89–006 

111TH CONGRESS REPORT " ! HOUSE OF REPRESENTATIVES 2d Session 111–647 

DENTAL EMERGENCY RESPONDER ACT OF 2010 

SEPTEMBER 28, 2010.—Committed to the Committee of the Whole House on the 

State of the Union and ordered to be printed 

Mr. WAXMAN, from the Committee on Energy and Commerce, 

submitted the following 

R E P O R T 

[To accompany H.R. 903] 

[Including cost estimate of the Congressional Budget Office] 

The Committee on Energy and Commerce, to whom was referred 

the bill (H.R. 903) to amend the Public Health Service Act to enhance the roles of dentists and allied dental personnel in the Nation’s disaster response framework, and for other purposes, having 

considered the same, report favorably thereon with an amendment 

and recommend that the bill as amended do pass. 

CONTENTS 

Page 

Amendment .............................................................................................................. 1 

Purpose and Summary ............................................................................................ 2 

Background and Need for Legislation .................................................................... 2 

Committee Consideration ........................................................................................ 2 

Committee Votes ...................................................................................................... 3 

Committee Oversight Findings and Recommendations ........................................ 3 

New Budget Authority, Entitlement Authority, and Tax Expenditures ............. 3 

Statement of General Performance Goals and Objectives .................................... 3 

Constitutional Authority Statement ...................................................................... 3 

Earmarks and Tax and Tariff Benefits .................................................................. 3 

Federal Advisory Committee Statement ................................................................ 4 

Applicability of Law to Legislative Branch ........................................................... 4 

Federal Mandates Statement ................................................................................. 4 

Committee Cost Estimate ....................................................................................... 4 

Congressional Budget Office Cost Estimate .......................................................... 4 

Section-by-Section Analysis of the Legislation ...................................................... 5 

Explanation of Amendment .................................................................................... 5 

Changes in Existing Law Made by the Bill, as Reported ..................................... 6 

AMENDMENT

The amendment is as follows: 


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Strike all after the enacting clause and insert the following: 

SECTION 1. SHORT TITLE. 

This Act may be cited as the ‘‘Dental Emergency Responder Act of 2010’’. 

SEC. 2. DENTAL EMERGENCY RESPONDERS: PUBLIC HEALTH AND MEDICAL RESPONSE. 

(a) NATIONAL HEALTH SECURITY STRATEGY.—Section 2802(b)(3) of the Public 

Health Service Act (42 U.S.C. 300hh–1(b)(3)) is amended— 

(1) in the matter preceding subparagraph (A), by inserting ‘‘and which may 

include dental health facilities’’ after ‘‘mental health facilities’’; and 

(2) in subparagraph (D), by inserting ‘‘(which may include such dental health 

assets)’’ after ‘‘medical assets’’. 

(b) ALL-HAZARDS PUBLIC HEALTH AND MEDICAL RESPONSE CURRICULA AND TRAINING.—Section 319F(a)(5)(B) of the Public Health Service Act (42 U.S.C. 247d– 

6(a)(5)(B)) is amended by striking ‘‘public health or medical’’ and inserting ‘‘public 

health, medical, or dental’’. 

SEC. 3. DENTAL EMERGENCY RESPONDERS: HOMELAND SECURITY. 

(a) NATIONAL RESPONSE FRAMEWORK.—Paragraph (6) of section 2 of the Homeland Security Act of 2002 (6 U.S.C. 101) is amended by inserting ‘‘and dental’’ after 

‘‘emergency medical’’. 

(b) NATIONAL PREPAREDNESS SYSTEM.—Subparagraph (B) of section 653(b)(4) of 

the Post-Katrina Emergency Management Reform Act of 2006 (6 U.S.C. 753(b)(4)) 

is amended by striking ‘‘public health and medical’’ and inserting ‘‘public health, 

medical, and dental’’. 

(c) CHIEF MEDICAL OFFICER.—Paragraph (5) of section 516(c) of the Homeland Security Act of 2002 (6 U.S.C. 321e(c)) is amended by striking ‘‘medical community’’ 

and inserting ‘‘medical and dental communities’’. 

PURPOSE AND SUMMARY

H.R. 903, the ‘‘Dental Emergency Responder Act of 2010’’, was 

introduced on February 4, 2009, by Rep. Bart Stupak (D–MI) and 

subsequently referred to the Committee on Energy and Commerce. 

