I 

110TH CONGRESS 

2D SESSION H. R. 5549 

To expand the dental workforce and improve dental access, prevention, and 

data reporting, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 6, 2008 

Mr. CUMMINGS 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 expand the dental workforce and improve dental access, 

prevention, and data reporting, and for other purposes. 

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 This Act may be cited as the ‘‘Deamonte Driver Den5 tal Care Access Improvement Act of 2008’’. 

6 SEC. 2. FINDINGS. 

7 The Congress finds as follows: 

8 (1) The Centers for Disease Control and Pre9 vention reports that between the periods 1988 to 


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1 1994 and 1994 and 2004, tooth decay increased 15 

2 percent among toddlers and preschoolers 2 to 5 

3 years old. 

4 (2) During the period 1999 to 2004, 28 percent 

5 of young children experienced cavities. 

6 (3) Among 2 year olds in the United States, 1- 

7 in-10 already have cavities, and by age 5 that figure 

8 jumps to 2-in-5 children. 

9 (4) Tooth decay is the single most common 

10 childhood chronic disease, and it disproportionately 

11 affects poor and minority children. 

12 (5) Eighty percent of dental decay occurs in 

13 just 25 percent of children. 

14 (6) Parents are 3 times more likely to report 

15 that their children’s dental needs are unmet, when 

16 compared with general medical care needs. 

17 (7) While 9,000,000 of the children in this Na18 tion do not have medical insurance, more than twice 

19 that number—23,000,000—do not have dental in20 surance. 

21 (8) One out of 20 middle-aged adults in the 

22 United States are missing all their teeth. 

23 (9) More than 40 percent of low income adults 

24 have at least 1 untreated decayed tooth compared to 

25 16 percent of non-poor adults. 


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1 (10) Employed adults lose more than 

2 164,000,000 hours of work each year due to oral 

3 health problems or dental visits. 

4 (11) For every adult 19 years or older without 

5 medical insurance, there are 3 without dental insur6 ance. 

7 (12) About 25 percent of adults 60 years old 

8 and older no longer have any natural teeth. Having 

9 missing teeth can affect nutrition, since people with10 out teeth often prefer soft, easily chewed foods. 

11 SEC. 3. DENTAL WORKFORCE IMPROVEMENT. 

12 (a) DENTISTRY WORKFORCE PILOT PROGRAM.— 

13 Title VII of the Public Health Service Act (42 U.S.C. 292 

14 et seq.) is amended by inserting after section 747 the fol15 lowing: 

16 ‘‘SEC. 747A. DENTISTRY WORKFORCE PILOT PROGRAM. 

17 ‘‘(a) GRANTS.—The Secretary shall make grants to 

18 schools of dentistry and hospitals with accredited training 

19 programs in pediatric dentistry to increase the number of 

20 individuals who pursue academic programs in pediatric 

21 dentistry or provide dental services to children. 

22 ‘‘(b) USE OF FUNDS.—The Secretary may not make 

23 a grant to a school of dentistry or a hospital under this 

24 section unless the school or hospital agrees to use the 


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1 grant to increase the number of individuals who provide 

2 dental care to children by— 

3 ‘‘(1) establishing, maintaining, or improving 

4 both pre- and post-doctoral academic programs in 

5 pediatric dentistry; 

6 ‘‘(2) recruiting and training dental students to 

7 pursue training in pediatric dentistry; 

8 ‘‘(3) strengthening training in pediatric den9 tistry within advanced education in general dentistry 

10 and general practice dentistry residencies in den11 tistry programs; 

12 ‘‘(4) recruiting and training practicing dentists 

13 through continuing education programs in pediatric 

14 dentistry; 

15 ‘‘(5) training pediatricians to examine chil16 dren’s mouths to conduct risk assessments and 

17 apply fluoride varnish; or 

18 ‘‘(6) training dental students, dentists, dental 

19 hygienists, and other dental professionals in dental 

20 health disparities and community-based dental 

21 health care. 

22 ‘‘(c) REPORTS TO CONGRESS.—Not later than 2 

23 years after the date of the enactment of this section, and 

24 biennially thereafter, the Secretary shall conduct an eval25 uation of the activities funded through grants under this 


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1 section and submit a report to the Congress on the results 

2 of such evaluation. 

3 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—To 

4 carry out this section, there are authorized to be appro5 priated such sums as may be necessary for each of fiscal 

6 years 2009 through 2014.’’. 

