I 

110TH CONGRESS 

1ST SESSION H. R. 1781 

To provide disadvantaged children with access to primary dental care services. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 29, 2007 

Mr. DINGELL (for himself, Mr. SIMPSON, Mr. HOYER, Mr. PALLONE, Mr. 

WAXMAN, Mr. CUMMINGS, Mr. WYNN, Mrs. CAPPS, Mr. TOWNS, Mr. 

ROSS, Mr. ENGEL, Ms. ESHOO, Mr. ALLEN, Ms. DEGETTE, and Ms. 

SCHAKOWSKY) introduced the following bill; which was referred to the 

Committee on Energy and Commerce, and in addition to the Committee 

on Ways and Means, for a period to be subsequently determined by the 

Speaker, in each case for consideration of such provisions as fall within 

the jurisdiction of the committee concerned 

A BILL 

To provide disadvantaged children with access to primary 

dental care services. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Children’s Dental Health Improvement Act of 2007’’. 

6 (b) TABLE OF CONTENTS.—The table of contents of 

7 this Act is as follows: 

Sec. 1. Short title. 

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TITLE I—IMPROVING DELIVERY OF PEDIATRIC DENTAL 

SERVICES UNDER MEDICAID AND SCHIP 

Sec. 101. Grants to improve the provision of dental services under Medicaid 

and SCHIP. 

Sec. 102. Guarantee of dental benefits under SCHIP. 

Sec. 103. State option to provide wrap-around SCHIP coverage to children who 

have other health coverage. 

TITLE II—CORRECTING GME PAYMENTS FOR DENTAL 

RESIDENCY TRAINING PROGRAMS 

Sec. 201. Limitation on the application of the 1-year lag in the Indirect Medical 

Education ratio (IME) changes and the 3-year rolling average 

for counting interns and residents for IME and Direct Graduate Medical Education (D–GME) payments under the Medicare program. 

TITLE III—IMPROVING DELIVERY OF PEDIATRIC DENTAL SERVICES UNDER COMMUNITY HEALTH CENTERS, PUBLIC HEALTH 

DEPARTMENTS, AND THE INDIAN HEALTH SERVICE 

Sec. 301. Grants to improve the provision of dental health services through 

community health centers and public health departments. 

Sec. 302. Dental officer multiyear retention bonus for the Indian health service. 

Sec. 303. Demonstration projects to increase access to pediatric dental services 

in underserved areas. 

Sec. 304. Technical correction. 

TITLE IV—IMPROVING ORAL HEALTH PROMOTION AND DISEASE 

PREVENTION PROGRAMS 

Sec. 401. Oral health initiative. 

Sec. 402. CDC reports. 

Sec. 403. Early childhood caries. 

Sec. 404. School-based dental sealant program. 

Sec. 405. Basic oral health promotion. 

1 TITLE I—IMPROVING DELIVERY 

2 OF PEDIATRIC DENTAL SERV3 ICES UNDER MEDICAID AND 

4 SCHIP 

5 SEC. 101. GRANTS TO IMPROVE THE PROVISION OF DENTAL 

6 SERVICES UNDER MEDICAID AND SCHIP. 

7 Title V of the Social Security Act (42 U.S.C. 701 

8 et seq.) is amended by adding at the end the following: 

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1 ‘‘SEC. 511. GRANTS TO IMPROVE THE PROVISION OF DEN2 TAL SERVICES UNDER MEDICAID AND SCHIP. 

3 ‘‘(a) AUTHORITY TO MAKE GRANTS.—In addition to 

4 any other payments made under this title to a State, the 

5 Secretary shall award grants to States that satisfy the re6 quirements of subsection (b) to improve the provision of 

7 dental services to children who are enrolled in a State plan 

8 under title XIX or a State child health plan under title 

9 XXI (in this section, collectively referred to as the ‘State 

10 plans’). 

11 ‘‘(b) REQUIREMENTS.—In order to be eligible for a 

12 grant under this section, a State shall provide the Sec13 retary with the following assurances: 

14 ‘‘(1) IMPROVED SERVICE DELIVERY.—The 

15 State shall have a plan to improve the delivery of 

16 dental services to children, including children with 

17 special health care needs, who are enrolled in the 

18 State plans, including providing outreach and ad19 ministrative case management, improving collection 

20 and reporting of claims data, and providing incen21 tives, in addition to raising reimbursement rates, to 

22 increase provider participation. 

23 ‘‘(2) ADEQUATE PAYMENT RATES.—The State 

24 has provided for payment under the State plans for 

25 dental services for children at levels consistent with 

26 the market-based rates and sufficient enough to enmstockstill on PROD1PC66 with BILLS

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1 list providers to treat children in need of dental serv2 ices. 

