Another Successful Annual Conference! 

On June 2, 2017 members and guests of the NYSOHC convened at the Radisson Hotel on Wolf Rd in Albany. It proved to be a very informative day for the 100+ attendees. 

On behalf of the Steering Committee and Executive Committee I would like to thank the speakers and our major sponsor:

A special CONGRATULATIONS goes out to Dr. Neal Demby, recipient of the Elmer Green Award. Dr. Demby's career in Public Health Dentistry has touched so many! 

The presentations are now available for your viewing. Please feel free to share the information with your colleagues. 

Dr. Dionne Richardson's presentation, "Oral Health Activities @ the NYS Department of Health":

NYS Oral Health Coalition Meeting DRichardson Final.pdf

Ms. Sylvia Pirani's presentation, "NYS Prevention Agenda 2013-2018: Progress Towards Becoming the Healthiest State":

SylviaOral health slides 5-30-17.pdf

School-Based Oral Health Programs: The Future is Now

Tele-dentistry Trends and Innovation

Keynote Speaker: Mr. Patrick Finnerty

"The Federal Landscape: What's Ahead for New York's Insurance Programs?"

Continuing Education Credits available for Dentists and Dental Hygienists!

2017 Annual Meeting

Friday, June 2

Radisson Hotel, Wolf Road, Albany NY

(Room block in effect until May 22th, 1-800-333-3333 mention the NYS Oral Health Coalition Block- $115/night)

10:00 A.M. – 3:00 P.M.


The Federal Landscape: What’s Ahead for New York’s Insurance Programs?

 Medicaid, Child Health Plus and the Affordable Care Act have been instrumental in reducing the uninsured rate in New York for children and adults and providing oral health and other essential benefits.  This session will provide the latest on legislative and administrative actions in Washington that could impact eligibility, benefits and funding for these programs.  Learn what you need to know about the federal landscape so you can be engaged and be prepared

Keynote: Mr. Patrick Finnerty, Senior Advisor for Oral Health Programs, DentaQuest.  Improving access to oral health services for Medicaid/CHIP children was a hallmark of Patrick’s tenure as Medicaid Director in Virginia. He is a frequent       speaker at national conferences and symposia regarding Medicaid, CHIP and other health care topics.  Patrick will be joinedby key New York advocates to talk about what is at stake for health coverage and provide information on efforts to protect these programs.


 New York State Oral Health Program Update

 Dr. Dionne Richardson, DDS, MPH, Dental Director, New York State Department of Health, Division of Family Health

 Need to know what is going on in oral health?  You’ll find out here.

 NYS Prevention Agenda 2013-18:  Progress Toward Becoming the Healthiest State

 Sylvia Pirani, MPH, MS, Director, Office of Public Health Practice, NYS Department of Health

Discussions will be underway soon for the next Prevention Agenda. Learn about the progress that has been made and thoughts for the coming version.


 ·         Tele-dentistry Trends and Innovation

 ·         School-Based Oral Health Programs:  The Future is Now

A room block is in place, mention the NYS Oral Health Coalition meeting to receive the special rate.

 Call for Nominations -Dr. Elmer L. Green Award

Elmer L. Green Public Health Award

Call for 2017 Nominations

Please read the material and criteria below for the Dr. Elmer L. Green Award.  To nominate a candidate for this award, please send a short narrative (maximum 1 page) as to the capabilities of the nominee.  Please email your nomination to NYSOHC c/o Noreen Myers-Wright,

 Please put “Elmer Green Award” in the subject line of the email.  If the review committee needs additional information, they will contact you.  Please submit your nominations by Friday, May 5, 2017, at 6 PM.  The Dr. Elmer L. Green Public Health Award will be presented at the Annual Meeting in Albany, NY on Friday, June 2, 2017.

The Elmer L. Green Public Health Award is presented in memory of the past director of the NY State Bureau of Dental Health. In 1973 he was hired by the NY State Department of Health as a regional public health dentist. Dr. Green was promoted to director of the Bureau of Dental Health in 1985 and served in that capacity until his retirement on April 15, 2010. He will be remembered for his mild manner, his ever present smile and his untiring devotion to oral health.   

