[Congressional Record Volume 168, Number 97 (Tuesday, June 7, 2022)]
[Senate]
[Pages S2835-S2836]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 5057. Mr. SANDERS submitted an amendment intended to be proposed 
to amendment SA 5051 submitted by Mr. Tester (for himself and Mr. 
Moran) and intended to be proposed to the bill H.R. 3967, to improve 
health care and benefits for veterans exposed to toxic substances, and 
for other purposes; which was ordered to lie on the table; as follows:

        At the end of title I, add the following:

           Subtitle C--Expansion of Dental Care for Veterans

     SEC. 121. PILOT PROGRAM TO FURNISH DENTAL CARE FROM THE 
                   DEPARTMENT OF VETERANS AFFAIRS IN THE SAME 
                   MANNER AS ANY OTHER MEDICAL SERVICE.

       (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 to assess 
     the feasibility and advisability of furnishing dental care in 
     the same manner as medical services furnished by the 
     Department, notwithstanding the limitations on the provision 
     of dental care under sections 1710(c) and 1712 of title 38, 
     United States Code.
       (b) Medical Services Defined.--In this section, the term 
     ``medical services'' has the meaning given that term in 
     section 1701(6) of title 38, United States Code

     SEC. 122. PILOT PROGRAM ON EXPANSION OF FURNISHING BY 
                   DEPARTMENT OF VETERANS AFFAIRS OF DENTAL CARE 
                   TO CERTAIN ENROLLED VETERANS.

       (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 under which 
     the Secretary 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) Duration.--The pilot program shall be carried out 
     during the two-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) 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.
       (C) Not fewer than four community-based outpatient clinics 
     with space available for the furnishing of dental care under 
     the pilot program.
       (D) Not fewer than four Federally Qualified Health Centers.
       (E) 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.
       (2) Considerations.--In selecting locations for the pilot 
     program, the Secretary shall consider the feasibility and 
     advisability of selecting locations in each of the following:
       (A) Rural areas.
       (B) Areas that are not in close proximity to an active duty 
     military installation.
       (C) Areas representing different geographic locations, such 
     as census tracts established by the Bureau of the Census.
       (3) 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.
       (4) 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) Services.--
       (1) Scope.--The dental care furnished to covered veterans 
     under the pilot program 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.
       (2) Dental therapists and tele-dentistry.--
       (A) 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.
       (B) Use of tele-dentistry.--When providing tele-dentistry 
     under subparagraph (A), the Secretary shall use Federal 
     employees to the maximum extent possible.
       (e) Voluntary Participation.--The participation of a 
     covered veteran in the pilot program shall be at the election 
     of the veteran.
       (f) Administration.--
       (1) Notice to covered veterans.--In carrying out the pilot 
     program, the Secretary shall inform all covered veterans of 
     the services and treatment available under the pilot program.
       (2) Copayments.--The Secretary may collect copayments for 
     dental 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.
       (3) Contracts.--
       (A) In general.--Subject to subparagraph (C), in carrying 
     out the pilot program, the Secretary may enter into contracts 
     with appropriate entities for the provision of dental care 
     under the pilot program.
       (B) Performance standards and metrics.--Each contract 
     entered into under subparagraph (A) shall specify performance 
     standards and metrics and processes for ensuring compliance 
     of the contractor concerned with such performance standards.
       (C) Limitation.--The Secretary may only enter into 
     contracts under subparagraph (A) 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.
       (g) 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 pilot program.
       (B) The number of covered veterans receiving dental care 
     under the pilot program and a description of the dental care 
     furnished to such veterans.
       (C) An analysis of the costs and benefits of 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, and 
     satisfaction of patients, and perceived quality of life of 
     covered veterans.
       (E) An analysis and assessment of the efficacy of mobile 
     clinics and home based dental care to service the dental 
     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 dental 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) 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 the pilot program.
       (I) Such recommendations as the Secretary considers 
     appropriate for the expansion of dental care to all veterans 
     eligible for health care from the Department.
       (h) Definitions.--In this section:
       (1) 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,

[[Page S2836]]

     United States Code, pursuant to paragraph (1) or (2) of such 
     section.
       (2) 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)).

     SEC. 123. 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. 124. 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. 125. 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 therapists, dental hygienists, and oral 
     surgeons who agree--
       (1) to be appointed by the Secretary as a dentist, dental 
     therapist, 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 therapist, 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.--
       (1) In general.--Except as provided in paragraph (2), the 
     Secretary may reimburse not more than--
       (A) $75,000 for each dentist participating in the program 
     under subsection (a);
       (B) $20,000 for each dental therapist participating in such 
     program;
       (C) $10,000 for each dental hygienist participating in such 
     program; and
       (D) $20,000 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 (D) of paragraph (1) not more than 
     $95,000.
       (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. 126. EDUCATIONAL AND TRAINING PARTNERSHIPS FOR DENTISTS, 
                   DENTAL THERAPISTS, 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 therapists, dental hygienists, and oral surgeons.

     SEC. 127. AUTHORIZATION OF APPROPRIATIONS.

       (a) In General.--There is authorized to be appropriated for 
     the Department of Veterans Affairs for fiscal year 2023 such 
     sums as may be necessary to carry out this subtitle.
       (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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