3 ‘‘(3) ENSURED ACCESS.—The State shall en4 sure it will make dental services available to children 

5 enrolled in the State plans to the same extent as 

6 such services are available to the pediatric popu7 lation of the State. 

8 ‘‘(c) USE OF FUNDS.— 

9 ‘‘(1) IN GENERAL.—Funds provided under this 

10 section may be used to provide administrative re11 sources (such as program development, provider 

12 training, data collection and analysis, research-re13 lated tasks, demonstration programs, and technical 

14 assistance) to assist States in providing and assess15 ing services that include preventive and therapeutic 

16 dental care regimens. 

17 ‘‘(2) LIMITATION.—Funds provided under this 

18 section may not be used for payment of direct den19 tal, medical, or other services or to obtain Federal 

20 matching funds under any Federal program. 

21 ‘‘(d) APPLICATION.—A State shall submit an applica22 tion to the Secretary for a grant under this section in such 

23 form and manner and containing such information as the 

24 Secretary may require. 

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1 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 

2 are authorized to be appropriated to make grants under 

3 this section $50,000,000 for fiscal year 2008 and each fis4 cal year thereafter. 

5 ‘‘(f) APPLICATION OF OTHER PROVISIONS OF

6 TITLE.— 

7 ‘‘(1) IN GENERAL.—Except as provided in para8 graph (2), the other provisions of this title shall not 

9 apply to a grant made under this section. 

10 ‘‘(2) EXCEPTIONS.—The following provisions of 

11 this title shall apply to a grant made under sub12 section (a) to the same extent and in the same man13 ner as such provisions apply to allotments made 

14 under section 502(c): 

15 ‘‘(A) Section 504(b)(6) (relating to prohi16 bition on payments to excluded individuals and 

17 entities). 

18 ‘‘(B) Section 504(c) (relating to the use of 

19 funds for the purchase of technical assistance). 

20 ‘‘(C) Section 504(d) (relating to a limita21 tion on administrative expenditures). 

22 ‘‘(D) Section 506 (relating to reports and 

23 audits), but only to the extent determined by 

24 the Secretary to be appropriate for grants made 

25 under this section. 

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1 ‘‘(E) Section 507 (relating to penalties for 

2 false statements). 

3 ‘‘(F) Section 508 (relating to non4 discrimination). 

5 ‘‘(G) Section 509 (relating to the adminis6 tration of the grant program).’’. 

7 SEC. 102. GUARANTEE OF DENTAL BENEFITS UNDER SCHIP. 

8 (a) IN GENERAL.—Section 2103(c)(1) of the Social 

9 Security Act (42 U.S.C. 1397cc(c)(1)) is amended by add10 ing at the end the following new subparagraph: 

11 ‘‘(E) Dental services described in section 

12 1905(r)(3) and provided in accordance with 

13 1902(a)(43).’’. 

14 (b) INFORMATION REPORTING.—Section 2108 of 

15 such Act (42 U.S.C. 1397hh) is amended by adding at 

16 the end the following new subsection: 

17 ‘‘(e) INFORMATION ON DENTAL SERVICES.— 

18 ‘‘(1) IN GENERAL.—Each State shall submit to 

19 the Secretary, not less frequently than annually and 

20 in a form and manner specified by the Secretary, the 

21 following information with respect to the provision of 

22 the care and services described in section 1905(r)(3) 

23 under the State child health plan to targeted low-in24 come children enrolled in the plan at any time dur25 ing the fiscal year involved: 

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1 ‘‘(A) The number of such enrolled children 

2 by age grouping. 

3 ‘‘(B) For children within each such age 

4 grouping, information of the type contained in 

5 questions 12(a)–(c) of CMS Form 416 that 

6 consists of the number of enrolled targeted low 

7 income children who receive any, preventive, or 

8 restorative care described in such section under 

9 the State plan. 

10 ‘‘(C) For the age grouping that includes 

11 age 8, the number of enrolled targeted low-in12 come children who receive a protective sealant 

13 on at least one permanent molar tooth. 

14 ‘‘(2) PUBLIC DISCLOSURE OF REPORTS.—The 

15 Secretary shall post on the public website of the Sec16 retary of Health and Human Services the results of 

17 information most recently reported under paragraph 

18 (1). The Secretary shall include in such posting in19 formation, by age grouping beginning with dental 

20 visits occurring by age one, on the estimated na21 tional averages for all States with respect to such in22 formation.’’. 

