[Congressional Record (Bound Edition), Volume 160 (2014), Part 3]
[Senate]
[Pages 3885-3887]
[From the U.S. Government Publishing Office, www.gpo.gov]




                       DEAMONTE DRIVER'S PASSING

  Mr. CARDIN. Mr. President, today I rise to mark the seventh 
anniversary of Deamonte Driver's death.
  Deamonte Driver was a 12-year-old child who lived in Prince George's 
County, MD, whose border sits only a few miles from the U.S. Capitol 
Building. He died 7 years ago at the Children's National Medical Center 
in Washington, DC, from a brain infection caused by an untreated tooth 
abscess.
  The Driver family, like many other families across the country, 
lacked dental insurance. At one time, the Drivers were covered by the 
Medicaid Program, but they lost that coverage when they moved into a 
shelter and their paperwork fell through the cracks. When advocates for 
the family tried to help the Drivers locate a dentist to treat 
Deamonte's cavities and tooth pain, it took more than 20 calls to find 
a dentist who would see him.
  Around mid-January in 2007, Deamonte began to complain of severe 
headaches. A subsequent evaluation at Children's Hospital led beyond 
the basic dental care that the family had

[[Page 3886]]

anticipated to emergency brain surgery. Deamonte later experienced 
seizures, and a second operation was required. After additional 
treatment and therapy, Deamonte appeared to be recovering, but medical 
intervention had come too late. By the end of his treatment, the total 
cost to our health care system exceeded one-quarter of a million 
dollars--more than 3,000 times the $80 cost of a tooth extraction.
  Deamonte Driver passed away on Sunday, February 25, 2007. This 
child's death was a national tragedy because it could have been 
prevented had he received timely and proper basic dental care. It was a 
tragedy because it happened right here in the United States, in a State 
that is one of the most affluent in the Nation. It happened in the 
State that is home to the first and one of the best dental schools in 
the Nation, the University of Maryland's dental school. It happened in 
Prince George's County, whose border is less than 6 miles from where we 
are standing in the U.S. Capitol.
  I have spoken on the Senate floor about Deamonte Driver several times 
since his death, and in the intervening years, both in Maryland and 
nationally, we have made tremendous progress. When Deamonte's story was 
brought to light, I believe it was a wakeup call for our Nation. It 
brought home the statement of former Surgeon General C. Everett Koop: 
``There is no health without oral health.''
  Medical research reinforces Dr. Koop's words. Scientists have 
discovered the nexus between tooth plaque and heart disease, that 
chewing stimulates brain cell growth, and that gum disease can signal 
diabetes, liver ailments, and hormone imbalances. They have identified 
the vital connection between oral health research and advanced 
treatments like gene therapy, which can help patients with chronic 
renal failure. They have found that investing in basic dental care for 
children and adults can reduce health care expenditures down the road 
for costly medical interventions related to other diseases.
  But for all their research findings, we also know that without 
insurance coverage and adequate access to providers, the needs of 
millions of children and adults will remain unmet, and the 
complications resulting from poor oral health will persist.
  That is why the progress we have made over the past 7 years is so 
important to America's health. I have come to the floor today to talk 
about what has been achieved and how we can move forward as a nation to 
ensure even greater access to oral health care.
  Since Deamonte's passing, the State of Maryland has emerged as a 
national leader in oral health--launching a $1.2 million oral health 
literacy campaign, raising Medicaid reimbursement rates for dentists in 
the program, and providing allied health professionals and hygienists 
the opportunity to practice outside clinics. The Deamonte Driver Dental 
Project Van, which was dedicated in front of the U.S. Capitol in May 
2010, provides care in underserved neighborhoods in Prince George's 
County, thanks to efforts conceived and launched by members of the 
Robert T. Freeman Dental Society. An arm of the National Dental 
Association, the society is named for Dr. Robert Tanner Freeman, who in 
1869 became the first Black graduate of the Harvard School of Dental 
Medicine.
  It was 2 years after Deamonte's death, in 2009, that Congress 
reauthorized the Children's Health Insurance Program. Some of my 
colleagues recalled the difficulty that Deamonte's mother had finding 
him care. Hers was not an isolated instance. For varied reasons, it is 
difficult for Medicaid and CHIP enrollees to find dental providers, and 
working parents whose children qualify for those programs are likely to 
be employed at jobs where they can't afford to spend 2 hours a day on 
the phone searching for a provider. So part of the CHIP Reauthorization 
Act requires HHS to include on its Insure Kids Now Web site a list of 
participating dentists and benefit information for all 50 States and 
the District of Columbia.
  Also in 2009, Congress passed the Edward M. Kennedy Serve America 
Act, which created the Healthy Futures Corps--a program that provides 
grants to States and nonprofit organizations so they can fund national 
service in low-income communities. The law's goal was to put into 
action key tools that can help close the gaps in health status--
prevention and health promotion. With the help of Senator Mikulski, we 
added language to that law specifying oral health as an area of focus. 
Now, the Healthy Futures Corps is recruiting young people to work in 
the dental profession, where severe shortages of providers exist in 
many urban and rural communities. The law is funding the work of 
individuals who can help parents find oral health care for themselves 
and their children. It is making a difference in the lives of the 
Healthy Futures Corps members who work in underserved communities and 
in the lives and health of those who can now get care.
  Then in 2010, Congress passed the Affordable Care Act, which 
guarantees pediatric dental coverage as part of each State's Essential 
Benefits health care package. The ACA also established an oral health 
care prevention education campaign at the Centers for Disease Control 
and Prevention, which is targeted toward key populations, including 
children and pregnant women, and it created demonstration programs to 
encourage innovation in oral health delivery. The law also 
significantly expanded workforce training programs for oral health 
professionals.
  Moving forward, the States have a critical role to play in ensuring 
that the ACA benefit is designed to incentivize prevention, recognize 
that some children have greater risk of dental disease than others, and 
deliver care based on their level of risk.
  Among the most cost-effective ways to improve children's dental 
health are investments in prevention. Dental sealants, clear plastic 
coatings applied to the chewing surface of molars, have been proven to 
prevent 60 percent of tooth decay at one-third the cost of filling a 
cavity. So it is essential that prevention be part of every State's 
benefit package.
  Further, in 2010, the U.S. Department of Health and Human Services 
launched its Oral Health Initiative, based on a bill I introduced with 
Senator Susan Collins. The initiative establishes a coordinated 
multiagency effort to improve access to care across the Nation.
  One of the most effective organizations in tracking access to care is 
the Pew Children's Dental Campaign, which produces report cards that 
grade the States on eight policies that are evidence-based solutions to 
the problem of tooth decay. In 2011, Maryland received an ``A'' grade 
in both reports for meeting or exceeding these benchmarks, which 
include dental sealant programs, community water fluoridation, Medicaid 
reimbursement and enrollment, and collection of data on children's 
dental health. Maryland's grade is significant because in the late 
1990s, my State had one of the worst records in the Nation with respect 
to oral health care for its underserved population. Now it is one of 
the top-ranked States for oral health care.
  Our State has just received even more good news. The number of 
children in Maryland with untreated tooth decay dropped 41 percent from 
2001 to 2011, and the overall oral health status of Maryland children 
has dramatically improved, according to a 2014 report conducted by the 
University of Maryland's School of Dentistry. The State assessment 
looked at 1,723 students in 52 schools from the five regions of the 
State. About 33 percent of the children had at least one dental sealant 
on their permanent first molars, and this milestone exceeded Federal 
goals by 5 percent. About 14 percent of students had untreated dental 
caries, a drop from 23 percent in 2000, and the State's achievement 
exceeded Federal goals by 12 percent. According to the assessment, 75 
percent of the children surveyed had a regular dentist.
  Another key player in our State's effort is the Baltimore Oral Health 
Impact Project, which provides care to children in Baltimore's public 
schools. Since February 2010, its providers have seen more than 3,500 
children and treated more than 1,500 for dental disease. The program 
places a high value

