,,ii  #aag? ,,congress  #a/ ,session    
,s4 #cjag  ,,9 ,,! ,,s5ate ,,( ,,!      
,,unit$ ,,/ates  ,octob] #bj1 #bjba,mr4 
,s&]s 7= himself1 ,mr4 ,blum5?al1 ,mr4  
,m55dez1 ,mrs4 ,gillibr&1 ,mr4 ,book]1 &
 ,ms4 ,hirono7 introduc$ ! foll[+ bill2 
:i* 0 read twice & ref]r$ to !          
,committee on ,vet]ans' ,affairs  ,a    
,,bill  ,to exp& ! provision &          
availability ( d5tal c>e furni%$ by !   
,dep>tm5t ( ,vet]ans ,affairs1 & = o!r  
purposes4  #a4 ,%ort title ,?is ,act may
 be cit$ z ! ,vet]ans ,d5tal ,c>e       
,eligibility ,expansion & ,enhancem5t   
,act4  #b4 ,s5se ( ,congress ,x is !    
s5se ( ,congress t-- 7#a7 ! ,dep>tm5t ( 
,vet]ans ,affairs has pione]$ a :ole    
heal? approa* to heal? c>e1 :i* br\ght  
m5tal heal? & suicide prev5tion "u !    
umbrella ( prim>y c>e & integrat$ heal?1
 provides access to alt]native m$ic9es1 
deliv]s a holi/ic approa* to heal? &    
well-be+1 & repeat$ly demon/rates bett] 
heal? outcomes ?an ! private sector at a
 l[ co/ to taxpay]s 9 ! ,unit$ ,/ates2  

7#b7 ! effects ( poor d5tal c>e are se5 
9 pati5ts :o are at risk ( or diagnos$ )
 diabetes1 c>diovascul> disease1        
pulmon>y conditions1 kidney impairm5t1 &
 ev5 dem5tia2  7#c7 ! ,dep>tm5t sp5ds   
c\ntless doll>s on prescription drugs1  
community c>e1 urg5t c>e1 & em]g5cy room
 visits on prev5table ailm5ts t w\ld be 
r$uc$ or elim9at$ ?r\gh prev5tative     
d5tal c>e2 &  7#d7 9 ord] to be/ a*ieve 
a :ole heal? model = ! provision ( heal?
 c>e to vet]ans & r$uce long-t]m co/s1 !
 ,dep>tm5t mu/ furni% vet]ans )         
prev5tative & compreh5sive d5tal c>e4   
#c4 ,requirem5t t ,secret>y ( ,vet]ans  
,affairs furni% d5tal c>e 9 ! same mann]
 z any o!r m$ical s]vice  7a7 ,9 g5]al  
,title #ch1 ,unit$ ,/ates ,code1 is     
am5d$-- 7#a7 9 section #agja7f77;,b71 by
 /rik+ z describ$ 9 sections #agaj &    
#agab ( ?is title2  7#b7 9 section      
#agaj7;c71 by /rik+ ! second s5t5ce2 &  
7#c7 9 section #agab-- 7,a7 by /rik+    
subsections 7a7 & 7b72  7,b7 by         
r$esignat+ subsections 7c71 7d71 & 7e7 z

 subsections 7a71 7b71 & 7c71           
respectively2 &  7,c7 9 subsection 7a71 
z r$esignat$ by subp>agraph 7,b7-- 7i7  
by /rik+ ,d5tal appliances & ins]t+ ,!  
,secret>y may furni% d5tures1 d5tal     
appliances2 &  7ii7 by /rik+ to be      
furni%$ by ! ,secret>y "u ?is section   
may be procur$ by ! ,secret>y & ins]t+  
"u ?is section & may procure su*        
appliances4  7b7 ,con=m+ & cl]ical      
am5dm5ts  7#a7 ,con=m+ am5dm5ts  7,a7   
,protection ( heal? c>e eligibility     
,section #aebe7;a7 ( su* title is am5d$ 
by /rik+ m$ic9es "u section #agab7;d7 & 
ins]t+ m$ic9es "u section #agab7;b74    
7,b7 ,d5tal insurance plan ,section     
#agab;,c7h7 ( su* title is am5d$-- 7i7  
by /rik+ section #agab ( ?is title &    
ins]t+ ?is *apt]2 &  7ii7 by /rik+ su*  
section #agab & ins]t+ ?is *apt]4  7#b7 
,head+ am5dm5t ,! head+ = section #agab 
( su* title is am5d$ to read z foll[s3  
#agab4 ,appliances2 drugs & m$ic9es =   
c]ta9 disabl$ vet]ans2 vacc9es  4  7#c7 
,cl]ical am5dm5t ,! table ( sections at 

! beg9n+ ( sub*apt] ,,ii ( *apt] #ag (  
su* title is am5d$ by /rik+ ! item      
relat+ to section #agab & ins]t+ !      
foll[+ new item3  #agab4 ,appliances2   
drugs & m$ic9es = c]ta9 disabl$ vet]ans2
 vacc9es4  4  7c7 ,effective date ,!    
am5dm5ts made by ?is section %all take  
effect on ! date t is "o ye> aft] ! date
 ( ! enactm5t ( ?is ,act4  #d4          
,expansion ( furni%+ by ,dep>tm5t (     
,vet]ans ,affairs ( d5tal c>e to all    
enroll$ vet]ans  7a7 ,9 g5]al ,!        
,secret>y ( ,vet]ans ,affairs %all      
furni% d5tal c>e to all vet]ans enroll$ 
9 ! sy/em ( annual pati5t enrollm5t ( ! 
,dep>tm5t ( ,vet]ans ,affairs e/abli%$ &
 op]at$ "u section #agje7;a7 ( title    
#ch1 ,unit$ ,/ates ,code1 pursuant to ! 
phas$ approa* requir$ "u ?is section4   
7b7 ,phase "o requir$  7#a7 ,comm5cem5t 
7,a7 ,9 g5]al ,comm5c+ n lat] ?an "o ye>
 aft] ! date ( ! enactm5t ( ?is ,act1 ! 
,secret>y ( ,vet]ans ,affairs %all      
furni% d5tal c>e to all cov]$ vet]ans :o
 are n eligible = d5tal s]vices &       