The goal of H.R. 903 is to include dental professionals and facilities into various components of the nation’s emergency response 

preparedness framework. 

BACKGROUND AND NEED FOR LEGISLATION

Recent disasters—the terrorist attacks of September 11, 2001, 

and Hurricanes Katrina and Rita—have made clear the critical 

need for a prepared, robust national medical response structure. 

Currently, however, the term ‘‘medical responder’’ (as used in relevant disaster-related federal law) does not include an important 

part of such a structure—dentists, allied dental personnel, and dental facilities. These individuals and offices are both eager and willing to participate and otherwise assist in supporting medical and 

public health responses to disasters. The purpose of this legislation 

is to provide them with the statutory authority to do so. With minimal additional training, they could readily fit into an all-hazards 

emergency healthcare response effort. 

COMMITTEE CONSIDERATION

H.R. 903, the ‘‘Dental Emergency Responder Act of 2010’’, was 

introduced by Rep. Stupak (D–MI) on February 4, 2009, and referred to the Committee on Energy and Commerce. The bill was 

subsequently referred to the Subcommittee on Health on February 

9, 2009. The Subcommittee met in open markup session to consider 

H.R. 903 on July 22, 2010. An amendment in the nature of a substitute (manager’s amendment) by Subcommittee Chairman 


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Pallone was adopted by a voice vote. Subsequently, H.R. 903 was 

forwarded to the full Committee, amended, by a voice vote. 

On July 28, 2010, the Committee on Energy and Commerce met 

in open markup session and considered H.R. 903 as approved by 

the Subcommittee. There were no amendments offered in full Committee and subsequently the Committee ordered H.R. 903 favorably 

reported to the House, as amended by the Subcommittee on 

Health, by a voice vote. 

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. A motion by Mr. 

Waxman ordering H.R. 903 reported to the House, as amended, 

was approved by a voice vote. There were no record votes taken 

during consideration of this bill. 

COMMITTEE OVERSIGHT FINDINGS AND RECOMMENDATIONS

In compliance with 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 portions of this report, including the finding that 

dentists, allied dental personnel, and dental facilities should be incorporated into the nation’s emergency response preparedness 

framework. 

NEW BUDGET AUTHORITY, ENTITLEMENT AUTHORITY, AND TAX

EXPENDITURES

Regarding compliance with clause 3(c)(2) of rule XIII of the Rules 

of the House of Representatives, the Committee adopts as its own 

the analysis of H.R. 903 prepared by the Director of the Congressional Budget Office. 

STATEMENT OF GENERAL PERFORMANCE GOALS AND OBJECTIVES

In accordance with clause 3(c)(4) of rule XIII of the Rules of the 

House of Representatives, the performance goals and objectives of 

the Committee are reflected in the descriptive portions of this report, including the goal to incorporate dentists, allied dental personnel, and dental facilities into the nation’s emergency response 

preparedness framework. 

CONSTITUTIONAL AUTHORITY STATEMENT

Pursuant to clause 3(d)(1) of rule XIII of the Rules of the House 

of Representatives, the Committee finds that the constitutional authority for H.R. 903 is provided under Article I, section 8, clauses 

3 and 18 of the Constitution of the United States. 

EARMARKS AND TAX AND TARIFF BENEFITS

H.R. 903 does not contain any congressional earmarks, limited 

tax benefits, or limited tariff benefits as defined in clause 9(d), 9(e), 

or 9(f) of rule XXI of the Rules of the House of Representatives. 


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FEDERAL ADVISORY COMMITTEE STATEMENT

The Committee finds that the legislation does not establish or 

authorize the establishment of an advisory committee within the 

definition of 5 U.S.C. App., section 5(b) of the Federal Advisory 

Committee Act. 

APPLICABILITY OF LAW TO THE LEGISLATIVE BRANCH

Section 102(b)(3) of Public Law 104–1 requires a description of 

the application of this bill to the legislative branch where the bill 

relates to terms and conditions of employment or access to public 

services and accommodations. H.R. 903 contains no such provisions. 

