[Congressional Bills 117th Congress]
[From the U.S. Government Publishing Office]
[S. 3017 Introduced in Senate (IS)]
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117th CONGRESS
1st Session
S. 3017
To expand the provision and availability of dental care furnished by
the Department of Veterans Affairs, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
October 20, 2021
Mr. Sanders (for himself, Mr. Blumenthal, Mr. Menendez, Mrs.
Gillibrand, Mr. Booker, and Ms. Hirono) introduced the following bill;
which was read twice and referred to the Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To expand the provision and availability of dental care furnished by
the Department of Veterans Affairs, 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 ``Veterans Dental Care Eligibility
Expansion and Enhancement Act''.
SEC. 2. SENSE OF CONGRESS.
It is the sense of Congress that--
(1) the Department of Veterans Affairs has pioneered a
whole health approach to health care, which brought mental
health and suicide prevention under the umbrella of primary
care and integrated health, provides access to alternative
medicines, delivers a holistic approach to health and well-
being, and repeatedly demonstrates better health outcomes than
the private sector at a low cost to taxpayers in the United
States;
(2) the effects of poor dental care are seen in patients
who are at risk of or diagnosed with diabetes, cardiovascular
disease, pulmonary conditions, kidney impairment, and even
dementia;
(3) the Department spends countless dollars on prescription
drugs, community care, urgent care, and emergency room visits
on preventable ailments that would be reduced or eliminated
through preventative dental care; and
(4) in order to best achieve a whole health model for the
provision of health care to veterans and reduce long-term
costs, the Department must furnish veterans with preventative
and comprehensive dental care.
SEC. 3. REQUIREMENT THAT SECRETARY OF VETERANS AFFAIRS FURNISH DENTAL
CARE IN THE SAME MANNER AS ANY OTHER MEDICAL SERVICE.
(a) In General.--Title 38, United States Code, is amended--
(1) in section 1701(6)(B), by striking ``as described in
sections 1710 and 1712 of this title'';
(2) in section 1710(c), by striking the second sentence;
and
(3) in section 1712--
(A) by striking subsections (a) and (b);
(B) by redesignating subsections (c), (d), and (e)
as subsections (a), (b), and (c), respectively; and
(C) in subsection (a), as redesignated by
subparagraph (B)--
(i) by striking ``Dental appliances'' and
inserting ``The Secretary may furnish dentures,
dental appliances''; and
(ii) by striking ``to be furnished by the
Secretary under this section may be procured by
the Secretary'' and inserting ``under this
section and may procure such appliances''.
(b) Conforming and Clerical Amendments.--
(1) Conforming amendments.--
(A) Protection of health care eligibility.--Section
1525(a) of such title is amended by striking
``medicines under section 1712(d)'' and inserting
``medicines under section 1712(b)''.
(B) Dental insurance plan.--Section 1712C(h) of
such title is amended--
(i) by striking ``section 1712 of this
title'' and inserting ``this chapter''; and
(ii) by striking ``such section 1712'' and
inserting ``this chapter''.
(2) Heading amendment.--The heading for section 1712 of
such title is amended to read as follows:
``Sec. 1712. Appliances; drugs and medicines for certain disabled
veterans; vaccines''.
(3) Clerical amendment.--The table of sections at the
beginning of subchapter II of chapter 17 of such title is
amended by striking the item relating to section 1712 and
inserting the following new item:
``1712. Appliances; drugs and medicines for certain disabled veterans;
vaccines.''.
(c) Effective Date.--The amendments made by this section shall take
effect on the date that is one year after the date of the enactment of
this Act.
SEC. 4. EXPANSION OF FURNISHING BY DEPARTMENT OF VETERANS AFFAIRS OF
DENTAL CARE TO ALL ENROLLED VETERANS.
(a) In General.--The Secretary of Veterans Affairs shall furnish
dental care to all veterans enrolled in the system of annual patient
enrollment of the Department of Veterans Affairs established and
operated under section 1705(a) of title 38, United States Code,
pursuant to the phased approach required under this section.
