(b) TABLE OF CONTENTS.—The table of contents of 
this Act is as follows: 
Sec. 1. Short title; table of contents. 
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. 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 SERV-
ICES 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 Serv-
ice. 
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.
TITLE I—IMPROVING DELIVERY 
OF PEDIATRIC DENTAL SERV-
ICES UNDER MEDICAID AND 
SCHIP 
SEC. 101. GRANTS TO IMPROVE THE PROVISION OF DENTAL 
SERVICES UNDER MEDICAID AND SCHIP. 
Title V of the Social Security Act (42 U.S.C. 701 
et seq.) is amended by adding at the end the following: 
‘‘SEC. 511. GRANTS TO IMPROVE THE PROVISION OF DEN-
TAL SERVICES UNDER MEDICAID AND SCHIP. 
‘‘(a) AUTHORITY TO MAKE GRANTS.—In addition to 
any other payments made under this title to a State, the 
Secretary shall award grants to States that satisfy the re-
quirements of subsection (b) to improve the provision of 
dental services to children who are enrolled in a State plan 
under title XIX or a State child health plan under title 
XXI (in this section, collectively, referred to as the ‘State 
plans’). 
‘‘(b) REQUIREMENTS.—In order to be eligible for a 
grant under this section, a State shall provide the Sec-
retary with the following assurances: 
‘‘(1) 
IMPROVED
SERVICE
DELIVERY.—The 
State shall have a plan to improve the delivery of 
dental services to children, including children with 
special health care needs, who are enrolled in the
State plans, including providing outreach and ad-
ministrative case management, improving collection 
and reporting of claims data, and providing incen-
tives, in addition to raising reimbursement rates, to 
increase provider participation. 
‘‘(2) ADEQUATE PAYMENT RATES.—The State 
has provided for payment under the State plans for 
dental services for children at levels consistent with 
the market-based rates and sufficient enough to en-
list providers to treat children in need of dental serv-
ices. 
‘‘(3) ENSURED ACCESS.—The State shall en-
sure it will make dental services available to children 
enrolled in the State plans to the same extent as 
such services are available to the general population 
of the State. 
‘‘(c) USE OF FUNDS.— 
‘‘(1) IN GENERAL.—Funds provided under this 
section may be used to provide administrative re-
sources (such as program development, provider 
training, data collection and analysis, and research- 
related tasks) to assist States in providing and as-
sessing services that include preventive and thera-
peutic dental care regimens.
‘‘(2) LIMITATION.—Funds provided under this 
section may not be used for payment of direct den-
tal, medical, or other services or to obtain Federal 
matching funds under any Federal program. 
‘‘(d) APPLICATION.—A State shall submit an applica-
tion to the Secretary for a grant under this section in such 
form and manner and containing such information as the 
Secretary may require. 
‘‘(e) AUTHORIZATION OF APPROPRIATIONS.—There 
are authorized to be appropriated to make grants under 
this section $50,000,000 for fiscal year 2005 and each fis-
cal year thereafter. 
‘‘(f) APPLICATION
OF
OTHER
PROVISIONS
OF 
TITLE.— 
‘‘(1) IN GENERAL.—Except as provided in para-
graph (2), the other provisions of this title shall not 
apply to a grant made under this section. 
‘‘(2) EXCEPTIONS.—The following provisions of 
this title shall apply to a grant made under sub-
section (a) to the same extent and in the same man-
ner as such provisions apply to allotments made 
under section 502(c): 
‘‘(A) Section 504(b)(6) (relating to prohi-
bition on payments to excluded individuals and 
entities).
‘‘(B) Section 504(c) (relating to the use of 
funds for the purchase of technical assistance). 
‘‘(C) Section 504(d) (relating to a limita-
tion on administrative expenditures). 
‘‘(D) Section 506 (relating to reports and 
audits), but only to the extent determined by 
the Secretary to be appropriate for grants made 
under this section. 
