[Congressional Record Volume 154, Number 85 (Thursday, May 22, 2008)]
[Senate]
[Page S4803]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Ms. COLLINS (for herself, Mr. Feingold, and Mr. Cardin):
  S. 3067. A bill to amend the Public Health Service Act to reauthorize 
the Dental Health Improvement Act; to the Committee on Health, 
Education, Labor, and Pensions.
  Ms. COLLINS. Mr. President, I am pleased to join my colleagues from 
Wisconsin and Maryland in introducing legislation to reauthorize the 
Collins-Feingold Dental Health Improvement Act, which was first signed 
into law as part of the Health Care Safety Net Act Amendments of 2002. 
The legislation we are introducing today will extend the authorization 
of this program, which provides grant funding to States to strengthen 
the dental workforce in our Nation's rural and underserved communities, 
for an additional 5 years.
  While oral health in America has improved dramatically over the last 
50 years, these improvements have not occurred evenly across our 
population, particularly among low-income individuals and families. Too 
many Americans today lack access to dental care. While there are 
clinically proven techniques to prevent or delay the progression of 
dental health problems, an estimated 47 million Americans live in areas 
lacking adequate dental services. As a consequence, these effective 
treatment and prevention programs are not being implemented in many of 
our communities. Astoundingly, as many as 11 percent of our Nation's 
rural population has never been to a dentist.
  The situation is exacerbated by the fact that our dental workforce is 
graying. More than 20 percent of dentists nationwide will retire in the 
next 10 years, and the number of dental graduates may not be enough to 
replace their retirees. As a consequence, many states are facing a 
serious shortage of dentists, particularly in rural areas.
  In Maine, there is one general practice dentist for every 2,300 
people in the Portland area. The numbers drop off dramatically, 
however, in other parts of our state. In Aroostook County, for example, 
where I am from, there is only one dentist for every 5,500 people. Of 
the 23 dentists practicing in Aroostook County, only a few are taking 
on any new cases.
  The Collins-Feingold Dental Health Improvement Act, which is now 
Section 340G of the Public Health Service Act, authorized a State grant 
program administered by the Health Resources and Services 
Administration at the Department of Health and Human services that is 
designed to improve access to oral health services in rural and 
underserved areas. States can use these grants to fund a wide variety 
of programs. For example, they can use the funds for loan forgiveness 
and repayment programs for dentists practicing in underserved areas. 
They can also use the grant funds to establish or expand community or 
school-based dental facilities or to set up mobile or portable dental 
clinics. To assist in their recruitment and retention efforts, States 
can use the funds for placement and support of dental students, 
residents and advanced dentistry trainees. Or, they can use the grant 
funds for continuing dental education, through distance-based education 
and practice support through teledentistry.

  Congress appropriated $2 million for this program for fiscal year 
2006 and fiscal year 2007 and just under $5 million for fiscal year 
2008.
  Thirty-six States have applied for grants from this program, but so 
far, the funding available has only been sufficient to fund programs in 
18 States. Clearly there is sufficient interest and need for this 
program to justify its extension, particularly given all of the recent 
reports documenting the very serious need to improve access to oral 
health care.
  Those 18 States that have been awarded funding under this program are 
doing great things to improve access to oral health services. Colorado, 
Georgia and Massachusetts are using the grant funds for loan 
forgiveness and repayment programs for dentists who practice in 
underserved areas and who agree to provide services to patients 
regardless of their ability to pay. Arkansas, Maine, Michigan, 
Mississippi and a number of other states are using the funds for 
recruitment and retention efforts. Delaware, Rhode Island and Vermont, 
which, like Maine, don't have dental schools, are using the funds to 
expand dental residency programs in their States.
  The legislation we are introducing today will authorize an additional 
$50 million over the next 5 years for this important program. The 
American Dental Association, the American Dental Education Association, 
and the American Academy of Pediatric Dentistry have all endorsed the 
legislation, and I encourage all of our colleagues to join us as 
cosponsors.
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