S.Amdt. 6373

1. Adds Subtitle H--Improvement of Health Care for Veterans With Chronic Conditions SEC. 1081. SHORT TITLE at the end of title X

   Adds a section

   In S.Amdt. 5499 as proposed

   (2) as a recognition of Senator Inhofe's long history of engaging with, and advocating for, Africa, the Department of Defense Africa Center for Strategic Studies should be renamed the James M. Inhofe Center for Africa Strategic Studies.

   Inserted: Subtitle H--Improvement of Health Care for Veterans With Chronic Conditions SEC. 1081. SHORT TITLE.

   Inserted: This subtitle may be cited as the "Improving Whole Health for Veterans with Chronic Conditions Act".

   Inserted: SEC. 1082. EXPANSION OF DENTAL CARE FURNISHED BY DEPARTMENT OF VETERANS AFFAIRS TO INCLUDE VETERANS DIAGNOSED WITH DIABETES AND HEART DISEASE.

   Inserted: (a) Expansion of Care.--

   Inserted: (1) In general.--Subsection (a)(1) of section 1712 of title 38, United States Code, is amended--

   Inserted: (A) in subparagraph (B)--

   Inserted: (i) by redesignating clauses (i) through (iv) as subclauses (I) through (IV), respectively, and moving those subclauses, as so redesignated, two ems to the right; and

   Inserted: (ii) in subclause (III), as redesignated by clause (i)--

   Inserted: (I) by striking "(I)" and inserting "(aa)"; and

   Inserted: (II) by striking "(II)" and inserting "(bb)";

   Inserted: (B) by redesignating subparagraphs (A) through (H) as clauses (i) through (viii), respectively, and moving those clauses, as so redesignated, two ems to the right;

   Inserted: (C) in the matter preceding clause (i), as redesignated by subparagraph (B), by striking "only for a dental condition or disability" and inserting "only--

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   Inserted: "(A) for a dental condition or disability";

   Inserted: (D) in clause (viii), as redesignated by subparagraph (B), by striking the period at the end and inserting "or"; and

   Inserted: (E) by adding at the end the following new subparagraph (B):

   Inserted: "(B) to any veteran enrolled in the system of annual patient enrollment under section 1705 of this title with a diagnosis of--

   Inserted: "(i) type 1 or type 2 diabetes; or

   Inserted: "(ii) ischemic heart disease.".

   Inserted: (2) Conforming amendments.--

   Inserted: (A) In general.--Such section is further amended--

   Inserted: (i) in subsection (a)(2), by striking "clause (B) of paragraph (1) of this subsection" and inserting "clause (ii) of paragraph (1)(A)"; and

   Inserted: (ii) in subsection (b), by striking "paragraph (1)(B) of subsection (a)" and inserting "subsection (a)(1)(A)(ii)".

   Inserted: (B) Medical care.--Section 1710(c) of such title is amended by striking "section 1712(a)" and inserting "section 1712(a)(1)(A)".

   Inserted: (C) Dental care for homeless veterans.--Section 2062(a) of such title is amended, in the matter preceding paragraph (1), by striking "section 1712(a)(1)(H)" and inserting "section 1712(a)(1)(A)(viii)".

   Inserted: (b) Administration of Expansion.--

   Inserted: (1) Voluntary participation.--The receipt by a covered veteran of covered care shall be at the election of the veteran.

   Inserted: (2) Scope of services.--The covered care furnished to a covered veteran shall be consistent with the dental services and treatment, and related dental appliances, furnished by the Secretary of Veterans Affairs to veterans with service-connected disabilities rated 100 percent disabling under the laws administered by the Secretary.

   Inserted: (3) Considerations.--In furnishing covered care to covered veterans, the Secretary shall test the efficacy of the use of the following:

   Inserted: (A) Mobile dental clinics to service rural areas that do not have a population base to warrant a full-time clinic but where there are covered veterans in need of dental care.

   Inserted: (B) Portable dental care units to service rural veterans in their homes, as the Secretary considers medically appropriate.

   Inserted: (C) Dental therapists and teledentistry to service the dental care needs of covered veterans.

   Inserted: (4) Notice to covered veterans.--The Secretary shall inform all covered veterans of the covered care available to such veterans.

   Inserted: (5) Contracts.--

   Inserted: (A) In general.--Subject to subparagraph (C), the Secretary may enter into contracts with appropriate entities for the provision of covered care to covered veterans.

   Inserted: (B) Performance standards and metrics.--Each contract entered into under subparagraph (A) shall specify performance standards and metrics and processes for ensuring compliance of the contractor concerned with such performance standards.

   Inserted: (C) Limitation.--The Secretary may only enter into contracts under subparagraph (A) if the Secretary determines that the Department of Veterans Affairs does not employ, and cannot recruit and retain, qualified dentists, dental hygienists, and oral surgeons in the applicable location.