23 (c) EFFECTIVE DATES.— 

24 (1) INCLUSION OF DENTAL BENEFITS.—The 

25 amendment made by subsection (a) shall take effect 

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1 on January 1, 2008, and shall apply to child health 

2 assistance provided on or after that date. 

3 (2) REPORTING.—The amendment made by 

4 subsection (b) shall apply to reports for years after 

5 the effective date described in paragraph (1). 

6 SEC. 103. STATE OPTION TO PROVIDE WRAP-AROUND 

7 SCHIP COVERAGE TO CHILDREN WHO HAVE 

8 OTHER HEALTH COVERAGE. 

9 (a) IN GENERAL.— 

10 (1) SCHIP.— 

11 (A) STATE OPTION TO PROVIDE WRAP12 AROUND COVERAGE.—Section 2110(b) of the 

13 Social Security Act (42 U.S.C. 1397jj(b)) is 

14 amended— 

15 (i) in paragraph (1)(C), by inserting 

16 ‘‘, subject to paragraph (5),’’ after ‘‘under 

17 title XIX or’’; and 

18 (ii) by adding at the end the fol19 lowing: 

20 ‘‘(5) STATE OPTION TO PROVIDE WRAP-AROUND

21 COVERAGE.—A State may waive the requirement of 

22 paragraph (1)(C) that a targeted low-income child 

23 may not be covered under a group health plan or 

24 under health insurance coverage, if the State satis25 fies the conditions described in section 2105(c)(8). 

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1 The State may waive such requirement in order to 

2 provide— 

3 ‘‘(A) dental services described in section 

4 2103(c)(1)(E); or 

5 ‘‘(B)(i) benefits for items or services that 

6 are not covered, or are only partially covered, 

7 under such plan; and 

8 ‘‘(ii) protection against incurring out of9 pocket costs (including premiums) in excess of 

10 the limitations otherwise applicable to a tar11 geted low-income child with the same family in12 come. 

13 In waiving such requirement, a State may limit the 

14 application of the waiver to children whose family in15 come does not exceed a level specified by the State, 

16 so long as the level so specified does not exceed the 

17 maximum income level otherwise established for 

18 other children under the State child health plan.’’. 

19 (B) CONDITIONS DESCRIBED.—Section 

20 2105(c) of the Social Security Act (42 U.S.C. 

21 1397ee(c)) is amended by adding at the end the 

22 following: 

23 ‘‘(8) CONDITIONS FOR PROVISION OF WRAP24 AROUND COVERAGE.—For purposes of section 

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1 2110(b)(5), the conditions described in this para2 graph are the following: 

3 ‘‘(A) INCOME ELIGIBILITY.—The State 

4 child health plan (whether implemented under 

5 title XIX or this title)— 

6 ‘‘(i) has the highest income eligibility 

7 standard permitted under this title as of 

8 January 1, 2008; 

9 ‘‘(ii) subject to subparagraph (B), 

10 does not limit the acceptance of applica11 tions for children; and 

12 ‘‘(iii) provides benefits to all children 

13 in the State who apply for and meet eligi14 bility standards. 

15 ‘‘(B) NO WAITING LIST IMPOSED.—With 

16 respect to all targeted low-income children, the 

17 State does not impose any numerical limitation, 

18 waiting list, or similar limitation on the eligi19 bility of such children for child health assist20 ance under such State plan. 

21 ‘‘(C) NO MORE FAVORABLE TREATMENT.— 

22 The State child health plan may not provide 

23 more favorable coverage of dental services to 

24 the children covered under section 2110(b)(5) 

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1 than to children otherwise covered under this 

2 title.’’. 

3 (C) STATE OPTION TO WAIVE WAITING PE4 RIOD.—Section 2102(b)(1)(B) of the Social Se5 curity Act (42 U.S.C. 1397bb(b)(1)(B)) is 

6 amended— 

7 (i) in clause (i), by striking ‘‘and’’ at 

8 the end; 

9 (ii) in clause (ii), by striking the pe10 riod and inserting ‘‘; and’’; and 

11 (iii) by adding at the end the fol12 lowing: 

13 ‘‘(iii) at State option, may not apply 

14 a waiting period in the case of a child de15 scribed in section 2110(b)(5), if the State 

16 satisfies the requirements of section 

17 2105(c)(8).’’. 

