Homeless man with serious mental illness (un-diagnosed) sleep near 15th avenue and Van Buren in Phoenix, Arizona.
Mercy Maricopa Integrated Care is now the Regional Behavioral Health Authority (RBHA) for Maricopa County, Arizona.
Its primary push has been the integration of mental and health services in Arizona for SMI (Seriously Mentally Ill) clients in Maricopa County through its IHH (Integrated Home Health) program.
Unfortunately this program falls short in many areas…not the least of which is its total disregard of providing quality dental care to its at risk, vulnerable population of SMI clients.
Everyone should have regular dental care. It is a critical part of your health component. According to the Arizona Department of Health Services: “Good oral health impacts general and overall health throughout a person’s life. Oral diseases have been linked to diabetes, heart disease and stroke” (source: http://www.azdhs.gov/phs/owch/oral-health/dental-health/).
In the case of Mercy Maricopa dental care is simply not a priority for them.
In fact Mercy Maricopa executive management, including its Chief Executive Officer, Eddy Broadway are so detached from the actual needs of the SMI clients they serve this whole issue of dental health care doesn’t even register on their radar.
I did an informal survey recently of 10 non Title 19 SMI clients at my clinic, when I was Chairman of the Clinical Advisory Council (CAC), 8 out of 10 had extremely serious dental problems. In 3 of the cases it was so severe I recommended they go to a hospital emergency room immediately for treatment, because their gums were bleeding so bad!
These include, but were not limited to, broken and missing teeth, severe tooth decay and chronic gum disease.
In many cases the severity of their dental problems were so chronic that it adversely affected their ability to eat most, if not all solid foods, simply because they had no teeth to chew their food properly in the first place!
I was talking to a physician recently about this issue of dental health (who specifically asked I not use his name in this report) who indicated that “Diabetes, AIDS and other syndromes have indicators that start in the mouth.”
“Periodontal disease, or gum disease, for example has been linked to more serious ailments like cardiovascular disease, stroke and bacterial pneumonia. If you are pregnant and have periodontal disease, there is a risk of delivering your baby pre-term or at a low-birth weight. The links between gum disease and overall health are still being explored, but one finding is that some systemic diseases like HIV and diabetes that compromise the immune system make periodontal disease more serious. Studies also show that oral bacteria can lead to cardiovascular diseases, arterial blockages and even stroke. Having one of the above ailments does not mean you will get gum disease, nor vice versa, but the knowledge that your oral health or lack thereof can be an indication that something more severe is happening in your body, should be great reason for most people to pay closer attention to their mouth. The treatment of oral disorders may prevent bigger issues later on”, he said.
I attempted on numerous occasions to address this issue in particular with my clinic administrator and IHH health coordinator, both of whom refused to discuss or meet with me on this issue. As did the Regional Director of my clinic who insisted I address any and all problems I was having in terms of the CAC at the clinic level. Not realizing of course that I tried that and was getting no where on many of these issues facing our clients.
I also tried unsuccessfully to engage my primary care physician at IHH Capitol, who didn’t even want to discuss the matter with me except to say she agreed with me.
Finally I contacted Mercy Maricopa customer service who refused to allow me to contact the CEO of Mercy Maricopa directly so I could discuss the issue with him, after a few minutes the representatives said my concerns were noted and they would have someone contact me soon. That, of course never happened, for whatever reason?
I also tried unsuccessfully to engage Governor Jan Brewer, on at least half dozen different occasions to discuss the issue with her. Her office staff, refused to set an appointment and refused to allow me to call and speak with her directly on this matter.
Apparently the governor is too busy to meet with constituents.
I had no other choice but to conclude that there was simply no interest whatsoever, at any level to address this health crisis in Maricopa County, at either the state, RBHA or clinic level.
At present the only SMI clients who have dental services provided to them as part of their health insurance coverage are those who have been approved for disability benefits by the Social Security Administration which covers them under Medicaid.
Sadly many SMI clients, despite being disabled by definition because of having a serious mental illness are routinely denied disability and many can only receive AHCCCS health insurance coverage at this time through the state of Arizona, AHCCCS is Arizona’s version of Medicaid – which currently doesn’t cover dental health services.
That leaves thousands of SMI clients unable to access quality, affordable dental health services in Maricopa County, Arizona.