(b) Phase One Required.--
(1) Commencement.--
(A) In general.--Commencing not later than one year
after the date of the enactment of this Act, the
Secretary of Veterans Affairs shall furnish dental care
to all covered veterans who are not eligible for dental
services and treatment and related dental appliances
under the laws administered by the Secretary as of the
date of the enactment of this Act.
(B) Phase one.--In this section, the furnishing of
dental care under subparagraph (A) shall be referred to
as ``phase one''.
(2) Duration of phase one.--Phase one shall be carried out
during the two-year period beginning on the date of the
commencement of phase one.
(3) Locations.--
(A) In general.--The Secretary shall carry out
phase one at the following locations:
(i) Each medical center of the Department
with an established dental clinic.
(ii) Not fewer than four military medical
treatment facilities of the Department of
Defense with the capacity to furnish dental
care, which shall be selected in consultation
with the Secretary of Defense.
(iii) Not fewer than four community-based
outpatient clinics with space available for the
furnishing of dental care under phase one.
(iv) Not fewer than four Federally
Qualified Health Centers.
(v) Not fewer than four facilities of the
Indian Health Service with established dental
clinics, which shall be selected in
consultation with the Secretary of Health and
Human Services.
(B) Considerations.--In selecting locations for
phase one, the Secretary shall consider the feasibility
and advisability of selecting locations in each of the
following:
(i) Rural areas.
(ii) Areas that are not in close proximity
to an active duty military installation.
(iii) Areas representing different
geographic locations, such as census tracts
established by the Bureau of the Census.
(C) Mobile dental clinics.--In carrying out phase
one, the Secretary shall test the efficacy of mobile
dental clinics to service rural areas that do not have
a population base to warrant a full-time clinic but
where there are covered veterans in need of dental
care.
(D) Home-based dental care.--In carrying out phase
one, the Secretary shall test the efficacy of portable
dental care units to service rural veteran in their
homes, as the Secretary considers medically
appropriate.
(4) Scope of services.--The dental care furnished to
covered veterans under phase one shall be consistent with the
dental services and treatment furnished by the Secretary to
veterans with service-connected disabilities rated 100-percent
disabling under the laws administered by the Secretary.
(5) Use of telemedicine.--When providing dental services
via telemedicine under phase one, the Secretary shall use
Federal employees to the maximum extent possible.
(6) Voluntary participation.--The participation of a
covered veteran in phase one shall be at the election of the
veteran.
(7) Copayments.--The Secretary may collect copayments for
dental care furnished under phase one in accordance with
authorities on the collection of copayments for medical care of
veterans under chapter 17 of title 38, United States Code.
(8) Administration.--
(A) Notice to covered veterans on phase one.--In
carrying out phase one, the Secretary shall inform all
covered veterans of the services and treatment
available under phase one.
(B) Contracts.--
(i) In general.--Subject to clause (iii),
in carrying out phase one, the Secretary may
enter into contracts with appropriate entities
for the provision of dental care under phase
one.
(ii) Performance standards and metrics.--
Each contract entered into under clause (i)
shall specify performance standards and metrics
and processes for ensuring compliance of the
contractor concerned with such performance
standards.
(iii) Limitation.--The Secretary may only
enter into contracts under clause (i) if the
Secretary determines that the Department does
not employ, and cannot recruit and retain,
qualified dentists, dental hygienists, and oral
surgeons in the applicable location.
(9) Definitions.--In this subsection:
(A) Covered veteran.--The term ``covered veteran''
means a veteran enrolled in the system of annual
patient enrollment of the Department of Veterans
Affairs established and operated under section 1705(a)
of title 38, United States Code, pursuant to paragraph
(1) or (2) of such section.
(B) Federally qualified health center.--The term
``Federally Qualified Health Center'' means a
Federally-qualified health center as defined in section
1905(l)(2)(B) of the Social Security Act (42 U.S.C.
1396d(l)(2)(B)).
