G-2302-17989

The mission of Pennsylvania Coalition for Oral Health (PCOH) is to improve oral health for all Pennsylvanians by uniting stakeholders to advance advocacy, policy, education and innovative approaches. CareQuest Institute supported PCOH directly with funding in 2020 and 2022 and has also supported PCOH through a Pennsylvania regional Collaborative since 2016. Funding has facilitated work with state departments to incorporate oral health in State Health Improvement Plans and maintain a steady drumbeat for restoration of Adult Dental Benefits in Medicaid, repealed in PA in 2011. Currently, PA’s Medicaid program covers only dental procedures that are deemed “medically necessary.” PA has a score of 23 on the Adult Dental Benefit Coverage Checker.

PCOH’s proposal this year will focus on a two-pronged advocacy plan to restore and expand dental benefits in Medicaid. PCOH will leverage political will in the state’s current administration to introduce and advocate for a full restoration of pre-2011 extensive Medicaid Benefits for adults. At the same time, PCOH will build upon interest from PA’s Department of Health Services and the new governor’s administration to identify and advocate for administrative additions of single benefits to the Medicaid program. These offices are under new administration and have indicated verbal buy-in for expansion of covered dental services. PCOH’s efforts at both the legislative and administrative level will allow for guaranteed progress within the space of Medicaid adult dental benefits with either restoration of full coverage for adults, or incremental progress. Alongside PCOH’s significant legislative expertise, the advocacy for Medicaid adult dental benefits will be supported through Community Advocates who will be trained to engage in the legislative process.

A smaller activity of the proposal is to disseminate information to Medicaid beneficiaries and providers about the new individual codes and treatments that have been added to the PA Medicaid fee schedule over the past two years.

The budget for this proposal is $48,721. About half of the budget is allocated toward staff time for the Executive Director, Policy and Advocacy Coordinator, Operations and Communications Coordinator, and Program and Evaluation Coordinator. Other line items are for meeting expenses for a Community Advocate training, communications costs, and subscription to a legislative services platform. This request represents 5% of the organization’s overall budget.