7 (b) GRANTS TO DEVELOP AND IMPLEMENT PILOT

8 PROGRAM TO TRAIN ALLIED DENTAL HEALTH PROFES9 SIONALS.—Title V of the Social Security Act (42 U.S.C. 

10 701, et seq.) is amended by adding at the end the fol11 lowing new sections: 

12 ‘‘SEC. 511. GRANTS TO DEVELOP AND IMPLEMENT PILOT 

13 PROGRAM TO TRAIN ALLIED DENTAL 

14 HEALTH PROFESSIONALS. 

15 ‘‘(a) IN GENERAL.—Not later than 1 year after the 

16 date of enactment of this section, the Secretary shall 

17 award a grant to establish a pilot program to increase ac18 cess to dental care for underserved populations through 

19 the use of new allied dental health professionals. In award20 ing the grant, the Secretary shall consider pilot program 

21 applications that meet the following criteria: 

22 ‘‘(1) The applicant plans to evaluate one or 

23 more distinct allied dental professional models. 


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1 ‘‘(2) The model is structured such that the al2 lied dental professionals work under the supervision 

3 of a licensed dentist or dentists. 

4 ‘‘(3) The application must include benchmarks 

5 reflecting the goal of increasing access to dental care 

6 for underserved populations. 

7 ‘‘(4) The models tested by the applicant must 

8 be structured to be replicable in other areas of the 

9 country. The models tested must include strategies 

10 to maximize cost-efficiency. 

11 ‘‘(b) ADJUSTMENT OF FUNDING.—The Secretary 

12 shall adjust funding for the pilot program according to 

13 the training needs of the allied dental professionals and 

14 the number of sites used for the pilot program. 

15 ‘‘(c) EVALUATION.—Not later than 2 years after the 

16 date of enactment of this section, and biennially there17 after, the Secretary shall conduct an evaluation of the ac18 tivities funded through grants under this section and sub19 mit a report to Congress on the results of such evaluation. 

20 ‘‘(d) AUTHORIZATION OF APPROPRIATIONS.—There 

21 are authorized to be appropriated to carry out this section 

22 such sums as may be necessary for each of fiscal years 

23 2009 through 2014.’’. 


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1 SEC. 4. ACCESS TO DENTAL CARE. 

2 (a) ACCESS TO DENTAL CARE PILOT PROGRAM.— 

3 Subpart I of part D of title III of the Public Health Serv4 ice Act (42 U.S.C. 254b et seq.) is amended by adding 

5 at the end the following: 

6 ‘‘SEC. 330M. ACCESS TO DENTAL CARE PILOT PROGRAM. 

7 ‘‘(a) GRANTS.—The Secretary shall award grants to 

8 Federally qualified health centers to expand and improve 

9 the provision of dental services to medically underserved 

10 populations. 

11 ‘‘(b) USE OF FUNDS.—The Secretary may not make 

12 a grant to a Federally qualified health center under this 

13 section unless the center agrees to use the grant to expand 

14 and improve the provision of dental services to medically 

15 underserved populations by— 

16 ‘‘(1) recruiting dentists, dental hygienists, or 

17 pediatric dentists; 

18 ‘‘(2) purchasing or renting equipment for the 

19 provision of dental services; 

20 ‘‘(3) constructing and expanding physical space 

21 for the provision of dental services; 

22 ‘‘(4) allowing contractual relationships between 

23 Federally qualified health centers and private dental 

24 providers to increase access to dental care for adults 

25 and children; or 


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1 ‘‘(5) establishing or maintaining mobile den2 tistry and teledentistry activities. 

3 ‘‘(c) REPORTS TO CONGRESS.—Not later than 1 year 

4 after the date of the enactment of this section, and bienni5 ally thereafter, the Secretary shall conduct an evaluation 

6 of the activities funded through grants under this section 

7 and submit a report to the Congress on the results of such 

8 evaluation. 

9 ‘‘(d) DEFINITIONS.—In this section: 

10 ‘‘(1) The term ‘Federally qualified health cen11 ter’ has the meaning given to such term in section 

12 1905(l)(2)(B) of the Social Security Act (42 U.S.C. 

13 1396d(l)(2)(B)). 

14 ‘‘(2) The term ‘pediatric dentist’ means an indi15 vidual who has successfully completed residency 

16 training from a pediatric dentistry program accred17 ited by the Commission on Dental Accreditation. 