While director, he developed a program to bring orthodontic care to thousands of children with debilitating malocclusions who could not afford correction. He shepherded this program from its infancy until it was available throughout the state.  

After  promoting  water  fluoridation  for  nearly  forty  years,  he  was  presented  the  Lifetime Achievement Award by the Commissioner of Health, Richard F. Daines MD, in November 2009.Currently over seventy percent of the population of NY State has access to optimum fluoridated municipal water. In 2005 Dr. Green also received the Governor’s Award for Excellence in State Government in recognition of his diligent work to direct public health programs and provide grants to local health departments, community programs and dental services in hospitals and public clinics.  

After receiving his doctor of dental surgery degree from Howard University, Dr. Green earned a master of public health degree from the University of Michigan. He used these credentials in mentoring the public health residents in Albany and to help supervise their clinical research.  

One of his closest colleagues, Dr. Jayanth Kumar, wrote: “For people who had the pleasure of working

with Dr. Green, he was most admired for his knowledge, humility and warmth.” Donna Altshul RDH, BS said “While working with Dr. Green it was evident that he was a very warm, compassionate and sincere person. He was dedicated and passionate about improving oral health in NY State.” Dr. Caswell Evens, Associate Dean, Prevention and Public Health Sciences, University of Illinois at Chicago, College of Dentistry, stated that “Elmer was a gentleman and modest in all things. He led the NY State oral health program for many years, even across numerous leadership changes in the state health department.”

With this award, the New York State Oral Health Coalition wants to recognize individuals who emulate a devotion to promoting oral public health in the same spirit as Dr. Elmer L. Green. The recipient should demonstrate achievement in the field of oral public health and evidence of challenging traditional policy or public health practice to improve oral health in an ongoing, creative and positive manner.  



 UPDATE.................Community Water Fluoridation


Another Opportunity for the Drinking Water Fluoridation Fund is Coming Soon!


Missed the previous opportunities to apply for grants from the Drinking Water Fluoridation Fund?  Start getting your materials together for Round 3.


The New York State Department of Health will release a third round of funding opportunities to support costs related to the construction, installation, repair, replacement, or upgrade of fluoride equipment in drinking water facilities. The funding will be available to counties, cities, towns, or villages that own their public water system.


The opportunities will be posted on Grants Gateway.  Watch for an announcement coming soon!




Proud Sponsor of the 2016 Annual Conference

Another Successful Conference

I would like to take this opportunity to thank our sponsor DentaQuest, the wonderful presenters, the conference committee and our dedicated and loyal attendees.  I received positive feedback from so many of you! I look forward to working with the steering committee in continuing to advocate for the oral health needs of all New Yorkers. The Annual Conference provides an opportunity for networking, education and recognition. 

A special CONGRATULATIONS goes out to Dr. Dolores Cottrell, recipient of the Elmer Green Award. Dolores has been a member of the coalition since its inception. Her career in Public Health Dentistry has touched so many! 

Enjoy the Summer!!


Paula Fischer

2016 Annual Conference

Friday, April 15

Hilton Garden Inn, Troy, NY

Networking and Coffee starting at 8:30 AM

Program from 10:00 AM – 3:00 PM



  • I.                    Registration and Coffee starting at 8:30 AM

Coming early?  Join us at 8:30 am for a facilitated conversation about connecting oral health programs and school nutrition programs. 

Nutrition and oral health are natural partners.  What is happening in schools?  What are some ideas about better ways to make connections?  Over a light breakfast, hear a presentation from Sherry Tomasky, Director Public Affairs, Hunger Solutions NY on school food programs and then help share some ideas of how we can expand the dialogue between these important programs in schools.

  • II.                  Welcome at 10:00 AM

  • III.                Oral Health Activities at the New York State Department of Health

KEYNOTE SPEAKER: Dr. Dionne Richardson, DDS, MPH

Dental Director, New York State Department of Health, Division of Family Health

As New York’s new Dental Director, Dr. Richardson will provide an update on the Department’s oral health programs, policies and initiatives.

