Reporter takes listeners to charity dental clinic to hear from patients Date: 06/26/14
By Mary Otto
KBIA Mid-Missouri Public Radio listeners were recently offered an insightful report on the problems poor adults in the state have been facing in getting dental care.
Nearly a decade ago, Missouri eliminated funding for all Medicaid beneficiaries except children, pregnant women and the disabled.
The move “left a lot of people with only bad options,” reporter Katie Hiler explained, borrowing a quote from the film “Argo.”
To illustrate the point, Hiler invited her audience along on a visit to a rare charity clinic called Smiles of Hope, run out of a converted church attic. At the clinic, dentist William Kane spoke of his efforts to meet the overwhelming need for services such as emergency extractions.
“We see patients, working poor, people who are on Medicaid, that the only time they get dentistry is when they go to the ER for antibiotics and pain medicine,” Kane says. “So we're seeing desperate people.” The story captured the sense of how a typical day at the busy clinic unfolds and what brings patients there from as far away as Kentucky and West Virginia.
Hiler ended her report with some news. A decision by the Missouri legislature to restore funding for adult dental care under Medicaid is expected to help to give some poor Missourians more options, she observed.
Yet at the same time, 300,000 low-income adults who would qualify for Medicaid under the Affordable Care Act are at this point shut out because of the state’s refusal to expand the program.
“Which means,” Hiler noted in closing, “Smiles of Hope isn’t going anywhere.”
Here Hiler offers some thoughts on what got her started on this story and how her work unfolded. She also shares some wisdom on what it takes to make a radio story come alive.
Q: What made you decide to look into the problems poor people face getting dental care in Missouri?
A: When I started at KBIA back in February, one of the first news items I wanted to report on was about Missouri’s new dental director, Dr. Ray Storm. Missouri had just reinstated the position after 10 years, when funding was cut, so I figured there would be a laundry list of issues the director would be dealing with. As it turns out, the position of dental director in Missouri doesn’t have a whole lot of power - it’s more of a supervisory role. Dr. Storm can’t tackle the issue of free dental screenings for children, but he knows a lot about what’s currently going on with dental care in the state. During our interview I asked him who was on the front lines in the battle for better oral healthcare in Missouri, and he mentioned Dr. William Kane and his Smiles of Hope Clinic in Dexter.
Q: At what point in your reporting did that great quote from Argo come to your mind?
A: In radio you’re always thinking about how you can tell a story through sound and how to grab someone’s attention right from the beginning. I was thinking about the theme of the piece, which was how desperate some folks in Missouri are for dental care, and the Argo quote about “the best bad option we have” came to mind. If you’ve seen the film as many times as I have, it’s not that surprising. It’s one of my favorites, and it just happened to describe this situation perfectly.
Q: How did you find Smiles of Hope and decide to spend the day there?
A: As I mentioned, it was Dr. Ray Storm who gave me Dr. Kane’s name and suggested I reach out to him. When I first spoke with Dr. Kane it was clear he was the kind of source reporters dream about – passionate, knowledgeable, and happy to talk to me. For the radio story I needed a variety of different kinds of sound to set the scene, so I asked if I could drive down and visit the clinic. I think he was really surprised that I would go out of my way to do that, but it is my responsibility as a reporter to not just tell the story but also capture the details of the setting where the story takes place.
Q: Can you tell us a little more about the decision of the Missouri state legislature to reinstate dental benefits for adults under Medicaid? What was behind that decision? What benefits will be covered?
A: The Missouri legislature has passed a budget that allocates $48 million in state and federal funds to support Medicaid dental care for adults, which should cover certain procedures relating to prevention, maintenance, restoration and emergency dental care for all Medicaid recipients. It will also bump up the reimbursement rate from around 35 percent to 60 percent. The hope is that a higher reimbursement rate will encourage more dentists to choose to accept Medicaid patients, which is an issue right now. Finally, it will allocate $1 million to fund four regional dental pilot projects aimed at keeping people from using the ER for dental emergencies. That money is in the current budget being considered by Governor Nixon but there is some concern now that in order to accommodate tax cuts enacted at the end of the legislative session the governor will have to consider cutting dental care for Medicaid recipients from the budget.
Q: You mention that there is still resistance to Medicaid expansion in the state. Are oral health advocates part of the push to expand the program?
A: The Missouri Coalition for Oral Health was a major supporter of getting dental care for Medicaid funded. They were also responsible for helping reinstate the dental director position and establish an oral health caucus in the Missouri General Assembly. Likewise the Missouri Foundation for Health has made dental care a priority issue and is pushing for the expansion of Medicaid in the state. Missouri voted to not expand Medicaid during this year’s legislative session, so the issue is on hold until session starts again in January.
Katie Hiler is a reporter for KBIA, Mid-Missouri's public radio station. She graduated from NYU's Science, Health and Environmental Reporting Program in 2013 with a degree in science journalism. She was the senior producer for The Doppler Effect, WNYUs Science and Tech news show. Hiler was an intern for The New York Times and produced the weekly Science Times podcast, and was an intern with WNYCs The Takeaway. She has published print and web pieces for The New York Times, Popular Mechanics, and Scienceline.org