Breaking Barriers in Dental Healthcare for People Diagnosed with Developmental Disabilities
The Vital Importance of Access to Dental Care
Access to dental and vision care is essential to maintaining overall health, but for individuals diagnosed with developmental disabilities, securing these services often presents unique challenges. While Medicaid (MO HealthNet) provides crucial coverage in Missouri, numerous barriers remain. Below is an in-depth look at the state of healthcare accessibility for this population, the obstacles they face, and the solutions that can transform their care.
At Sunnyhill, we are committed to empowering individuals diagnosed with developmental disabilities and ensuring they have access to the healthcare they need. However, systemic barriers continue to limit access to dental care. One such example is the story of Warren, a 69-year-old man diagnosed with developmental disabilities, who has faced significant struggles due to limitations in Medicaid coverage. His difficulty accessing $14,000 in necessary dental treatments demonstrates just how urgent these issues are.
Self-Advocates Corner: Warren’s Journey
Warren has spent years struggling to get the care he needs. Despite routine dental care being covered under Medicaid, more advanced procedures like crowns, dentures, and implants are not. Warren faced a dire situation: after requiring $8,000 worth of bridgework to fix severe oral health issues, he was unable to afford the treatment due to Missouri’s restrictive Medicaid asset limits. His family’s trust exceeded the $5,000 asset cap, restricting them to just $4,000 in annual withdrawals, forcing Warren to wait two years to get the treatment he desperately needed. During that time, his oral health deteriorated, and the pain affected his daily life.
Now, Warren needs additional extensive dental care, including four titanium implants, three extractions, two crowns, and possibly root canals. The cost of this care totals $14,000—a financial burden that Medicaid cannot address. Warren’s case is not unique. Many individuals at Sunnyhill face similar dental challenges, from extractions to implants, but lack the financial means to cover these costs. This underscores the urgent need for an emergency quality-of-life fund to help cover these gaps.
Systemic Barriers: The Hidden Struggles
Warren’s story is a vivid example of the broader, systemic challenges that individuals diagnosed with developmental disabilities face when accessing healthcare.
Medicaid Limitations: Medicaid only covers routine checkups but excludes necessary, restorative treatments like crowns, dentures, and implants. This leaves individuals with extensive dental needs to face a huge financial burden.
Cost Barriers: Specialized dental procedures, such as implants and root canals, are costly. Many dentists, when faced with these financial barriers, opt for extractions instead of restorative care, leaving patients with lifelong oral health problems. Medicaid’s stringent income and asset limits force families into difficult financial decisions, delaying care and worsening health outcomes.
Lack of Specialized Training: A significant number of dentists lack the knowledge and skills required to treat individuals diagnosed with developmental disabilities, which discourages many from accepting these patients or providing comprehensive care.
Socioeconomic Challenges: Individuals relying on Medicaid face severe financial strain, limiting their ability to seek proper dental care and leaving them with untreated oral health issues.
Behavioral and Communication Barriers: Anxiety, behavioral challenges, and communication difficulties can make dental visits stressful, and many individuals require sedation, which adds another layer of cost.
Transportation and Access: For individuals in rural areas, accessing dental services is a constant challenge, with some patients needing to travel hours to receive care.
The State of Dental Care in Missouri: Coverage and Challenges
Dental care for people diagnosed with developmental disabilities is a growing concern in Missouri, as gaps in coverage and access continue to impact health outcomes.
MO HealthNet Coverage: While children under 21 receive comprehensive dental coverage through MO HealthNet, adults face significant gaps. Routine exams are now covered for adults (as of July 1, 2024), but advanced treatments like crowns, dentures, and orthodontic services are still not included.
Provider Shortages: The lack of providers willing to accept Medicaid, particularly those equipped to care for individuals diagnosed with developmental disabilities, exacerbates the problem.
Rural Disparities: Transportation and provider shortages are even more pronounced in rural areas, making it harder for individuals to access the care they need.
Specialized Care Needs: Many individuals require sedation or general anesthesia for dental procedures, which are not only expensive but also difficult to obtain.
Proposed Solutions: Bridging the Gap
To address these barriers, Sunnyhill proposes a multifaceted approach:
The Sunny Day Fund: A dedicated fund to subsidize dental and vision services for individuals diagnosed with developmental disabilities whose needs exceed Medicaid coverage.
Provider Training Programs: Offering specialized training to ensure dentists are equipped to treat individuals diagnosed with developmental disabilities, helping to overcome the gap in care.
Caregiver Education: Equipping families and caregivers with tools and knowledge to prioritize oral and vision health.
Policy Advocacy: Advocating for policy changes that expand Medicaid coverage to include advanced dental procedures and more frequent vision care.
Proposed Solutions: Bridging the Gap
To address these barriers, Sunnyhill proposes a multifaceted approach:
The Sunny Day Fund: A dedicated fund to subsidize dental and vision services for individuals diagnosed with developmental disabilities whose needs exceed Medicaid coverage.
