HR 5549 IHCommentsClose CommentsPermalink

To expand the dental workforce and improve dental access, prevention, and data reporting, and for other purposes.CommentsClose CommentsPermalink

March 6, 2008

Mr. CUMMINGS introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committee on Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concernedCommentsClose CommentsPermalink

To expand the dental workforce and improve dental access, prevention, and data reporting, and for other purposes.CommentsClose CommentsPermalink

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,CommentsClose CommentsPermalink

SECTION 1. SHORT TITLE.

This Act may be cited as the `Deamonte Driver Dental Care Access Improvement Act of 2008'.CommentsClose CommentsPermalink

SEC. 2. FINDINGS.

The Congress finds as follows:CommentsClose CommentsPermalink





(1) The Centers for Disease Control and Prevention reports that between the periods 1988 to 1994 and 1994 and 2004, tooth decay increased 15 percent among toddlers and preschoolers 2 to 5 years old.CommentsClose CommentsPermalink





(2) During the period 1999 to 2004, 28 percent of young children experienced cavities.CommentsClose CommentsPermalink





(3) Among 2 year olds in the United States, 1-in-10 already have cavities, and by age 5 that figure jumps to 2-in-5 children.CommentsClose CommentsPermalink





(4) Tooth decay is the single most common childhood chronic disease, and it disproportionately affects poor and minority children.CommentsClose CommentsPermalink





(5) Eighty percent of dental decay occurs in just 25 percent of children.CommentsClose CommentsPermalink





(6) Parents are 3 times more likely to report that their children's dental needs are unmet, when compared with general medical care needs.CommentsClose CommentsPermalink





(7) While 9,000,000 of the children in this Nation do not have medical insurance, more than twice that number--23,000,000--do not have dental insurance.CommentsClose CommentsPermalink





(8) One out of 20 middle-aged adults in the United States are missing all their teeth.CommentsClose CommentsPermalink





(9) More than 40 percent of low income adults have at least 1 untreated decayed tooth compared to 16 percent of non-poor adults.CommentsClose CommentsPermalink





(10) Employed adults lose more than 164,000,000 hours of work each year due to oral health problems or dental visits.CommentsClose CommentsPermalink





(11) For every adult 19 years or older without medical insurance, there are 3 without dental insurance.CommentsClose CommentsPermalink





(12) About 25 percent of adults 60 years old and older no longer have any natural teeth. Having missing teeth can affect nutrition, since people without teeth often prefer soft, easily chewed foods.CommentsClose CommentsPermalink

SEC. 3. DENTAL WORKFORCE IMPROVEMENT.

(a) Dentistry Workforce Pilot Program- Title VII of the Public Health Service Act (42 U.S.C. 292 et seq.) is amended by inserting after section 747 the following:CommentsClose CommentsPermalink

`SEC. 747A. DENTISTRY WORKFORCE PILOT PROGRAM.

`(a) Grants- The Secretary shall make grants to schools of dentistry and hospitals with accredited training programs in pediatric dentistry to increase the number of individuals who pursue academic programs in pediatric dentistry or provide dental services to children.CommentsClose CommentsPermalink





`(b) Use of Funds- The Secretary may not make a grant to a school of dentistry or a hospital under this section unless the school or hospital agrees to use the grant to increase the number of individuals who provide dental care to children by--CommentsClose CommentsPermalink





`(1) establishing, maintaining, or improving both pre- and post-doctoral academic programs in pediatric dentistry;CommentsClose CommentsPermalink





`(2) recruiting and training dental students to pursue training in pediatric dentistry;CommentsClose CommentsPermalink





`(3) strengthening training in pediatric dentistry within advanced education in general dentistry and general practice dentistry residencies in dentistry programs;CommentsClose CommentsPermalink





`(4) recruiting and training practicing dentists through continuing education programs in pediatric dentistry;CommentsClose CommentsPermalink





`(5) training pediatricians to examine children's mouths to conduct risk assessments and apply fluoride varnish; orCommentsClose CommentsPermalink





