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SDM’s BUMP UP dental program helps patients no longer covered by state insurance
By Brian Fitzgerald
Former Governor Jane Swift’s cuts in health programs — including most dental services for low-income people — in order to balance the state budget have produced anger and frustration across Massachusetts. Disadvantaged people seeking treatment for a painful toothache are now feeling the pain financially as well.
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| Stephen DuLong | |
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But BU’s Goldman School of Dental Medicine has responded locally
with a plan that provides low-cost access to many procedures no longer
covered by the commonwealth. Combined with the benefits still covered
by MassHealth, the state’s Medicaid program, the plan, called the
Boston University MassHealth Patient Upgrade Program (BUMP UP), will enable
these patients to continue to receive basic dental treatment, including
emergency treatment, diagnosis and treatment planning, cleanings, fillings,
and routine extractions.
“Included in our school’s mission statement is offering excellent
health care services to the community, and we take that very seriously,”
says Stephen DuLong, SDM associate dean for clinical services. “The
cuts left many people without a way to afford basic treatment. The only
treatment that had been left covered by the state were emergencies, extractions,
and dentures — and that coverage for dentures has recently been
eliminated.”
Indeed, MassHealth ended financial support for complete and partial dentures
on January 1, 2003. SDM announced on January 13, however, that it will
extend the BUMP UP plan to help clients meet the costs of necessary denture
services.
BUMP UP isn’t an insurance plan, but rather a supplemental, low-
cost self-pay plan. After paying an annual administrative fee of $65,
patients are not charged for such services as the initial oral exam. They
also receive free treatment planning, along with reduced charges for services,
including cleanings ($12), fillings ($12), and periodontal surgery ($50).
The program provides affordable access to basic procedures necessary to
achieve and maintain good oral health.
The school recently took out a two-day ad in the Boston Metro newspaper
to publicize the program, which, says DuLong, has been well received so
far by patients who depend on SDM for their dental care, and by the school’s
more than 300 students who are active in community clinics. About 40 percent
of their patients had been covered by MassHealth, and many of those eligible
are joining BUMP UP.
The SDM students’ work is not only essential to the oral health
of a vulnerable segment of the population, but also is invaluable for
their own education. DuLong says that working with these patients “is
a tremendous learning opportunity for our students. This is one of the
ways they acquire the skills necessary to learn the profession. They have
developed tremendous doctor-patient relationships, so they are very appreciative
of BUMP UP.” He adds that this is in addition to the program’s
primary purpose: benefiting those who would have nowhere else to turn
for dental services.
The plan is not a cure-all because some of the needier patients won’t
be able to afford even the minimal fees. But BUMP UP is responding to
crucial needs in the community during critical fiscal times. The state
is facing a budget gap of as much as $600 million this fiscal year, and
its short-term prognosis is poor, with the deficit projected to be up
to $3.6 billion next year.
When Swift announced her proposed budget in January 2002, the Boston-area
dental school community was aghast, but not silent. The following month,
SDM Dean Spencer Frankl joined officials, professors, and students from
both the Harvard and Tufts dental schools for a rally at the State House
to denounce the $36 million in cuts affecting dental care for half a million
financially disadvantaged adults. The funding decisions “are fundamentally
contrary to the ethical, educational, and clinical standards taught,”
according to a joint statement from the schools. The elimination of “basic
adult dental services from Medicaid demonstrates an ignorant and poor
understanding of the role oral health plays in each person’s general
health.”
DuLong points out that Surgeon General David Satcher’s 2000 report
Oral Health in America links dental health with overall health and notes
that oral examinations contribute to the identification of over 100 systemic
diseases, including AIDS, diabetes, and nutritional deficiencies. (See
story on SDM’s Oral AIDS Clinic at www.bu.edu/bridge/archive/2002/08-30/aids.htm.)
“Ignoring oral health problems can lead to needless pain and suffering,
causing devastating complications to an individual’s well-being,”
says the report, “with financial and social costs that significantly
diminish the quality of life and burden American society.”
The cuts will stretch the financial resources of SDM, but in its 40 years,
the institution consistently has been committed to the community, with
such initiatives as the APEX Program, which provides dental students with
the opportunity to work in a variety of urban health centers (including
Boston Health Care for the Homeless). SDM’s oral health education
visits at public schools have provided free sealants — a plastic
used to protect pits in tooth surfaces against cavities — for children
in Boston as well as in Chelsea.
However, the budget cuts have struck a blow at the very heart of SDM’s
efforts to help the disadvantaged. BUMP UP won’t be able to absorb
all of MassHealth’s former patients, and DuLong wonders what will
happen to the people who won’t be able to afford even the minimal
fees, and “fall out of the system.”
At last year’s State House rally, Mandy Louis (SDM’02) expressed
the same concerns. “The thought of shutting out an entire demographic
of patients, particularly the ones already compromised,” she said,
“is most disturbing and perilous” and unfair to a population
“that is all too often neglected and ignored.”
24 January 2003
Boston University
Office of University Relations