   Inserted: (c) Report.--

   Inserted: (1) In general.--Not later than two years after the date of the enactment of this Act, the Secretary of Veterans Affairs shall submit to the Committee on Veterans' Affairs of the Senate and the Committee on Veterans' Affairs of the House of Representatives a report on the expansion of the provision of dental care pursuant to subsection (a).

   Inserted: (2) Contents.--The report under paragraph (1) shall include the following:

   Inserted: (A) A description of the implementation and operation of the expansion of the provision of dental care pursuant to subsection (a).

   Inserted: (B) The number of covered veterans receiving dental care pursuant to such expansion and a description of the dental care furnished to such veterans.

   Inserted: (C) An analysis of the costs and benefits of such expansion, including a comparison of costs and benefits by location type.

   Inserted: (D) An assessment of the impact of such expansion on the health of covered veterans, including--

   Inserted: (i) an assessment of the veterans' diabetes or ischemic heart disease;

   Inserted: (ii) an assessment of appointments for care, prescriptions, hospitalizations, emergency room visits, wellness, employability, and satisfaction of such veterans; and

   Inserted: (iii) an assessment of the perceived quality of life of such veterans.

   Inserted: (E) An analysis and assessment of the efficacy of mobile clinics and home-based dental care to service the dental needs of covered veterans, to include a cost-benefit analysis of such services.

   Inserted: (F) An analysis and assessment of the efficacy of dental therapists and teledentistry to service the dental needs of covered veterans, to include a cost benefit analysis of such services.

   Inserted: (G) The findings and conclusions of the Secretary with respect to health care outcomes for covered veterans.

   Inserted: (H) A comparison of the costs for private sector dental care with cost of furnishing dental care from the Department, broken down by each locality.

   Inserted: (I) Such recommendations for the expansion of dental care to non-covered veterans with diagnoses that may be affected by poor oral health.

   Inserted: (d) Definitions.--In this section:

   Inserted: (1) Covered care.--The term "covered care" means outpatient dental services and treatment, and related dental appliances, furnished pursuant to section 1712(a)(1)(B) of title 38, United States Code, as amended by subsection (a)(1)(E).

   Inserted: (2) Covered veteran.--The term "covered veteran" means a veteran described in section 1712(a)(1)(B) of title 38, United States Code, as amended by subsection (a)(1)(E).

   Inserted: (e) Effective Date.--This section and the amendments made by this section shall take effect on the date that is one year after the date of the enactment of this Act.

   Inserted: SEC. 1083. STUDENT LOAN REPAYMENT PROGRAM TO INCENTIVIZE DENTAL TRAINING AND ENSURE THE DENTAL WORKFORCE OF THE DEPARTMENT OF VETERANS AFFAIRS.

   Inserted: (a) Program Required.--The Secretary of Veterans Affairs, to ensure that the Department of Veterans Affairs has sufficient staff to provide dental service to veterans, shall implement a loan reimbursement program for qualified dentists, dental therapists, dental hygienists, and oral surgeons who agree--

   Inserted: (1) to be appointed by the Secretary as a dentist, dental therapist, dental hygienist, or oral surgeon, as the case may be, under section 7401 of title 38, United States Code; and

   Inserted: (2) to serve as a dentist, dental therapist, dental hygienist, or oral surgeon, as the case may be, of the Department pursuant to such appointment at a dental clinic of the Department for a period of not less than five years.

   Inserted: (b) Maximum Amount.--

   Inserted: (1) In general.--Except as provided in paragraph (2), the Secretary may reimburse not more than--

   Inserted: (A) $75,000 for each dentist participating in the program under subsection (a);

   Inserted: (B) $20,000 for each dental therapist participating in such program;

   Inserted: (C) $10,000 for each dental hygienist participating in such program; and

   Inserted: (D) $20,000 for each credentialed doctor of medicine in dentistry serving as an oral surgeon and participating in such program.

   Inserted: (2) Dual eligibility.--The Secretary may reimburse an individual serving in multiple positions described in subparagraphs (A) through (D) of paragraph (1) not more than $95,000.

   Inserted: (c) Selection of Locations.--The Secretary shall monitor demand among veterans for dental care and require participants in the program under subsection (a) to choose from dental clinics of the Department with the greatest need for dentists, dental therapists, dental hygienists, or oral surgeons, as the case may be, according to facility enrollment and patient demand.

   Inserted: SEC. 1084. EDUCATIONAL AND TRAINING PARTNERSHIPS FOR DENTISTS, DENTAL THERAPISTS, DENTAL HYGIENISTS, AND ORAL SURGEONS.

   Inserted: The Secretary of Veterans Affairs shall enter into educational and training partnerships with dental schools to provide training and employment opportunities for dentists, dental therapists, dental hygienists, and oral surgeons.

   Inserted: SEC. 1085. AUTHORIZATION OF APPROPRIATIONS.

   Inserted: There is authorized to be appropriated for the Department of Veterans Affairs for fiscal year 2023 such sums as may be necessary to carry out this subtitle and the amendments made by this subtitle.

   Original wording

   At the end of title X, add the following:

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As printed