[House Report 117-211]
[From the U.S. Government Publishing Office]
117th Congress } { Report
HOUSE OF REPRESENTATIVES
1st Session } { 117-211
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ORAL HEALTH LITERACY AND AWARENESS ACT OF 2021
_______
December 8, 2021.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Pallone, from the Committee on Energy and Commerce, submitted the
following
R E P O R T
[To accompany H.R. 4555]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 4555) to amend the Public Health Service Act to
authorize a public education campaign across all relevant
programs of the Health Resources and Services Administration to
increase oral health literacy and awareness, having considered
the same, reports favorably thereon without amendment and
recommends that the bill do pass.
CONTENTS
Page
I. Purpose and Summary.............................................. 1
II. Background and Need for the Legislation.......................... 2
III. Committee Hearings............................................... 2
IV. Committee Consideration.......................................... 3
V. Committee Votes.................................................. 3
VI. Oversight Findings............................................... 3
VII. New Budget Authority, Entitlement Authority, and Tax Expenditures 3
VIII.Federal Mandates Statement....................................... 4
IX. Statement of General Performance Goals and Objectives............ 4
X. Duplication of Federal Programs.................................. 4
XI. Committee Cost Estimate.......................................... 4
XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits...... 4
XIII.Advisory Committee Statement..................................... 4
XIV. Applicability to Legislative Branch.............................. 4
XV. Section-by-Section Analysis of the Legislation................... 5
XVI. Changes in Existing Law Made by the Bill, as Reported............ 5
I. Purpose and Summary
H.R. 4555, the ``Oral Health Literacy and Awareness Act of
2021,'' would authorize a public education campaign across all
relevant programs of the Health Resources and Services
Administration (HRSA) to increase oral health literacy and
awareness.
II. Background and Need for Legislation
Oral health, defined as the health of the teeth, gums, and
the entire oral-facial system, is an integral component of
general health and well-being. Cavities (tooth decay), gum
(periodontal) disease, and oral cancer are the most common yet
preventable diseases affecting oral health.\1\ More than one in
four adults have untreated cavities, and nearly half of those
aged 30 or older show signs of gum disease, which if left
untreated can lead to tooth loss.\2\ The consequences of poor
oral health for adults and children include an annual average
of 34 million school hours lost due to emergency dental care
and an over $45 billion loss in productivity in the United
States due to untreated dental disease.\3\
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\1\Centers for Disease Control and Prevention, Oral Health
Conditions (Nov. 3, 2020) (www.cdc.gov/oralhealth/conditions/
index.html).
\2\Centers for Disease Control and Prevention, Cost-Effectiveness
of Oral Diseases Interventions: Power of Prevention (May 13, 2021)
(www.cdc.gov/chronicdisease/programsimpact/pop/oral-disease.htm).
\3\Id.
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Regular preventive dental care can catch oral health
problems early when they are easiest to treat.\4\ However, less
than half of the American population uses the oral health care
system.\5\ A key tool in increasing utilization of the oral
health care system and preventing poor oral health is the
promotion of oral health literacy (OHL), or ``the individual
capacity to understand and use dental information to transform
oral health behaviors.''\6\ Individuals with limited OHL have
been found to have increased risk for poor oral health such as
higher risk for periodontal disease.\7\ Emerging evidence
suggests that improving OHL may help to increase adherence to
medical instructions, self-management skills, and overall
treatment outcomes.\8\
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\4\Vujicic M. & Nasseh, K, A Decade in Dental Care Utilization
Among Adults and Children (2001-2010), National Library of Medicine,
National Center for Biotechnology Information (Apr. 2014)
(pubmed.ncbi.nlm.nih.gov/24299620/).
\5\U.S. Department of Health and Human Services, Healthy People
2020, Children, adolescents, and adults who visited the dentist in the
past year (age adjusted, percent, 2+ years) (accessed Nov. 30, 2021)
(www.healthypeople.gov/2020/data-search/Search-the-Data?nid=5028).
\6\Yue Sun et al., Trends and Developments in Oral Health Literacy:
A Scientometric Research Study (1991--2020), BDJ Open (Mar. 1, 2021)
(doi.org/10.1038/s41405-021-00066-5).