‘‘(E) Section 507 (relating to penalties for 
false statements). 
‘‘(F) 
Section 
508 
(relating 
to 
non-
discrimination). 
‘‘(G) Section 509 (relating to the adminis-
tration of the grant program).’’. 
SEC. 102. STATE OPTION TO PROVIDE WRAP-AROUND 
SCHIP COVERAGE TO CHILDREN WHO HAVE 
OTHER HEALTH COVERAGE. 
(a) IN GENERAL.— 
(1) SCHIP.— 
(A) STATE
OPTION
TO
PROVIDE
WRAP- 
AROUND
COVERAGE.—Section 2110(b) of the 
Social Security Act (42 U.S.C. 1397jj(b)) is 
amended—
(i) in paragraph (1)(C), by inserting 
‘‘, subject to paragraph (5),’’ after ‘‘under 
title XIX or’’; and 
(ii) by adding at the end the fol-
lowing: 
‘‘(5) STATE OPTION TO PROVIDE WRAP-AROUND 
COVERAGE.—A State may waive the requirement of 
paragraph (1)(C) that a targeted low-income child 
may not be covered under a group health plan or 
under health insurance coverage, if the State satis-
fies the conditions described in subsection (c)(8). 
The State may waive such requirement in order to 
provide— 
‘‘(A) dental services; 
‘‘(B) cost-sharing protection; or 
‘‘(C) all services. 
In waiving such requirement, a State may limit the 
application of the waiver to children whose family in-
come does not exceed a level specified by the State, 
so long as the level so specified does not exceed the 
maximum income level otherwise established for 
other children under the State child health plan.’’. 
(B) 
CONDITIONS
DESCRIBED.—Section 
2105(c) of the Social Security Act (42 U.S.C.
1397ee(c)) is amended by adding at the end the 
following: 
‘‘(8) CONDITIONS
FOR
PROVISION
OF
WRAP- 
AROUND
COVERAGE.—For 
purposes 
of 
section 
2110(b)(5), the conditions described in this para-
graph are the following: 
‘‘(A) INCOME
ELIGIBILITY.—The State 
child health plan (whether implemented under 
title XIX or this XXI)— 
‘‘(i) has the highest income eligibility 
standard permitted under this title as of 
January 1, 2004; 
‘‘(ii) subject to subparagraph (B), 
does not limit the acceptance of applica-
tions for children; and 
‘‘(iii) provides benefits to all children 
in the State who apply for and meet eligi-
bility standards. 
‘‘(B) NO WAITING LIST IMPOSED.—With 
respect to children whose family income is at or 
below 200 percent of the poverty line, the State 
does not impose any numerical limitation, wait-
ing list, or similar limitation on the eligibility of 
such children for child health assistance under 
such State plan.
‘‘(C) NO MORE FAVORABLE TREATMENT.— 
The State child health plan may not provide 
more favorable coverage of dental services to 
the children covered under section 2110(b)(5) 
than to children otherwise covered under this 
title.’’. 
(C) STATE OPTION TO WAIVE WAITING PE-
RIOD.—Section 2102(b)(1)(B) of the Social Se-
curity Act (42 U.S.C. 1397bb(b)(1)(B)) is 
amended— 
(i) in clause (i), by striking ‘‘and’’ at 
the end; 
(ii) in clause (ii), by striking the pe-
riod and inserting ‘‘; and’’; and 
(iii) by adding at the end the fol-
lowing: 
‘‘(iii) at State option, may not apply 
a waiting period in the case of a child de-
scribed in section 2110(b)(5), if the State 
satisfies 
the 
requirements 
of 
section 
2105(c)(8).’’. 
