IndigenousNetwork was able to attend this week’s media briefing hosted by American Community Media, held in partnership with California’s Department of Health Care Services. The focus of the session was on Medi-Cal’s underused dental and vision benefits, which remain some of the least accessed forms of preventive care in the state despite being fully covered. The conversation reflected broader issues seen in Indigenous and rural health systems, where benefits exist on paper but structural barriers, from geographic isolation to historic mistrust, keep many from receiving care.
Dr. Donny Shiu, Chief of the Medi-Cal Vision Program, described vision care as “a gateway for whole-person health.” A graduate of UC Berkeley with over three decades in optometry, Shiu has spent seventeen years at the Department of Health Care Services. He said early detection in routine eye exams often reveals chronic conditions such as diabetes and hypertension. “We restored the adult vision benefits to make sure that access to eyeglasses and exams are available,” he said. “Everyone deserves the ability to see clearly and live fully.” His emphasis on prevention connected directly to concerns voiced in Indigenous communities about delayed diagnosis and the compounding effects of untreated illness.
Dana Durham, Chief of the Medi-Cal Dental Services Division, framed oral health as a mirror of overall well-being. “Dental really is part of CalAIM,” she said, referring to the state’s broad healthcare reform initiative aimed at treating the whole person rather than isolated symptoms. Durham, who has over sixteen years of public service in Medi-Cal policy, reminded attendees that dental benefits come automatically with Medi-Cal enrollment, including for undocumented individuals. “If you have Medi-Cal, you should not be paying for dental care,” she said. “Oral health is tied to overall health.” Durham’s remarks come as Indigenous and immigrant advocates point out that access is not only about eligibility but also about awareness, transportation, and language. In many tribal and rural areas, community health workers fill these gaps by helping residents schedule appointments, interpret paperwork, and understand coverage.
Eileen Espejo, Managing Director of Health at Children Now, linked oral and vision care to child development. “If a child has untreated tooth decay or tooth pain, it can lead to difficulties in sleeping, eating, or concentrating,” she said. “Prevention is key. We don’t want to see kids in pain from something that’s preventable.” Espejo, who has worked on statewide pediatric oral health initiatives and legislative reform, described how her organization helps local programs establish school-based dental care and integrate oral health into regular pediatric visits. She said these programs can reduce absenteeism and improve learning outcomes. “We’ve seen that chronic absenteeism tracks closely with poor oral health,” she said. “Children who are in pain are missing school, and parents are missing work.”
The discussion turned to disparities across California, including lower dental utilization in the San Joaquin Valley and northern counties—regions that also have significant Indigenous populations. Espejo acknowledged the reality. “There may not be enough providers, or access may be limited,” she said, noting that cultural and logistical barriers often compound the problem. Durham added that her department is expanding outreach through community health workers and mobile dental clinics. These models are increasingly relevant to tribal health programs, which have long used similar outreach systems to reach remote families.
The context of this conversation matters. Indigenous communities across the United States continue to face what many describe as “coverage without access.” Clinics exist, but long travel distances, staffing shortages, and histories of exclusion make care inconsistent. In California, where Medi-Cal expansion theoretically covers all low-income residents, the same problem persists in rural and tribal territories. A 2024 report on Medi-Cal dental utilization showed that American Indian and Alaska Native beneficiaries use these benefits at some of the lowest rates in the state.
The panelists’ collective message was straightforward. The benefits are there, and they are free. But they only work when people use them. “Education is key,” said Shiu. “All you have to do is ask.” That simple statement echoed the broader theme that information gaps remain the biggest obstacle to equitable health outcomes.
For Indigenous newsrooms, the briefing underscored a familiar pattern in public health coverage: programs that are well-intentioned but underutilized due to lack of culturally grounded communication. As Indigenous media continue reporting on healthcare inequities—from reproductive rights to environmental health—the question remains how these state systems can meet communities where they are. The DHCS officials’ openness to partnerships with local media and community health workers suggests that the bridge may come through trusted messengers rather than bureaucratic channels.
The conclusion was both pragmatic and urgent. As Espejo said, “Children remain eligible and covered in Medi-Cal. Please make sure you’re taking your child for regular dental and medical checkups.” Her appeal, though directed at the general public, speaks directly to Indigenous and rural communities still fighting to turn policy into practice.
