While most dental offices across North Carolina have resumed routine procedures, the Adult Dental Clinic and Children’s Dental Clinic in Macon County are seeing patients only on an emergency basis.
It’s likely the Adult Dental Clinic will no longer serve any patients soon. As part of the 2020-21 fiscal year budget, county manager Derek Roland has recommended to county commissioners to eliminate the Adult Dental Clinic program beginning July 1.
“A continued decline in participation at the Adult Dental Clinic combined with the inability to recruit and retain a dentist or dental hygienist will lead to an estimated revenue shortfall in the program of $99,798 for the coming fiscal year,” Roland said. “Due to significant revenue loss anticipated in the coming year and uncertainty surrounding economic recovery, the (fiscal year) 21 operating budget cannot continue to absorb annual revenue losses in adult dental, without sacrifice to those services upon which the majority of our residents depend.”
The number of unduplicated patients the Adult Dental Clinic served from 2015-2017 remained fairly steady, dropping from 927 to 874. However, it’s seen a significant decrease in recent years, dipping to 696 in 2018 and 494 in 2019.
The decrease is likely tied to the county being unable to hire a full-time dentist since March 2018 or a full-time hygienist since September 2019.
Attracting someone to take those positions has been a challenge. The salary the county is offering isn’t as much as what a dentist can make by owning a private practice.
Carmine Rocco, who served as the interim health director before Kathy McGaha was named to the position in April, acknowledged in March 2019 the difficulty in finding a full-time dentist.
“We’re in competition with the private industry and surrounding counties, folks that can provide much more than we can with our current salary scale,” he said.
Going back to July 2018, health director Jim Bruckner also spoke about the difficulty about filling the vacancy.
“We have people apply, but as soon as we tell them what the salary is they stop talking to us,” Bruckner said. “The average salary for a dentist in North Carolina is $152,000 and we are offering $113,000 in salary ($140,000 with benefits added in). It’s an uphill battle even getting people to interview at that level.”
Contracted dentists have been working at the Adult Dental Clinic, but it’s come at the county’s expense.
“While this arrangement has enabled the service to continue, the annualized rate charged by the contract dentist is 32 percent higher than the $180,937 total compensation package budgeted for a full-time dentist,” Roland said. “In addition to the significant rate increase, MCPH also must pay mileage reimbursement and overnight lodging costs for the dentist.”
Commissioners will hold a budget work sessions in the coming weeks to finalize the budget. The county will benefit financially in a number of areas, Roland said, by eliminating the Adult Dental Clinic.
“The county will indirectly benefit as regular cleaning, disinfecting and upkeep of the leased space, currently performed by building and grounds, will no longer be required,” Roland said. “Future costs will be avoided as well, due to software upgrades in Adult Dental, which were projected during the coming fiscal year.”