  • IV.                Breakouts
  • ·       Understanding and Promoting Oral Health Equity: Starting the Conversation
  • April is National Minority Health Month and improving the overall health of low-income communities means improving outcomes for oral health.  This workshop will explore the concepts and implications of health equity and begin to address how oral health can be incorporated into a health equity agenda. 
  • Yvonne J. Graham
  • Associate Commissioner, Director, Office of Minority Health & Health Disparities Prevention, New York State Department of Health
  • Becca Telzak
  • Director of Health Programs, Make the Road New York
  • Rucha Kavathe, PhD
  • Project Manager, Community Education & Empowerment Directorate (CEED), UNITED SIKHS
  • ·       Getting the Most Out of Electronic Health and Dental Records in an Era of Health System Transformation

New York State eMEDNY, NY Medicaid EHR Incentive Program, Division of Operations and Systems, will explain the Electronic Health Record Incentive Payment Program reimbursements and current transition to a new Medicaid management system. The New York State Regional Extension Centers, New York eHealth Collaborative (NYeC) and New York City Regional Electronic Adoption Center for Health (NYC REACH), will explain how dentists can obtain services to improve electronic transformation, care coordination, patient engagement, and workflow improvement.


Michael Edmonds

Senior Consultant at New York State Technology Enterprise Corporation. New York State eMEDNY, NY Medicaid EHR Incentive Program, Division of Operations and Systems.

Emily Carroll

Senior External Relations Specialist for NYC REACH within the Primary Care Information Project (PCIP), part of the NYC Department of Health and Mental Hygiene. NYC REACH is the federally designated regional extension center (REC) for NYC.

Roy Gomes, RHIT, CHPS

Implementation Project Manager, New York eHealth Collaborative. Eligible Expansion Program (EP2). NYeC is the federally designated regional extension center (REC) for NYS.

Panel Members:

Carol Sloane, RDH

Assistant Dean Allied Education & Director of Clinical Operations, Stony Brook School of Dental Medicine.

Fred S. Ferguson, D.D.S.

Distinguished Teaching Professor, Department of Orthodontics and Pediatric Dentistry. Director of the Advanced Education Program in Pediatric Dentistry. Stony Brook School of Dental Medicine.

Jan Abbott

Mid-Market Area Manager - Public Health at Henry Schein Practice Solutions, Henry Schein, Inc. Dentrix and axiUm Enterprise.


  • ·       NYS Oral Health Coalition Elections
  • ·       Presentation of the Elmer Green Award


  • I.                    Health System Transformation in New York State

  • KEYNOTE SPEAKER: Mr. Greg Allen
  • Director, Program Development and Management, Office of Health Insurance Programs, New York State Department of Health.


New York’s health system is undergoing an extraordinary period of change from Medicaid Redesign, to the Delivery System Reform and Incentive Program (DSRIP) to Value-Based Payments. Learn about these elements and how they fit together in the State’s plan for health system transformation. 

  • II.                  Reactor panel – What might health transformation mean for patients and programs?  What are the challenges and possibilities for oral health?
  • Kate Breslin
  • President and CEO, Schuyler Center for Analysis and Advocacy
  • Co-Chair, Social Determinants of Health Workgroup, NYS DSRIP
  • Clifford Hames, DDS
  • Chief Dental Officer and Chief Infection Control Officer, HRHCare Community Health
  • III.                Audience Q&A /Discussion

Participate in a conversation with Mr. Allen and the panelists to learn more about the future direction of New York’s health care system.

ADJOURN 3:00 pm


Dr. Dionne Richardson, DDS, MPH

Dental Director, New York State Department of Health, Division of Family Health

Prior to joining the New York State Department of Health in January 2016, Dr. Richardson was the dental director for the Mississippi State Department of Health and has more than 20 years of post-doctoral training and experience in the field.  Her prior work as a state dental director includes directing a program that is an integral part of the Maternal and Child Health (MCH) Program including programs such as School Based Health Center Sealant programs. Dr. Richardson’s background and experience closely aligns with the direction the Division is taking oral health related to a life course perspective.  Dr.  Richardson is also a graduate of New York’s Dental Public Health Residency Program.  

Mr. Greg Allen

Director, Program Development and Management, Office of Health Insurance Programs, New York State Department of Health.