18 ‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—To 

19 carry out this section, there are authorized to be appro20 priated such sums as may be necessary for each of fiscal 

21 years 2009 through 2014. 

22 ‘‘SEC. 330N. EARLY CHILDHOOD CARIES PREVENTION AND 

23 MANAGEMENT DEMONSTRATION GRANTS. 

24 ‘‘(a) GRANTS.—The Secretary is authorized to award 

25 grants to public or private entities to develop, implement, 


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1 and evaluate public health and clinical strategies to pre2 vent and manage early childhood caries. 

3 ‘‘(b) USE OF FUNDS.—The Secretary shall make 

4 grants to eligible entities to demonstrate the effectiveness 

5 of preventing and managing early childhood caries by— 

6 ‘‘(1) developing materials and methods for early 

7 detection, anticipatory guidance, primary prevention, 

8 and disease suppression of early childhood caries; 

9 ‘‘(2) developing and testing models of care de10 livery that engage nutritional, behavioral, edu11 cational, and pharmacologic approaches in early 

12 childhood caries prevention and control; 

13 ‘‘(3) training dentists, physicians, and nurse 

14 practitioners in the medical and behavioral manage15 ment of early childhood caries; 

16 ‘‘(4) partnering with Head Start, the Special 

17 Supplemental Nutrition Program for Women, In18 fants, and Children (WIC) established under section 

19 17 of the Child Nutrition Act of 1966, or other early 

20 childhood programs to engage families in positive 

21 oral health behaviors and practices to reduce or 

22 eliminate early childhood caries; or 

23 ‘‘(5) developing public health strategies includ24 ing public education, public policy, and public proVerDate Aug 31 2005 04:22 Mar 07, 2008 Jkt 069200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H5549.IH H5549

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1 grams targeting children under the age of 6 years at 

2 risk for early childhood caries. 

3 ‘‘(c) AUTHORIZATION OF APPROPRIATIONS.—To 

4 carry out this section, there are authorized to be appro5 priated such sums as may be necessary for each of fiscal 

6 years 2009 through 2014.’’. 

7 (b) DENTAL SERVICES CREDIT.— 

8 (1) IN GENERAL.—Subpart D of part IV of 

9 subchapter A of chapter 1 of the Internal Revenue 

10 Code of 1986 (relating to business related credits) is 

11 amended by inserting after section 45N the following 

12 new section: 

13 ‘‘SEC. 45O. DENTAL SERVICES. 

14 ‘‘(a) IN GENERAL.—For purposes of section 38, the 

15 qualified dental services credit determined under this sub16 section for any taxable year is an amount equal the 15 

17 percent of the qualified dental receipts of the taxpayer for 

18 such taxable year. 

19 ‘‘(b) LIMITATION.—The credit determined under sub20 section (a) with respect to any taxpayer for any taxable 

21 year shall not exceed $5,000. 

22 ‘‘(c) QUALIFIED DENTAL RECEIPTS.—For purposes 

23 of this section, the term ‘qualified dental receipts’ means 

24 any amount received as compensation for providing dental 

25 services— 


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1 ‘‘(1) under a State plan under title XIX of the 

2 Social Security Act or under a State child health 

3 plan under title XXI of such Act; or 

4 ‘‘(2) from an individual who is not covered by 

5 a health insurance plan at the time such services are 

6 provided.’’. 

7 (2) CONFORMING AMENDMENTS.— 

8 (A) Section 38(b) of such Code is amended 

9 by striking ‘‘plus’’ at the end of paragraph 

10 (30), by striking the period at the end of para11 graph (31) and inserting ‘‘, plus’’, and by add12 ing at the end the following: 

13 ‘‘(32) the qualified dental services credit deter14 mined under section 45O(a).’’. 

15 (B) The table of sections of such subpart 

16 is amended by inserting after the item relating 

17 to section 45N the following new item: 

‘‘Sec. 45O. Dental services.’’. 

18 SEC. 5. PUBLIC EDUCATION AND AWARENESS CAMPAIGN. 

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

20 Service Act (42 U.S.C. 254b et seq.) as amended by sec21 tion 4, is amended by adding at the end the following: 

22 ‘‘SEC. 330O. PUBLIC EDUCATION AND AWARENESS CAM23 PAIGN. 