(2) APPLICATION OF ENHANCED MATCH UNDER 
MEDICAID.—Section 1905 of the Social Security Act 
(42 U.S.C. 1396d) is amended—
(A) in subsection (b), in the fourth sen-
tence, by striking ‘‘or subsection (u)(3)’’ and 
inserting ‘‘(u)(3), or (u)(4)’’; and 
(B) in subsection (u)— 
(i) by redesignating paragraph (4) as 
paragraph (5); and 
(ii) by inserting after paragraph (3) 
the following: 
‘‘(4) For purposes of subsection (b), the ex-
penditures described in this paragraph are expendi-
tures for items and services for children described in 
section 2110(b)(5), but only in the case of a State 
that 
satisfies 
the 
requirements 
of 
section 
2105(c)(8).’’. 
(3) APPLICATION OF SECONDARY PAYOR PROVI-
SIONS.—Section 2107(e)(1) of the Social Security 
Act (42 U.S.C. 1397gg(e)(1)) is amended— 
(A) by redesignating subparagraphs (B) 
through (D) as subparagraphs (C) through (E), 
respectively; and 
(B) by inserting after subparagraph (A) 
the following: 
‘‘(B) Section 1902(a)(25) (relating to co-
ordination of benefits and secondary payor pro-
visions) with respect to children covered under 
a waiver described in section 2110(b)(5).’’. 
(b) EFFECTIVE DATE.—The amendments made by 
subsection (a) shall take effect on January 1, 2004, and 
shall apply to child health assistance and medical assist-
ance provided on or after that date. 
TITLE 
II—CORRECTING 
GME 
PAYMENTS 
FOR 
DENTAL 
RESIDENCY TRAINING PRO-
GRAMS 
SEC. 201. LIMITATION ON THE APPLICATION OF THE 1- 
YEAR LAG IN THE INDIRECT MEDICAL EDU-
CATION RATIO (IME) CHANGES AND THE 3- 
YEAR ROLLING AVERAGE FOR COUNTING IN-
TERNS AND RESIDENTS FOR IME AND DI-
RECT GRADUATE MEDICAL EDUCATION (D– 
GME) PAYMENTS UNDER THE MEDICARE 
PROGRAM. 
(a) IME RATIO AND ROLLING AVERAGE.—Section 
1886(d)(5)(B)(vi) of the Social Security Act (42 U.S.C. 
1395ww(d)(5)(B)(vi)) is amended by adding at the end 
the following new sentence: ‘‘For cost reporting periods 
beginning during fiscal years beginning on or after Octo-
ber 1, 2004, subclauses (I) and (II) shall be applied only 
with respect to a hospital’s approved medical residency
training program in the fields of allopathic medicine and 
osteopathic medicine.’’. 
(b) 
D–GME 
ROLLING
AVERAGE.—Section 
1886(h)(4)(G) of the Social Security Act (42 U.S.C. 
1395ww(h)(4)(G)) is amended by adding at the end the 
following new clause: 
‘‘(iv) APPLICATION FOR FY 2005 AND 
SUBSEQUENT YEARS.—For cost reporting 
periods beginning during fiscal years be-
ginning on or after October 1, 2004, 
clauses (i) through (iii) shall be applied 
only with respect to a hospital’s approved 
medical residency training program in the 
fields of allopathic medicine and osteo-
pathic medicine.’’.
TITLE 
III—IMPROVING 
DELIV-
ERY OF PEDIATRIC DENTAL 
SERVICES 
UNDER 
COMMU-
NITY HEALTH CENTERS, PUB-
LIC 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 DE-
PARTMENTS. 
Subpart I of part D of title III of the Public Health 
Service Act (42 U.S.C. 254b et seq.) is amended by insert 
before section 330, the following: 
‘‘SEC. 329. GRANT PROGRAM TO EXPAND THE AVAIL-
ABILITY OF SERVICES. 
‘‘(a) IN GENERAL.—The Secretary, acting through 
the Health Resources and Services Administration, shall 
establish a program under which the Secretary may award 
grants to eligible entities and eligible individuals to expand 
the availability of primary dental care services in dental 
health professional shortage areas or medically under-
served areas. 