`(6) training dental students, dentists, dental hygienists, and other dental professionals in dental health disparities and community-based dental health care.CommentsClose CommentsPermalink





`(c) Reports to Congress- Not later than 2 years after the date of the enactment of this section, and biennially thereafter, the Secretary shall conduct an evaluation of the activities funded through grants under this section and submit a report to the Congress on the results of such evaluation.CommentsClose CommentsPermalink





`(d) Authorization of Appropriations- To carry out this section, there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2009 through 2014.'.CommentsClose CommentsPermalink





(b) Grants To Develop and Implement Pilot Program To Train Allied Dental Health Professionals- Title V of the Social Security Act (42 U.S.C. 701, et seq.) is amended by adding at the end the following new sections:CommentsClose CommentsPermalink

`SEC. 511. GRANTS TO DEVELOP AND IMPLEMENT PILOT PROGRAM TO TRAIN ALLIED DENTAL HEALTH PROFESSIONALS.

`(a) In General- Not later than 1 year after the date of enactment of this section, the Secretary shall award a grant to establish a pilot program to increase access to dental care for underserved populations through the use of new allied dental health professionals. In awarding the grant, the Secretary shall consider pilot program applications that meet the following criteria:CommentsClose CommentsPermalink





`(1) The applicant plans to evaluate one or more distinct allied dental professional models.CommentsClose CommentsPermalink





`(2) The model is structured such that the allied dental professionals work under the supervision of a licensed dentist or dentists.CommentsClose CommentsPermalink





`(3) The application must include benchmarks reflecting the goal of increasing access to dental care for underserved populations.CommentsClose CommentsPermalink





`(4) The models tested by the applicant must be structured to be replicable in other areas of the country. The models tested must include strategies to maximize cost-efficiency.CommentsClose CommentsPermalink





`(b) Adjustment of Funding- The Secretary shall adjust funding for the pilot program according to the training needs of the allied dental professionals and the number of sites used for the pilot program.CommentsClose CommentsPermalink





`(c) Evaluation- Not later than 2 years after the date of enactment of this section, and biennially thereafter, the Secretary shall conduct an evaluation of the activities funded through grants under this section and submit a report to Congress on the results of such evaluation.CommentsClose CommentsPermalink





`(d) Authorization of Appropriations- There are authorized to be appropriated to carry out this section such sums as may be necessary for each of fiscal years 2009 through 2014.'.CommentsClose CommentsPermalink

SEC. 4. ACCESS TO DENTAL CARE.

(a) Access to Dental Care Pilot Program- Subpart I of part D of title III of the Public Health Service Act (42 U.S.C. 254b et seq.) is amended by adding at the end the following:CommentsClose CommentsPermalink

`SEC. 330M. ACCESS TO DENTAL CARE PILOT PROGRAM.

`(a) Grants- The Secretary shall award grants to Federally qualified health centers to expand and improve the provision of dental services to medically underserved populations.CommentsClose CommentsPermalink





`(b) Use of Funds- The Secretary may not make a grant to a Federally qualified health center under this section unless the center agrees to use the grant to expand and improve the provision of dental services to medically underserved populations by--CommentsClose CommentsPermalink





`(1) recruiting dentists, dental hygienists, or pediatric dentists;CommentsClose CommentsPermalink





`(2) purchasing or renting equipment for the provision of dental services;CommentsClose CommentsPermalink





`(3) constructing and expanding physical space for the provision of dental services;CommentsClose CommentsPermalink





`(4) allowing contractual relationships between Federally qualified health centers and private dental providers to increase access to dental care for adults and children; orCommentsClose CommentsPermalink





`(5) establishing or maintaining mobile dentistry and teledentistry activities.CommentsClose CommentsPermalink





`(c) Reports to Congress- Not later than 1 year after the date of the enactment of this section, and biennially thereafter, the Secretary shall conduct an evaluation of the activities funded through grants under this section and submit a report to the Congress on the results of such evaluation.CommentsClose CommentsPermalink





