The PJC’s Health Rights project seeks to protect and expand poor people’s eligibility for adequate health care coverage and access to appropriate, affordable, effective and culturally competent health care.

• Beginning with a full feature article in the Washington Post, Deamonte’s story gained national and even international attention, including the NBC Nightly News, CNN, XM Radio, PBS, ABC’s Good Morning America, the LA Times, Reader’s Digest, USA Today, Associated Press, El Pais (Spain), BBC Radio (London), Tokyo Broadcasting System, German Public Radio, and the Guardian (UK newspaper). The Washington Post continues to cover the story on a regular basis. The PJC has raised awareness among millions of parents, especially low-income parents, of the necessity of obtaining dental care for their children. A national conversation about the importance of dental care for poor children has ensued.
• On May 2, 2007, PJC testified before the Domestic Policy Sub-Committee of the U.S. House Committee on Government Oversight and Reform. Our testimony focused on how the system failed Deamonte and what Congress could do to achieve better access to oral health care for poor children nationally. On October 2, 2007, the sub-committee issued its findings, and concluded that Deamonte was far from the only child enrolled in the United Healthcare Medicaid health plan who lacked access to dental care: almost 11,000 children had not seen a dentist in 4 or more years, and more than 22,000 Maryland children had not seen a dentist in at least three years.  The Committee concluded that the health plan's true dental network in Prince George's County was extremely thin: despite United's claim that they had almost 100 dentists in their network, seven dentists provided more than half the care received by United members in Prince George's County.  Because the Congressional Committee put pressure on the federal oversight agency to do its job, the Center for Medicaid and Medicare Services (CMS), for the first time in eight years, began to review how well individual states were succeeding at providing access to dental care for poor children. Maryland was the first state to be critically reviewed. The CMS report, with very strong recommendations, was issued in November 2007. CMS scheduled seventeen more states to be monitored by March 2008.
• The Dental Action Committee (DAC) was formed in June 2007 by DHMH Secretary John Colmers. PJC served on the DAC, along with about two dozen other representatives of dentists, dental hygienists, managed care organizations, local health departments, schools, HeadStart, community clinics, pediatricians, the dental school, and other advocates. The PJC chaired the Rates and Models sub-committee, which was charged with developing core recommendations for increasing dental reimbursement rates and for reforming the structure of the delivery system (one of the most controversial issues faced by the DAC). On September 11, 2007, the Dental Action Committee issued its final report with 60 recommendations in the areas of reimbursement rates, delivery models, public health strategies, provider participation, scope of practice, and outreach and education. The report highlighted 7 "main" recommendations, including a recommendation to change the delivery system from a two-tiered managed care organization (MCO) based system with financial incentives aligned toward profit rather than dental care, to a single statewide "administrative services only" (ASO) delivery system that would align the finances toward provision of care. 
• Secretary Colmers accepted all 7 primary DAC recommendations. New DAC sub-committees have begun work on implementation plans. The PJC chairs two of those sub-committees: dental screenings in public schools, and a comprehensive oral health literacy campaign. And Governor O’Malley has included $9M in new state funds in the FY 2009 budget to begin to raise dental reimbursement rates and to build more dental clinics. 
•  Congress has continued to focus attention on this issue.   At least 6 bills have been introduced that seek to address different aspects of the problem. Two follow-up Congressional hearings have been scheduled. And Maryland Congressman Elijah Cummings has become a crusader for reform. He has held at least 7 press conferences in 8 months where he has spoken eloquently about solving this problem.
• On August 8, 2007, the U of M Dental School and United Healthcare MCO signed an MOU (brokered by Congressman Cummings) agreeing that United will grant $170,000 per year to the dental school to fund a pediatric dental case manager, a pediatric dental fellow, a mini-pediatric dental residency program to train general dentists to treat children, and a training program for pediatricians to learn how to do oral health screenings, oral health education and dental referrals. 