‘‘(b) ELIGIBILITY.—
‘‘(1) ENTITIES.—To be eligible to receive a 
grant under this section an entity— 
‘‘(A) shall be— 
‘‘(i) a health center receiving funds 
under section 330 or designated as a Fed-
erally qualified health center; 
‘‘(ii) a county or local public health 
department, if located in a federally-des-
ignated dental health professional shortage 
area; 
‘‘(iii) an Indian tribe or tribal organi-
zation (as defined in section 4 of the In-
dian Self-Determination and Education 
Assistance Act (25 U.S.C. 450b)); 
‘‘(iv) a dental education program ac-
credited by the Commission on Dental Ac-
creditation; or 
‘‘(v) 
a 
community-based 
program 
whose child service population is made up 
of at least 33 percent of children who are 
eligible children, including at least 25 per-
cent of such children being children with 
mental retardation or related develop-
mental disabilities, unless specific docu-
mentation of a lack of need for access by 
this sub-population is established; and 
‘‘(B) shall prepare and submit to the Sec-
retary an application at such time, in such 
manner, and containing such information as the 
Secretary may require, including information 
concerning dental provider capacity to serve in-
dividuals with developmental disabilities. 
‘‘(2) INDIVIDUALS.—To be eligible to receive a 
grant under this section an individual shall— 
‘‘(A) be a dental health professional li-
censed or certified in accordance with the laws 
of State in which such individual provides den-
tal services; 
‘‘(B) prepare and submit to the Secretary 
an application at such time, in such manner, 
and containing such information as the Sec-
retary may require; and 
‘‘(C) provide assurances that— 
‘‘(i) the individual will practice in a 
federally-designated dental health profes-
sional shortage area; or 
‘‘(ii) not less than 25 percent of the 
patients of such individual are—
‘‘(I) receiving assistance under a 
State plan under title XIX of the So-
cial Security Act (42 U.S.C. 1396 et 
seq.); 
‘‘(II) receiving assistance under a 
State plan under title XXI of the So-
cial Security Act (42 U.S.C. 1397aa 
et seq.); or 
‘‘(III) uninsured. 
‘‘(c) USE OF FUNDS.— 
‘‘(1) ENTITIES.—An entity shall use amounts 
received under a grant under this section to provide 
for the increased availability of primary dental serv-
ices in the areas described in subsection (a). Such 
amounts may be used to supplement the salaries of-
fered for individuals accepting employment as den-
tists in such areas. 
‘‘(2) INDIVIDUALS.—A grant to an individual 
under subsection (a) shall be in the form of a 
$1,000 bonus payment for each month in which such 
individual is in compliance with the eligibility re-
quirements of subsection (b)(2)(C). 
‘‘(d) AUTHORIZATION OF APPROPRIATIONS.— 
‘‘(1) IN GENERAL.—Notwithstanding any other 
amounts appropriated under section 330 for health
centers, there is authorized to be appropriated 
$40,000,000 for each of fiscal years 2005 through 
2009 to hire and retain dental health care providers 
under this section. 
‘‘(2) USE OF FUNDS.—Of the amount appro-
priated for a fiscal year under paragraph (1), the 
Secretary shall use— 
‘‘(A) not less than 65 percent of such 
amount to make grants to eligible entities; and 
‘‘(B) not more than 35 percent of such 
amount to make grants to eligible individuals.’’. 
SEC. 302. DENTAL OFFICER MULTIYEAR RETENTION BONUS 
FOR THE INDIAN HEALTH SERVICE. 
(a) TERMS AND DEFINITIONS.—In this section: 
(1) CREDITABLE
SERVICE.—The term ‘‘cred-
itable service’’ includes all periods that a dental offi-
cer spent in graduate dental educational (GDE) 
training programs while not on active duty in the In-
dian Health Service and all periods of active duty in 
the Indian Health Service as a dental officer. 
