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Amid massive changes in health care, the city Health and Hospitals Corporation’s recent decision to close 10 of the city’s 16 community dental clinics and move their operations into other facilities like hospitals and school clinics got little notice. Sure, poor children ages 3 to 21 had received free dental care at the clinics for years, but HHC promised that free services would still be available at the new locations.

Now, some City Councilmembers are questioning how well HHC has delivered on that promise. After the clinic on Ninth Avenue in Councilwoman Christine Quinn’s district closed, her staff conducted a survey of the four new locations. When her aides called, clinic staff at three of the four said free care was not available.

“I’m concerned there may be a real communications problem, not on the part of the receptionist and the clinic but between the … Health and Hospitals Corporation and their clinics,” Quinn told the council health committee in November.

“I will work with HHC and clarify how information is being shared,” Health commissioner Neal Cohen responded at the hearing. According to Cohen, these clinics are supposed to try to get poor clients into public assistance programs, such as Medicaid, that will pay for their dental care, but aren’t supposed to turn anyone down.

So City Limits followed up on Quinn’s quick-and-dirty survey, calling the same four locations again. While one clinic staffer did tell us that care “is not free–you get billed,” what was most striking about the other three locations was how hard it was to get in touch with anyone at all. At two clinics, no one bothered to pick up the line. At the fourth, no one but back office staff was available before 1 pm, and they knew nothing about free care.

HHC justifies the decision to close the clinics by saying that antiquated equipment and poor facilities at the free clinics would have cost $7 million to replace or repair. And Dr. D. Madeline Franklin, Senior Director of Oral Health Programs and Policy at HHC, says the word did go out to these clinics. “There was communication with each of the programs receiving the patients,” she said. “The policy of the Health and Hospitals Corporation is not to turn away patients.”

The confusion, suggests Franklin, might be that the new facilities charge on a sliding scale. That means services aren’t technically free–poor customers do receive a bill, but don’t have to pay it. For clients to get the right information when they call the clinics, they must ask the right question.

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