Report
to/Rapport au:
Health,
Recreation and Social Services Committee/
Comité de la santé, des loisirs et des services
sociaux
and Council/et au Conseil
27 January 2004/le 27 janvier 2004
Submitted
by/Soumis par: Chair, Poverty Issues
Advisory Committee/
Présidente, Comité consultatif sur les questions liées à la pauvreté
Contact/Personne-ressource: Brenda Emond
Advisory Committee Coordinator, Corporate Services Department
Coordonnatrice de comités consultatifs, Services généraux
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Ref N°:
ACS2004-CCV-POI-0002 |
SUBJECT: POVERTY
ISSUES ADVISORY COMMITTEE – INDENTIFYING GAPS- A PRELIMINARY REVIEW OF THE
DENTAL SERVICES AVAILABLE FOR LOW-INCOME FAMILIES
OBJET: COMITÉ CONSULTATIF SUR LES QUESTIONS LIÉES À
LA PAUVRETÉ –
DÉTERMINER LES FAILLES – EXAMEN PRÉLIMINAIRE DES SERVICES DENTAIRES OFFERTS AUX
FAMILLES À FAIBLE REVENU
REPORT RECOMMENDATIONS
That the Health, Recreation and Social Services Committee recommend that Council approve the following:
1. That staff investigate and conduct research to identify the negative outcomes of poor dental health on low-income populations in Ottawa with the following questions in mind;
i)
What is the dental-health needs
of low-income families?
ii)
How many low-income families
are unable to meet their needs with existing services?
2. That the City develop more adequate
programs and subsidies that meet the dental health needs of low-income
families, focus on prevention.
3. That the City partner with Dental
Health Associations to create a centralized, public pro-bono program similar to
that of the former Dental Wives’ Association.
4. That the City lobby the provincial government to have dental health services covered under OHIP.
1.
que
le personnel mène une enquête et une recherche afin de déterminer les
conséquences fâcheuses de la mauvaise santé dentaire sur la population à faible
revenu d’Ottawa en tenant compte des questions suivantes :
i)
quels
sont les besoins en soins dentaires des familles à faible revenu?
ii)
Combien
de familles à faible revenu ne peuvent répondre à leurs besoins avec les
services actuels?
2.
que
la Ville élabore plus de programmes appropriés et accorde plus de subventions
qui répondent aux besoins en soins dentaires des familles à faible revenu, et
qu’elle se concentre sur la prévention;
3.
Que
la Ville s’associe aux associations dentaires en vue de créer un programme
public centralisé bénévole semblable à celui de l’ancienne Dental Wives’
Association;
4.
Que
la Ville exerce des pressions sur le gouvernement provincial afin que les
services de soins dentaires soient couverts par l’OHIP.
At the 26 January 2004 meeting of the Poverty Issues Advisory Committee,
the following report of the Income Adequacy and Social Support Sub-committee
was unanimously approved:
The Committee contacted several public and private
offices for information including the Emergency Health and Social Services,
urban and rural private offices and clinics, the Ottawa Dental Society, the
Canadian Dental Association and Algonquin College’s Dental clinic. In addition, the report on dental services
from the former Region and the Hamilton report on Community Oral Health Program
Concepts and Principles were used as reference documents.
Dental Services Available
In Ottawa, dependant children from families on Ontario Works or living on a low income can access preventive dental services, even without dental insurance. This service is provided at a City clinic or through a private dentist’s office. Ongoing oral health education and information in school is also provided by the City’s Public Health Department in English, French and several other languages. Adults on Ontario works or living on a low income may receive emergency dental services if they qualify for Essential Health and Social Supports (EHSS).
Some private dental clinics also provide pro-bono dental health services including cleaning and filling. Others permit financial arrangements or offer discounts for specific groups. For example, one rural private dental office provides a 10% discount for seniors. Algonquin College and la Cité Collégiale also offer dental services which are below regular rates. However, there is currently a long waiting list to access the clinic at La Cité Collégiale.
Gaps – What
is missing?
EHSS subsidies for dental health services are too
limited. They simply do not cover all dental needs for low-income families.
This is especially true for adults who can only receive a subsidy once they
have a dental emergency. There is no subsidy available for ongoing preventive
dental care.
Private dentist fees are too high for the working poor. Low-income families cannot afford to pay fees which range between $70.00 and $200.00 for a first visit. Although the fees at dental hygiene schools at colleges are lower, they are in high demand and cannot provide the full range of oral care. Moreover, while pro-brono dental services are available at some select offices, this is entirely discretionary and is not publicized – perhaps to prevent unmanageable demand. Currently, there is no central database which provides low-income families with a list of dentists in the City who offer pro-bono services or discounts.
In the rural areas, there appear to be no City-operated dental clinics for low-income families. Rural waiting list for private clinics are also too long.
The Dental Wives’ Association used to coordinate a program which gave low income residents access to free dental services for a pre-determined period every year. However, this program has been terminated.
Poor dental health is concentrated within low income and other disadvantaged groups. According to the Ontario Association of Public Health Dentistry, over 85% of people living on a low-income do not have dental insurance. People living on a low income also get more teeth extracted and have higher rates of edentulous ness (no teeth).
The City states on its website that “teeth are
important for chewing food well, speaking properly, general good health,
smiling and appearance”. For families on a low income, all of this may be
jeopardized without adequate and appropriate access to dental services. Naturally, there is also a social impact
associated with poor dental health as people may consequently lack the
self-confidence necessary to secure employment. They may also be subject to discrimination in job interviews
because their appearance does not meet the standard. Given the high risks associated with poor dental health and the
gaps identified in services for low income families, the following
recommendations are submitted for consideration:
1. Conduct research to identify the negative outcomes of poor dental health on low-income populations in Ottawa with the following questions in mind:
i) What are the dental-health needs of low-income families?
ii) How many low-income families are unable to meet their needs with existing services?
2. Develop more adequate programs and subsidies that meet the dental health needs of low-income families. Focus on prevention.
3. Partner with Dental Health Associations to create a centralized, public pro-bono program similar to that of the former Dental Wives’ Association.
4. Lobby the provincial government to have dental health services covered under OHIP.”
This
report raises many issues and possible avenues for investigation related to
dental care needs which have broad policy and financial implications for the
City. In order to assist the Poverty
Issues Advisory Committee in understanding the role of City in dental care, the
role of the Province, the services available, and the current policy issues,
the Dental Officer of Health would be willing to prepare a presentation for a
future HRSS date and to provide professional advice related to identifying
dental needs and the options for addressing those needs discussed in the
recommendations. There is presently no
national data and very limited provincial data regarding dental health. Recommendation 1 represents a very
significant and extensive investigation that could not be undertaken within
existing resources.
The
role of the City is to oversee the administration of Provincial Mandatory
Programs and Council approved services.
Additional resources for investigation of dental needs would be required
and at a minimum this level of research would require the work of one full-time
staff for a minimum of 12 months, at a minimum cost of $75,000. Depending on the scope of the research it
could require more staff for up to 24 months at a cost of $150,000.
The Coordinator, Health, Recreation and
Social Services Committee will inform the PIAC of the disposition of this item.