(c) Expansion.--
(1) In general.--After the completion of phase one, the
Secretary shall expand the provision of dental care under this
section to all veterans, including through the use of the
recommendations of the Secretary under subsection (d)(2)(F), as
follows:
(A) In phase two, which shall--
(i) commence not later than 90 days after
the completion of phase one; and
(ii) consist of the provision of dental
care to all veterans enrolled in the system of
annual patient enrollment of the Department of
Veterans Affairs established and operated under
section 1705(a) of title 38, United States
Code, pursuant to paragraph (1), (2), (3), or
(4) of such section.
(B) In phase three, which shall--
(i) commence not later than 90 days after
the completion of phase two; and
(ii) consist of the provision of dental
care to all veterans enrolled in such system
pursuant to paragraph (1), (2), (3), (4), (5),
or (6) of such section.
(C) In phase four, which shall--
(i) commence not later than 90 days after
the completion of phase three; and
(ii) consist of the provision of dental
care to all veterans enrolled in such system.
(2) Facility expansion.--Under each phase specified in
paragraph (1), the Secretary shall expand the number of
facilities described in subsection (b)(3) furnishing dental
care under this section commensurate to the number of new
veterans furnished care under such phase, including through the
use of any other facilities to which veterans have access.
(3) Duration.--Each phase specified in paragraph (1) shall
be carried out during a period not to exceed two years and all
such phases, including phase one, shall be carried out for a
period not to exceed eight years.
(4) Conclusion.--Upon the conclusion of phase four
specified under paragraph (1)(C), all veterans enrolled in the
system of annual patient enrollment of the Department of
Veterans Affairs established and operated under section 1705(a)
of title 38, United States Code, shall be eligible for dental
care from the Department.
(d) Reports.--
(1) In general.--Not later than 90 days before the
completion of phase one, and not later than 180 days after the
completion of each subsequent phase under subsection (c)(1),
the Secretary shall submit to the Committee on Veterans'
Affairs and the Committee on Armed Services of the Senate and
the Committee on Veterans' Affairs and the Committee on Armed
Services of the House of Representatives a report on the phase
about to be completed and the plans of the Secretary for
implementation of expansion of the provision of dental care
pursuant to subsection (c).
(2) Contents.--Each report under paragraph (1) shall
include the following:
(A) A description of the implementation and
operation of the phase covered by the report.
(B) The number of veterans receiving dental care
under such phase and a description of the dental care
furnished to such veterans.
(C) An analysis of the costs and benefits of such
phase, including a comparison of costs and benefits by
location type.
(D) An assessment of the impact of such phase on
appointments for care, prescriptions, hospitalizations,
emergency room visits, wellness, employability, and
satisfaction of patients, and perceived quality of life
of veterans.
(E) An analysis and assessment of the efficacy of
mobile clinics and home-based dental care to service
the dental needs of veterans during such phase.
(F) The findings and conclusions of the Secretary
with respect to such phase.
(G) A comparison of the costs for private sector
dental care with cost of furnishing dental care from
the Department, broken down by each locality included
in such phase.
(H) Such recommendations for the expansion of
dental care pursuant to subsection (c) as the Secretary
considers appropriate.
SEC. 5. REQUIREMENT OF DENTAL CLINIC OF DEPARTMENT OF VETERANS AFFAIRS
IN EACH STATE.
(a) In General.--The Secretary of Veterans Affairs shall ensure
that each State has a dental clinic of the Department of Veterans
Affairs to service the needs of the veterans within that State.
(b) Effective Date.--This section shall take effect on the date
that is one year after the date of the enactment of this Act.
SEC. 6. PROGRAM ON EDUCATION TO PROMOTE DENTAL HEALTH IN VETERANS.
(a) Program Required.--The Secretary of Veterans Affairs shall
carry out a program of education to promote dental health for veterans
who are enrolled in the system of annual patient enrollment of the
Department of Veterans Affairs established and operated under section
1705(a) of title 38, United States Code.
(b) Elements.--The program required by subsection (a) shall provide
education for veterans on the following:
(1) The association between dental health and overall
health and well-being.
