Starting Wednesday, most adult Medi-Cal patients with tooth decay will have to pay their own dental bills.
In addition, as public service cuts go into effect in Stanislaus County and statewide, people who struggle with mental illness or substance abuse will have a harder time getting treatment.
Many of the service cuts affect low-income residents, seniors, the disabled and the growing ranks of people who have lost health insurance during the recession.
Although health care lobbyists still are urging the state to spare the ax, Denti-Cal benefits for most low-income adults are scheduled to end Wednesday, the start of the state's 2009-10 budget year.
Cut off will be almost 55,000 adults, age 21 and older, who are eligible for Denti-Cal coverage in Stanislaus County. The program still will cover children, pregnant women, people in nursing homes and young adults until their 21st birthday, as well as certain dental services at federally qualified clinics.
In some cases, treatment that began before a patient turned 21 may be completed; the same policy applies to other adults who began treatment before Wednesday, said the state Department of Public Health Services.
The state is cutting other optional Medi-Cal benefits including optometry, podiatry, audiology, speech therapy, chiropractic service, acupuncture and psychology service.
In other changes effective Wednesday, Stanislaus County is shrinking capacity in drug and alcohol treatment programs and cutting mental health services in Ceres, Oakdale and Patterson.
The county's substance abuse services are being consolidated at Stanislaus Recovery Center in Ceres, putting an end to services in Turlock, Modesto, Patterson and Oakdale. That will increase the waiting time for people needing treatment, said Linda Downs, assistant director of county Behavioral Health and Recovery Services.
Ceres, Oakdale and Patterson residents who need help with psychiatric medication will be directed to Modesto. Those folks were receiving help at offices shared with other agencies in those cities.
In addition, Stanislaus County is reducing its drug court caseload from 90 to 75 defendants and will have doctors perform fewer psychiatric consultations in nursing facilities.
As the cutoff date approaches, the Sacramento-based California Dental Association is fighting to preserve some of the adult Denti-Cal benefits. It has sponsored legislation to retain coverage for simple fillings and asked for $1.5 million to expand a charity care program statewide.
Help only in emergencies
The association hopes the legislation will be approved as part of a budget deal for the 2009-10 fiscal year, which begins Wednesday.
Health advocates predict that people suffering from tooth decay will beg for relief at hospital emergency rooms. Medi-Cal has agreed to pay for only emergency treatment of pain or infection and extraction of the teeth involved. Golden Valley Health Centers or other safety-net clinics that offer dental care on a sliding fee scale could be an option for patients.
Bruce Valentine, a Modesto dentist and spokesman for the Stanislaus Dental Society, said a growing number of uninsured people will be at risk of severe oral infections as long as the state withholds funding from Denti-Cal.
"If they eliminate the program altogether, I think they will have some real issues," he said. "There are just too many people in the state who have no coverage."
Bee staff writer Ken Carlson can be reached at email@example.com or 578-2321.