[[Page 3887]]

on delivering comprehensive and compassionate oral health care.
  This organization has also launched the Baltimore Oral Health 
Academy, offering scholarships to students who choose to pursue careers 
as a clinical dental professional including dental assistants and 
hygienists, and who agree to serve in a public health setting.
  Nationally, HRSA's National Health Service Corps addresses the 
nationwide shortage of primary care oral health providers in dental 
health professional shortage areas--HPSA--by offering incentives in the 
form of scholarships and loan repayments to primary care dentists and 
registered dental hygienists to practice in underserved communities. 
The Corps has awarded more than 1,100 new loan repayment awards to 
dentists and nearly 300 new loan repayment awards to registered dental 
hygienists. But this is not nearly enough to erase the shortages. The 
NHSC has also implemented a part-time service program for providers who 
did not wish to make a full-time commitment, and I am hopeful that this 
new option will increase participation in the coming years.
  Our Nation has made significant progress in improving children's 
dental health in the 7 years since Deamonte died, but there is still 
much work to be done. The access problem in some communities has become 
so severe that many people are forced to seek treatment for tooth pain 
in the Nation's emergency rooms, increasing the overall cost of care 
and receiving uncoordinated care in the least cost-efficient setting. 
In fact, more people seek treatment in emergency rooms for tooth pain 
than they do for asthma.
  I will continue to work to increase funding for grants to States and 
expand training opportunities for dentists. We do not have enough 
professionals who are trained and available to treat children and 
adults with dental problems, and it is our responsibility to fix that. 
We must improve public reimbursement to dental providers in offices and 
clinics so that no one who needs treatment will be turned away.
  Soon, Congress will turn again to the Reauthorization of the CHIP 
program, and I will be once again fighting for the strongest possible 
language we can get to promote children's oral health. For my 
colleagues who may not be familiar with CHIP's track record on oral 
health, I would like to leave you with three facts:
  First, tooth decay is the single most common chronic disease of 
childhood, and it is five times more common than asthma. The 
complications of dental disease, which we now know can be fatal, are 
completely and easily preventable if we give children the care they 
need. Second, because of Congress's passage of the 2009 Children's 
Health Insurance Program Reauthorization Act, in 2013, more than 8 
million American children had comprehensive dental coverage through 
CHIP. Third, CHIP has kept comprehensive coverage affordable. Under 
CHIP, families cannot pay more than 5 percent of their annual income in 
out-of-pocket costs for their children's medical and dental care.
  What we have been able to achieve for children is due to support in 
Congress and also to the efforts of the many nonprofit organizations, 
universities, and providers who are also working across the Nation to 
make sure that we will never forget Deamonte and never forget our 
responsibility to improving oral health care for America's children.
  On this sad anniversary, in Maryland and throughout the Nation there 
are signs of hope for the future of oral health care. I thank my 
colleagues for the role they have played in this process and look 
forward to working with them in the months to come to strengthen oral 
health care access for our Nation's children.

                          ____________________