(2) DENTAL OFFICER.—The term ‘‘dental offi-
cer’’ means an officer of the Indian Health Service 
designated as a dental officer. 
(3) DIRECTOR.—The term ‘‘Director’’ means 
the Director of the Indian Health Service.
(4) RESIDENCY.—The term ‘‘residency’’ means 
a graduate dental educational (GDE) training pro-
gram of at least 12 months leading to a specialty, 
including general practice residency (GPR) or an ad-
vanced education general dentistry (AEGD). 
(5) SPECIALTY.—The term ‘‘specialty’’ means a 
dental specialty for which there is an Indian Health 
Service specialty code number. 
(b) REQUIREMENTS FOR BONUS.— 
(1) IN GENERAL.—An eligible dental officer of 
the Indian Health Service who executes a written 
agreement to remain on active duty for 2, 3, or 4 
years after the completion of any other active duty 
service commitment to the Indian Health Service 
may, upon acceptance of the written agreement by 
the Director, be authorized to receive a dental officer 
multiyear retention bonus under this section. The 
Director may, based on requirements of the Indian 
Health Service, decline to offer such a retention 
bonus to any specialty that is otherwise eligible, or 
to restrict the length of such a retention bonus con-
tract for a specialty to less than 4 years. 
(2) LIMITATIONS.—Each annual dental officer 
multiyear retention bonus authorized under this sec-
tion shall not exceed the following:
(A) $14,000 for a 4-year written agree-
ment. 
(B) $8,000 for a 3-year written agreement. 
(C) $4,000 for a 2-year written agreement. 
(c) ELIGIBILITY.— 
(1) IN GENERAL.—In order to be eligible to re-
ceive a dental officer multiyear retention bonus 
under this section, a dental officer shall— 
(A) be at or below such grade as the Di-
rector shall determine; 
(B) have completed any active duty service 
commitment of the Indian Health Service in-
curred for dental education and training or 
have 8 years of creditable service; 
(C) have completed initial residency train-
ing, or be scheduled to complete initial resi-
dency training before September 30 of the fiscal 
year in which the officer enters into a dental of-
ficer multiyear retention bonus written service 
agreement under this section; and 
(D) have a dental specialty in pediatric 
dentistry or oral and maxillofacial surgery. 
(2) EXTENSION TO OTHER OFFICERS.—The Di-
rector may extend the retention bonus to dental offi-
cers other than officers with a dental specialty in pe-
diatric dentistry, as well as to other dental hygien-
ists with a minimum of a baccalaureate degree, 
based on demonstrated need. 
(d) TERMINATION
OF ENTITLEMENT
TO SPECIAL 
PAY.—The Director may terminate, with cause, at any 
time a dental officer’s multiyear retention bonus contract 
under this section. If such a contract is terminated, the 
unserved portion of the retention bonus contract shall be 
recouped on a pro rata basis. The Director shall establish 
regulations that specify the conditions and procedures 
under which termination may take place. The regulations 
and conditions for termination shall be included in the 
written service contract for a dental officer multiyear re-
tention bonus under this section. 
(e) REFUNDS.— 
(1) IN GENERAL.—Prorated refunds shall be re-
quired for sums paid under a retention bonus con-
tract under this section if a dental officer who has 
received the retention bonus fails to complete the 
total period of service specified in the contract, as 
conditions and circumstances warrant. 
(2) DEBT TO UNITED STATES.—An obligation 
to reimburse the United States imposed under para-
graph (1) is a debt owed to the United States.
(3) NO DISCHARGE IN BANKRUPTCY.—Notwith-
standing any other provision of law, a discharge in 
bankruptcy under title 11, United States Code, that 
is entered less than 5 years after the termination of 
a retention bonus contract under this section does 
not discharge the dental officer who signed such a 
contract from a debt arising under the contract or 
under paragraph (1). 
