Dental van helps those without health care

The wait for the dentist had been a long one for Angela Estes – at least seven years.

“I think this is a great idea,” said Estes of Lake Stevens. “It would be an easier way to reach people, maybe even the elderly.”

Her appointment was conducted in a specially outfitted 42-foot-long Winnebago van parked at the rear door of the nonprofit Providence Everett Healthcare Clinic. Checkups and other dental services are provided free to patients one day a month.

Dan Bates / The Herald Dr. Donald Hayes begins work on 7-year-old Regina Hermosillo of Snohomish in a mobile dental van outside Providence Everett Healthcare Clinic in Everett recently.

The van is outfitted with all the equipment of a modern dental office, including two dental chairs, an X-ray machine and sterilization equipment.

Staffed by dentists and other volunteers with Northwest Medical Teams International, it is one example of expanded services being provided in Snohomish County to people who were being shut out of health care.

For several years, problems with Medicaid, the state program that pays for medical care for families on welfare and the disabled, meant thousands of area children and adults couldn’t get in to see a doctor.

Problems began in 2001 when the state rejected bids from five managed care plans to serve Healthy Options patients, the Medicaid health plan for the working poor. That made it more difficult for the poor to get care, triggering a local health care crisis.

Since the money paid to care for the patients didn’t cover the costs of caring for them, many area private medical clinics simply said they could no longer take new Medicaid patients.

By 2002, a Snohomish County Medical Society survey showed that only 5 percent of the 325 primary care doctors working in private medical clinics were accepting new Medicaid patients.

The problem was so acute that state Department of Health and Social Services officials said Snohomish County was one of the three worst counties in Washington for Medicaid patients to get health care. The lack of access to dental care, they said, was at least as bad.

With no place else to get help, people seeking medical care often end up in hospital emergency rooms, one factor making Providence Everett Medical Center’s emergency department one of the busiest in the state.

This year, a series of events has significantly improved the ability of Medicaid and Medicare patients and the uninsured to get health care in Snohomish County.

Last January, the nonprofit Providence Everett Healthcare Clinic opened at 1001 Broadway, the result of a nine-month fund drive in 2003 that raised more than $1 million in private donations.

The clinic joined two other nonprofits in the county serving Medicaid, Medicare and uninsured patients: Sea Mar in Marysville, and the Community Health Center of Snohomish County, which has clinics in Everett and Lynnwood.

“We now see about 500 to 600 people a month,” said Dr. Tony Roon, who oversees the Providence clinic, which estimated that it treated about 3,500 patients and scheduled 6,000 appointments in 2004.

This year, the clinic expects to book about 7,500 appointments.

Donations during the startup fund drive are helping cover the estimated $100,000 operating loss during its first year. The clinic hopes to break even by 2006, Roon said.

Next, about 19,000 more area children and adults got access to health care through the Healthy Options plan in 2004. These low-income working families covered through Medicaid were assigned to a plan, guaranteeing access to a medical clinic.

“What this does is help organize the system of care better so folks are assigned to a primary care provider and they’re not trying to call around and find somebody,” said Mary Anne Lindeblad, who oversees managed care programs for DSHS.

Private clinics joined nonprofits in accepting these Medicaid patients. The Community Health Center of Snohomish County, for example, took more than 2,000 new Healthy Options patients in 2004, executive director Ken Green said, as well as another 2,200 other Medicaid patients.

Now, 217 physicians in the county take these patients, said Rick Cooper, executive director of The Everett Clinic. His organization treats about 9,000 Healthy Options patients at its 10 area clinics.

All those changes are thought to be a factor in the decrease in patients going to Providence Everett’s emergency room for problems that could be cared for in a clinic.

In 2001, an estimated 19 percent of patients fit that category, Roon said. In 2004, it was about 10 percent of the estimated 92,000 patients.

Despite the improvements, about 30,000 local residents on state medical assistance, including the aged, blind and disabled, don’t have access to medical services that come with having an assigned health care provider.

“It’s patched,” Lindeblad said of the local changes in medical care. “It doesn’t fix everything.”

And no one accurately knows how many county residents don’t have health insurance, and so have problems with, or cannot get, health care.

What improved access to health care means is apparent in the smiling faces of patients now getting treatment, such as Virginia Hermosillo of Snohomish and daughters Kayla, 6, and Regina, 7. They recently were treated in the dental van at Providence Healthcare Clinic.

“I always let the kids go first to the dentist,” Hermosillo said. “Now it’s my teeth that need some work.”

Hermosillo volunteers at her children’s school, Peaceful Glen Christian, to help offset tuition. “One income is not enough,” she said. “We live paycheck to paycheck.

“God’s blessed us with this dental van.”

Reporter Sharon Salyer: 425-339-3486 or salyer@heraldnet.com.

Free dental van

The dental van provides free care once a month to patients of Providence Everett Healthcare Clinic, which is in the College Plaza shopping center, 1001 Broadway, Suite A3, Everett. Call 425-317-0300.

Other area nonprofit clinics that accept Medicaid, Medicare and uninsured patients:

* Community Health Center of Snohomish County, 425-789-3333, which provides dental services on a sliding fee scale.

* Sea Mar Community Health Center in Marysville, 360-653-1742.