Mr. Allen is responsible for Medicaid services planning and policy in addition to development of new and emerging program areas. Mr. Allen is responsible for managing policy and payment support for all NYS Medicaid’s inpatient, clinic, practitioner and pharmacy services as well as payment policy for mental health, chemical dependence and developmental disabilities services. Mr. Allen and his team have recently been engaged in the NYS Medicaid Redesign process including the statewide roll out of the health home care management program for high need, high cost populations. Mr. Allen also has lead responsibility for managing the state’s recently approved $8B Medicaid Waiver including its centerpiece the Delivery System Reform Incentive Payment (DSRIP) program.


 NYS Oral Health Coalition Elections

 Presentation of the Elmer Green Award

   --Registration Opens March 7, 2016 --   


Hotel:  A block of rooms are available until March 23, 2016, $129/night.

To reserve a room visit the Hotel website,, or call (877) STAY HGI by March 23, 2016,  Group Booking Code, OHCA. 

Best Wishes Lee...You will be missed!!!

I remember the phone ringing during the Holidays and wondering "why is Lee calling me"? I had an uneasy feeling and knew something was up. Lee called to let me know he was going to have to resign his position as Co-Chair of the NYSOHC. He was offered an opportunity he couldn't refuse, a position in California with a major insurance company to create a state sponsored dental insurance plan for Californians. Right up his alley. 

I will miss our conversations. I still include him on some emails so he is kept appraised of the coalitions activities. I am very fortunate to have dedicated colleagues on the executive committee and steering committee always willing to step up. Their support has provided for a smooth transition. 

It has been my pleasure serving with Lee and I wish him all the Best in CA!


Paula Fischer,RDH


Water Fluoridation Equipment Grants Now Available 

The New York State Department of Health has released two funding opportunities to support counties, cities, towns, or villages (municipalities) that own their public water system, for costs related to the construction, installation, repair, replacement, or upgrade of fluoride equipment in drinking water facilities. 

One opportunity supports municipalities with funding up to $50,000 for the planning and implementation of community water fluoridation. Component 1 of this opportunity will pay for development of an engineering report to initiate or maintain water fluoridation. Component 2 will pay for the upgrade, replacement, repair or purchase of equipment to initiate or maintain water fluoridation. 

Applications for both components will be accepted on a rolling basis from October 22, 2015 until February 29, 2016. It is anticipated that applications received on or before November 15, 2015 will be reviewed and contracts executed by February 15, 2016. It is anticipated that applications received November 16, 2015–February 29, 2016 will be reviewed by May 1, 2016. Additional details on both components can be found at: Grants Gateway ID: DOH01- DWFC1-2015/ID: DOH01- DWFC2-2015. 

The second opportunity is an RFA which will support municipalities seeking between $50,001 and $1 million to upgrade, replace or repair existing water fluoridation equipment or install fluoridation systems in public water systems that have authorized the implementation of fluoridation. An applicant conference for this RFA will be held on November 10, 2015 at 2:00 pm. See the RFA for more information. Applications are being accepted until February 29, 2016. Additional details can be found at: RFA- Grants Gateway # DOH01-DWF3-2015.

Both opportunities are now posted on the NYS Grants Gateway

The funding for these opportunities was included in the 2015-2016 New York State Budget.


NYS Electronic Health Record Incentive Program Results for Dentists


The Medicaid Eligible Expansion Program (EP2 offered by NYeC) extends the original Medicaid Specialist REC (Regional Extension Center) initiative through Sept. 30, 2016. This program provides outreach, technical, and support services for EHR adoption and for achieving Meaning Use. Unlike the original REC program, which was aimed at primary care physicians, this new extension is open to all eligible Medicaid providers, including specialists. Eligible providers, including dentists, are eligible to receive support from the REC for MU incentives and are now encouraged to enroll in this adoption program. The program will help dentists qualify for up to $63,750 under the Medicaid Incentive Program for the adoption, implementation, and upgrade of a certified EHR and attestation of Meaningful Use Stage 1 and 2.  To date, over $30 million has been dispersed to 1,500 dentists. To learn more select this Web link:


Dentists are eligible for the Medicaid Expansion Program (EP2) if they:

·        Are enrolled as an active fee-for-service Medicaid provider and are in good standing with NYS

·        Billable and payable by Medicaid

·        Meet the 30% of patient visit volume as defined by the Centers for Medicare and Medicaid Services

Under the Medicaid EHR Incentive Program, dentists can qualify for the first payment of $21,250 by adopting, implementing, and upgrading (AIU) a certified EHR technology in the first year, and $8,500 for demonstrating Meaningful Use of certified EHR technology for each subsequent year.


