[Congressional Bills 110th Congress]
[From the U.S. Government Publishing Office]
[S. 2723 Introduced in Senate (IS)]







110th CONGRESS
  2d Session
                                S. 2723

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


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                             March 6, 2008

Mr. Brown (for himself and Mr. Cochran) introduced the following bill; 
     which was read twice and referred to the Committee on Finance

_______________________________________________________________________

                                 A BILL


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

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

SECTION 1. SHORT TITLE.

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

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) The Centers for Disease Control and Prevention reports 
        that between the periods 1988 to 1994 and between 1994 and 
        2004, tooth decay increased 15 percent among toddlers and 
        preschoolers 2 to 5 years old.
            (2) During the period 1999 to 2004, 28 percent of young 
        children experienced cavities.
            (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.
            (4) Tooth decay is the single most common childhood chronic 
        disease, and it disproportionately affects poor and minority 
        children.
            (5) Eighty percent of dental decay occurs in just 25 
        percent of children.
            (6) Parents are 3 times more likely to report that their 
        children's dental needs are unmet, when compared with general 
        medical care needs.
            (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.
            (8) One out of 20 middle-aged adults in the United States 
        are missing all their teeth.
            (9) More than 40 percent of low income adults have at least 
        1 untreated decayed tooth compared to 16 percent of non-poor 
        adults.
            (10) Employed adults lose more than 164,000,000 hours of 
        work each year due to oral health problems or dental visits.
            (11) For every adult 19 years or older without medical 
        insurance, there are 3 without dental insurance.
            (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.

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:

``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.
    ``(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--
            ``(1) establishing, maintaining, or improving both pre- and 
        post-doctoral academic programs in pediatric dentistry;
            ``(2) recruiting and training dental students to pursue 
        training in pediatric dentistry;
            ``(3) strengthening training in pediatric dentistry within 
        advanced education in general dentistry and general practice 
        dentistry residencies in dentistry programs;
            ``(4) recruiting and training practicing dentists through 
        continuing education programs in pediatric dentistry;
            ``(5) training pediatricians to examine children's mouths 
        to conduct risk assessments and apply fluoride varnish; or
            ``(6) training dental students, dentists, dental 
        hygienists, and other dental professionals in dental health 
        disparities and community-based dental health care.
    ``(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.
    ``(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.''.
    (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:

``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:
            ``(1) The applicant plans to evaluate 1 or more distinct 
        allied dental professional models.
            ``(2) The model is structured such that the allied dental 
        professionals work under the supervision of a licensed dentist 
        or dentists.
            ``(3) The application must include benchmarks reflecting 
        the goal of increasing access to dental care for underserved 
        populations.
            ``(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.
    ``(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.
    ``(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.
    ``(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.''.

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:

``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.
    ``(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--
            ``(1) recruiting dentists, dental hygienists, or pediatric 
        dentists;
            ``(2) purchasing or renting equipment for the provision of 
        dental services;
            ``(3) constructing and expanding physical space for the 
        provision of dental services;
            ``(4) allowing contractual relationships between Federally 
        qualified health centers and private dental providers to 
        increase access to dental care for adults and children; or
            ``(5) establishing or maintaining mobile dentistry and 
        teledentistry activities.
    ``(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.
    ``(d) Definitions.--In this section:
            ``(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)).
            ``(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.
    ``(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.

``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.
    ``(b) Use of Funds.--The Secretary shall make grants to eligible 
entities to demonstrate the effectiveness of preventing and managing 
early childhood caries by--
            ``(1) developing materials and methods for early detection, 
        anticipatory guidance, primary prevention, and disease 
        suppression of early childhood caries;
            ``(2) developing and testing models of care delivery that 
        engage nutritional, behavioral, educational, and pharmacologic 
        approaches in early childhood caries prevention and control;
            ``(3) training dentists, physicians, and nurse 
        practitioners in the medical and behavioral management of early 
        childhood caries;
            ``(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; or
            ``(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.
    ``(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.''.
    (b) Dental Services Credit.--
            (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:

``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 to 15 percent of the qualified dental receipts of 
the taxpayer for such taxable year.
    ``(b) Limitation.--The credit determined under subsection (a) with 
respect to any taxpayer for any taxable year shall not exceed $5,000.
    ``(c) Qualified Dental Receipts.--For purposes of this section, the 
term `qualified dental receipts' means any amount received as 
compensation for providing dental services--
            ``(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; or
            ``(2) from an individual who is not covered by a health 
        insurance plan at the time such services are provided.''.
            (2) Conforming amendments.--
                    (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:
            ``(32) the qualified dental services credit determined 
        under section 45O(a).''.
                    (B) The table of sections of such subpart is 
                amended by inserting after the item relating to section 
                45N the following new item:

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

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:

``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.
    ``(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.''.

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

    (a) Reporting Information on Dental Care for Children.--
            (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,''.
            (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:
    ``(e) Information on Dental Care for Children.--
            ``(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:
                    ``(A) The number of enrolled children by age 
                grouping used for reporting purposes under section 
                1902(a)(43).
                    ``(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).
                    ``(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.
            ``(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.''.
    (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.)--
            (1) are comparable to the payment rates for such services 
        established by private health insurance issuers;
            (2) are adequate to compensate providers for the actual 
        cost of providing such services; and
            (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.

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.
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