Monday, June 4, 2001

Darcy Owen of the University of California at Los Angeles,
a resident at the Queen's Medical Center dental clinic,
recently inspected 9-year-old Jonese Dela Cruz's teeth.

Queen’s dental
clinic to keep
serving poor

The cash-strapped facility
gets $350,000 from the state to
stay open for another year

By Helen Altonn

Thousands of poor, seriously ill and injured islanders who benefit annually from the Queen's Medical Center dental clinic will be relieved to know it has been given another year of life.

The state Health Department has agreed to support the program with $305,000 in the next fiscal year, said Dr. Mark Greer, chief of the Dental Health Division.

Queen's said last November it planned to close the dental residency program this month because of an annual $350,000 loss, primarily due to low Medicare and Medicaid payments and free care for the poor.

The Health Department provided $400,000 to keep it going for one year after first lady Vicky Cayetano met in December with Health Director Bruce Anderson and Dan Jessop, Queen's executive vice president and chief operating officer.

Queen's was to try to look for other options after the state funding ran out.

Dr. Samuel Ishimura, director of the dental residency program, said it is reorganizing and has hired a grant writer to seek federal funds or other resources to sustain the program.

"But it is hard," he said, citing tough competition for funds and difficulty matching the program with available grants.

He said the clinic is increasing its fees, collecting from patients who can pay and urging Medicaid to increase its reimbursement rate. It is only 28 percent of what the clinic charges, he said, "but we can't turn people away. They come in genuinely in pain, medically compromised, turned down by other dental offices."

Dr. Angela Chin, a graduate of the residency program who now has a private practice in Aiea, serves as chief of Queen's Dental Division. It is a voluntary and elected position.

She said she has formed a core committee with 10 volunteer dental staff members to look at ways to save the program and make it more efficient.

"It's tough, but if we don't find this funding, the way things are going ... We're very concerned," she said.

Greer, also a graduate of the dental residency program, said funds available for dental services for disabled adults are being used to keep the residency program afloat another year. "Beyond that there's no specific commitment for state support."

But, he said, "We hope we can continue working with Queen's this year to see what might be feasible in dealing with next year's Legislature to get public support for the dental program."

If the program were to close, Hawaii would have to fly disabled and medically fragile people needing dental surgery to California, Greer pointed out. "It's well worth the $305,000.

"It's a wonderful program, a tremendous community service, and also provides very good training, particularly dealing with people with disabilities.

"It was my experience at Queen's that led to me doing the kind of work I do."

The clinic has eight paid staff members, including the director and two residents. About 45 dentists volunteer their services.

The clinic's two residents are the only dentists in the state on call 24 hours a day, he said. Together, they work about 300 hours a year on nights and weekends, mostly handling emergency room cases, he said.

Darcy Owen of the University of California, Los Angeles, and Gary Komenaka of the University of Oregon said they are winding up their year's residency with a lot more confidence than when they began.

The program has given them a chance to work on difficult cases with dental specialists. Two plastic surgeons and five oral surgeons are on the call list.

Both residents plan to start private practice with associates after two new residents take their place next month. Owen is going back to California, and Komenaka hopes to remain in Hawaii, his home state.

They said they have had "a great experience" at Queen's, learning advanced procedures they did not get to do in dental school, such as working on impacted wisdom teeth with an oral surgeon.

"It's hard to know what private practice will be like," Owen said. "Just getting our hands wet in all specialties has been great. ... You never know exactly what the day will bring. It's never boring."

Nine-year-old Jonese Dela Cruz did not flinch while Owen worked on a cavity. Her 4-year-old brother, C.J., watched the action, then went with her to the "Treasure Box" for a treat.

Marina Dela Cruz, the children's mother, said Jonese's teeth "'were really bad" when they began going to the clinic last year, but only one cavity remained to be filled yesterday. "I like it here," said the Makiki woman.

Clients include handicapped children, people with severe mental illnesses, members of substance abuse and AIDS programs, and state and federal prisoners.

Chin points out that the clinic not only serves the poor, elderly and medically fragile, but provides dental trauma care for people in accidents, who are beaten or suffer a stroke or debilitating condition. "It could be any healthy person that has a dental trauma or unexpected medical condition.

"It could happen at any time. It doesn't matter who you are, the program may be of value to you."

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