SEC. 303. DEMONSTRATION PROJECTS TO INCREASE AC-
CESS TO PEDIATRIC DENTAL SERVICES IN 
UNDERSERVED AREAS. 
(a) AUTHORITY TO CONDUCT PROJECTS.—The Sec-
retary of Health and Human Services, through the Admin-
istrator of the Health Resources and Services Administra-
tion and the Director of the Indian Health Service, shall 
establish demonstration projects that are designed to in-
crease access to dental services for children in underserved 
areas, as determined by the Secretary. 
(b) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated such sums as may be nec-
essary to carry out this section. 
SEC. 304. TECHNICAL CORRECTION. 
Section 340G(b)(1)(B) of the Public Health Service 
Act (42 U.S.C. 256g(b)(1)(B)) is amended by striking 
‘‘and’’ at the end and inserting ‘‘or’’.
TITLE 
IV—IMPROVING 
ORAL 
HEALTH 
PROMOTION 
AND 
DISEASE PREVENTION PRO-
GRAMS 
SEC. 401. ORAL HEALTH INITIATIVE. 
(a) ESTABLISHMENT.—The Secretary of Health and 
Human Services shall establish an oral health initiative 
to reduce the profound disparities in oral health by im-
proving the health status of vulnerable populations, par-
ticularly low-income children and children with develop-
mental disabilities, to the level of health status that is en-
joyed by the majority of Americans. 
(b) ACTIVITIES.—The Secretary of Health and 
Human Services shall, through the oral health initiative— 
(1) carry out activities to improve intra- and 
inter-agency collaborations, including activities to 
identify, engage, and encourage existing Federal and 
State programs to maximize their potential to ad-
dress oral health; 
(2) carry out activities to encourage public-pri-
vate partnerships to engage private sector commu-
nities of interest (including health professionals, 
educators, State policymakers, foundations, business, 
and the public) in partnerships that promote oral 
health and dental care;
(3) carry out activities to reduce the disease 
burden in high risk populations through the applica-
tion of best-science in oral health, including pro-
grams such as community water fluoridation and 
dental sealants; and 
(4) carry out activities to improve the oral 
health literacy of the public through school-based 
education programs. 
(c) COORDINATION.—The Secretary of Health and 
Human Services shall— 
(1) through the Administrator of the Centers 
for Medicare & Medicaid Services, establish the 
Chief Dental Officer for the medicaid and State chil-
dren’s health insurance programs established under 
titles XIX and XXI, respectively, of the Social Secu-
rity Act (42 U.S.C. 1396 et seq. 1397aa et seq.); 
(2) through the Administrator of the Health 
Resources and Services Administration, establish the 
Chief Dental Office for all oral health programs 
within the Health Resources and Services Adminis-
tration; 
(3) through the Director of the Centers for Dis-
ease Control and Prevention, establish the Chief 
Dental Officer for all oral health programs within 
such Centers; and
(4) carry out this section in collaboration with 
the Administrators and Chief Dental Officers de-
scribed in paragraphs (1), (2), and (3). 
(d) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section, 
$25,000,000 for fiscal year 2005, and such sums as may 
be necessary for each subsequent fiscal year. 
SEC. 402. CDC REPORTS. 
(a) COLLECTION
OF DATA.—The Director of the 
Centers for Disease Control and Prevention, in collabora-
tion with other organizations and agencies, shall collect 
data through State-based oral health surveillance systems 
describing the dental, craniofacial, and oral health of resi-
dents of all 50 States and certain Indian tribes. 
(b) REPORTS.—The Director of the Centers for Dis-
ease Control and Prevention shall compile and analyze 
data collection under subsection (a) and annually prepare 
and submit to the appropriate committees of Congress a 
report concerning the oral health of States and Indian 
tribes. 
