,,ii  #aacth ,,congress  #ast ,session  
,s4 #aehf  ,,in ,,the ,,senate ,,of     
,,the ,,united ,,states  ,october #bh1  
#bjac,mr4 ,sanders introduced the       
following bill2 which was read twice and
 referred to the ,committee on          
,veterans' ,affairs  ,a ,,bill  ,to     
amend title #ch1 ,united ,states ,code1 
to improve dental health care for       
veterans1 and for other purposes4  #a4  
,short title ,this ,act may be cited as 
the ,enhanced ,dental ,care for         
,veterans ,act of #bjac4  #b4           
,restorative dental services for        
veterans ,section #agaj7;c7 of title    
#ch1 ,united ,states ,code1 is amended--
 7#a7 in the second sentence-- 7,a7 by  
redesignating subparagraphs 7,a7 and    
7,b7 as clauses 7i7 and 7ii71           
respectively2 and  7,b7 by redesignating
 paragraphs 7#a7 and 7#b7 as            
subparagraphs 7,a7 and 7,b71            
respectively2  7#b7 by inserting 7#a7   
after 7c72  7#c7 by striking ,the       
,secretary and inserting the following3 

7#b7 ,the ,secretary  2 and  7#d7 by    
adding at the end the following new     
paragraph3  7#c7 ,in addition to the    
dental services1 treatment1 and         
appliances authorized to be furnished by
 paragraph 7#b71 the ,secretary may     
furnish dental services and treatment1  
and dental appliances1 needed to restore
 functioning in a veteran that is lost  
as a result of any services or treatment
 furnished under this subsection4  4    
#c4 ,pilot program on expansion of      
furnishing of dental care to all        
enrolled veterans  7a7 ,pilot program   
required ,commencing not later than #ahj
 days after the date of the enactment of
 this ,act1 the ,secretary of ,veterans 
,affairs shall carry out a pilot program
 to assess the feasibility and          
advisability of furnishing dental care  
to veterans enrolled in the system of   
patient enrollment under section #agje  
of title #ch1 ,united ,states ,code1 who
 are not eligible for dental services   
and treatment1 and related dental       

appliances1 under current authorities4  
7b7 ,duration of pilot program ,the     
pilot program shall be carried out      
during the three-year period beginning  
on the date of the commencement of the  
pilot program4  7c7 ,locations  7#a7 ,in
 general ,the ,secretary shall carry out
 the pilot program at not fewer than #af
 locations as follows3 7,a7 ,four       
,department of ,veterans ,affairs       
medical centers with an established     
dental clinic4  7,b7 ,four ,department  
medical centers with a current contract 
for the furnishing of dental care4  7,c7
 ,four ,community-,based ,outpatient    
,clinics 7,c,b,o,cs7 with space         
available for the furnishing of services
 and treatment under the pilot program4 
7,d7 ,four facilities selected from     
among ,federally ,qualified ,health     
,centers 7,f,q,h,cs7 and ,indian ,health
 ,service facilities with established   
dental clinics1 of which-- 7i7 at least 
one facility shall be such an ,indian   
,health ,service facility2 and  7ii7 any

 ,indian ,health ,service facility so   
selected shall be selected in           
consultation with the ,secretary of     
,health and ,human ,services4  7#b7     
,considerations ,in selecting locations 
for the pilot program1 the ,secretary   
shall consider the feasibility and      
advisability of selecting locations in  
each of the following3 7,a7 ,rural      
areas4  7,b7 ,areas that are not in     
close proximity to an active duty       
military installation4  7,c7 ,areas     
representing different geographic       
locations1 such as census tracts        
established by the ,bureau of ,census4  
7d7 ,scope of services ,the dental      
services and treatment furnished to     
veterans under the pilot program shall  
be consistent with the dental services  
and treatment furnished by the          
,secretary to veterans with             
service-connected disabilities rated    
#ajj percent disabling under the laws   
administered by the ,secretary4  7e7    
,voluntary participation ,the           

participation of a veteran in the pilot 
program shall be at the election of the 
veteran4  7f7 ,limitation on amount of  
services  7#a7 ,in general ,except as   
provided in paragraph 7#c71 the total   
amount the ,secretary may expend        
furnishing dental services and treatment
 to any veteran participating in the    
pilot program during any one-year period
 may not exceed such amount as the      
,secretary determines appropriate4 ,the 
amount so determined may not be less    
than #a1jjj4  7#b7 ,consultation ,the   
,secretary shall make the determination 
under paragraph 7#a7-- 7,a7 in          
consultation with the ,director of the  
,indian ,health ,service2 and  7,b7 in  
consultation with the ,director of the  
,centers for ,medicare and ,medicaid    
,services if one or more ,federally     
,qualified ,health ,centers is selected 
as a location for the pilot program     
under subsection 7c77#a77;,d74  7#c7    
,services in excess of limitation amount
 ,the total amount expended by the      

