[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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