Gov. Tony Evers is unveiling a $43.4 million dental access initiative as part of his 2019-21 biennial budget, which will be released later this month.

“There is a lack of access, particularly in our rural communities,” said Evers’ spokeswoman Melissa Baldauff. “During the campaign, the governor talked a lot about access to health care. Access in rural areas is a challenge.”

The proposal features using $21.8 million in state dollars, with the other half coming from federal aid. The $21.8 million includes an additional $9.6 million in general purpose revenue in 2020 and another $11.6 million in 2021, according to an outline Evers’ office released.

The largest component is increasing the Medicaid dental access incentive payment, which totals $7.8 million in 2020 and $8.7 million in 2021, the outline states.

“Dental providers would receive increased reimbursement rates if they served a certain percentage of (Medicaid assistance) patient base,” the document reads. “Non-profit providers would receive a 50 percent reimbursement increase if they serve a patient base of at least 50 percent. For-profit providers would receive a 30 percent reimbursement increase if they serve a patient base of at least five percent.”

State Sen. Kathy Bernier, R-Lake Hallie, said the plan seems unnecessarily complicated, but she generally endorses the idea of increasing the reimbursement rate. Bernier said she’s sponsored similar measures in the past.

“We don’t necessarily have a shortage of dentists yet, but they don’t get paid enough,” Bernier said. “This (reimbursement increase proposal) would be an excellent use of the surplus. Every dentist I’ve spoken to said they’ll take the Medicaid patients, but they can’t lose money on it.”

The governor’s proposal also includes creating a “dental therapist licensure,” allowing for a midlevel dental provider. Several states, including Minnesota, already allow for this provider. That proposal doesn’t cost any additional state dollars.

Baldauff said data indicate there is a shortage of dentists statewide.

“The most updated estimate is 204 dental providers needed to remove health shortage area designations,” she said, adding that a Kaiser Family Foundation report recommends one provider for every 5,000 residents.

Another component of the plan is a rural dental loan repayment, costing $60,000 each year of the biennium. It is an award for dentists and physicians who elect to serve in rural areas. “This initiative would provide funding for three dentists at the same level as physicians.”

Low-income dental grants would expand, with an additional $425,000 in 2020 and $850,000 in 2021. The proposal states these dental clinics are “safety nets that provide services to low-income Medicaid recipients and the uninsured.” Each year, about 20 clinics apply for these grants, but only 11 receive the awards. This proposal would increase the number of clinics that would win grants.

The final measure includes a “Seal-A-Smile” care, providing preventive services to children in grades K-12. That proposal would cost $275,000 in 2020 and $450,000 in 2021.

“This will be included in the governor’s budget, which will be released Feb. 28,” Baldauff said. “We are releasing some of the initiatives early. We want to bring attention to some of the pieces now, so they don’t get lost in the budget conversation. We’re proud to be able to do this comprehensive package.”