Program Availability

There is limited space in the program, and dentists will be accommodated on a first-come, first-served basis. If you are a qualified dentist and do not already have a certified EHR/DHR in your practice, the time to enroll is now.


Technical Assistant Services Available for Dentists

The following table lists general categories and types of support available for dentists though this grant.

Adoption/Implementation/ Upgrade (AIU)

Assistance in the selection, implementation, or upgrade of a certified electronic health record (EHR) and electronic dental record system (EDR) software system with health information exchange capabilities

Support Services

Workflow analysis and redesign, Project management, Staff training

Privacy & Security Training

HIPAA Compliancy, Security Risk Analysis


Exchange of health information from an EHR

Access, Training, & Guidance

Interoperability and secure messaging, where applicable


Phases of Achievement

Supporting documentation will be required of the providers to demonstrate achievement of each of these phases:

  1. Provider/Practice site participation agreement with the NYeC
  2. Successful AIU of Certified EHR
  3. Attestation of reaching CMS’ criteria for Meaningful Use Stage 1 and Stage 2


Enrollment Contact Information - Web link:


Name: Steven Russell
Phone: 585-698-0674



NYSOHC 2014 Annual Meeting a Success!

With attendance that surpassed our February meeting, it is gratifying, as Lottie Jameson and Mary Ellen Yankosky leave their positions as Co-Chairs to see how the Coalition has grown over the last couple of years.  We are convinced we have left the leadership of the Coalition in great hands – Welcome Dr. Lee Perry, Dentaquest Director and Paula Fischer, Project Coordinator, State University at Buffalo School of Dental Medicine!  Lee and Paula will join Steven Russell, Vice Chair, Nick Tucci, Treasurer, and Bridget Walsh, Secretary. Joining the Steering Committee will be Sangeeta Gajendra, Clinical Chief, Eastman Dental Center; Roseanne Henley, Clinical Manager, St. Peter’s Hospital Dental Center and Jill Guiles, North Country Family Health Center Dental Department.

A Special Thanks to our Presenters for Enhancing our Theme: 
Oral Health Programs and Practices Making a Difference

State Oral Health Plan and Prevention Agenda Update
Jay Kumar, DDS, Director, NYSDOH, Bureau of Dental Health

Impacting State and Local Level Policies to Prevent Dental Disease in Young Children: First Year Update
Bridget Walsh, Schuyler Center for Analysis and Advocacy, Senior Policy Analyst/Oral Health Campaign Coordinator

Preparing Dental Students for Community Health Practice & Inter-Professional Collaboration
Neal G. Herman, DDS, New York University,

Teledentistry Expands Student Experiences
Julie Ruggiero, RDH, St. Joseph’s Neighborhood Center/Monroe Community College Dental Hygiene Collaboration

Project Stay:  Oral Health Education, Nutrition and Tobacco Cessation Counseling and Facilitating Dental Clinical Care for Young Adults.
Noreen Myers-Wright, MA, CHES, RDH, Project Coordinator, Columbia University College Dental Medicine, Section of Public Oral Health/Mailman School of Public Health, Department of Health Policy & Management

Milestones across the Mountains
Elizabeth Bray, RDH, Bassett Healthcare Network, School-Based Dental Health Program

Collaborative Practice and Direct Access to Preventive Dental Hygiene Services
Mary Ellen Yankosky, BS, RDH, Dental Hygienists’ Association of the State of New York, Director, Policy and Advocacy and Co-Chair, NYSOHC

Children's Dental Health Project

1020 19th Street NW, Ste. 400 | Washington, DC 20036

(202) 417- 3594 | | @Teeth_Matter




    DentaQuest Provides Support 

    November 25, 2013 –DentaQuest, a leading oral health company, recently presented a donation to support the work of the New York State Oral Health Coalition as it implements the New York State Oral Health Plan on behalf of all New Yorkers.