Provider Training Programs: Offering specialized training to ensure dentists are equipped to treat individuals diagnosed with developmental disabilities, helping to overcome the gap in care.
Caregiver Education: Equipping families and caregivers with tools and knowledge to prioritize oral and vision health.
Policy Advocacy: Advocating for policy changes that expand Medicaid coverage to include advanced dental procedures and more frequent vision care.
Call to Action: Join the Movement for Change
The issues surrounding healthcare access for individuals diagnosed with developmental disabilities cannot be ignored any longer. Although Sunnyhill continues to seek funding and advocacy support, the reality is that many grant proposals are denied due to a focus on global initiatives rather than addressing the urgent needs of our local communities. This leaves vulnerable populations like those in Missouri underserved.
We need your help to bridge this gap. By supporting the Sunny Day Fund, we can:
Provide essential dental and vision care to individuals who need it most.
Advocate for changes in policy to ensure broader coverage and better care options.
Ensure that individuals like Warren receive the dignity and healthcare they deserve.
Together, we can create a future where every person, regardless of their diagnosis, has access to the healthcare they need to live a healthy, fulfilling life.
Get Involved: Join the Movement for Change
❄️ Be Part of Let It Snow – Flurries of Hope! ❄️
This holiday season, we invite you to join Sunnyhill in making a difference. Through our Let It Snow – Flurries of Hope campaign, you can help bring hope and support to individuals in our programs in two powerful ways:
Contribute to the Annual Appeal
Every donation to our Annual Appeal fuels Sunnyhill’s programs and services, ensuring that we can continue providing year-round care for those we serve. Your generosity helps us create a supportive and inclusive community for individuals with developmental disabilities.Buy a Snowflake to Spread Holiday Cheer
Each Sunnyhill Snowflake you purchase provides warmth, essentials, meals, and the joy of the season to individuals in need. Every snowflake lights up a life and brings essential support to those who need it most.
This season, Sunnyhill’s Snowflake of Hope wish is that each individual we serve feels the warmth of community and the security of having their essential needs met. Let’s come together to make this wish come true and let it snow hope and cheer! Make sure to visit Sunnyhill’s social media and website to see wishes from our community and staff.
Shine your light of generosity on those supported by Sunnyhill’s programs and services this holiday season. For all donations over $250, contributors will receive a custom resin snowflake created by a Sunnyhill artist.
Upcoming Events:
The Sunlit Circle Ticket Package On Sale Now - $500 Donation for VIP experiences at March Matchness on 3/20/25, Sunnyhill Derby on 5/3/25, ARTventure 2025, July 2025, and Sunnyhill's Pickleball Tournament on 9/14/25
3/20/2025: March Matchness, Top Golf Chesterfield, MO
A unique twist on college basketball tournament season – enjoy golf, delicious brunch buffet, bottomless drinks, and spirited games while helping us raise $50,000 to make Sunnyhill Adventures more inclusive with extended golf carts.
More Information: https://MarchMatchness25.eventbrite.com
Support the Sunny Day Fund! 🌞
Launched in October 2024, the Sunny Day Fund provides crucial support for Sunnyhill individuals facing challenges like health expenses, utility bills, food insecurity, and housing instability. This fund removes barriers, allowing individuals to focus on their goals and well-being.
How It Works:
10% of all donations and fundraising proceeds go directly to the Sunny Day Fund. You can also contribute fully to the fund to maximize its impact. We aim to raise $250,000 annually to provide ongoing support.How You Can Help:
Donate: Your gift helps cover urgent needs like health, housing, and daily essentials.
Spread the Word: Share the Sunny Day Fund with friends and family.
Get Involved: Join volunteer opportunities and events to strengthen the fund’s impact.
Together, we can make life’s challenges a little easier, one sunny day at a time! 🌞
Opportunities to Give to Sunnyhill
1/30/25, 4 PM - 8 PM: Giveback Night at Panera at Sunset Hills: 10740 Sunset Hills Plaza, Sunset Hills, MO 63127, Tell them you are there for Sunnyhill.
1/30/25 - 2/28/25: Dave & Buster’s Power Card, 50% of the purchase will be donated to Sunnyhill!
March 9th, 2025: Chili Cook Off at Elks Lodge #9. Click for More Information
Wellness Focus: Caregivers Corner
Dental visits can be anxiety-inducing, especially for individuals diagnosed with developmental disabilities. The "Tell-Show-Do" method is an effective way for caregivers to help individuals feel more comfortable with dental care routines. Here’s how it works:
Tell: Start by explaining the process in simple, clear terms. Let the person know what to expect and encourage questions. For example: “We’re going to put some toothpaste on the brush, then gently clean your teeth, starting with the front ones.”
Show: Demonstrate the process. Show the toothbrush, toothpaste, and floss, and demonstrate brushing on yourself or a model. Let the person hold the tools to become familiar with them.