(2) Proper techniques for dental care.
(3) Signs and symptoms of commonly occurring dental
conditions.
(4) Treatment options for commonly occurring dental issues.
(5) Options for obtaining access to dental care, including
information on eligibility for dental care through the
Department.
(6) Available and accessible options for obtaining low or
no-cost dental care, including through dental schools and
Federally Qualified Health Centers.
(7) Such other matters relating to dental health as the
Secretary considers appropriate.
(c) Delivery of Educational Materials.--
(1) In general.--The Secretary shall provide educational
materials to veterans under the program required by subsection
(a) through a variety of mechanisms, including the following:
(A) The availability and distribution of print
materials at facilities of the Department (including at
medical centers, clinics, Vet Centers, and readjustment
counseling centers) and to providers (including members
of Patient Aligned Care Teams).
(B) The availability and distribution of materials
over the internet, including through webinars, My
HealtheVet, and VA.gov.
(C) Presentations by the dental program office of
the Department of information, including both small
group and large group presentations, and distribution
of such information to all locations in which the
program is being carried out.
(2) Selection of mechanisms.--In selecting mechanisms under
paragraph (1), the Secretary shall select mechanisms designed
to maximize the number of veterans who receive education under
the program.
(d) Construction.--Nothing in this section shall be construed to
alter or revise the eligibility of any veteran for dental care under
the laws administered by the Secretary.
(e) Definitions.--In this section--
(1) Federally qualified health center.--The term
``Federally Qualified Health Center'' means a Federally-
qualified health center as defined in section 1905(l)(2)(B) of
the Social Security Act (42 U.S.C. 1396d(l)(2)(B)).
(2) Vet center.--The term ``Vet Center'' has the meaning
given that term in section 1712A(h) of title 38, United States
Code.
(f) Effective Date.--This section shall take effect on the date
that is one year after the date of the enactment of this Act.
SEC. 7. STUDENT LOAN REPAYMENT PROGRAM TO INCENTIVIZE DENTAL TRAINING
AND ENSURE THE DENTAL WORKFORCE OF THE DEPARTMENT OF
VETERANS AFFAIRS.
(a) Program Required.--The Secretary of Veterans Affairs, to ensure
that the Department of Veterans Affairs has sufficient staff to provide
dental service to veterans, shall implement a loan reimbursement
program for qualified dentists, dental hygienists, and oral surgeons
who agree--
(1) to be appointed by the Secretary as a dentist, dental
hygienist, or oral surgeon, as the case may be, under section
7401 of title 38, United States Code; and
(2) to serve as a dentist, dental hygienist, or oral
surgeon, as the case may be, of the Department pursuant to such
appointment at a dental clinic of the Department for a period
of not less than five years.
(b) Maximum Amount.--The Secretary may reimburse not more than--
(1) $75,000 for each dentist participating in the program
under subsection (a);
(2) $10,000 for each dental hygienist participating in such
program; and
(3) $20,000 for each oral surgeon participating in such
program.
(c) Selection of Locations.--The Secretary shall monitor demand
among veterans for dental care and require participants in the program
under subsection (a) to choose from dental clinics of the Department
with the greatest need for dentists, dental hygienists, or oral
surgeons, as the case may be, according to facility enrollment and
patient demand.
SEC. 8. EDUCATIONAL AND TRAINING PARTNERSHIPS FOR DENTISTS, DENTAL
HYGIENISTS, AND ORAL SURGEONS.
The Secretary of Veterans Affairs shall enter into educational and
training partnerships with dental schools to provide training and
employment opportunities for dentists, dental hygienists, and oral
surgeons.
SEC. 9. AUTHORIZATION OF APPROPRIATIONS.
(a) In General.--There is authorized to be appropriated for the
Department of Veterans Affairs for fiscal year 2021 such sums as may be
necessary to carry out this Act and the amendments made by this Act.
(b) Availability.--The amount authorized to be appropriated under
subsection (a) shall be available for obligation for the eight-year
period beginning on the date that is one year after the date of the
enactment of this Act.
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