    The New York State Oral Health Coalition is the only statewide organization to bring the full breadth of health and human services professionals together to develop public health strategies for the people of New York.  The Coalition engages dentists, hygienists, and public health professionals with nationally recognized evidence-based practices, emerging New York State policies or grants, and community-based success stories to improve access to care and expand prevention strategies.
    “DentaQuest’s mission is to improve the oral health of all,” said Dr. Perry, DentaQuest Dental Director. “Oral Health Coalitions fulfill an important role in improving oral health through their support of programs that fulfil the goals of the state oral health plan. DentaQuest’s donation will help support the NYSOHF’s infrastructure needs as it works on behalf of all New Yorkers.”
    About DentaQuest
    DentaQuest is a leading dental benefits administrator, providing cost-effective administration in every arena of dental benefits, including group, individual, healthcare marketplaces, Medicaid, CHIP, and Medicare Advantage. We are creating an environment of better oral health for nearly 20 million members across the United States. We emphasize prevention and encourage good oral health for all. DentaQuest is supported in its mission to improve the oral health of all by the DentaQuest Foundation, the leading U.S. philanthropy focused solely on oral health and the DentaQuest Institute which is helping oral healthcare professionals improve the quality, efficiency and effectiveness of care delivery. Learn more at

     (DentaQuest delivers a donation to the New York State Oral Health Coalition.  L-R: Dr. Lee Perry, DentaQuest Dental Director, Kristin LaRoche, DentaQuest Government Relations, Mary Ellen Yankosky, NYSOHC Co-Chair and Director, Policy and Advocacy Dental Hygienists' Association of the State of NY, and Kathy Rucinski, DentaQuest Vice President Provider Relations).

    About the New York State Oral Health Coalition
    The New York State Oral Health Coalition is a broad-based association, established in 2006. It is comprised of programs and organizations, healthcare providers, state oral health officials, insurers, health advocates, and policy leaders from across New York. Coalition members met regularly with the New York State Department of Health Bureau of Dental Health, the New York State Public Health Association, and other stakeholders to develop the New York State Oral Health Plan, a blueprint for achieving optimal oral health for all New Yorkers. The Plan, which was released in August of 2006, addresses the burden of oral disease across the state and documents goals, objectives, and strategies that cover a broad spectrum of issues related to policy development, prevention, access to care, workforce, communications, and surveillance and research. Learn more at:


NYS OHC Fundraising Campaign

The New York State Oral Health Coalition is the only statewide organization to bring the full breadth of health and human
services professionals together to develop leading public health strategies for the people of New York.

We engage dentists, hygienists, and public health professionals with nationally recognized evidence-based practices, emerging
New York State policies or grants, and community-based success stories to improve access to care and expand population
prevention strategies.

We are seeking just $30,000 between now and our Annual Meeting in November to establish the infrastructure for
implementation of our Strategic Plan in the upcoming year. Please consider what your organization, your colleagues, friends,
and family can do to help the New York State Oral Health Coalition sustain its mission.

With your help, we can become the most valuable statewide resource of health professionals seeking to
cost-effectively reduce dental diseases in their communities.

Please donate now!!




Update from

September 2013

A Profile of Active Dentists in New York

This brief describes demographic, educational, and practice characteristics of actively practicing dentists in New York. Despite the fact that almost
all of the state’s regions are well above the national rate of 55 dentists per 100,000 population, access to basic oral health services in New York is problematic, particularly for Medicaid-insured patients. Download this research brief: nydentist2013.pdf

A Profile of Dental Hygienists in New York

This brief describes the active dental hygienist workforce in New York. The analysis finds that dental hygienists are unevenly distributed across the state, with substantial maldistribution in the counties of New York City. The vast majority of dental hygienists work in private dental practices and nearly half work part time. Download this research brief: nyhygienist2013.pdf



Report Finds Lower-Income People in Top Performing States Often Better Off Than Higher-Income People in Lagging States; Millions Would Have Better Care and Healthier Lives If All States Could Do As Well As The Top Performers

New York, NY, September 18, 2013 - Access to affordable health care and quality of care vary greatly for low-income people based on where they live, according to a new Commonwealth Fund scorecard. The Scorecard provides the first state-by-state comparison of the health care experiences of the 39 percent of Americans with incomes less than 200 percent of the federal poverty level, or $47,000 a year for a family of four and $23,000 for an individual. Low-income people account for at least 25 percent of total state populations, and as much as nearly half (47%) in some states - including Arkansas, Louisiana, Mississippi, and New Mexico.