FEDERAL MANDATES STATEMENT

Section 423 of the Congressional Budget and Impoundment Control Act of 1974 (as amended by section 101(a)(2) of the Unfunded 

Mandates Reform Act, P.L. 104–4) requires a statement on whether 

the provisions of the report include unfunded mandates. In compliance with this requirement the Committee adopts as its own the 

estimates of federal mandates prepared by the Director of the Congressional Budget Office. 

COMMITTEE COST ESTIMATE

Pursuant to clause 3(d)(2) of rule XIII of the Rules of the House 

of Representatives, the Committee adopts as its own the cost estimate of H.R. 903 prepared by the Director of the Congressional 

Budget Office pursuant to section 402 of the Congressional Budget 

Act of 1974. 

CONGRESSIONAL BUDGET OFFICE COST ESTIMATE

With respect to the requirements of clause 3(c)(3) of rule XIII of 

the Rules of the House of Representatives and section 402 of the 

Congressional Budget Act of 1974, the Committee has received the 

following cost estimate for H.R. 903 from the Director of Congressional Budget Office: 

AUGUST 27, 2010. 

Hon. HENRY A. WAXMAN, Chairman, Committee on Energy and Commerce, 

House of Representatives, Washington, DC. 

DEAR MR. CHAIRMAN: The Congressional Budget Office has prepared the enclosed cost estimate for H.R. 903, the Dental Emergency Responder Act of 2010. 

If you wish further details on this estimate, we will be pleased 

to provide them. The CBO staff contact is Lisa Ramirez-Branum. 

Sincerely, 

DOUGLAS W. ELMENDORF. 

Enclosure. 

H.R. 903—Dental Emergency Responder Act of 2010 

H.R. 903 would amend responsibilities of federal agencies that 

are tasked with developing and implementing the National Health 

Security Strategy under the Public Health Service Act and the NaVerDate Mar 15 2010 07:08 Oct 05, 2010 Jkt 089006 PO 00000 Frm 00004 Fmt 6659 Sfmt 6602 E:\HR\OC\HR647.XXX HR647

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tional Response Plan under the Homeland Security Act of 2002. 

The bill would direct the Secretary of Health and Human Services 

to include, under the preparedness goals of the National Health Security Strategy, dental health facilities as entities to prepare for 

and respond to public health emergencies. The bill also would include dental personnel within the definition of emergency response 

provider and require federal agencies with responsibilities under 

the National Response Plan to address the preparedness and deployment of dental resources. 

Based on the cost of similar requirements, CBO estimates that 

implementing H.R. 903 would have a negligible impact on federal 

spending over the next five years; any additional spending would 

be subject to the availability of appropriated funds. Enacting this 

legislation would not affect direct spending or revenues; therefore, 

pay-as-you-go procedures do not apply. 

H.R. 903 contains no intergovernmental or private-sector mandates as defined in the Unfunded Mandates Reform Act and would 

impose no costs on state, local, or tribal governments. 

The CBO staff contact for this estimate is Lisa Ramirez-Branum. 

The estimate was approved by Peter H. Fontaine, Assistant Director for Budget Analysis. 

SECTION-BY-SECTION ANALYSIS OF THE LEGISLATION

Section 1. Short title; table of contents 

Section 1 designates the short title of the Act as the ‘‘Dental 

Emergency Responder Act of 2010’’. 

Section 2. Dental emergency responders: public health and medical 

response 

Section 2(a) amends section 2802(b)(3) of the Public Health Service Act to include dental health facilities in the National Health Security Strategy. 

Section 2(b) amends section 319F(a)(5)(B) of the Public Health 

Service Act to include dental entities in the All-Hazards Public 

Health and Medical Response Curricula and Training. 

Section 3. Dental emergency responders: homeland security 

Section 3(a) amends paragraph 6 of section 2 of the Homeland 

Security Act of 2002 to include dental providers in the National Response Framework. 

Section 3(b) amends subparagraph (B) of section 653(b)(4) of the 

Post-Katrina Emergency Management Reform Act of 2006 to include dental resources in the National Preparedness System. 

Section 3(c) amends paragraph (5) of section 516(c) of the Homeland Security Act to include coordination with the dental community as a responsibility of the Chief Medical Officer of the Department of Homeland Security. 

EXPLANATION OF AMENDMENT

Rep. Pallone (D–NJ) offered an amendment in the nature of a 

substitute during Subcommittee mark up. This amendment made 

two technical changes in the bill clarifying that the Department of 

Health and Human Services has the discretion, but is not required, 


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to include dentists and dental facilities in the national response 

framework. The amendment was adopted by voice vote. 