18 (2) APPLICATION OF ENHANCED MATCH UNDER

19 MEDICAID.—Section 1905 of the Social Security Act 

20 (42 U.S.C. 1396d) is amended— 

21 (A) in subsection (b), in the fourth sen22 tence, by striking ‘‘or subsection (u)(3)’’ and 

23 inserting ‘‘(u)(3), or (u)(4)’’; and 

24 (B) in subsection (u)— 

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1 (i) by redesignating paragraph (4) as 

2 paragraph (5); and 

3 (ii) by inserting after paragraph (3) 

4 the following: 

5 ‘‘(4) For purposes of subsection (b), the ex6 penditures described in this paragraph are expendi7 tures for items and services for children described in 

8 section 2110(b)(5), but only in the case of a State 

9 that satisfies the requirements of section 

10 2105(c)(8).’’. 

11 (3) APPLICATION OF SECONDARY PAYER PROVI12 SIONS.—Section 2107(e)(1) of the Social Security 

13 Act (42 U.S.C. 1397gg(e)(1)) is amended— 

14 (A) by redesignating subparagraphs (B) 

15 through (D) as subparagraphs (C) through (E), 

16 respectively; and 

17 (B) by inserting after subparagraph (A) 

18 the following: 

19 ‘‘(B) Section 1902(a)(25) (relating to co20 ordination of benefits and secondary payer pro21 visions) with respect to children covered under 

22 a waiver described in section 2110(b)(5).’’. 

23 (b) EFFECTIVE DATE.—The amendments made by 

24 subsection (a) shall take effect on January 1, 2008, and 

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1 shall apply to child health assistance and medical assist2 ance provided on or after that date. 

3 TITLE II—CORRECTING GME 

4 PAYMENTS FOR DENTAL 

5 RESIDENCY TRAINING PRO6 GRAMS 

7 SEC. 201. LIMITATION ON THE APPLICATION OF THE 1- 

8 YEAR LAG IN THE INDIRECT MEDICAL EDU9 CATION RATIO (IME) CHANGES AND THE 3- 

10 YEAR ROLLING AVERAGE FOR COUNTING IN11 TERNS AND RESIDENTS FOR IME AND DI12 RECT GRADUATE MEDICAL EDUCATION (D–

13 GME) PAYMENTS UNDER THE MEDICARE 

14 PROGRAM. 

15 (a) IME RATIO AND ROLLING AVERAGE.—Section 

16 1886(d)(5)(B)(vi) of the Social Security Act (42 U.S.C. 

17 1395ww(d)(5)(B)(vi)) is amended by adding at the end 

18 the following new sentence: ‘‘For cost reporting periods 

19 beginning during fiscal years beginning on or after Octo20 ber 1, 2007, subclauses (I) and (II) shall be applied only 

21 with respect to a hospital’s approved medical residency 

22 training program in the fields of allopathic medicine and 

23 osteopathic medicine.’’. 

24 (b) D–GME ROLLING AVERAGE.—Section 

25 1886(h)(4)(G) of the Social Security Act (42 U.S.C. 

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1 1395ww(h)(4)(G)) is amended by adding at the end the 

2 following new clause: 

3 ‘‘(iv) APPLICATION FOR FY 2008 AND

4 SUBSEQUENT YEARS.—For cost reporting 

5 periods beginning during fiscal years be6 ginning on or after October 1, 2007, 

7 clauses (i) through (iii) shall be applied 

8 only with respect to a hospital’s approved 

9 medical residency training program in the 

10 fields of allopathic medicine and osteo11 pathic medicine.’’. 

12 TITLE III—IMPROVING DELIV13 ERY OF PEDIATRIC DENTAL 

14 SERVICES UNDER COMMU15 NITY HEALTH CENTERS, PUB16 LIC HEALTH DEPARTMENTS, 

17 AND THE INDIAN HEALTH 

18 SERVICE 

19 SEC. 301. GRANTS TO IMPROVE THE PROVISION OF DENTAL 

20 HEALTH SERVICES THROUGH COMMUNITY 

21 HEALTH CENTERS AND PUBLIC HEALTH DE22 PARTMENTS. 

23 Subpart I of part D of title III of the Public Health 

24 Service Act (42 U.S.C. 254b et seq.) is amended by adding 

25 at the end the following: 

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1 ‘‘SEC. 330M. GRANT PROGRAM TO EXPAND THE AVAIL2 ABILITY OF SERVICES. 

3 ‘‘(a) IN GENERAL.—The Secretary, acting through 

4 the Health Resources and Services Administration, shall 

5 establish a program under which the Secretary may award 

6 grants to eligible entities and eligible individuals to expand 

7 the availability of primary dental care services in dental 

8 health professional shortage areas and medically under9 served areas. 