The report also compares the health care experiences of those with low incomes to those with higher incomes - over 400 percent of poverty, or $94,000 for
a family of four - and finds striking disparities by income within each state. Yet, the wide differences by geography often put higher-income as well as low-income families at risk. The report finds that higher-income people living in states that lag far behind are often worse off than low-income people in states that rank at the very top of the scorecard. For example, low-income elderly Medicare beneficiaries in Connecticut and Wisconsin are less likely to receive
high-risk medications than are higher-income elderly in Mississippi, Louisiana, and Alabama.

The stark differences in health care access, quality, and outcomes detailed in the report add up to substantial loss of lives and missed opportunities to
improve health and quality of care. According to the Scorecard, if all states could reach benchmarks set by the leading states for their more advantaged populations:

  • an estimated 86,000 fewer people would die prematurely each year,
  • 750,000 fewer low-income Medicare beneficiaries would be prescribed potentially dangerous medications,
  • tens of millions of adults and children would receive needed preventive care like vaccines, check-ups, and cancer screenings,
  • nearly 9 million fewer low-income adults under age 65 would lose six or more teeth because of tooth decay, infection, or gum disease, and
  • 30 million more low-income adults and children would have health insurance coverage, reducing the number of uninsured by half.

“We found repeated evidence that we are often two Americas, divided by income and geography when it comes to opportunities to lead long and healthy lives. These are more than numbers,” said Cathy Schoen, Commonwealth Fund Senior Vice President and lead author of the report. “We are talking about people’s lives, health, and well-being. Our hope is that state policymakers and health care leaders use these data to target resources to improve access, care, and the health of residents with below-average incomes.”

The report, Health Care in the Two Americas: Findings from the Scorecard on State Health System Performance for Low-Income Populations, and online interactive map rank states on 30 indicators covering issues such as access to affordable health care, preventive care and quality, potentially avoidable hospital use, and health outcomes. The report also examines how well the top-performing state in each category does for its high-income residents and sets that as a benchmark in order to assess the potential if all states could do as well.

Income-Related Health Disparities Exist Within and Among States

The report finds substantial variation in health care and health outcomes for low-income people - a two- to five-fold difference. While there was room for every state to improve, states in the Upper Midwest, Northeast, and Hawaii performed best, while Southern and South Central states often lagged.

Some findings of wide geographic disparities and gaps in care include:

  • The percentage of uninsured low-income adults ranged from a low of 12 percent in Massachusetts to a high of 55 percent in Texas.
  • Only 32 percent of low-income adults ages 50 or older received recommended preventive care, such as cancer screenings and vaccines, ranging from 26 percent or less in Idaho, Oklahoma, and California, to 42 percent in Massachusetts, the top-ranked state for this indicator.
  • In eight states, 40 percent or more of Medicare beneficiaries received medications considered high-risk for the elderly - rates more than double that
    of states with safer prescribing.
  • Asthma-related hospitalizations among children from low-income communities in New York were eight times higher than in Oregon, the state with
    the lowest rate. (477 per 100,000 in New York compared to 56 per 100,000 in Oregon.)
  • At least one of four low-income adults under 65 in West Virginia, Tennessee, Alabama, Mississippi, and Kentucky lost six or more teeth due to decay
    or disease, compared to less than 10 percent in Connecticut, Hawaii, and Utah, the states with the lowest rates.

Demonstrating the potential to improve, the report finds that in top-performing states, low-income people often fared better than the national average, and even better than higher-income people in the worst-performing states. On nearly half of the indicators, including potentially preventable hospitalizations, infant mortality, smoking, and obesity, lower-income or less-advantaged people in high-performing states did better than more-advantaged people in low-performing states.

