[Congressional Record (Bound Edition), Volume 148 (2002), Part 1]
[Extensions of Remarks]
[Page 413]
[From the U.S. Government Publishing Office, www.gpo.gov]




            CHILDREN'S DENTAL HEALTH IMPROVEMENT ACT OF 2002

                                 ______
                                 

                          HON. JOHN P. MURTHA

                            of pennsylvania

                    in the house of representatives

                       Tuesday, January 29, 2002

  Mr. MURTHA. Mr. Speaker, dental care is the most frequently cited 
unmet health need of children. In fact, unmet children's dental care 
need, is three times greater than the unmet need for children's medical 
care, four times greater than the unmet need for prescription drugs, 
and five times greater than the unmet need for children's vision care. 
Dental decay is the most prevalent chronic disease of childhood.
  To help in eradicating this hidden epidemic, Congresswomen Lowey, 
Roybal-Allard, Morella and Congressmen Upton, Norwood, Stark, Doyle, 
Moran, Andrews and I are introducing the ``Children's Dental Health 
Improvement Act of 2002''. With its enactment, this legislation will 
improve the access and delivery of dental care to low-income children 
across the country.
  In September 2000, the U.S. Surgeon General reported in ``Oral Health 
in America: A Report of the Surgeon General'' that 14 percent of 
children in America were without health insurance coverage and that 
more than twice that number, 23 million children, were without any 
level of dental care. Pediatric health care providers and children's 
hospitals across America see the results of this lack of care every 
day, as they care for children with serious dental problems that could 
have easily been avoided had they had access to preventative and 
routine dental care.
  The need to improve the oral health of America's children is well 
documented. According to the National Health and Nutrition Interview 
Survey, poor children age 2-9 have twice the levels of untreated 
decayed teeth as nonpoor children. According the U.S. Surgeon General, 
``there are at least 2.6 children without dental insurance for each 
child without medical insurance.'' Progressive tooth decay causes 
children to suffer pain and infection, dysfunctions in eating and 
speech, distraction and irritable behavior and creates attendant 
learning dysfunctions and limitations. According to the National 
Institute of Dental and Craniofacial Research reports, 80 percent of 
tooth decay is isolated in only 25 percent of the children, with the 
most untreated disease occurring in low-income children. In addition, 
the social impact of oral disease in children is substantial. More than 
51 million school hours are lost each year to dental-related illness in 
children.
  The ``Children's Dental Health Improvement Act of 2002'', will 
provide states the flexibility to utilize the Children's Health 
Insurance Program (CHIP) to provide dental coverage to low-income 
children (below 200% of poverty) including children who may have 
limited medical coverage that does not include dental services. The 
legislation will improve the dental health of uninsured and 
underinsured low-income children by allowing states the flexibility to 
utilize CHIP to provide funding for dental coverage to low-income 
children; providing $40 million to community health centers and public 
health departments to expand dental health services through the hiring 
of additional dental-health professionals.
  While several factors influence access for low-income groups to 
dental care, the primary one being limited dentist participation in 
Medicaid. The primary factor here is in, large part, due to poor 
reimbursement rates in Medicaid. The legislation seeks to improve 
dental care access under Medicaid and the Indian Health Service (IHS) 
by providing $50 million as financial incentives and planning grants to 
states to improve their Medicaid program in terms of adequate payment 
rates, access to care and improved service delivery; again, providing 
$40 million to community and IHS health centers and public health 
departments to expand dental health services through the hiring of 
additional dental health professionals.
  Despite Medicaid and CHIP, dental care is the least utilized core 
pediatric health service for low-income children. The Department of 
Health and Human Services (HHS) Oral Health Initiative (OHI) effort to 
coordinate dental health service within CMS lacks statutory authority 
necessary to enforce oral health initiatives. The legislation seeks to 
remedy this by providing statutory authority for the OHI and authorizes 
$25 million to improve the oral health of low-income populations.
  In addition, the bill contains the following technical provisions:
  The bill streamlines the process for the designation of dental health 
professional shortage areas;
  Ensures that entities eligible for funding include both ``school-
linked'' as well as school-based organizations, clarifies that an 
eligible entitle can be public or non-profit health organization or 
tribal organization;
  Creating authority for HHS to establish demonstration projects to 
increase access to dental services for children in underserved areas.
  This legislation has the endorsement and is fully supported by over 
40 national health organizations including, National Association of 
Children's Hospitals, American Academy of Pediatrics, March of dimes, 
American Dental Association and Family Voices.
  There can be no substitute for providing for our children's health. 
The ``Children's Dental Health Improvement Act of 2002'' will go a long 
way to filling a large gap that exists in our current health programs 
for children. Clearly, more effort and support is needed. Therefore, I 
believe that Congress must act now. I ask that all Members of the House 
and Senate join in to support and vote for passage of the ``Children's 
Dental Health Improvement Act of 2002''.

                          ____________________