Title II — Public Health programs

S. 1522 · 113th Congress · Sep 18, 2013 · Lineage

II Public Health programs

A National Health Service Corps

Sec. 201 National Health Service Corps

(a)

In general— Section 331 of the Public Health Service Act (42 U.S.C. 254d) is amended—

(1)

in subsection (a)(3), by adding at the end the following:

“(F) The term dental therapist means, with respect to a State that licenses such dental therapists, a mid-level dental practitioner who is licensed to practice under the law of the State and who provides preventive and restorative services directly to the public, commensurate with the scope of the practice.”

(2)

in subsection (b)—

(A)

in paragraph (1), by inserting “, dental therapy,” after “dental”; and

(B)

in paragraph (2), by inserting “dental therapists,” after “dentists,”.

(b)

Facilitation of effective provision of corps services— Section 336(f)(3) of the Public Health Service Act (42 U.S.C. 254h–1(f)(3)) is amended by inserting “dental therapists” after “midwives,”.

(c)

Scholarship program and loan repayment program—

(1)

Scholarship program— Section 338A of the Public Health Service Act (42 U.S.C. 254l) is amended—

(A)

in subsection (a)(1), by inserting “dental therapists,” after “dentists,”; and

(B)

in subsection (b)(1), by inserting “including dental therapy,” after “or other health profession,”.

(2)

Loan repayment program— Section 338B of the Public Health Service Act (42 U.S.C. 254l–1) is amended—

(A)

in subsection (a)(1), by inserting “dental therapists,” after “dentists,”; and

(B)

in subsection (b)(1)—

(i)

in subparagraph (A), by inserting “dental therapist,” after “nurse practitioner,”;

(ii)

in subparagraph (B), by inserting “dental therapy,” after “mental health,”; and

(iii)

in subparagraph (C)(ii), by inserting “, including dental therapy,” after “health profession”.

(3)

Authorization of appropriations— Section 338H of the Public Health Service Act (42 U.S.C. 254q) is amended—

(A)

in subsection (a), by striking “this section” and inserting “this subpart”; and

(B)

by adding at the end the following:

“(d) Authorization of appropriations with respect to oral health professionals—To carry out this subpart with respect to dentists, dental therapists, and dental hygienists, in addition to the amounts authorized under subsection (a), there is authorized to be appropriated such sums as may be necessary for fiscal years 2014 through 2017, which shall be used to provide an emergency expansion for scholarships to, and loan repayments on behalf of, such oral health professionals.”

Sec. 202 Community based dental residencies

Section 340H of the Public Health Service Act (42 U.S.C. 256h) is amended by adding at the ending the following:

“(k) Additional funding—For the purpose of expanding the program under this section, there is authorized to be appropriated such sums as may be necessary for the 5-year period beginning with the fiscal year that begins not less than 1 year and not more than 2 years after the date of enactment of the Comprehensive Dental Reform Act of 2013”

B Oral health education

Sec. 211 Authorization of appropriations for oral health education for medical providers

Section 747(c) of the Public Health Service Act (42 U.S.C. 293k(c)) is amended by adding at the end the following:

“(4) Oral health education—In addition to other amounts authorized under this subsection for purposes of carrying out this section, there is authorized to be appropriated such sums as may be necessary for fiscal years 2014 through 2017 for the purpose of educating nondental medical professionals, including physicians, nurses, nurse practitioners, physician assistants, and pharmacists, about oral health, including issues such as oral hygiene instruction, topical application of fluoride, and oral health screenings, with the goal of integrating oral health care into overall health care.”

Sec. 212 Oral health education for other non-health professionals

Subpart I of part C of title VII of the Public Health Service Act (42 U.S.C. 293k et seq.) is amended by inserting after section 748 the following:

“748A. Oral health education for other non-oral health professionals

“(a) In general—The Secretary may make grants to, or enter into contracts with, an accredited public or nonprofit private hospital, an educational institution, or a public or private nonprofit entity which the Secretary has determined is capable of carrying out such grant or contract to educate individuals, such as community health workers, social workers, nutritionists, health educators, occupational therapists, and psychologists, to promote oral health education and literacy and to provide support for behavior change and assistance with care coordination with respect to oral health.

“(b) Authorization of appropriations—To carry out this section, there is authorized to be appropriated such sums as may be necessary for fiscal years 2014 through 2017.”