,secretary in furnishing dental services
 and treatment to a particular veteran  
participating in the pilot program      
during a one-year period may exceed the 
amount determined under paragraph 7#a7  
if the ,secretary determines1 before    
furnishing such services and treatment1 
based on an examination of the veteran  
by a dentist participating in the pilot 
program that the furnishing of such     
services and treatment is necessary4    
,any determination under this paragraph 
shall be made on a case-by-case basis4  
7g7 ,copayments ,the ,secretary may     
collect copayments for dental services  
and treatment furnished under the pilot 
program in accordance with authorities  
on the collection of copayments for     
medical care of veterans under chapter  
#ag of title #ch1 ,united ,states ,code4
  7h7 ,program administration  7#a7     
,notice to covered veterans on pilot    
program ,in carrying out the pilot      
program1 the ,secretary shall inform all
 veterans eligible to participate in the

 pilot program of the services and      
treatment available under the pilot     
program4  7#b7 ,contracts ,in carrying  
out the pilot program1 the ,secretary   
may enter into contracts with           
appropriate entities for the provision  
of dental services and treatment under  
the pilot program4 ,each such contract  
shall specify performance standards and 
metrics and processes for ensuring      
compliance of the contractor concerned  
with such performance standards4  7i7   
,reports  7#a7 ,preliminary reports     
7,a7 ,in general ,not later than each of
 one year and three years after the date
 of the commencement of the pilot       
program1 the ,secretary 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 pilot  
program4  7,b7 ,contents ,each report   
under subparagraph 7,a7 shall include   
the following3 7i7 ,a description of the
 implementation and operation of the    

pilot program4  7ii7 ,the number of     
veterans receiving services and         
treatment under the pilot program1 and a
 description of the dental services and 
treatment furnished to such veterans4   
7iii7 ,an analysis of the costs and     
benefits of the pilot program1 including
 a comparison of costs and benefits by  
location type4  7iv7 ,the current       
findings and conclusions of the         
,secretary with respect to the pilot    
program4  7v7 ,such recommendations for 
the continuation or expansion of the    
pilot program as the ,secretary         
considers appropriate4  7#b7 ,final     
report  7,a7 ,in general ,not later than
 #ahj days after the completion of the  
pilot program1 the ,secretary 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 pilot program4  7,b7 ,contents ,the 
report under subparagraph 7,a7 shall    
include the following3 7i7 ,the findings

 and conclusions of the ,secretary with 
respect to the pilot program4  7ii7     
,such recommendations for the           
continuation or expansion of the pilot  
program as the ,secretary considers     
appropriate4  #d4 ,program on education 
to promote dental health in veterans    
7a7 ,program required  7#a7 ,in general 
,the ,secretary of ,veterans ,affairs   
shall carry out a program of education  
to promote dental health for veterans   
who are enrolled in the system of       
patient enrollment of the ,department of
 ,veterans ,affairs under section #agje 
of title #ch1 ,united ,states ,code4    
7#b7 ,construction ,nothing in the      
program shall be deemed to alter or     
revise the eligibility of any veteran   
for dental care under the laws          
administered by the ,secretary4  7b7    
,elements ,the program required by      
subsection 7a7 shall provide education  
for veterans on the following3 7#a7 ,the
 association between dental health and  
overall health and well-being4  7#b7    

,proper techniques for dental care4     
7#c7 ,signs and symptoms of commonly    
occurring dental issues1 including      
caries4  7#d7 ,treatment options for    
commonly occurring dental issues4  7#e7 
,options for obtaining access to dental 
care1 including information on          
eligibility for dental care through the 
,department and on purchasing private   
dental insurance4  7#f7 ,options for    
obtaining low or no-cost dental care1   
including through dental schools and    
,federally ,qualified ,health ,centers4 
7#g7 ,such other matters relating to    
dental health as the ,secretary         
considers appropriate4  7c7 ,delivery of
 educational materials  7#a7 ,in general
 ,the ,secretary shall provide          
educational materials to veterans under 
the program required by subsection 7a7  
through a variety of mechanisms1        
including the following3 7,a7 ,the      
availability and distribution of print  
materials at ,department facilities1    
including medical centers1 clinics1 ,vet

 ,centers1 and readjustment counseling  
centers4  7,b7 ,the availability and    
distribution of materials over the      
,internet1 including through webinars   
and ,my ,healthe,vet4  7,c7             
,presentations of information1 including
 both small group and large group       
presentations4  7#b7 ,selection of      
mechanisms ,in selecting mechanisms for 
purposes of this subsection1 the        
,secretary shall select mechanisms      
designed to maximize the number of      
veterans who receive education under the
 program4  #e4 ,information on dental   
services for inclusion in electronic    
medical records under dental insurance  
pilot program  7a7 ,in general          
,commencing not later than #ahj days    
after the date of the enactment of this 
,act1 the ,secretary of ,veterans       
,affairs shall expand the dental        
insurance pilot program established by  
section #ag4afi of title #ch1 ,code of  
,federal ,regulations1 to establish a   
mechanism by which private sector dental

 care providers may forward to the      
,department of ,veterans ,affairs       
information on dental care furnished to 
individuals under the pilot program for 
inclusion in the electronic medical     
records of the ,department with respect 
to such individuals4  7b7 ,construction 
with current pilot program requirements 
7#a7 ,in general ,nothing in this       
section shall be construed to revise    
eligibility for participation in1 or the
 locations of1 the pilot program        
referred to in subsection 7a74  7#b7    
,duration ,the ,secretary may continue  
the pilot program for two years in      
addition to the duration otherwise      
provided for the pilot program in       
section #ag4afi of title #ch1 ,code of  
,federal ,regulations1 if the ,secretary
 determines that the continuation is    
needed to assess the mechanism required 
by subsection 7a74  7#c7 ,voluntary     
participation in mechanism ,the         
participation in the mechanism required 
by subsection 7a7 of an individual      

otherwise participating in the pilot    
program shall be at the election of the 
individual4  7c7 ,inclusion of          
information on mechanism in reports     
,each report to ,congress on the pilot  
program after the date of the           
commencement of the mechanism required  
by subsection 7a7 shall include         
information on the mechanism1 including 
a current assessment of the feasibility 
and advisability of using the mechanism 
to include information on dental care   
furnished to individuals in the         
electronic medical records of the       
,department with respect to such        
individuals4