10 ‘‘(b) ELIGIBILITY.— 

11 ‘‘(1) ENTITIES.—To be eligible to receive a 

12 grant under this section an entity— 

13 ‘‘(A) shall be— 

14 ‘‘(i) a health center receiving funds 

15 under section 330 or designated as a Fed16 erally qualified health center; 

17 ‘‘(ii) a county or local public health 

18 department, if located in a federally-des19 ignated dental health professional shortage 

20 area; 

21 ‘‘(iii) an Indian tribe or tribal organi22 zation (as defined in section 4 of the In23 dian Self-Determination and Education 

24 Assistance Act (25 U.S.C. 450b)); 

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1 ‘‘(iv) a dental education program ac2 credited by the Commission on Dental Ac3 creditation; or 

4 ‘‘(v) a community-based program the 

5 child service population of which is made 

6 up of at least 33 percent of children who 

7 are eligible children, including at least 25 

8 percent of such children being children 

9 with mental retardation or related develop10 mental disabilities, unless specific docu11 mentation of a lack of need for access by 

12 this sub-population is established; and 

13 ‘‘(B) shall prepare and submit to the Sec14 retary an application at such time, in such 

15 manner, and containing such information as the 

16 Secretary may require, including information 

17 concerning dental provider capacity to serve in18 dividuals with developmental disabilities. 

19 ‘‘(2) INDIVIDUALS.—To be eligible to receive a 

20 grant under this section an individual shall— 

21 ‘‘(A) be a dental health professional li22 censed or certified in accordance with the laws 

23 of State in which such individual provides den24 tal services; 

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1 ‘‘(B) prepare and submit to the Secretary 

2 an application at such time, in such manner, 

3 and containing such information as the Sec4 retary may require; and 

5 ‘‘(C) provide assurances that— 

6 ‘‘(i) the individual will practice in a 

7 federally-designated dental health profes8 sional shortage area; or 

9 ‘‘(ii) not less than 25 percent of the 

10 patients of such individual are— 

11 ‘‘(I) receiving assistance under a 

12 State plan under title XIX of the So13 cial Security Act (42 U.S.C. 1396 et 

14 seq.); 

15 ‘‘(II) receiving assistance under a 

16 State plan under title XXI of the So17 cial Security Act (42 U.S.C. 1397aa 

18 et seq.); or 

19 ‘‘(III) uninsured. 

20 ‘‘(c) USE OF FUNDS.— 

21 ‘‘(1) ENTITIES.—An entity shall use amounts 

22 received under a grant under this section to provide 

23 for the increased availability of primary dental serv24 ices in the areas described in subsection (a). Such 

25 amounts may be used to supplement the salaries ofmstockstill on PROD1PC66 with BILLS

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1 fered for individuals accepting employment as den2 tists in such areas. 

3 ‘‘(2) INDIVIDUALS.—A grant to an individual 

4 under subsection (a) shall be in the form of a 

5 $1,000 bonus payment for each month in which such 

6 individual is in compliance with the eligibility re7 quirements of subsection (b)(2)(C). 

8 ‘‘(d) PRIMARY DENTAL CARE SERVICES DEFINED.— 

9 For purposes of this section, the term ‘primary dental care 

10 services’ means dental services necessary to prevent dis11 ease and promote oral health, restore oral structures to 

12 health and function, and treat emergency conditions, and 

13 includes dental services described in section 1905(r)(3) of 

14 the Social Security Act (42 U.S.C. 1396d(r)(3)). 

15 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.— 

16 ‘‘(1) IN GENERAL.—Notwithstanding any other 

17 amounts appropriated under section 330 for health 

18 centers, there is authorized to be appropriated 

19 $40,000,000 for each of fiscal years 2008 through 

20 2012 to hire and retain dental health care providers 

21 under this section. 

22 ‘‘(2) USE OF FUNDS.—Of the amount appro23 priated for a fiscal year under paragraph (1), the 

24 Secretary shall use— 

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1 ‘‘(A) not less than 65 percent of such 

2 amount to make grants to eligible entities; and 

3 ‘‘(B) not more than 35 percent of such 

4 amount to make grants to eligible individuals.’’. 

5 SEC. 302. DENTAL OFFICER MULTIYEAR RETENTION BONUS 

6 FOR THE INDIAN HEALTH SERVICE. 

7 (a) TERMS AND DEFINITIONS.—In this section: 

8 (1) CREDITABLE SERVICE.—The term ‘‘cred9 itable service’’ includes all periods that a dental offi10 cer spent in graduate dental educational (GDE) 

11 training programs while not on active duty in the In12 dian Health Service and all periods of active duty in 

13 the Indian Health Service as a dental officer. 

14 (2) DENTAL OFFICER.—The term ‘‘dental offi15 cer’’ means an officer of the Indian Health Service 

16 designated as a dental officer. 