Sec. 213 Dental education

Section 748 of the Public Health Service Act (42 U.S.C. 293k–2) is amended—

(1)

in subsection (a)(1)(H), by striking “pediatric training programs” and inserting “pediatric dental training programs”; and

(2)

in subsection (c)—

(A)

by striking the subsection heading and inserting “Requirements for award.—”;

(B)

by amending the matter preceding paragraph (1) to read as follows: “With respect to training provided for under this section, the Secretary shall award grants or contracts only to eligible entities that meet at least 7 of the following criteria:”;

(C)

in paragraph (2), by striking “have a record of training the greatest percentage of providers, or that have demonstrated significant improvements in the percentage of providers, who enter and” and inserting “train significant numbers of providers who”;

(D)

in paragraph (3)—

(i)

by striking “have a record of training” and inserting “intent to train”; and

(ii)

by striking the period at the end and inserting “and have faculty with experience in treating underserved populations.”;

(E)

in paragraph (8), by inserting “or have established” after “establish”; and

(F)

by adding at the end the following:

“(9) Qualified applicants that require not less than 200 hours of community-based education rotations.”

Sec. 214 Oral health professional student loans

Part F of title VII of the Public Health Service Act (42 U.S.C. 295j) is amended by adding at the end the following:

“799C. Oral health professional student loans

“(a) In general—The Secretary shall establish and operate a student loan fund for oral health professional students, including dental hygienists, dental therapists, and dentists.

“(b) Content—The Secretary shall establish and operate the student loan fund program under subsection (a) in the same manner and subject to the same terms as the loan fund program established with schools of nursing under section 835.

“(c) Authorization of appropriations—To carry out this section, there are authorized to be appropriated such sums as may be necessary for fiscal years 2014 through 2017.”

C Other oral health programs

Sec. 221 Access points

Subpart X of part D of title III of the Public Health Service Act (42 U.S.C. 256f et seq.) is amended by adding at the end the following:

“340G–2. Funding for oral health services

“(a) In general—The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall establish a program to award grants to eligible entities to provide oral health services, or to contract with private dental practices to provide comprehensive oral health services, to low income individuals and individuals who are underserved with respect to oral health care.

“(b) Technical assistance—The Secretary shall provide technical assistance to entities receiving grants under subsection (a) to provide technical assistance to such entities in order to—

“(1) with respect to oral health care services, increase utilization and efficiency and minimize missed appointments, contract with offsite providers, recruit providers (including oral health specialists), and operate programs outside the physical facilities to take advantage of new systems to improve access to oral health services;

“(2) address barriers to access to such services and conduct targeted outreach to special populations such as pregnant women, individuals with disabilities, individuals with chronic conditions such as diabetes, and individuals residing in long-term care facilities; or

“(3) contract with private dental practices that will provide oral health services other than preventive oral health care, including restoration and maintenance of oral health, in order to meet the need for oral health services in the community.

“(c) Eligible entities—To be eligible to receive a grant under subsection (a), an entity shall—

“(1) be—

“(A) a Federally qualified health center (as defined in section 1861(aa) of the Social Security Act);

“(B) a safety net clinic or a free clinic (as defined by the Secretary);

“(C) a health care clinic that provides services to tribal organizations or urban Indian organizations (as such terms are defined in section 4 of the Indian Health Care Improvement Act); or

“(D) any other interested public or private sector health care provider or organization that the Secretary determines has a demonstrated history in serving a high number of uninsured and or low-income individuals or those who lack ready access to oral health services; and

“(2) demonstrate a clear need to expand oral health care services beyond preventive oral health care.

“(d) Allocation for hiring oral health care specialists—A portion of the funds available under this section shall be allocated toward hiring oral health care specialists, such as oral surgeons and endodontists, at entities receiving grants under this section.

“(e) Authorization of appropriations—To carry out this section, there is authorized to be appropriated such sums as may be necessary for each of fiscal years 2014 through 2017.”

Sec. 222 Dental clinics in schools

Part Q of title III of the Public Health Service Act (42 U.S.C. 280h et seq.) is amended by adding at the end the following:

“399Z–2. Dental clinics in schools

“(a) In general—The Secretary shall award grants to qualified entities for the purpose of funding the building, operation, or expansion of dental clinics in schools.

“(b) Qualified entities—To receive a grant under this section, a qualified entity shall submit an application to the Secretary at such time, in such manner, and containing such information as the Secretary may require.

