[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[H.R. 4150 Introduced in House (IH)]

<DOC>






118th CONGRESS
  1st Session
                                H. R. 4150

To improve the provision of health care furnished by the Department of 
    Veterans Affairs for veterans diagnosed with diabetes and heart 
                    disease, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 15, 2023

 Ms. Brownley introduced the following bill; which was referred to the 
                     Committee on Veterans' Affairs

_______________________________________________________________________

                                 A BILL


 
To improve the provision of health care furnished by the Department of 
    Veterans Affairs for veterans diagnosed with diabetes and heart 
                    disease, 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 ``Improving Whole Health for Veterans 
with Chronic Conditions 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 that 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 shown to worsen the 
        symptoms of diabetes and heart disease;
            (3) diabetes and heart disease are shown to increase risk 
        of periodontal disease;
            (4) the combination of diabetes, heart disease, and 
        periodontal disease can be fatal; and
            (5) to best achieve a whole health model for the provision 
        of health care to veterans with diabetes and heart disease and 
        reduce long-term costs, the Department must furnish 
        preventative and comprehensive dental care to veterans 
        diagnosed with diabetes and heart disease.

SEC. 3. DEFINITIONS.

    In this Act:
            (1) Covered care.--The term ``covered care'' means dental 
        care that is comprehensive in nature and consistent with the 
        dental services and treatment furnished by the Secretary of 
        Veterans Affairs to veterans pursuant to section 1712(a)(1)(G) 
        of title 38, United States Code.
            (2) Covered veteran.--The term ``covered veteran'' means a 
        veteran who--
                    (A) is enrolled in the system of annual patient 
                enrollment of the Department of Veterans Affairs 
                established and operated under subsection (a) of 
                section 1705 of title 38, United States Code, pursuant 
                to paragraph (1) or (2) of such subsection or is not 
                enrolled in such system but is otherwise entitled to 
                hospital care and medical services under subsection 
                (c)(2) of such section;
                    (B) is not eligible for dental services and 
                treatment and related dental appliances under the laws 
                administered by the Secretary of Veterans Affairs as of 
                the date of the enactment of this Act; and
                    (C) has a diagnosis of--
                            (i) type 1 or type 2 diabetes; or
                            (ii) ischemic heart disease.

SEC. 4. PILOT PROGRAM TO FURNISH DENTAL CARE FROM THE DEPARTMENT OF 
              VETERANS AFFAIRS TO CERTAIN VETERANS DIAGNOSED WITH 
              DIABETES OR ISCHEMIC HEART DISEASE.

    (a) In General.--Commencing not later than one year after the date 
of the enactment of this Act, the Secretary of Veterans Affairs shall 
carry out a pilot program (in this section referred to as the ``pilot 
program'') under which the Secretary shall furnish covered care to 
covered veterans for the duration of the pilot program.
    (b) Duration.--The pilot program shall be carried out during the 
four-year period beginning on the date of the commencement of the pilot 
program.
    (c) Locations.--
            (1) In general.--The Secretary shall carry out the pilot 
        program at the following locations:
                    (A) Each medical center of the Department with an 
                established dental clinic.
                    (B) Each community-based outpatient clinic with an 
                established dental clinic.
            (2) Mobile dental clinics.--In carrying out the pilot 
        program, 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.
            (3) Home-based dental care.--In carrying out the pilot 
        program, the Secretary shall test the efficacy of portable 
        dental care units to service rural veteran in their homes, as 
        the Secretary considers medically appropriate.
    (d) Dental Therapists and Tele-Dentistry.--
            (1) In general.--In carrying out the pilot program, The 
        Secretary shall test the efficacy of the use of dental 
        therapists and tele-dentistry to service the dental care needs 
        of covered veterans.
            (2) Use of tele-dentistry.--When providing tele-dentistry 
        under paragraph (1), the Secretary shall use Federal employees 
        to the maximum extent possible.
    (e) Administration.--
            (1) Notice to covered veterans.--In carrying out the pilot 
        program, the Secretary shall inform all covered veterans of the 
        covered care available under the pilot program.
            (2) Copayments.--The Secretary may collect copayments for 
        covered care furnished under the pilot program in accordance 
        with authorities on the collection of copayments for medical 
        care of veterans under chapter 17 of title 38, United States 
        Code.
    (f) Reports.--
            (1) In general.--Not later than 90 days before the 
        completion of the pilot program, and not later than 180 days 
        after the completion of the pilot program, 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 pilot program.
            (2) Contents.--Each report under paragraph (1) shall 
        include the following:
                    (A) A description of the implementation and 
                operation of the provision of covered care under the 
                pilot program.
                    (B) The number of covered veterans receiving 
                covered care under the pilot program and a description 
                of the covered care furnished to such veterans.
                    (C) An analysis of the costs and benefits of 
                covered care provided under the pilot program, 
                including a comparison of costs and benefits by 
                location type.
                    (D) An assessment of the impact of the pilot 
                program on appointments for care, prescriptions, 
                hospitalizations, emergency room visits, wellness, 
                employability, satisfaction, and perceived quality of 
                life of covered veterans related to their diagnosis of 
                diabetes or ischemic heart disease.
                    (E) An analysis and assessment of the efficacy of 
                mobile clinics and portable dental care units, to the 
                extent such modalities are used, to service the needs 
                of covered veterans under the pilot program.
                    (F) An analysis and assessment of the efficacy of 
                dental therapists and tele-dentistry to service the 
                needs of covered veterans under the pilot program, to 
                include a cost benefit analysis of such services.
                    (G) The findings and conclusions of the Secretary 
                with respect to the pilot program.
                    (H) Such recommendations as the Secretary considers 
                appropriate for the expansion of dental care to all 
                veterans eligible for health care from the Department.
    (g) Impact on Community Care.--Nothing in this section limits a 
covered veteran from accessing care or services pursuant to section 
1703 of title 38, United States Code.

SEC. 5. 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 
covered care to covered 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 selected under 
        subsection (c) for a period that is not less than the duration 
        of the pilot program under section 4.
    (b) Maximum Amount.--
            (1) In general.--Except as provided in paragraph (2), the 
        Secretary may reimburse not more than--
                    (A) $100,000 for each dentist participating in the 
                program under subsection (a);
                    (B) $25,000 for each dental hygienist participating 
                in such program; and
                    (C) $40,000 for each credentialed doctor of 
                medicine in dentistry serving as an oral surgeon and 
                participating in such program.
            (2) Dual eligibility.--The Secretary may reimburse an 
        individual serving in multiple positions described in 
        subparagraphs (A) through (C) of paragraph (1) not more than 
        $140,000.
    (c) Selection of Locations.--The Secretary shall monitor demand 
among covered veterans for covered 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. 6. AUTHORIZATION OF APPROPRIATIONS.

    (a) In General.--There is authorized to be appropriated for the 
Department of Veterans Affairs for fiscal year 2024 such sums as may be 
necessary to carry out 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.
                                 <all>