Do: Follow through with the routine, gently and patiently. Provide positive reinforcement along the way: “You’re doing great! Now we’re going to brush your front teeth, just like I showed you.”
This method can reduce anxiety and promote better oral health, while also strengthening the relationship between caregivers and the individuals they care for.
Additional Tips for Caregivers
Consistency: Make dental care a daily routine at the same time each day.
Comfort: Create a calming, comfortable environment, which could be anywhere other than the bathroom.
Positioning: For those with limited mobility, position yourself for easier access when brushing.
Adaptations: Consider using special tools like enlarged toothbrush handles or electric toothbrushes.
Praise and Encouragement: Reinforce positive behavior to build trust and cooperation.
By using these techniques, caregivers can significantly reduce anxiety, foster a positive dental care experience, and ensure better overall health for the individuals they care for.
Community spotlight: Carol House Furniture
Community Spotlight: Carol House Furniture
Sunnyhill is thrilled to recognize Carol House Furniture for going above and beyond to make Josh feel like a VIP during his recent shopping experience. In December, Josh received "Replacement Funds" from the Productive Living Board to help furnish his apartment, which only had a bed and little else to make it feel like home. After losing his job due to medical needs, Josh's situation was especially challenging. With a budget of $800, Josh was able to find a perfect, comfortable chair, thanks to the generosity and kindness of Brook Dubman, the owner of Carol House Furniture. Brook connected Josh with Jonathan, a dedicated staff member who spent several hours assisting Josh in selecting the perfect piece within his $800 budget. Jonathan also made sure to arrange for quick and free delivery, ensuring Josh's new chair arrived without delay. Carol House Furniture’s tagline, "Because You Like Nice Things," truly rings true. Everyone deserves to enjoy nice things, and Carol House went above and beyond to make sure Josh experienced just that, providing him with personalized care every step of the way.
Executive Message: Amy Wheeler, CEO
This month, we’re highlighting the challenges individuals diagnosed with developmental disabilities face in accessing dental and vision care. Warren’s story exemplifies the struggles many experience due to limited Medicaid coverage and high treatment costs. His journey underscores the urgency of breaking down these barriers.
However, we can’t do it alone. Your support makes all the difference. Whether it’s contributing to the Sunny Day Fund, sharing this message to raise awareness, or advocating for policy changes, together we can create a future where individuals with developmental disabilities no longer face unnecessary struggles in accessing healthcare.
We invite you to read more in this month's issue, learn how you can get involved, and help us continue making a positive impact in the lives of those we support.
Amy Guignon, Applied Behavioral Services
We’re hiring at least two new BCBAs and have an In-Home Lead BCBA starting in February. Several RBT positions are also open to support service delivery for the people we support at Sunnyhill.Jayne Grisham, Adventures Camp & Travel
No Update for January 2025.Tamico Jones, Advocacy & Family Navigation Services
Sunnyhill’s Community Outreach calendar is filling up for the spring. We look forward to continuing to educate communities creating inclusive environments.Becky Mullins, Greater St. Louis ISL & Waiver
With Medicaid being the primary insurance for the people we support and a limited number of people carrying private insurance, dental care is often difficult to obtain. The people we support sometimes end up visiting dental clinics that are not always able to provide consistency in staffing. This means that the people we support do not have the ability to build rapport and become comfortable with their dental provider. When dental providers recommend advanced services such as root canals, extractions, bridges, etc. the people we support often have to travel out of town to find a provider that takes their insurance or they are faced with an expensive treatment plan. Since dental care can affect an individual’s overall health and well-being, affordability and accessibility of these services is very important to us.Megan Shoults, Jefferson County ISL & Waiver
We’re incredibly grateful for our generous donors, including a $1,500 family gift, support from the Knights of Columbus, and numerous Amazon wish list contributions—bringing joy this holiday season!Our Annual Jefferson County Party on December 16th was a huge success, with over 200 attendees enjoying great food, dancing, and a visit from Santa. On December 19th, 98% of employees participated in Annual Jefferson County Training, including Fire Extinguisher safety.
As we finalize transitioning five homes to the Jefferson County waiver, our team continues to reduce overtime while maintaining top-quality care. Thank you for making this progress possible!
Amanda Kehoe, Individualized Supporting Living Assistance (ISLA) and Pre-ISLA
This month the ISLA team has been focusing on safety, specifically how to stay safe in the winter months. We continue to give out resources like heat up STL & warning centers. We continue to have these talks, so our individuals are ready and prepared.Jennifer Gibbs, Nursing
No Update for January 2025.
Kathleen Branson, CFO
Sunnyhill’s audited financials for FY2024 are now available and will be publishing our updated 990 in February.Kelly Scarcliff, Human Resources
Sunnyhill is excited to launch our SEED program to amplify the voices of our workforce.Interested in learning about employment opportunities at Sunnyhill? Visit our career listings on Indeed.
Jim Schmitt, Information Technology & Security Services
No Update for January 2025.Chris Shoults, Facility & Maintenance
No Update for January 2025.