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

25 the Director of the Centers for Disease Control and PreVerDate Aug 31 2005 04:22 Mar 07, 2008 Jkt 069200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H5549.IH H5549

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1 vention, shall directly or through grants, cooperative 

2 agreements, or contracts to eligible entities conduct, sup3 port, and promote a comprehensive public education and 

4 awareness campaign on preventing, controlling, and ulti5 mately eliminating early childhood caries. The campaign 

6 shall target pregnant women, and parents and caregivers 

7 of children under the age of 6 years. 

8 ‘‘(b) AUTHORIZATION OF APPROPRIATIONS.—There 

9 is authorized to be appropriated to carry out this section 

10 $2,000,000 for each of fiscal years 2009 through 2013.’’. 

11 SEC. 6. ACCESS TO DENTAL CARE UNDER MEDICAID AND 

12 SCHIP. 

13 (a) REPORTING INFORMATION ON DENTAL CARE

14 FOR CHILDREN.— 

15 (1) MEDICAID.—Section 1902(a)(43)(D)(iii) of 

16 the Social Security Act (42 U.S.C. 

17 1396a(a)(43)(D)(iii)) is amended by inserting ‘‘and 

18 other information relating to the provision of dental 

19 services to such children described in section 

20 2108(e)’’ after ‘‘receiving dental services,’’. 

21 (2) CHIP.—Section 2108 of the Social Security 

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

23 the end the following new subsection: 

24 ‘‘(e) INFORMATION ON DENTAL CARE FOR CHIL25 DREN.— 


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1 ‘‘(1) IN GENERAL.—Each annual report under 

2 subsection (a) shall include the following information 

3 with respect to care and services described in section 

4 1905(r)(3) provided to targeted low-income children 

5 enrolled in the State child health plan under this 

6 title at any time during the year involved: 

7 ‘‘(A) The number of enrolled children by 

8 age grouping used for reporting purposes under 

9 section 1902(a)(43). 

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

11 grouping, information of the type contained in 

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

13 consists of the number of enrolled targeted low 

14 income children who receive any, preventive, or 

15 restorative dental care under the State plan). 

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

17 children 8 years of age, the number of such 

18 children who have received a protective sealant 

19 on at least one permanent molar tooth. 

20 ‘‘(2) INCLUSION OF INFORMATION ON ENROLL21 EES IN MANAGED CARE PLANS.—The information 

22 under paragraph (1) shall include information on 

23 children who are enrolled in managed care plans and 

24 other private health plans and contracts with such 


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1 plans under this title shall provide for the reporting 

2 of such information by such plans to the State.’’. 

3 (b) ASSESSMENT OF ADEQUACY OF DENTAL REIM4 BURSEMENT RATES FOR ALL ELIGIBLE BENE5 FICIARIES.—Not later than 1 year after the date of enact6 ment of this Act, the Comptroller General of the United 

7 States shall study and report to Congress on the extent 

8 to which payment rates for dental services provided to in9 dividuals who are eligible for medical assistance under 

10 State Medicaid plans under title XIX of the Social Secu11 rity Act (42 U.S.C. 1396 et seq.) or child health assistance 

12 or other health benefits coverage under State child health 

13 plans under title XXI of such Act (42 U.S.C. 1397aa et 

14 seq.)— 

15 (1) are comparable to the payment rates for 

16 such services established by private health insurance 

17 issuers; 

18 (2) are adequate to compensate providers for 

19 the actual cost of providing such services; and 

20 (3) in the case of such services provided under 

21 State Medicaid plans, satisfy the requirement of sec22 tion 1902(a)(30)(A) of such Act (42 U.S.C. 

23 1396a(a)(30)(A)) to assure that payments are con24 sistent with efficiency, economy, and quality of care 

25 and are sufficient to enlist enough providers so that 


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1 care and services are available under the plan at 

2 least to the extent that such care and services are 

3 available to the general population in the geographic 

4 area. 

5 SEC. 7. COORDINATION AND REPORT BY THE SECRETARY 

6 OF HEALTH AND HUMAN SERVICES. 

7 The Secretary of Health and Human Services shall 

8 coordinate with relevant government agencies to ensure 

9 the inclusion of dental health prevention and promotion 

10 activities within existing prenatal and maternal child 

11 health programs, and shall, not later than 2 years after 

12 the date of enactment of this Act, submit to Congress a 

13 report on the status of such programs. 

Æ 


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