17 (3) DIRECTOR.—The term ‘‘Director’’ means 

18 the Director of the Indian Health Service. 

19 (4) RESIDENCY.—The term ‘‘residency’’ means 

20 a graduate dental educational (GDE) training pro21 gram of at least 12 months leading to a specialty, 

22 including general practice residency (GPR) or an ad23 vanced education general dentistry (AEGD). 

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1 (5) SPECIALTY.—The term ‘‘specialty’’ means a 

2 dental specialty for which there is an Indian Health 

3 Service specialty code number. 

4 (b) REQUIREMENTS FOR BONUS.— 

5 (1) IN GENERAL.—An eligible dental officer of 

6 the Indian Health Service who executes a written 

7 agreement to remain on active duty for 2, 3, or 4 

8 years after the completion of any other active duty 

9 service commitment to the Indian Health Service 

10 may, upon acceptance of the written agreement by 

11 the Director, be authorized to receive a dental officer 

12 multiyear retention bonus under this section. The 

13 Director may, based on requirements of the Indian 

14 Health Service, decline to offer such a retention 

15 bonus to any specialty that is otherwise eligible, or 

16 to restrict the length of such a retention bonus con17 tract for a specialty to less than 4 years. 

18 (2) LIMITATIONS.—Each annual dental officer 

19 multiyear retention bonus authorized under this sec20 tion shall not exceed the following: 

21 (A) $50,000 for a 4-year written agree22 ment. 

23 (B) $10,000 for a 3-year written agree24 ment. 

25 (C) $8,000 for a 2-year written agreement. 

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1 (c) ELIGIBILITY.— 

2 (1) IN GENERAL.—In order to be eligible to re3 ceive a dental officer multiyear retention bonus 

4 under this section, a dental officer shall— 

5 (A) be at or below such grade as the Di6 rector shall determine; 

7 (B) have completed any active duty service 

8 commitment of the Indian Health Service in9 curred for dental education and training or 

10 have 8 years of creditable service; 

11 (C) have completed initial residency train12 ing, or be scheduled to complete initial resi13 dency training before September 30 of the fiscal 

14 year in which the officer enters into a dental of15 ficer multiyear retention bonus written service 

16 agreement under this section; and 

17 (D) have a recognized dental specialty. 

18 (2) EXTENSION TO OTHER OFFICERS.—The Di19 rector may extend the retention bonus to dental offi20 cers other than officers with a dental specialty in pe21 diatric dentistry, as well as to other dental hygien22 ists with a minimum of a baccalaureate degree, 

23 based on demonstrated need. 

24 (d) TERMINATION OF ENTITLEMENT TO SPECIAL

25 PAY.—The Director may terminate, with cause, at any 

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1 time a dental officer’s multiyear retention bonus contract 

2 under this section. If such a contract is terminated, the 

3 unserved portion of the retention bonus contract shall be 

4 recouped on a pro rata basis. The Director shall establish 

5 regulations that specify the conditions and procedures 

6 under which termination may take place. The regulations 

7 and conditions for termination shall be included in the 

8 written service contract for a dental officer multiyear re9 tention bonus under this section. 

10 (e) REFUNDS.— 

11 (1) IN GENERAL.—Prorated refunds shall be re12 quired for sums paid under a retention bonus con13 tract under this section if a dental officer who has 

14 received the retention bonus fails to complete the 

15 total period of service specified in the contract, as 

16 conditions and circumstances warrant. 

17 (2) DEBT TO UNITED STATES.—An obligation 

18 to reimburse the United States imposed under para19 graph (1) is a debt owed to the United States. 

20 (3) NO DISCHARGE IN BANKRUPTCY.—Notwith21 standing any other provision of law, a discharge in 

22 bankruptcy under title 11, United States Code, that 

23 is entered less than 5 years after the termination of 

24 a retention bonus contract under this section does 

25 not discharge the dental officer who signed such a 

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1 contract from a debt arising under the contract or 

2 under paragraph (1). 

3 SEC. 303. DEMONSTRATION PROJECTS TO INCREASE AC4 CESS TO PEDIATRIC DENTAL SERVICES IN 

5 UNDERSERVED AREAS. 

6 (a) AUTHORITY TO CONDUCT PROJECTS.—The Sec7 retary of Health and Human Services, through the Admin8 istrator of the Health Resources and Services Administra9 tion and the Director of the Indian Health Service, shall 

10 establish demonstration projects that are designed to in11 crease access to dental services for children in underserved 

12 areas, as determined by the Secretary. 