Low-Income Families Suffer from Lack of Access to Affordable, Timely Health Care

The report finds that low-income people were more likely to be uninsured or underinsured than those with higher incomes. In 2010-2011 nearly 56 million low-income people were uninsured or underinsured, ranging from a low of 36 percent in Massachusetts to a high of more than 60 percent in Alaska, Colorado, Florida, Idaho, Montana, Nevada, New Mexico, Texas, Utah, and Wyoming.

Insurance and access to health care are closely linked: the report finds that insured low-income people have similar rates of having a usual source of care and receiving recommended care as insured high-income people. However, insurance alone doesn’t guarantee receipt of high-quality, safe care, as demonstrated by the varied experience of low- and higher-income Medicare beneficiaries, all of whom are insured.

The report findings point to the need to strengthen primary care to ensure timely access, reduce reliance on emergency rooms, and improve care for those with chronic disease. The Scorecard finding that those living in low-income communities often fare worse points to the need for targeted efforts focused on “hot spots,” or communities with very high rates of hospital or emergency room use, to act early, prevent complications and improve population health.

Improvement is Possible

According to the report, the Affordable Care Act represents a historic opportunity for states to provide better health care to economically vulnerable people by providing resources to overcome the geographic and income divide - especially for states with high rates of poverty. The authors note that investing those resources well has the potential to improve the health and productivity of the entire state. The scorecard offers targets to improve as well as a way of tracking progress by state over time.

“The Scorecard’s startling findings show us where our bright and weak spots are when it comes to providing health care to millions of Americans living on modest or low incomes,” said Commonwealth Fund President David Blumenthal, M.D. “And the timing is important. We are at an unprecedented moment in the history of our nation. We have the potential to raise the bar, unite the country, and realize the promise of a more equal opportunity to thrive by expanding health care coverage and innovating to find the most effective ways to deliver high-quality, safe care for everyone.”

Data and Resources Available

The report and additional resources, including an interactive map, state profiles, an infographic, and a slide show explainer, “A Tale of Two States: The Health Care Income Divide Visualized,” will be available at:

Methodology: The low-income scorecard compares states on 30 indicators spanning access and affordability, prevention/quality, potentially avoidable hospital use, and health outcomes. It draws from the most current data available, generally 2010-2011. Where possible the indicators compare experiences by income. Where person-specific income information was not available, the analysis uses low-income communities or education to assess income-related differences. States were ranked on each indicator and dimension. For selected indicators the analysis assesses potential gains if the state improved to the top rate set by leading states for low- income or high-income residents. The website provides state-specific profiles.


Oral Health News

The American Academy of Pediatrics recently updated its web site
dedicated to
Children's Oral Health. This AAP site continues to offer
valuable tools and resources, but in a more streamlined and easy to
navigate format.

The PEW Report
Making Coverage Matter was released May 24, 2011.
New York improved from a C grade to a B. Check out our Fact Sheet for details.

On May 15, 2011, the New York State Medicaid Program Dental Policy and Procedure Manual was released. For more information on this provider manual, Click here for more information on the Dental Manual.

To learn about New York's Medicaid Redesign Team, contact the Team,
and to stay informed as they work on their initiatives, visit

The Ad Hoc Group on Local Oral Health Programs for the Association of
State and Territorial Dental Directors Best Practices Committee released
Local Oral Health Programs and Best Practices Voices from the Field:
The End-Users' Perspective
report in February, 2011.

The Older Adults Basic Screening Survey Webinar held on January 20th,
2011 is archived and available for viewing on the ASTDD site.

Other Updates...

Summary of Oral Health Provisions in Health Care Reform








The New York State Oral Health Coalition, along with many organizations joined the Coalition for Health Funding and the Committee for Education Funding in support of a sign-on letter, directed to the House and Senate Appropriations Committees. The letter urged them to provide a 302(b) allocation to the
Labor-HHS-Education Subcommittee that protects those important programs against further cuts. The letter reflected nearly 400 signatures representative of
national, regional and state organizations who share the same concerns should further cuts be made to allocations that benefit health and education funding in the United States. For more information, please visit its website at: and follow on Twitter @healthfunding

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