[Congressional Record Volume 168, Number 158 (Thursday, September 29, 2022)]
[Senate]
[Pages S5901-S5902]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

  SA 6373. Mr. SANDERS submitted an amendment intended to be proposed 
to amendment SA 5499 submitted by Mr. Reed (for himself and Mr. Inhofe) 
and intended to be proposed to the bill H.R. 7900, to authorize 
appropriations for fiscal year 2023 for military activities of the 
Department of Defense, for military construction, and for defense 
activities of the Department of Energy, to prescribe military personnel 
strengths for such fiscal year, and for other purposes; which was 
ordered to lie on the table; as follows:

        At the end of title X, add the following:

   Subtitle H--Improvement of Health Care for Veterans With Chronic 
                               Conditions

     SEC. 1081. SHORT TITLE.

       This subtitle may be cited as the ``Improving Whole Health 
     for Veterans with Chronic Conditions Act''.

     SEC. 1082. EXPANSION OF DENTAL CARE FURNISHED BY DEPARTMENT 
                   OF VETERANS AFFAIRS TO INCLUDE VETERANS 
                   DIAGNOSED WITH DIABETES AND HEART DISEASE.

       (a) Expansion of Care.--
       (1) In general.--Subsection (a)(1) of section 1712 of title 
     38, United States Code, is amended--
       (A) in subparagraph (B)--
       (i) by redesignating clauses (i) through (iv) as subclauses 
     (I) through (IV), respectively, and moving those subclauses, 
     as so redesignated, two ems to the right; and
       (ii) in subclause (III), as redesignated by clause (i)--

       (I) by striking ``(I)'' and inserting ``(aa)''; and
       (II) by striking ``(II)'' and inserting ``(bb)'';

       (B) by redesignating subparagraphs (A) through (H) as 
     clauses (i) through (viii), respectively, and moving those 
     clauses, as so redesignated, two ems to the right;
       (C) in the matter preceding clause (i), as redesignated by 
     subparagraph (B), by striking ``only for a dental condition 
     or disability'' and inserting ``only--
       ``(A) for a dental condition or disability'';
       (D) in clause (viii), as redesignated by subparagraph (B), 
     by striking the period at the end and inserting ``or''; and
       (E) by adding at the end the following new subparagraph 
     (B):
       ``(B) to any veteran enrolled in the system of annual 
     patient enrollment under section 1705 of this title with a 
     diagnosis of--
       ``(i) type 1 or type 2 diabetes; or
       ``(ii) ischemic heart disease.''.
       (2) Conforming amendments.--
       (A) In general.--Such section is further amended--
       (i) in subsection (a)(2), by striking ``clause (B) of 
     paragraph (1) of this subsection'' and inserting ``clause 
     (ii) of paragraph (1)(A)''; and
       (ii) in subsection (b), by striking ``paragraph (1)(B) of 
     subsection (a)'' and inserting ``subsection (a)(1)(A)(ii)''.
       (B) Medical care.--Section 1710(c) of such title is amended 
     by striking ``section 1712(a)'' and inserting ``section 
     1712(a)(1)(A)''.
       (C) Dental care for homeless veterans.--Section 2062(a) of 
     such title is amended, in the matter preceding paragraph (1), 
     by striking ``section 1712(a)(1)(H)'' and inserting ``section 
     1712(a)(1)(A)(viii)''.
       (b) Administration of Expansion.--
       (1) Voluntary participation.--The receipt by a covered 
     veteran of covered care shall be at the election of the 
     veteran.
       (2) Scope of services.--The covered care furnished to a 
     covered veteran shall be consistent with the dental services 
     and treatment, and related dental appliances, furnished by 
     the Secretary of Veterans Affairs to veterans with service-
     connected disabilities rated 100 percent disabling under the 
     laws administered by the Secretary.
       (3) Considerations.--In furnishing covered care to covered 
     veterans, the Secretary shall test the efficacy of the use of 
     the following:
       (A) 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.
       (B) Portable dental care units to service rural veterans in 
     their homes, as the Secretary considers medically 
     appropriate.
       (C) Dental therapists and teledentistry to service the 
     dental care needs of covered veterans.
       (4) Notice to covered veterans.--The Secretary shall inform 
     all covered veterans of the covered care available to such 
     veterans.
       (5) Contracts.--
       (A) In general.--Subject to subparagraph (C), the Secretary 
     may enter into contracts with appropriate entities for the 
     provision of covered care to covered veterans.
       (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 of Veterans Affairs does not employ, and 
     cannot recruit and retain, qualified dentists, dental 
     hygienists, and oral surgeons in the applicable location.
       (c) Report.--
       (1) In general.--Not later than two years after the date of 
     the enactment of this Act, the Secretary of Veterans Affairs 
     shall submit to the Committee on Veterans' Affairs of the 
     Senate and the Committee on Veterans' Affairs of the House of 
     Representatives a report on the expansion of the provision of 
     dental care pursuant to subsection (a).
       (2) Contents.--The report under paragraph (1) shall include 
     the following:
       (A) A description of the implementation and operation of 
     the expansion of the provision of dental care pursuant to 
     subsection (a).
       (B) The number of covered veterans receiving dental care 
     pursuant to such expansion and a description of the dental 
     care furnished to such veterans.
       (C) An analysis of the costs and benefits of such 
     expansion, including a comparison of costs and benefits by 
     location type.
       (D) An assessment of the impact of such expansion on the 
     health of covered veterans, including--
       (i) an assessment of the veterans' diabetes or ischemic 
     heart disease;
       (ii) an assessment of appointments for care, prescriptions, 
     hospitalizations, emergency room visits, wellness, 
     employability, and satisfaction of such veterans; and
       (iii) an assessment of the perceived quality of life of 
     such 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, to include a cost-benefit analysis 
     of such services.
       (F) An analysis and assessment of the efficacy of dental 
     therapists and teledentistry to service the dental needs of 
     covered veterans, to include a cost benefit analysis of such 
     services.
       (G) The findings and conclusions of the Secretary with 
     respect to health care outcomes for covered veterans.
       (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.
       (I) Such recommendations for the expansion of dental care 
     to non-covered veterans with diagnoses that may be affected 
     by poor oral health.
       (d) Definitions.--In this section:
       (1) Covered care.--The term ``covered care'' means 
     outpatient dental services and treatment, and related dental 
     appliances, furnished pursuant to section 1712(a)(1)(B) of 
     title 38, United States Code, as amended by subsection 
     (a)(1)(E).
       (2) Covered veteran.--The term ``covered veteran'' means a 
     veteran described in section 1712(a)(1)(B) of title 38, 
     United States Code, as amended by subsection (a)(1)(E).
       (e) Effective Date.--This section and 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. 1083. 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,

[[Page S5902]]

     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 therapists, dental hygienists, or oral 
     surgeons, as the case may be, according to facility 
     enrollment and patient demand.

     SEC. 1084. 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. 1085. AUTHORIZATION OF APPROPRIATIONS.

       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 and the amendments made 
     by this subtitle.
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