13 (b) AUTHORIZATION OF APPROPRIATIONS.—There is 

14 authorized to be appropriated such sums as may be nec15 essary to carry out this section. 

16 SEC. 304. TECHNICAL CORRECTION. 

17 Section 340G(b)(1)(B) of the Public Health Service 

18 Act (42 U.S.C. 256g(b)(1)(B)) is amended by striking 

19 ‘‘and’’ at the end and inserting ‘‘or’’. 

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1 TITLE IV—IMPROVING ORAL 

2 HEALTH PROMOTION AND 

3 DISEASE PREVENTION PRO4 GRAMS 

5 SEC. 401. ORAL HEALTH INITIATIVE. 

6 (a) ESTABLISHMENT.—The Secretary of Health and 

7 Human Services shall establish an oral health initiative 

8 to reduce the profound disparities in oral health by im9 proving the health status of vulnerable populations, par10 ticularly low-income children, children with developmental 

11 disabilities, and ethnic and racial minority populations 

12 that experience a disproportionate level of dental disease, 

13 to the level of health status that is enjoyed by the majority 

14 of people in the United States. 

15 (b) ACTIVITIES.—The Secretary of Health and 

16 Human Services shall, through the oral health initiative— 

17 (1) carry out activities to improve intra-agency 

18 and inter-agency collaborations, including activities 

19 to identify, engage, and encourage existing Federal 

20 and State programs to maximize their potential to 

21 address oral health; 

22 (2) carry out activities to encourage public-pri23 vate partnerships to engage private sector commu24 nities of interest (including health professionals, 

25 educators, State policymakers, foundations, business, 

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1 and the public) in partnerships that promote oral 

2 health and dental care, in addition to allowing for 

3 contractual relationships between federally qualified 

4 health centers and private dental providers to in5 crease access to dental care for adults and children; 

6 (3) carry out activities to reduce the disease 

7 burden in high risk populations through the applica8 tion of best-science in oral health, including pro9 grams such as community water fluoridation and 

10 dental sealants; 

11 (4) carry out activities to improve the oral 

12 health literacy of the public through school-based 

13 education programs; and 

14 (5) provide for the development, implementa15 tion, or integration of outreach and education pro16 grams to families of children enrolled in Medicaid or 

17 SCHIP, particularly such children who are members 

18 of populations that experience oral health disparities, 

19 that increase awareness of dental coverage, when to 

20 seek dental services, and how to obtain such serv21 ices. 

22 (c) COORDINATION.—The Secretary of Health and 

23 Human Services shall— 

24 (1) through the Administrator of the Centers 

25 for Medicare and Medicaid Services, establish the 

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1 Chief Dental Officer for the Medicaid and State chil2 dren’s health insurance programs established under 

3 titles XIX and XXI, respectively, of the Social Secu4 rity Act (42 U.S.C. 1396 et seq. 1397aa et seq.); 

5 (2) through the Administrator of the Health 

6 Resources and Services Administration, establish the 

7 Chief Dental Office for all oral health programs 

8 within the Health Resources and Services Adminis9 tration; 

10 (3) through the Director of the Centers for Dis11 ease Control and Prevention, establish the Chief 

12 Dental Officer for all oral health programs within 

13 such Centers; and 

14 (4) carry out this section in collaboration with 

15 the Administrators and Chief Dental Officers de16 scribed in paragraphs (1), (2), and (3). 

17 (d) AUTHORIZATION OF APPROPRIATIONS.—There is 

18 authorized to be appropriated to carry out this section, 

19 $25,000,000 for fiscal year 2008, and such sums as may 

20 be necessary for each subsequent fiscal year. 

21 SEC. 402. CDC REPORTS. 

22 (a) COLLECTION OF DATA.—The Director of the 

23 Centers for Disease Control and Prevention, in collabora24 tion with other organizations and agencies, shall collect 

25 data through State-based oral health surveillance systems 

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1 describing the dental, craniofacial, and oral health of resi2 dents of all 50 States and certain Indian tribes. 

3 (b) REPORTS.—The Director of the Centers for Dis4 ease Control and Prevention shall compile and analyze 

5 data collection under subsection (a) and annually prepare 

6 and submit to the appropriate committees of Congress a 

7 report concerning the oral health of States and Indian 

8 tribes. 

9 SEC. 403. EARLY CHILDHOOD CARIES. 

10 (a) IN GENERAL.—The Secretary of Health and 

11 Human Services, acting through the Director of the Cen12 ters for Disease Control and Prevention, shall— 

13 (1) expand existing surveillance activities to in14 clude children at high risk of early childhood caries, 

15 including sub-populations such as children with de16 velopmental disabilities; 

17 (2) assist State, local, and tribal health agen18 cies and departments in collecting, analyzing and 

19 disseminating data on early childhood caries; and 

20 (3) develop, implement, and evaluate programs 

21 that promote comprehensive approaches and public 

22 education programs to prevent early childhood car23 ies. 

