Bigger clinic means more people can see a dentist

CEDAR RAPIDS — Heidi Franklin said she cried when she finally was able to get a dental appointment at the Eastern Iowa Health Center.

The 42-year-old Covington woman is on Medicaid, the federal-state health care insurance program that subsidizes care for low-income Iowans, and she really needed to see a dentist.

“No one would take my (Medicaid) dental insurance. And the University of Iowa Dental School is booked up for a year," Franklin said, referring to the UI program in Iowa City that accepts Medicaid patients.

She said she tried for a year to get into the Eastern Iowa Health Center’s Dental Health clinic, but it had no openings. Late last year, the clinic called, giving her an appointment last week in its new, expanded space.

"I cried about getting in here,“ she said. ”It has been so frustrating trying to get treatment.“

The Eastern Iowa Health Center held a “floss-cutting” Thursday for its $5.6 million, 8,000 square-foot dental clinic expansion, at 1210 Fourth Ave. SE. It almost triples the space of the original 2,900-square-foot clinic, increasing the number of chairs to 18.

The clinic reported 10,339 patient visits in 2023. The expanded clinic, which began accepting patients in November, expects to have 65,000 visits this year.

"We were unable to take new patients during the last three years, despite the overwhelming need," said Joe Lock, president and CEO of the Eastern Iowa Health Center.

The expanded clinic has 36 employees, up from 16, and six dentists. Dr. Diana Jones is the chief dental officer.

No insurance

An estimated 91 million adults in America had no dental insurance at the end of 2023, according to the CareQuest Institute of Oral Health.

The vast majority are low-income, minorities and older Americans.

Oral health for the low income is covered to some extent by the government's Medicaid program, but many dentists do not accept Medicaid patients because of the program’s low reimbursement rates. Also, Medicare does not cover most dental services.

No more candy

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Makayla Speer, 21, of Cedar Rapids, had multiple fillings done last week at the dental clinic, with more appointments to come.

Speer said she was able to get an appointment at the clinic about five years ago after her private dentist stopped accepting her state insurance.

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“I actually was terrified of dentists. But less so now. I used to eat a lot of candy, but no more,“ she said. ”Then I had braces.“

Franklin and Speer both applauded the care they receive at the dental clinic. The dentists and staff are caring, quick and efficient, they said.

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The clinic handles basic dental needs like cleanings, fillings. They can do preparation work for tooth crowns. There is no oral surgeon on staff.

Not free

The Eastern Iowa Health Center and Dental Clinic are nonprofit operations and act as a federally qualified safety net provider for low-income and other vulnerable populations.

It receives $1.74 million in federal funding annually. That's about 8 percent of the clinics' $18.5 million budget.

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“People assume we are a free clinic, but we're not,” Lock said. “But if someone cannot afford it, we treat you anyway.”

“Nonprofit is a tax status — not a way of life,” he said. ”We've got to make a little money somewhere.“

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Patient fees are on a sliding scale.

The fees are based on a sliding scale, based on household income and household size. The result is usually a 40 to 60 percent discount from the regular fees, which are the same as private dentists charge, Dental Clinic Manager Jill O'Hara said.

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Seventy-seven percent of the dental clinic's visits are by people living below the federal poverty line, which is now an annual income below $31,200 for a family of four.

“About 65 percent of our patients are people of color,” Lock said.

Center patients speak 44 languages, with English the most common, followed by Swahili. The clinic has interpreters available if needed for foreign language speakers.

"There are seven classes of people we never turn away — children, veterans, pregnant women, the homeless, refugees, immigrants and individuals needing a medical clearance prior to major surgery," Lock said.

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The dental clinic, he added, also takes emergency cases and walk-ins — usually 10 to 15 per day — at 7:45 a.m. Monday through Friday and at 12:45 p.m. Monday through Thursday. The clinic is closed Friday afternoons.

O'Hara said the clinic takes patients under 18 at any time, and a few new adult patients are added per month, but they have to be in one of the seven groups Lock cited.

For those lacking transportation, the clinic has a medium-sized Neighborhood Transportation Service bus to transport patients at no charge. It costs $70 per hour to run the bus, with funding from a grant from Linn County, Cedar Rapids and the federal government. The grant has three years left, Lock said.

What’s next?

The expanded clinic is two stories, with the second floor vacant, leaving room for expansion, possible an optical service or a physical therapy/occupational therapy service.

Lock also is looking into opening a pharmacy, with an estimated cost of $1.6 million, on the center’s campus.

However, those ideas take money to set up and operate.

Lock says he's raised $500,000 for a future use, with consideration being given to acquiring a specialized robot that could help dispense and package prescriptions at a pharmacy.