University of Kansas researchers plan to use a $1.5 million federal grant to help Kansans with disabilities catch up to their non-disabled peers in several health categories.
Jean Hall, director of KU’s Institute for Health and Disability Policy Studies, will lead a team of partners from nonprofit organizations and government agencies to improve physical activity, nutrition and oral health for Kansans with disabilities.
Kansas is one of 19 states to get the grants from the Centers for Disease Control and Prevention.
Hall said the CDC required grant recipients to focus some attention on increasing physical activity, and her team members chose nutrition and oral health as the other areas they wanted to address.
“Based on survey data from the state, those are really big issues,” Hall said.
‘A good start’
Research compiled by Hall’s team shows that Kansans with disabilities are five times more likely to report that they had a heart attack than non-disabled peers, and 75 percent are overweight.
Additionally, almost 36 percent of Kansans with disabilities surveyed reported having no dental care in the past year, compared with 23 percent of non-disabled Kansans.
Hall said her group will work with partners like Oral Health Kansas as well as disability caregivers and health care providers to make dental care, healthy foods, and workout facilities and equipment more accessible to Kansans with intellectual and developmental disabilities or physical disabilities that limit mobility.
Todd Brennan, a case manager with Jenian in Johnson County, said focusing on those three areas would be “a good start” for his clients with intellectual and developmental disabilities.
Dental care in particular is elusive for that population, because many Kansans with intellectual and developmental disabilities need to be sedated for treatment. That’s expensive work, and most Kansans with intellectual and developmental disabilities are on Medicaid, which pays about 40 cents on the dollar compared to private dental insurance.
Brennan said Johnson County is down to one dentist who will do it, after the state cut Medicaid reimbursements another 4 percent.
“This is an issue for all types of health care professionals,” Brennan said in an email. “The best doctors, dentists and psychiatrists often will not take a Medicaid patient. We see it all the time.”
Brennan said the grant “sounds encouraging” but predicted Hall’s group would bump up against systemic problems that would make it difficult to provide disabled people the same health care as their non-disabled peers.
For example, Brennan said doctors recently canceled surgery for a client with a broken foot because of her “disruptive behaviors.” He had been trying for months, unsuccessfully, to get that client psychiatric care to address those behaviors.
Dentist shortage a factor
Hall said a general shortage of dentists in the state makes it challenging for Kansans with disabilities to access oral health care, and that will factor into her team’s work.
“There’s not a lot we can do,” Hall said. “We can only work with the providers that are there.”
For several years, Oral Health Kansas has pushed for the Legislature to allow licensing for mid-level “dental therapists” who would be allowed to perform more dental work than hygienists but less than dentists.
The Kansas Dental Association, an advocacy group for the state’s dentists, has opposed the legislation.
Hall said the change might improve oral care for Kansans with disabilities.
“To the extent we could advocate for the mid-level providers, if that were a good solution, we’d certainly do that,” Hall said.
Hall also said low Medicaid reimbursements for dental care are “penny wise and pound foolish” if they reduce access to care because studies have shown that unmet dental needs lead to costly medical problems.
People with disabilities who don’t get proper dental care also are much more likely to suffer oral pain, she said, which limits the foods they can eat.
“That ties back to the nutrition,” Hall said.
Hall said her team will encourage more physicians to ask Kansans with disabilities about their activity level and let them know it’s OK to recommend more activity, just as they would for non-disabled patients.
She said all Kansans have a stake in the success of the five-year grant program.
“If you improve health outcomes for people with disabilities in the state, everyone’s health care costs go down,” Hall said. “It’s pretty simple. And besides, wouldn’t you want your neighbor to be as healthy as you are?”
Andy Marso is a reporter for KHI News Service in Topeka, a partner in the Heartland Health Monitor team. You can reach him on Twitter @andymarso