24 (b) APPROPRIATENESS OF ACTIVITIES.—The Sec25 retary of Health and Human Services shall carry out promstockstill on PROD1PC66 with BILLS

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1 grams and activities under subsection (a) in a culturally 

2 competent manner with respect to populations at risk of 

3 early childhood caries. 

4 (c) AUTHORIZATION OF APPROPRIATIONS.—There is 

5 authorized to be appropriated to carry out this section, 

6 such sums as may be necessary for fiscal year 2008 and 

7 each subsequent fiscal year. 

8 SEC. 404. SCHOOL-BASED DENTAL SEALANT PROGRAM. 

9 Section 317M(c) of the Public Health Service Act (42 

10 U.S.C. 247b–14(c)) is amended— 

11 (1) in paragraph (1), by inserting ‘‘and school12 linked’’ after ‘‘school-based’’; 

13 (2) in the first sentence of paragraph (2)— 

14 (A) by inserting ‘‘and school-linked’’ after 

15 ‘‘school-based’’; and 

16 (B) by inserting ‘‘or Indian tribe’’ after 

17 ‘‘State’’; and 

18 (3) by striking paragraph (3) and inserting the 

19 following: 

20 ‘‘(3) ELIGIBILITY.—To be eligible to receive 

21 funds under paragraph (1), an entity shall— 

22 ‘‘(A) prepare and submit to the State or 

23 Indian tribe an application at such time, in 

24 such manner and containing such information 

25 as the State or Indian tribe may require; and 

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1 ‘‘(B) be a— 

2 ‘‘(i) public elementary or secondary 

3 school— 

4 ‘‘(I) that is located in an urban 

5 area in which more than 50 percent of 

6 the student population is participating 

7 in Federal or State free or reduced 

8 meal programs; or 

9 ‘‘(II) that is located in a rural 

10 area and, with respect to the school 

11 district in which the school is located, 

12 the district involved has a median in13 come that is at or below 235 percent 

14 of the poverty line, as defined in sec15 tion 673(2) of the Community Serv16 ices Block Grant Act (42 U.S.C. 

17 9902(2)); or 

18 ‘‘(ii) public or non-profit organization, 

19 including a grantee under section 330 and 

20 urban Indian clinics under title V of the 

21 Indian Health Care Improvement Act, that 

22 is under contract with an elementary or 

23 secondary school described in subpara24 graph (B) to provide dental services to 

25 school-age children.’’. 

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1 SEC. 405. BASIC ORAL HEALTH PROMOTION. 

2 (a) IN GENERAL.—The Secretary of Health and 

3 Human Services, acting through the Director of the Cen4 ters for Disease Control and Prevention and in consulta5 tion with dental organizations (including organizations 

6 having expertise in the prevention and treatment of oral 

7 disease in underserved pediatric populations), shall award 

8 grants to States and Indian tribes to improve the basic 

9 capacity of such States and tribes to improve the oral 

10 health of children and their families. 

11 (b) REQUIREMENTS.—A State or Indian tribe shall 

12 use amounts received under a grant under this section to 

13 conduct one or more of the following activities: 

14 (1) Establish an oral health plan, oral health 

15 policies, effective prevention programs, and account16 ability measures and systems. 

17 (2) Establish and guide coalitions, partnerships, 

18 and alliances to accomplish the establishment of the 

19 plan, policies, programs, and systems under para20 graph (1). 

21 (3) Monitor changes in oral disease burden, dis22 parities, and the utilization of preventive services by 

23 high-risk populations. 

24 (4) Identify, test, establish, support, and evalu25 ate prevention interventions to reduce oral health 

26 disparities. 

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1 (5) Promote public awareness and education in 

2 support of improvements of oral health. 

3 (6) Support training programs for dental and 

4 other health professions needed to strengthen oral 

5 health prevention programs. 

6 (7) Establish, enhance, or expand oral disease 

7 prevention and disparity reduction programs. 

8 (8) Evaluate the progress and effectiveness of 

9 the State’s oral disease prevention and disparity re10 duction program. 

11 (c) AUTHORIZATION OF APPROPRIATIONS.—There is 

12 authorized to be appropriated to carry out this section, 

13 $58,000,000 for fiscal year 2008 and such sums as may 

14 be necessary for each subsequent fiscal year. 

Æ 

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