“(c) Requirements—An entity receiving a grant under this section shall—

“(1) provide comprehensive oral health services at a dental clinic based at a school, including oral health education, oral screening, fluoride application, prophylaxis, sealants, and basic restorative services;

“(2) develop a coordinated system of care by referring patients to an available qualified oral health provider in the community for any required oral health services not provided in the dental clinic in the school, including restorative services, to ensure that all the oral health needs of students are met; and

“(3) maintain clinic hours that extend beyond school hours.

“(d) Authorization of appropriations—For purposes of carrying out this section, there is authorized to be appropriated such sums as may be necessary for fiscal years 2014 through 2017.”

Sec. 223 Emergency room care coordination

Part B of title III of the Public Health Service Act (42 U.S.C. 243 et seq.) is amended by adding at the end the following:

“320B. Emergency room care coordination with respect to dental care

“(a) In general—The Secretary, acting through the Administrator of the Health Resources and Services Administration, shall establish a grant program to enable individuals to receive dental care at a facility operated by a grant recipient rather than at a hospital emergency room.

“(b) Eligible entities—To be eligible to receive a grant under this section an entity shall—

“(1) be—

“(A) a Federally qualified health center (as defined in paragraph (4) of section 1861(aa) of the Social Security Act) or rural health clinic (as defined in paragraph (2) of such section);

“(B) a private dental practice; or

“(C) any other interested public or private sector health care provider or organization, such as a dental school, that the Secretary determines has the capacity to serve in a coordinated, cost-effective manner, a high number of individuals who lack access to oral health services; and

“(2) partner with a hospital or urgent care center.

“(c) Oral health education for primary care and ER health care providers—The Secretary shall allocate a portion of the amounts appropriated under subsection (e) toward medical education for primary care and emergency room physicians, nurses, nurse practitioners, physician assistants, and nurse practitioners to be trained in oral health.

“(d) Report—Not later than January 1, 2017, the Secretary shall submit to Congress a report on the best practices determined by the program established under this section to address oral health needs of individuals who go to emergency rooms in need of oral health care.

“(e) Authorization of appropriations—To carry out this section, there is authorized to be appropriated such sums as may be necessary for fiscal years 2014 through 2017.”

Sec. 224 Research funding

For fiscal years 2014 through 2017, there is authorized to be appropriated such sums as may be necessary to each of—

(1)

the Centers for Disease Control and Prevention, for the purpose of conducting research on—

(A)

the prevention of oral disease;

(B)

oral disease management; and

(C)

evidence-based strategies to prevent tooth decay;

(2)

the Agency for Healthcare Research and Quality, for the purpose of conducting—

(A)

research with respect to oral health services and the delivery of oral health services; and

(B)

an evaluation of oral health service delivery to underserved and vulnerable populations;

(3)

the National Institute of Dental and Craniofacial Research for the purpose of conducting research on oral health disease management including pharmaceutical-behavioral intervention; and

(4)

the Maternal and Child Health Bureau for the purpose of conducting research on perinatal, postnatal, and childhood oral health issues.

Sec. 225 Mobile and portable dental services

Subpart X of part D of title III of the Public Health Service Act (42 U.S.C. 256f et seq.), as amended by section 221, is further amended by adding at the end the following:

“340G–3. Mobile and portable dental services

“(a) In general—The Secretary shall award grants to Federally qualified health centers (as defined in paragraph (4) of section 1861(aa) of the Social Security Act), rural health clinics (as defined in paragraph (2) of such section), nonprofit dental clinics, and dental schools to provide mobile and portable, comprehensive dental services that provide for the restoration or maintenance of oral health and function (including dental services provided by licensed providers through telehealth-enabled collaboration and supervision) and outreach for dental services to underserved populations. Eligible entities shall deliver such services at locations such as senior centers, nursing homes, assisted living facilities, schools, licensed day care centers that serve eligible individuals who receive benefits under the State Children's Health Insurance Program under title XXI of the Social Security Act (42 U.S.C. 1397aa et seq.) or the Medicaid program under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.), and facilities that provide services under the Special Supplemental Nutrition Program for Women, Infants, and Children (the WIC program) or the Head Start Act (42 U.S.C. 9831 et seq.). The Secretary shall award the grants to entities that can provide coordinated care and continuity of care.

“(b) Authorization of appropriations—To carry out this section, there are authorized to be appropriated such sums as may be necessary.”

D Oral health services as an essential health benefit

Sec. 231 Oral health services as an essential health benefit

Section 1302(b)(1) of the Patient Protection and Affordable Care Act (42 U.S.C. 18022(b)(1)) is amended by adding at the end the following:

“(K) Oral health services.”