`(d) Definitions- In this section:CommentsClose CommentsPermalink





`(1) The term `Federally qualified health center' has the meaning given to such term in section 1905(l)(2)(B) of the Social Security Act (42 U.S.C. 1396d(l)(2)(B)).CommentsClose CommentsPermalink





`(2) The term `pediatric dentist' means an individual who has successfully completed residency training from a pediatric dentistry program accredited by the Commission on Dental Accreditation.CommentsClose CommentsPermalink





`(e) Authorization of Appropriations- To carry out this section, there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2009 through 2014.CommentsClose CommentsPermalink

`SEC. 330N. EARLY CHILDHOOD CARIES PREVENTION AND MANAGEMENT DEMONSTRATION GRANTS.

`(a) Grants- The Secretary is authorized to award grants to public or private entities to develop, implement, and evaluate public health and clinical strategies to prevent and manage early childhood caries.CommentsClose CommentsPermalink





`(b) Use of Funds- The Secretary shall make grants to eligible entities to demonstrate the effectiveness of preventing and managing early childhood caries by--CommentsClose CommentsPermalink





`(1) developing materials and methods for early detection, anticipatory guidance, primary prevention, and disease suppression of early childhood caries;CommentsClose CommentsPermalink





`(2) developing and testing models of care delivery that engage nutritional, behavioral, educational, and pharmacologic approaches in early childhood caries prevention and control;CommentsClose CommentsPermalink





`(3) training dentists, physicians, and nurse practitioners in the medical and behavioral management of early childhood caries;CommentsClose CommentsPermalink





`(4) partnering with Head Start, the Special Supplemental Nutrition Program for Women, Infants, and Children (WIC) established under section 17 of the Child Nutrition Act of 1966, or other early childhood programs to engage families in positive oral health behaviors and practices to reduce or eliminate early childhood caries; orCommentsClose CommentsPermalink





`(5) developing public health strategies including public education, public policy, and public programs targeting children under the age of 6 years at risk for early childhood caries.CommentsClose CommentsPermalink





`(c) Authorization of Appropriations- To carry out this section, there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2009 through 2014.'.CommentsClose CommentsPermalink





(b) Dental Services Credit-CommentsClose CommentsPermalink





(1) IN GENERAL- Subpart D of part IV of subchapter A of chapter 1 of the Internal Revenue Code of 1986 (relating to business related credits) is amended by inserting after section 45N the following new section:CommentsClose CommentsPermalink

`SEC. 45O. DENTAL SERVICES.

`(a) In General- For purposes of section 38, the qualified dental services credit determined under this subsection for any taxable year is an amount equal the 15 percent of the qualified dental receipts of the taxpayer for such taxable year.CommentsClose CommentsPermalink





`(b) Limitation- The credit determined under subsection (a) with respect to any taxpayer for any taxable year shall not exceed $5,000.CommentsClose CommentsPermalink





`(c) Qualified Dental Receipts- For purposes of this section, the term `qualified dental receipts' means any amount received as compensation for providing dental services--CommentsClose CommentsPermalink





`(1) under a State plan under title XIX of the Social Security Act or under a State child health plan under title XXI of such Act; orCommentsClose CommentsPermalink





`(2) from an individual who is not covered by a health insurance plan at the time such services are provided.'.CommentsClose CommentsPermalink





(2) CONFORMING AMENDMENTS-CommentsClose CommentsPermalink





(A) Section 38(b) of such Code is amended by striking `plus' at the end of paragraph (30), by striking the period at the end of paragraph (31) and inserting `, plus', and by adding at the end the following:CommentsClose CommentsPermalink





`(32) the qualified dental services credit determined under section 45O(a).'.CommentsClose CommentsPermalink





(B) The table of sections of such subpart is amended by inserting after the item relating to section 45N the following new item:CommentsClose CommentsPermalink





`Sec. 45O. Dental services.'.CommentsClose CommentsPermalink

SEC. 5. PUBLIC EDUCATION AND AWARENESS CAMPAIGN.

