Cavity Kids: Poor Sacramento children have low access to dental care

• http://centerforhealthreporting.org/project/cavity-kids-poor-sacramento-children-have-low-access-dental-care
• http://www.sacbee.com/2012/02/12/4256975_a4257526/model-dental-program-proves-painful.html
• http://centerforhealthreporting.org/article/demands-escalate-change-kids-dental-plan-sacramento819?page=full
• http://www.sacbee.com/2012/02/11/4257161/children-forced-to-wait-months.html

Provide names of other journalists involved.

Lauren Whaley, CHCF Center for Health Reporting

List date(s) this work was published or aired.

February 13, 2012, February 24, 2012, May 25, 2012

Provide a brief synopsis of the story or stories, including any significant findings.

If you’re a poor child in Sacramento County, chances are high that you’ll suffer for months with painful or rotted teeth before seeing a dentist. In fact, chances are that if you are one of the almost 100,000 poor children residing in Sacramento County, you won’t see a dentist at all over a year’s time. CHCF Center for Health Reporting writer Jocelyn Wiener pored over state data and found that Sacramento County’s Medi-Cal managed care dental program for poor children consistently produced some of the state’s worst access rates. Her months’ long investigation found ongoing lax state oversight of the program, despite repeated calls for reform from children’s advocates. Wiener’s February 13 piece, plus 13 subsequent stories and several blogposts by Center reporter Emily Bazar, and provocative photos by Bee photojournalist Lezlie Sterling, placed an increasingly harsh light on the state’s management of the program and the performance of private plans under contract to the state to provide the service.

Explain types of documents, data or Internet resources used. Were FOI or public records act requests required? How did this affect the work?

State data was used to compare access rates for Medi-Cal children in different counties. There were also various reports and studies commissioned by Sacramento County and state advocacy groups — some of them a decade old — that contributed to the story.

Explain types of human sources used.

For this series of stories, the reporters interviewed elected state officials, elected officials’ staff, state health officials, state health department spokespersons, county health officials, county dental society spokespersons, national experts on managed care dentistry, advocates for children’s causes, dentists and dental office managers, dental plan officials, and Medi-Cal children and their parents.

Results:

The day after publication of the first story, the president of the State Senate, Darrell Steinberg, cited the article in demanding an investigation into the program’s failings. The head of the state department overseeing the program promised changes. From that point on, the pressure of continuing articles produced an avalanche of response and change, ultimately resulting in a new law passed by the California Legislature and signed by Gov. Jerry Brown, new California state Department of Health Care Services procedures and regulations, and a sudden halt in state plans to move almost 900,000 low-income children into a managed care dental program. In each case, officials cited the articles as a reason for the change. In addition, one Sacramento County dental plan with very low access rates ceased operations in response to a state audit prompted by the Center’s articles.

Follow-up (if any). Have you run a correction or clarification on the report or has anyone come forward to challenge its accuracy? If so, please explain.

No.

Advice to other journalists planning a similar story or project.

This is just common sense, but combing through data — state and county — can bring eye-popping results. Most data just sits there, without evaluation or a critical look. It is simply COLLECTED. In this case, when it was compared and contrasted and published — that’s all it took. One other thing that hardly needs saying — stick with a story. The Center set out to write one comprehensive piece and ended up with almost 20 separate articles, many of which pushed the story to a new level.