locations in the Valley. Collection rates for people paying out of pocket — those without insurance or state assistance — are pretty low, said Glenn Cassidy, communications director for the Farm Workers Clinic.
Farm Workers uses a sliding fee scale, too, “which unfortunately still makes it unaffordable for many, many people,” Cassidy said. “It’s an unfortunate situation.”
The Farm Workers Clinic takes as many patients as possible, but must focus on emergency care.
“For adult dental care, if we don’t spread it around, there’s no one clinic that can shoulder the burden of the cost,” he said.
The story’s the same at Neighborhood Health, said chief operating officer Rhonda Hauff.
“We have far greater need than we’re able to serve for the adult populations at all of our sites,” she said. The Neighborhood Connections program, which runs on grants, provides full service for the uninsured homeless, but “for the general adult population who don’t have any resources, I think (Union Gospel Mission) is going to fill a need.”
The clinic isn’t just for those using the mission’s other services, Phillips says. It’s for any low-income adults who need dental work but would be more likely to pay their rent than seek care — those who may be a couple paychecks away from being on the street.
“This will provide the ability for a lot of families to continue to live where they live, have some normalcy and to have the care that they need,” he said. “This will be a huge benefit to our Valley.”
· This report has been updated to correct which agency provided a $250,000 grant. It was the Washington Dental Service Foundation.