Subpart I of part D of title III of the Public Health Service Act (42 U.S.C. 254b et seq.) as amended by section 4, is amended by adding at the end the following:CommentsClose CommentsPermalink

`SEC. 330O. PUBLIC EDUCATION AND AWARENESS CAMPAIGN.

`(a) In General- The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall directly or through grants, cooperative agreements, or contracts to eligible entities conduct, support, and promote a comprehensive public education and awareness campaign on preventing, controlling, and ultimately eliminating early childhood caries. The campaign shall target pregnant women, and parents and caregivers of children under the age of 6 years.CommentsClose CommentsPermalink





`(b) Authorization of Appropriations- There is authorized to be appropriated to carry out this section $2,000,000 for each of fiscal years 2009 through 2013.'.CommentsClose CommentsPermalink

SEC. 6. ACCESS TO DENTAL CARE UNDER MEDICAID AND SCHIP.

(a) Reporting Information on Dental Care for Children-CommentsClose CommentsPermalink





(1) MEDICAID- Section 1902(a)(43)(D)(iii) of the Social Security Act (42 U.S.C. 1396a(a)(43)(D)(iii)) is amended by inserting `and other information relating to the provision of dental services to such children described in section 2108(e)' after `receiving dental services,'.CommentsClose CommentsPermalink





(2) CHIP- Section 2108 of the Social Security Act (42 U.S.C. 1397hh) is amended by adding at the end the following new subsection:CommentsClose CommentsPermalink





`(e) Information on Dental Care for Children-CommentsClose CommentsPermalink





`(1) IN GENERAL- Each annual report under subsection (a) shall include the following information with respect to care and services described in section 1905(r)(3) provided to targeted low-income children enrolled in the State child health plan under this title at any time during the year involved:CommentsClose CommentsPermalink





`(A) The number of enrolled children by age grouping used for reporting purposes under section 1902(a)(43).CommentsClose CommentsPermalink





`(B) For children within each such age grouping, information of the type contained in questions 12(a)-(c) of CMS Form 416 (that consists of the number of enrolled targeted low income children who receive any, preventive, or restorative dental care under the State plan).CommentsClose CommentsPermalink





`(C) For the age grouping that includes children 8 years of age, the number of such children who have received a protective sealant on at least one permanent molar tooth.CommentsClose CommentsPermalink





`(2) INCLUSION OF INFORMATION ON ENROLLEES IN MANAGED CARE PLANS- The information under paragraph (1) shall include information on children who are enrolled in managed care plans and other private health plans and contracts with such plans under this title shall provide for the reporting of such information by such plans to the State.'.CommentsClose CommentsPermalink





(b) Assessment of Adequacy of Dental Reimbursement Rates for All Eligible Beneficiaries- Not later than 1 year after the date of enactment of this Act, the Comptroller General of the United States shall study and report to Congress on the extent to which payment rates for dental services provided to individuals who are eligible for medical assistance under State Medicaid plans under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) or child health assistance or other health benefits coverage under State child health plans under title XXI of such Act (42 U.S.C. 1397aa et seq.)--CommentsClose CommentsPermalink





(1) are comparable to the payment rates for such services established by private health insurance issuers;CommentsClose CommentsPermalink





(2) are adequate to compensate providers for the actual cost of providing such services; andCommentsClose CommentsPermalink





(3) in the case of such services provided under State Medicaid plans, satisfy the requirement of section 1902(a)(30)(A) of such Act (42 U.S.C. 1396a(a)(30)(A)) to assure that payments are consistent with efficiency, economy, and quality of care and are sufficient to enlist enough providers so that care and services are available under the plan at least to the extent that such care and services are available to the general population in the geographic area.CommentsClose CommentsPermalink

SEC. 7. COORDINATION AND REPORT BY THE SECRETARY OF HEALTH AND HUMAN SERVICES.

The Secretary of Health and Human Services shall coordinate with relevant government agencies to ensure the inclusion of dental health prevention and promotion activities within existing prenatal and maternal child health programs, and shall, not later than 2 years after the date of enactment of this Act, submit to Congress a report on the status of such programs.CommentsClose CommentsPermalink