California’s Denti-Cal program for low-income residents suffers from low utilization rates for children that probably result from the difficulty people have finding a dentist who will accept patients whose care is reimbursed through the program, a state audit concludes.

And that shortage of dentists in the program, in turn, can be traced to the fact that California’s reimbursement rates are lower than the national average and roughly 35 percent of the amount dentists in other states are paid for the same services.

The problems are leaving California’s low-income children “at higher risk of dental disease” which can cause pain, illness and even death, the auditor noted.

The problems are especially troubling because the program is on the verge of a massive expansion thanks to the federal Affordable Care Act, which has made dental care insurance available to millions of Californians who lacked it before.

Other problems in the program  cited by the California State Auditor:

–The state Department of Health Services is not monitoring reimbursement rates to determine if they are sufficient to provide access to the program;

–A private dental plan contracted with the state to provide outreach to potential clients is probably not fulfilling its obligations;

–The state lacks sufficient data to understand whether the program is working and of not, why not.

To download the full report, click here.