[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 1954 Introduced in Senate (IS)]
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118th CONGRESS
1st Session
S. 1954
To improve the provision of health care furnished by the Department of
Veterans Affairs for veterans diagnosed with diabetes and heart
disease, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 13, 2023
Mr. Sanders (for himself, Mr. Whitehouse, Mr. Welch, Mr. Merkley, Mr.
Wyden, Mr. Blumenthal, Mr. Booker, Mr. Fetterman, Mr. Menendez, Mr.
Durbin, Ms. Stabenow, and Ms. Hirono) introduced the following bill;
which was read twice and referred to the Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To improve the provision of health care furnished by the Department of
Veterans Affairs for veterans diagnosed with diabetes and heart
disease, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Improving Whole Health for Veterans
with Chronic Conditions Act''.
SEC. 2. 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. 3. DEFINITIONS.
In this Act:
(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. 4. 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. 5. 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. 6. 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 Act.
(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.
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