SEC. 403. EARLY CHILDHOOD CARIES. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Director of the Cen-
ters for Disease Control and Prevention, shall—
(1) expand existing surveillance activities to in-
clude the identification of children at high risk of 
early childhood caries, including sub-populations 
such as children with developmental disabilities; 
(2) assist State, local, and tribal health agen-
cies and departments in collecting, analyzing and 
disseminating data on early childhood caries; and 
(3) provide for the development of public health 
nursing programs and public health education pro-
grams on early childhood caries prevention. 
(b) APPROPRIATENESS
OF ACTIVITIES.—The Sec-
retary of Health and Human Services shall carry out pro-
grams and activities under subsection (a) in a culturally 
appropriate manner with respect to populations at risk of 
early childhood caries. 
(c) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section, 
such sums as may be necessary for each fiscal year. 
SEC. 404. SCHOOL-BASED DENTAL SEALANT PROGRAM. 
Section 317M(c) of the Public Health Service Act (as 
added by section 1602 of Public Law 106–310) is amend-
ed— 
(1) in paragraph (1), by inserting ‘‘and school- 
linked’’ after ‘‘school-based’’; 
(2) in the first sentence of paragraph (2)—
(A) by inserting ‘‘and school-linked’’ after 
‘‘school-based’’; and 
(B) by inserting ‘‘or Indian tribe’’ after 
‘‘State’’; and 
(3) by striking paragraph (3) and inserting the 
following: 
‘‘(3) ELIGIBILITY.—To be eligible to receive 
funds under paragraph (1), an entity shall— 
‘‘(A) prepare and submit to the State or 
Indian tribe an application at such time, in 
such manner and containing such information 
as the State or Indian tribe may require; and 
‘‘(B) be a— 
‘‘(i) public elementary or secondary 
school— 
‘‘(I) that is located in an urban 
area in which more than 50 percent of 
the student population is participating 
in Federal or State free or reduced 
meal programs; or 
‘‘(II) that is located in a rural 
area and, with respect to the school 
district in which the school is located, 
the district involved has a median in-
come that is at or below 235 percent
of the poverty line, as defined in sec-
tion 673(2) of the Community Serv-
ices Block Grant Act (42 U.S.C. 
9902(2)); or 
‘‘(ii) public or non-profit organization, 
including a grantee under section 330 and 
urban Indian clinics under title V of the 
Indian Health Care Improvement Act, that 
is under contract with an elementary or 
secondary school described in subpara-
graph (B) to provide dental services to 
school-age children.’’. 
SEC. 405. BASIC ORAL HEALTH PROMOTION. 
(a) IN GENERAL.—The Secretary of Health and 
Human Services, acting through the Director of the Cen-
ters for Disease Control and Prevention and in consulta-
tion with dental organizations (including organizations 
having expertise in the prevention and treatment of oral 
disease in underserved pediatric populations), shall award 
grants to States and Indian tribes to improve the basic 
capacity of such States and tribes to improve the oral 
health of children and their families. 
(b) REQUIREMENTS.—A State or Indian tribe shall 
use amounts received under a grant under this section to 
conduct one or more of the following activities:
(1) Establish an oral health plan, policies, effec-
tive prevention programs, and accountability meas-
ures and systems. 
(2) Establish and guide coalitions, partnerships, 
and alliances to accomplish the establishment of the 
plan, policies, programs and systems under para-
graph (1). 
(3) Monitor changes in oral disease burden, dis-
parities, and the utilization of preventive services by 
high-risk populations. 
(4) Identify, test, establish, support, and evalu-
ate prevention interventions to reduce oral health 
disparities. 
(5) Promote public awareness and education in 
support of improvements of oral health. 
(6) Support training programs for dental and 
other health professions needed to strengthen oral 
health prevention programs. 
(7) Establish, enhance, or expand oral disease 
prevention and disparity reduction programs. 
(8) Evaluate the progress and effectiveness of 
the State’s oral disease prevention and disparity re-
duction program. 
(c) AUTHORIZATION OF APPROPRIATIONS.—There is 
authorized to be appropriated to carry out this section,