• DHMH has required the managed care organizations (MCOs) to clean up their dental provider directories every six months, to contact every member child who has not seen a dentist in at least two years and get them into care, and to affirmatively make a dental appointment for any child whose parent contacts member services in search of a dental referral. No more handing out lists of dentists.
• For the first time in anyone's memory, Maryland's dentists and dental hygienists have agreed to cooperate on legislation (The Public Health Dental Hygiene Act) that will increase access to dental care for poor children by permitting experienced dental hygienists to provide preventive oral health care in public health settings without the supervision of a dentist.
• The Maryland State Dental Association is sponsoring trainings for general dentists on how to care for young children. 
• The Maryland Graduate School of Social Work has designed an interdisciplinary “mini-mester” learning and service project focused on increasing access to dental care for Baltimore City children. More than 30 graduate students (dental, medical, law, nursing, pharmacy and social work) are enrolled.   The PJC’s Laurie Norris was a guest speaker during the inaugural class. 
• The PJC, in conjunction with The Megaphone Project and Advocates for Children and Youth, has produced The Silent Epidemic: Dental Disease Among Maryland's Children.  (See it on YouTube: http://youtube.com/watch?v=s7tGk2sZSGg .) The 7-minute video vividly shows the devastating consequences of the lack of access to dental care for Maryland's low-income children, and encourages lawmakers to implement reforms intended to address the oral health care crisis. More than 300 copies of the video have been distributed. 
• The Maryland General Assembly passed, and the Governor signed, significant improvements for children’s dental health, including (1) a $7 million-per-year cash infusion (matched by another $7 million annually from the federal government) that will increase funding for Medicaid dental services over the next three years; (2) augmenting the volunteer efforts of dentists and all oral health practitioners by providing additional funding to improve access to oral health, (3) mandating a new statewide single-payer Medicaid dental system to be implemented by March 2009 to simplify access to dental care for poor children, and to make it easier for dentists to take Medicaid patients. The hope is that this encourages more dentists to participate in the Medicaid program and eliminates another barrier for families seeking dental care. (4) The state has also set aside additional funds in a grant program for Maryland's 23 counties and Baltimore to help local governments and nonprofits improve access to dental care for underserved populations.
• Collaboration with Maryland State Dental Association.  The PJC has been actively working with the Maryland State Dental Association to educate dentists about the increased rates for Medicaid dental services, and to encourage dentists to accept more Medicaid patients. On July 1, 2008, the Baltimore Sun ran a powerful Op-Ed from the President of the Maryland State Dental Association. The PJC is currently working with Maryland dentists and other interested parties to develop and launch a marketing and education campaign aimed at Maryland dentists to persuade more of them to get on board to begin serving our low-income children.  One aspect of the campaign is a series of short video clips to be circulated by email.  The pilot video clip can be viewed at http://youtube.com/watch?v=s7tGk2sZSGg.
• The Children's Dental Health Project was awarded a prestigious three-year grant from the federal Maternal and Child Health Bureau, Department of Health and Human Services. The new National Oral Health Policy Center at Children's Dental Health Project will work jointly with AMCHP, ASTDD, MSDA and NASHP to promote a better understanding of effective policy options to address the incredible disparities in children’s oral health. The Policy Center intends to publish policy trend reports; train policymakers on how to address oral health; and expand and diversify the audience engaged in promoting children’s oral health.
• National provider organizations have begun to look to the PJC for expertise on oral health advocacy, for example The National Dental Association and the American Academy of Pediatric Dentistry.

FOCUS ON CHILDREN’S ACCESS TO DENTAL CARE

“We have a health care crisis on our hands—a dental care crisis—and we have had for quite some time. Somehow, it has been all right for us to ignore it. I hope it is not all right for us to ignore it any longer. Let us not fail to heed the warning Deamonte’s death provides. Let us not, by our indifference or incompetence, have to bear on our consciences the burden of more dead children.”

 — Laurie Norris, PJC staff attorney in testimony given to Subcommittee on Domestic Policy Committee on Oversight and Government Reform, U.S. House Of Representatives, May 2007