NC legislators hear details on reductions in children's dental services

lbonner@newsobserver.comMarch 12, 2014 

Budget cuts to the dental section in the state health department have left some counties without public hygienists to check children’s teeth and direct them to dentists for care.

Public health officials told legislators Wednesday how they have reorganized public health services for children in response to budget cuts.

State oral health services have contracted, leaving 25 counties without state hygienists or locally funded dental programs.

The state budget cut $850,000 from the oral health section and eliminated 15 jobs. Five of the positions cut were vacant; 10 were filled. The Women’s and Children’s Health Section plans to cut 160 jobs this fall and merge three state offices that monitor services for infants and toddlers with severe developmental delays. The state offices would merge with a contract office at East Carolina University, and workers losing state jobs will be able to apply for jobs at the university.

The staff and budget cuts in oral health were a factor in the firing last year of the former section director, Dr. Rebecca King, who objected to the reductions. She could not be reached Wednesday for comment.

The state decided to focus dental services in the poorest counties, said Danny Staley, deputy director of the Division of Public Health at the state Department of Health and Human Services.

Some of the larger counties, including Wake and Durham, have locally funded dental programs. But some poor rural counties, including Greene, Perquimans and Pasquotank, have no community dental programs and have been left without state hygienists, according to information provided by DHHS.

The state had been checking the teeth of every kindergartner and fifth-grader each year, gathering information to track dental disease over time and to support requests for money for oral health.

The state has stopped checking fifth-graders’ teeth. A sampling of third-graders’ teeth will be checked instead. The change means fewer children will be checked each year, but the switch to third grade puts the state in line with what the Centers for Disease Control and Prevention expects, Staley said.

Rep. Bert Jones, a Reidsville Republican and a dentist, said preventing oral health problems is good for patients’ health and “the state’s pocket book.”

People with dental problems often go to hospital emergency rooms for help, Jones said.

Later, he sidestepped a question about budget cuts reducing preventive dental care.

“I am always concerned about the quality of dental care in our state,” he said.

Rep. Nelson Dollar, a Cary Republican and chief House budget writer, said he couldn’t answer questions about the reduced services because he missed Staley’s presentation.

Legislators had more questions about changes to the offices that help infants and toddlers who have significant developmental delays. State workers monitor special services that community contractors provide children through age 3, said Dr. Kevin Ryan, chief of the Women’s and Children’s Health Section. State employees will do the work themselves if no community providers are available, he said.

State-run offices in New Bern, Rocky Mount and Wilmington are expected to be consolidated at ECU. Legislators from the southeast asked whether their counties were absorbing the worst of the budget cuts.

The legislature cut $8 million from the Infant Toddler Program this year, and is expected to cut another $10 million next year.

The $10 million cut will be spread across the state, Ryan said, and merging the offices was an important part of the strategy to provide the same services with less money.

“We’re charged to serve the same number of children, but we’re charged to do it with $10 million fewer. That will be a real challenge,” he said.

Nearly 20,000 infants and toddlers were served by the program in 2012-13.

Bonner: 919-829-4821; Twitter: @Lynn_Bonner

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