OLD Medical and Dental Care@100% Medical and Dental Care@100% means all children and families can easily access care. A countywide system of care for all awaits us if we collaborate, innovate and use technology wisely.

KEEPING A CHILD, parent or care-giving grandparent healthy means giving them access to timely and affordable health care—surviving the day may depend on it. Lack of access to health care may itself constitute neglect, an adverse childhood experience that can damage a child psychologically and physically. If we don’t ensure access and affordability, we will not only fail those kids, but also create intractable problems for the rest of us.

In this chapter, we take on a very complicated system with numerous challenges and provide an overview of the medical and dental systems with all their solvable problems. Get ready to be overwhelmed and also inspired. We will guide you through all the steps to put ideas into action.

What this is not

This is not a chapter about medical procedures or protocols for health care providers. This is not about medical advice or how to treat trauma from the point of view of medical professionals. This is a chapter about ensuring that everyone in your county

can access medical and dental care when it’s needed. It’s about a profession that has the term “caring” often associated with it. So let’s collectively care deeply about making your county the healthiest in the state.

“Why don’t parents just call the doctor?”

Health care as a survival issue. In our 100% Community initiative, we brand medical and dental care as one of our survival services. Simply put, untreated or poorly treated health or dental ailments can drag down school performance, strain relationships and generally stand in the way of a good life for kids, parents and anybody else. Neglect, the main reason parents have their children taken into child protective services’ custody, may be the result of parents not being able to get medical or dental care for their child. Our best bet for addressing a host of health challenges is easy access to a quality, comprehensive health care system at an affordable price. We need not become the United Kingdom—where everything is free at the point of service—but we should make sure that parents don’t skip their kid’s medical treatment because they can’t afford it.

First things first

What are the root causes of people not having access to affordable and accessible medical and dental care?

Let’s get this complex dialogue rolling:

Lack of insurance: In the United States, your health insurance varies depending on where you (or your spouse or parent) works, which means that every time employment or familial relationships are disrupted, so is health insurance. If you get a great new job or get married, you also get to deal with health insurance paperwork, and that’s the best case scenario. We also inflict this burdensome chore on those who were recently laid off and those who are getting divorced—even those fleeing an abusive relationship. Enrolling in health insurance, especially if you don’t get it through a job, can be cumbersome and complex. Inevitably, a certain percentage of the population won’t figure it out, or won’t recognize that they really need to figure it out, which limits their access.

• Lack of coverage: Health insurance isn’t always very comprehensive. Sometimes, you can get the care you need for a $5 copayment. Sometimes, you have to pay the full price until you hit your $6,000 deductible. It just depends on your plan. Those with less comprehensive plans and not a lot of pocket money are effectively shut out of the system.
• Inability to pay: The people who need it most are often not in a situation to pay for it, or not in a situation where they have the wherewithal to fill out the insurance paperwork. Teens running away from or getting thrown out of abusive homes, women or men fleeing abusive relationships, and those descending into horrible addictions, are examples of people who are not likely to come to the system of their own accord. Unfortunately, the system is not likely to find them either.
• Lack of providers: In some areas, there are chronic shortages of health providers. If you have to make ten calls just to find someone accepting new patients, only to make an appointment three months from now, access is effectively restricted. Ditto if the provider works on the other side of a large city or in the next county over, and you don’t have a car.
• Immigration status: Non-citizens are ineligible for many services. ICE has raided emergency rooms and clinics, making asylum seekers afraid to seek care. Legal immigrants fear that it will be harder to become a citizen if they enroll in public insurance plans like Medicaid or subsidies on health insurance exchanges.

With data from the Resilient Community Experience Survey and other sources, you will have a good idea about where in your county the need for medical and dental services exist and why they are difficult to access for both parents or children. You may be surprised by your survey results and learn that a challenge is far bigger or smaller or more localized than originally thought.