[Congressional Record Volume 169, Number 120 (Thursday, July 13, 2023)]
[Senate]
[Pages S2852-S2853]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]
SA 726. Mr. SANDERS (for himself, Mr. Fetterman, Mr. Welch, Mr.
Wyden, Mr. Durbin, and Ms. Stabenow) submitted an amendment intended to
be proposed by him to the bill S. 2226, to authorize appropriations for
fiscal year 2024 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--Improving Whole Health for Veterans With Chronic Conditions
Act
SEC. 1091. SHORT TITLE.
This subtitle may be cited as the ``Improving Whole Health
for Veterans with Chronic Conditions Act''.
SEC. 1092. 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. 1093. DEFINITIONS.
In this subtitle:
(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. 1094. 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. 1095. 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. 1096. 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 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.
[[Page S2853]]
______