In a series of stories, “The Burden of Poverty: A Backpack of Heartache,” reporters at the School News Network, based in Grand Rapids, Mich., are exploring the deep challenges poverty creates for local students and their families as well as strategies schools are employing to helping disadvantaged students succeed.
Articles in the series so far have examined the correlation between low test scores and low income and have provided a candid look at the struggles of a nearly homeless honor student. The series has highlighted the ways schools are trying to address the health disparities that can make it harder for poor children to succeed in school.
One recent story looked at the role school nurses play in helping poor children cope with chronic diseases. A Nov. 14 piece explains how a school-based dental program attends to the oral health needs of children who might otherwise be distracted from their studies by the debilitating pain of untreated dental disease. Continue reading
Noam Levey, who received a 2013 AHCJ Reporting Fellowship on Health Care Performance, recently reported on health care spending in Mozambique for the Los Angeles Times. In the piece, Levey pointed out that Mozambique’s economy is booming – but in contrast, its health care spending is lagging.
The decision to limit health resources had an especially profound effect in remote areas of Mozambique. Levey reported from Chokwe, a rural town about 100 miles north of the coastal capital of Maputo, and described a newborn baby boy who stopped breathing shortly after his birth, just before sunset.
Nurses were able to revive him with a ventilator and a suction machine. But if he had been born only two hours later, he would have died – limited resources mean the ward is staffed only until 7 p.m.
A new federal report raises questions about the billing practices of nearly 100 Indiana Medicaid dentists, as well as the quality of care provided by several dental chains that serve poor children in the state.
While the report, produced by the U.S. Department of Health and Human Services’ Office of Inspector General, does not explicitly name specific dentists or clinics, the authors note that two-thirds of the dentists whose billing practices raised concerns worked for four dental chains. Three of the chains have been the focus of state and federal scrutiny, they observed.
Photo: Pia Christensen/AHCJ
“One chain has been under scrutiny in several States for providing unnecessary services,” the authors wrote. “Thirty-one dentists whom we identified with questionable billing worked for this chain,” they added. The remark was footnoted with a reference to a June 2012 report, “The Business Behind Dental Treatment for America’s Poorest Children,” by David Health and Jill Rosenbaum for the Center for Public Integrity and Frontline that focused on the Georgia-based Kool Smiles dental chain. (See ‘Dollars and dentists:’ Investigating the dental care crisis in the U.S. and Complaints to attorneys general yield sources for dental investigation.)
The Journalism Center on Children & Families, formerly the Casey Journalism Center, is scheduled to close at the end of the year. Over the past 20 years, JCCF, based at the Philip Merrill College of Journalism at the University of Maryland, has worked to help reporters do a better job of telling the stories of vulnerable people.
Now funding is running out, as JCCF’s director Julie Drizin explained in her announcement: “The College has concluded that this Center is not sustainable in the current economic climate.”
The center has offered grants, fellowships and other resources that have resulted in deeper coverage of health, justice and economic issues as they relate to children and families. In keeping with the center’s mission, Drizin has taught an undergraduate class at the college of journalism. Recently, she gathered a team of student reporters to cover a free two-day dental clinic sponsored by the University of Maryland School of Public Health’s Center for Health Equity.
The student’s coverage of the 100-chair clinic resulted in a compelling assortment of stories that are packaged together on the JCCF website as part of the “On The Beat” feature. One of the most striking aspects of the students’ reporting is the variety of angles they managed to find while all covering the same event – angles that professional journalists might find useful.
In this Q&A for AHCJ, Drizin offers insights into how, as a teacher, she turned this free dental clinic into a window on the human condition for her class. She reflects upon the tradition of advocacy journalism. And she shares the best piece of advice she offered to her students as they headed out to cover the event.
A newly published federal study finds that millions of American young people have been missing out on key preventive health care services, including simple treatments that can protect against tooth decay.
Fifty-six percent of the nation’s children did not see a dentist in 2009. That same year, a full 86 percent did not receive a dental sealant or topical fluoride treatment, two measures shown to greatly reduce cavities, according to the study, published Sept. 12 in the Centers for Disease Control (CDC)’s Morbidity and Mortality Weekly Report.