\7\Id.
\8\Id.
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H.R. 4555 directs HRSA to implement a public education
campaign across all relevant programs to increase OHL and
awareness, including through the health center program, oral
health workforce programs, maternal and child health programs,
the Ryan White HIV/AIDS Program, and the rural health programs.
The legislation authorizes $750,000 each year for fiscal years
2022 through 2026 to carry out the awareness campaign. This
bill will also help HRSA to identify strategies that will
provide insight into the outcomes and effectiveness of targeted
oral health literacy campaigns and will inform future efforts
to improve OHL for all Americans.
III. Committee Hearings
For the purposes of section 3(c) of rule XIII of the Rules
of the House of Representatives, the following hearing was used
to develop or consider H.R. 4555:
The Subcommittee on Health held a legislative hearing on
October 20, 2021, entitled ``Enhancing Public Health:
Legislation to Protect Children and Families.'' The
Subcommittee received testimony from the following witnesses:
Bruce L. Cassis, D.D.S., President, Academy
of General Dentistry;
Raymond DuBois, M.D., Ph.D., Former
President, American Association for Cancer Research;
Donald M. Lloyd-Jones, M.D., Sc.M.,
President, American Heart Association;
Ellyn Miller, President and Founder,
Smashing Walnuts Foundation;
Rick Nolan, Former U.S. Representative (MN);
Jenny Radesky, M.D., Assistant Professor of
Pediatrics, University of Michigan Medical School; and
Stacey Stewart, President and CEO, March of
Dimes.
IV. Committee Consideration
H.R. 4555, the ``Oral Health Literacy and Awareness Act of
2021,'' was introduced on July 20, 2021, by Representatives
Cardenas (D-CA) and Bilirakis (R-FL) and referred to the
Committee on Energy and Commerce. Subsequently, on July 21,
2021, the bill was referred to the Subcommittee on Health.
On November 4, 2021, the Subcommittee on Health met in open
markup session, pursuant to notice, to consider H.R. 4555 and
eight other bills. No amendments were offered during
consideration of the bill. Upon conclusion of consideration of
the bill, the Subcommittee on Health agreed to report the bill
favorably to the full Committee, amended, by a voice vote.
On November 17, 2021, the full Committee met in open markup
session, pursuant to notice, to consider H.R. 4555 and 11 other
bills. No amendments were offered during consideration of the
bill. Upon conclusion of consideration of the bill, the full
Committee agreed to a motion on final passage offered by
Representative Pallone (D-NJ), Chairman of the Committee, to
order H.R. 4555 reported favorably to the House, as amended, by
a voice vote.
V. Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list each record vote
on the motion to report legislation and amendments thereto. The
Committee advises that there were no record votes taken on H.R.
4555, including a motion by Mr. Pallone ordering H.R. 4555
favorably reported to the House, without amendment.
VI. Oversight Findings
Pursuant to clause 3(c)(1) of rule XIII and clause 2(b)(1)
of rule X of the Rules of the House of Representatives, the
oversight findings and recommendations of the Committee are
reflected in the descriptive portion of the report.
VII. New Budget Authority, Entitlement Authority, and Tax Expenditures
Pursuant to 3(c)(2) of rule XIII of the Rules of the House
of Representatives, the Committee adopts as its own the
estimate of new budget authority, entitlement authority, or tax
expenditures or revenues contained in the cost estimate
prepared by the Director of the Congressional Budget Office
pursuant to section 402 of the Congressional Budget Act of
1974.
The Committee has requested but not received from the
Director of the Congressional Budget Office a statement as to
whether this bill contains any new budget authority, spending
authority, credit authority, or an increase or decrease in
revenues or tax expenditures.
VIII. Federal Mandates Statement
The Committee adopts as its own the estimate of Federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
IX. Statement of General Performance Goals and Objectives
Pursuant to clause 3(c)(4) of rule XIII, the general
performance goal or objective of this legislation is to
increase oral health literacy and awareness.
