With only one Medicaid provider serving lower-income residents for full dental care across the Yampa Valley, wait times for regular preventative care appointments for adults can be as long as six months.

The sole Medicaid dental office with dentists on staff in Routt and Moffat counties is nonprofit Northwest Colorado Health. The organization is taking multiple steps to shorten appointment wait times.

The organization is opening a new in-school clinic for dental hygiene services on Wednesday starting March 16 at Steamboat Springs Middle School for children 18 and younger, said Suzi Mariano, Northwest Colorado Health’s senior director of marketing and development. That follows the opening in December of an in-school dental hygiene clinic Thursdays in Hayden. Mariano said Northwest Colorado Health is in talks with the school districts and community partners for a plan to continue similar services this summer.

Thanks to federal grants, the nonprofit ordered an approximately $568,000 mobile dental bus set to arrive in January 2023, Mariano said.

In addition, construction is underway at the Northwest Colorado Health headquarters in Steamboat, adjacent to UCHealth Yampa Valley Medical Center, to carve out 890 square feet for additional space to add three new dental chairs. The Steamboat expansion should be completed by late summer and will be open four days a week. The renovation costs $432,000, funded by American Rescue Plan Act Funding for Health Centers.

“Our goal wait time for pediatric and adult patients when we are fully staffed and fully operational at all clinics would be to get acute patient in within 24 business hours and routine care within 30 days,” Mariano said.

In order to be fully staffed, the nonprofit organization needs to hire a third full-time dentist, four dental assistants and two dental hygienists during a time when hiring health care employees is difficult in rural resort towns with escalating housing prices.

Northwest Colorado Health dental clinics hold open one to two emergency visit times each day, and otherwise current wait times include six to eight weeks for pediatric appointments, one to seven days for adult emergency appointments and six months for adult preventative appointments. Mariano said the agency prioritizes emergencies and then pediatric routine preventative care for children in their formative years.

“We have to take care of the people most in need first, urgent situations and kids,” Mariano said. “When you have limited resources, you have to prioritize.

“Over the years we have added additional dental services at various clinic locations because the community need has increased significantly. This has been due to a lack of providers accepting Medicaid and uninsured patients, along with pent-up demand due to complications from COVID.”

For example, the nonprofit treated 2,196 dental patients in 2018 and 2,243 in 2019. During 2021, the nonprofit treated 2,710 dental patients total, including 1,664 in Craig, 481 in Steamboat and 565 in Oak Creek.

Currently in the Yampa Valley, only one private dental hygiene provider accepts Medicaid patients, according to multiple listings and sources. Longtime professional dental hygienist Shelly Barnes-Camilletti at Rocky Mountain Dental Hygiene in Steamboat stepped in to help in 2015. She provides hygiene and X-rays for children and adult Medicaid patients, and her practice has a one-month wait time for appointments.

“There is not a lot of options for Medicaid dental in all of western Colorado,” Barnes-Camilletti said, noting other Medicaid dental offices are located in Silverthorne or Grand Junction.

The hygienist and former basketball coach in Hayden said her players asked her if she could take care of their teeth at the dental practices where she had worked.

“I saw kids not being able to do anything with their health. I felt like I needed to help,” Barnes-Camilletti said.

Dentist Madeline Connick, who lives in Steamboat and works at the Northwest Colorado Health dental clinic in Craig, said serving lower-income patients is exactly what she wanted to do after training in similar dental clinic rotations while studying at the University of Michigan.

“You feel good about yourself at the end of the day, especially on days you can help somebody who really had no other options and you can make it a positive experience for them,” said Connick, who started at Northwest Colorad Health in fall 2019. “Almost on a weekly basis I see somebody who has either been avoiding care or hasn’t been able to get care in years, and giving them even a plan or path forward gives them a sense of empowerment.”

The dentist said the high cost of office space, housing and wages in rural resort areas make it difficult for private dental practices to accept Medicaid patients considering the reduced reimbursement payments provided compared to other insurance plans.

According to the Health Policy Institute of the American Dental Association, Medicaid reimbursements in 2020 in Colorado for child dental care paid 55% compared to private insurance and 56% for adults. The nationwide Medicaid reimbursement average rate was 61% for child services and 53% for adult care, compared to private insurance.

Right now, hiring is a key pinch point locally.

“It’s very hard if not impossible to get somebody here for those type of support jobs, because of the cost of living and the housing issues, and looking at training people from scratch is really costly or time-intensive,” Connick said.

Editor’s note: This story has been updated to reflect updated details from the source on the new Steamboat Springs Middle School clinic.