Meanwhile, oral disease remains prevalent among young people. Approximately 23 percent of children aged 2 to 11 years have at least one primary tooth with untreated decay and 20 percent of adolescents aged 12 to 19 years have at least one permanent tooth with untreated decay, the report notes. Continue reading
Last year about this time, we were reading about Covered California’s decision to require parents seeking pediatric dental coverage on the state’s new insurance exchange to buy separate stand-alone plans for their children.
Pediatric dental coverage was designated as one of 10 essential benefits under the Affordable Care Act (ACA). But most dental insurance is sold separately from other kinds of health insurance, and some people supported the idea of selling pediatric dental benefits separately on the state exchange. They contended that consumers who did not want or need pediatric dental benefits should not be required to buy them.
At the same time, Covered California’s plan to offer pediatric dental coverage through stand-alone plans came as a disappointment to oral health advocates. They argued that embedding dental benefits into the health care plans for sale on the state exchange would help expand children’s access to dental care and lower the costs of the benefits by distributing the burden of paying for them across a broader group of people.
After a hint from her own dentist, Sheila Hagar started looking into concerns about the rising numbers of Medicaid kids getting braces in Washington. Hagar, who is medical and social services reporter for the Union-Bulletin, in Walla Walla, sought sources and found statistics that made her jaw drop.
“We should be taking care of people who really have a need,” a frustrated Walla Walla orthodontist, Thomas Utt, D.D.S., told her. “While his office – Walla Walla Orthodontics – is authorized to treat Medicaid-eligible children with braces,” Hagar wrote, “Utt grits his teeth at what he sees as misuse of funds and a lack of clarity over just what ‘medically necessary’ means when it comes to correcting kids’ teeth.”
Here, Hagar tells us more about how she tackled the reporting that led to her July 5 package “State Foots Skyrocketing $27 Million Bill for Braces” and what she is learning about orthodontic benefits under Medicaid. She also shares some wisdom on what to do when no one is returning your calls on an uncomfortable subject. Read how she did her reporting.
Megan Sandel, M.D., M.P.H., an expert on the impact of housing on child health, says journalists would do well to broaden the conversation about health care to include questions about social support – especially support for safe, affordable and stable housing.
Sandel has contributed a tip sheet that includes key stories to pursue and critical insights on the housing-as-health-care trend.
Find out why housing has an enormous impact on educational attainment and economic stability, how unequal enforcement of health and safety codes creates disparities and what the three essential elements of healthy housing are. See the tip sheet now.
Have you visited a school-based dental sealant program in your state or community? There may be a good story there.
Can’t find one to visit? That may be another worthwhile story.
Dental sealants are thin, plastic coatings that are applied to children’s permanent back teeth to seal the narrow grooves on the chewing surfaces and keep out decay-causing bacteria and food particles. Studies show that the procedure can reduce the incidence of tooth decay by 60 percent.
But poor and high-risk kids who could benefit the most from sealants are not always receiving them.
This new tip sheet from Mary Otto, AHCJ’s oral health core topic leader, explains why not all children who should have sealants are getting them and how to check into it in your community. Read more …
Quite a few folks in Tennessee are upset right now with DentaQuest, the giant dental benefits company that took over the contract to provide oral health services to poor kids under the state’s Medicaid program earlier this year.
Two hundred black dentists are riled that they were cut from the provider network. The state dental association has withdrawn its support for DentaQuest’s contract. And some consumers (including a group home operator) are saying the company is making it harder for patients to get the care they need.
Meanwhile, company officials insist that no child with TennCare benefits has lost access to dental care under their watch. They defend their performance in Tennessee, saying that screenings have increased and that the state network of 864 providers – one for every 857 patients – exceeds nationally recommended standards.
What is going on? The Tennessean’s Tom Wilemon has been working to find out. His story last month offered a look at the situation.
In this Q&A, he gives an update and some additional insights into his reporting. He also shares some wisdom with others who might find themselves tackling a similar story.