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 (existing law proposed to be omitted is enclosed in black brackets, new matter is printed in italic, 

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 B—FEDERAL-STATE COOPERATION

* * * * * * * 

SEC. 319F. PUBLIC HEALTH COUNTERMEASURES TO A BIOTERRORIST 

ATTACK. 

(a) ALL-HAZARDS PUBLIC HEALTH AND MEDICAL RESPONSE CURRICULA AND TRAINING.— 

(1) * * * 

* * * * * * * 

(5) DISSEMINATION AND TRAINING.— 

(A) * * * 

(B) CERTAIN ENTITIES.—The education and training activities described in subparagraph (A) may be carried out 

by Federal øpublic health or medical¿ public health, medical, or dental entities, appropriate educational entities, 

professional organizations and societies, private accrediting organizations, and other nonprofit institutions or entities meeting criteria established by the Secretary. 

* * * * * * * 

TITLE XXVIII—NATIONAL ALL-HAZARDS 

PREPAREDNESS FOR PUBLIC HEALTH 

EMERGENCIES 

Subtitle A—National All-Hazards Preparedness and Response Planning, Coordinating, and Reporting 

* * * * * * * 

SEC. 2802. NATIONAL HEALTH SECURITY STRATEGY. 

(a) * * * 

(b) PREPAREDNESS GOALS.—The National Health Security Strategy shall include provisions in furtherance of the following: 


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(1) * * * 

* * * * * * * 

(3) MEDICAL.—Increasing the preparedness, response capabilities, and surge capacity of hospitals, other health care facilities (including mental health facilities and which may include 

dental health facilities), and trauma care and emergency medical service systems, with respect to public health emergencies, 

which shall include developing plans for the following: 

(A) * * * 

* * * * * * * 

(D) Effective utilization of any available public and private mobile medical assets (which may include such dental 

health assets) and integration of other Federal assets. 

* * * * * * * 

HOMELAND SECURITY ACT OF 2002 

* * * * * * * 

SEC. 2. DEFINITIONS. 

In this Act, the following definitions apply: 

(1) * * * 

* * * * * * * 

(6) The term ‘‘emergency response providers’’ includes Federal, State, and local governmental and nongovernmental 

emergency public safety, fire, law enforcement, emergency response, emergency medical and dental (including hospital 

emergency facilities), and related personnel, agencies, and authorities. 

* * * * * * * 

TITLE V—NATIONAL EMERGENCY 

MANAGEMENT 

* * * * * * * 

SEC. 516. CHIEF MEDICAL OFFICER. 

(a) * * * 

* * * * * * * 

(c) RESPONSIBILITIES.—The Chief Medical Officer shall have the 

primary responsibility within the Department for medical issues related to natural disasters, acts of terrorism, and other man-made 

disasters, including— 

(1) * * * 

* * * * * * * 

(5) serving as the Department’s primary point of contact for 

State, local, and tribal governments, the ømedical community¿ 

medical and dental communities, and others within and outVerDate Mar 15 2010 07:08 Oct 05, 2010 Jkt 089006 PO 00000 Frm 00007 Fmt 6659 Sfmt 6602 E:\HR\OC\HR647.XXX HR647

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side the Department, with respect to medical and public health 

matters; 

* * * * * * * 

POST-KATRINA EMERGENCY MANAGEMENT REFORM 

ACT OF 2006 

* * * * * * * 

TITLE VI—NATIONAL EMERGENCY 

MANAGEMENT 

* * * * * * * 

Subtitle C—Comprehensive Preparedness 

System 

CHAPTER 1—NATIONAL PREPAREDNESS SYSTEM 

* * * * * * * 

SEC. 653. FEDERAL PREPAREDNESS. 

(a) * * * 

(b) OPERATIONAL PLANS.—An operations plan developed under 

subsection (a)(4) shall meet the following requirements: 

(1) * * * 

* * * * * * * 

(4) The operations plan shall address, as appropriate, the following matters: 

(A) * * * 

(B) The preparedness and deployment of øpublic health 

and medical¿ public health, medical, and dental resources, 

including resources to address the needs of evacuees and 

populations with special needs. 

* * * * * * * 


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