X. Duplication of Federal Programs
Pursuant to clause 3(c)(5) of rule XIII, no provision of
H.R. 4555 is known to be duplicative of another Federal
program, including any program that was included in a report to
Congress pursuant to section 21 of Public Law 111-139 or the
most recent Catalog of Federal Domestic Assistance.
XI. Committee Cost Estimate
Pursuant to clause 3(d)(1) of rule XIII, the Committee
adopts as its own the cost estimate prepared by the Director of
the Congressional Budget Office pursuant to section 402 of the
Congressional Budget Act of 1974.
XII. Earmarks, Limited Tax Benefits, and Limited Tariff Benefits
Pursuant to clause 9(e), 9(f), and 9(g) of rule XXI, the
Committee finds that H.R. 4555 contains no earmarks, limited
tax benefits, or limited tariff benefits.
XIII. Advisory Committee Statement
No advisory committee within the meaning of section 5(b) of
the Federal Advisory Committee Act was created by this
legislation.
XIV. Applicability to Legislative Branch
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
XV. Section-by-Section Analysis of the Legislation
Section 1. Short title
Section 1 designates that the Act may be cited as the
``Oral Health Literacy and Awareness Act of 2021.''
Sec. 2. Oral health literacy and awareness campaign
Section 2 amends the Public Health Service Act (PHSA) to
direct the Secretary of Health and Human Services (HHS), acting
through the HRSA Administrator, to establish a public education
campaign across all relevant programs of HRSA (including the
health center program, oral health workforce programs, maternal
and child health programs, the Ryan White HIV/AIDS Program, and
rural health programs) to increase oral health literacy and
awareness.
Section 2 instructs the Secretary to identify oral health
literacy and awareness strategies that are evidence-based and
focused on oral health care education and to design the
campaign to communicate directly with specific populations,
including children, pregnant women, parents, the elderly,
individuals with disabilities, and ethnic and racial
minorities, in a culturally and linguistically appropriate
manner.
Section 2 also instructs the Secretary to include a process
for measuring outcomes and effectiveness and to submit a report
on the outcomes and effectiveness of the campaign after three
years to the House Committee on Energy and Commerce and the
Senate Committee on Health, Education, Labor, and Pensions.
Section 2 authorizes $750,000 for each of fiscal years 2022
through 2026 to carry out these activities.
XVI. Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (new matter is
printed in italics and existing law in which no change is
proposed is shown in roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE
* * * * * * *
Part D--Primary Health Care
* * * * * * *
Subpart X--Primary Dental Programs
* * * * * * *
SEC. 340G-2. ORAL HEALTH LITERACY AND AWARENESS.
(a) Campaign.--The Secretary, acting through the
Administrator of the Health Resources and Services
Administration, shall establish a public education campaign
(referred to in this subsection as the ``campaign'') across all
relevant programs of the Health Resources and Services
Administration (including the health center program, oral
health workforce programs, maternal and child health programs,
the Ryan White HIV/AIDS Program, and rural health programs) to
increase oral health literacy and awareness.
(b) Strategies.--In carrying out the campaign, the Secretary
shall identify oral health literacy and awareness strategies
that are evidence-based and focused on oral health care
education, including education on prevention of oral disease
such as early childhood and other caries, periodontal disease,
and oral cancer.
(c) Focus.--The Secretary shall design the campaign to
communicate directly with specific populations, including
children, pregnant women, parents, the elderly, individuals
with disabilities, and ethnic and racial minority populations,
including Indians, Alaska Natives, and Native Hawaiians, in a
culturally and linguistically appropriate manner.
(d) Outcomes.--In carrying out the campaign, the Secretary
shall include a process for measuring outcomes and
effectiveness.
(e) Report to Congress.--Not later than 3 years after the
date of enactment of this section, the Secretary shall submit
to the Committee on Energy and Commerce of the House of
Representatives and the Committee on Health, Education, Labor,
and Pensions of the Senate a report on the outcomes and
effectiveness of the campaign.
(f) Authorization of Appropriations.--To carry out this
section, there is authorized to be appropriated $750,000 for
each of fiscal years 2022 through 2026.
* * * * * * *
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