New Hampshire Legal Assistance Wants State Found in Contempt

This case has been in and out of court since 1999.

It started when New Hampshire Legal Assistance filed a suit claiming that the Department of Health and Human Services was failing to provide the children of low-income families with the dental care required by Medicaid.

About five years later, in 2004, HHS promised to change, signing what has become known as the Hawkins Consent Decree.

It covered about 60,000 children statewide, including many in The North Country.

But New Hampshire Legal Assistance says the state isn’t keeping the promises.

And the case is back in court again.

Kay Drought is the litigation director for New Hampshire Legal Assistance.

“The Department of Health and Human Services has made some improvements, but even now tens of thousands of children do not receive the regular and necessary dental care that they are entitled to.”

For the third time since 2004 the group is asking the Federal District Court for help.

The previous two times – in 2007 and 2008 – the court warned the state to do better.

But it did not find HHS in contempt.

Now, in its newest filings, the group accuses HHS of “ongoing and continued violations” of the court’s orders.

They say not enough of the 60, 000 children who need help are getting it.

For example, they contend during fiscal 2009 about 23,000 children did not get a single dental examination.

They are supposed to get two a year.

Children who need orthodontic care also not being served, they say.

In some cases, families in the North Country have been told to take their children to dentists 100 miles away.

WHIRRING SOUND OF DRILL

Jeremy Draper is a dentist with the Molar Express.

It is run by the North Country Health Consortium and provides dental care to children in Coos.

Draper says he sees lots of problems.

“Some of the kids that have decay, it is not one or two cavities, it is seven or eight, or 10 or 12. It is large numbers of gross decay.”

Dr. Draper says poor dental care isn’t just about teeth that aren’t pretty.

Studies show poor dental care causes other problems.

“The conditions of their gums, the conditions of their teeth. All these things relate to their overall level of health. There is a direct correlation, a big one.”

Nancy Smith, with the Attorney General’s office, is representing HHS in the case. She preferred not to be interviewed on tape.

But she said the state disagrees with New Hampshire Legal Assistance’s interpretation of what is required under Medicaid law.

She also said the state plans to argue that it is not violating the Hawkins Consent Decree.

Meanwhile, many of the children the 1999 lawsuit was originally supposed to help are now old enough that they could have children of their own.