treatm5t & relat$ d5tal appliances "u ! 
laws adm9i/]$ by ! ,secret>y z ( ! date 
( ! enactm5t ( ?is ,act4  7,b7 ,phase "o
 ,9 ?is section1 ! furni%+ ( d5tal c>e  
"u subp>agraph 7,a7 %all be ref]r$ to z 
phase "o4  7#b7 ,duration ( phase "o    
,phase "o %all be c>ri$ out dur+ !      
two-ye> p]iod beg9n+ on ! date ( !      
comm5cem5t ( phase "o4  7#c7 ,locations 
7,a7 ,9 g5]al ,! ,secret>y %all c>ry out
 phase "o at ! foll[+ locations3 7i7    
,ea* m$ical c5t] ( ! ,dep>tm5t ) an     
e/abli%$ d5tal cl9ic4  7ii7 ,n few] ?an 
f\r milit>y m$ical treatm5t facilities (
 ! ,dep>tm5t ( ,def5se ) ! capacity to  
furni% d5tal c>e1 :i* %all be select$ 9 
consultation ) ! ,secret>y ( ,def5se4   
7iii7 ,n few] ?an f\r community-bas$    
outpati5t cl9ics ) space available = !  
furni%+ ( d5tal c>e "u phase "o4  7iv7  
,n few] ?an f\r ,f$]ally ,qualifi$      
,heal? ,c5t]s4  7v7 ,n few] ?an f\r     
facilities ( ! ,indian ,heal? ,s]vice ) 
e/abli%$ d5tal cl9ics1 :i* %all be      
select$ 9 consultation ) ! ,secret>y (  

,heal? & ,human ,s]vices4  7,b7         
,consid]ations ,9 select+ locations =   
phase "o1 ! ,secret>y %all consid] !    
feasibility & advisability ( select+    
locations 9 ea* ( ! foll[+3 7i7 ,rural  
areas4  7ii7 ,areas t are n 9 close     
proximity to an active duty milit>y     
in/allation4  7iii7 ,areas repres5t+    
diff]5t geographic locations1 su* z     
c5sus tracts e/abli%$ by ! ,bureau ( !  
,c5sus4  7,c7 ,mobile d5tal cl9ics ,9   
c>ry+ out phase "o1 ! ,secret>y %all te/
 ! efficacy ( mobile d5tal cl9ics to    
s]vice rural areas t d n h a population 
base to w>rant a full-"t cl9ic b :]e !re
 are cov]$ vet]ans 9 ne$ ( d5tal c>e4   
7,d7 ,home-bas$ d5tal c>e ,9 c>ry+ out  
phase "o1 ! ,secret>y %all te/ !        
efficacy ( portable d5tal c>e units to  
s]vice rural vet]an 9 _! homes1 z !     
,secret>y consid]s m$ically appropriate4
  7#d7 ,scope ( s]vices ,! d5tal c>e    
furni%$ to cov]$ vet]ans "u phase "o    
%all be consi/5t ) ! d5tal s]vices &    
treatm5t furni%$ by ! ,secret>y to      

vet]ans ) s]vice-connect$ disabilities  
rat$ #ajj-p]c5t disabl+ "u ! laws       
adm9i/]$ by ! ,secret>y4  7#e7 ,use (   
telem$ic9e ,:5 provid+ d5tal s]vices via
 telem$ic9e "u phase "o1 ! ,secret>y    
%all use ,f$]al employees to ! maximum  
ext5t possible4  7#f7 ,volunt>y         
p>ticipation ,! p>ticipation ( a cov]$  
vet]an 9 phase "o %all be at ! election 
( ! vet]an4  7#g7 ,copaym5ts ,!         
,secret>y may collect copaym5ts = d5tal 
c>e furni%$ "u phase "o 9 accordance )  
au?orities on ! collection ( copaym5ts =
 m$ical c>e ( vet]ans "u *apt] #ag (    
title #ch1 ,unit$ ,/ates ,code4  7#h7   
,adm9i/ration  7,a7 ,notice to cov]$    
vet]ans on phase "o ,9 c>ry+ out phase  
"o1 ! ,secret>y %all in=m all cov]$     
vet]ans ( ! s]vices & treatm5t available
 "u phase "o4  7,b7 ,contracts  7i7 ,9  
g5]al ,subject to clause 7iii71 9 c>ry+ 
out phase "o1 ! ,secret>y may ent] into 
contracts ) appropriate entities = !    
provision ( d5tal c>e "u phase "o4  7ii7
 ,p]=mance /&>ds & metrics ,ea* contract

 ent]$ into "u clause 7i7 %all specify  
p]=mance /&>ds & metrics & processes =  
ensur+ compliance ( ! contractor conc]n$
 ) su* p]=mance /&>ds4  7iii7           
,limitation ,! ,secret>y may only ent]  
into contracts "u clause 7i7 if !       
,secret>y det]m9es t ! ,dep>tm5t does n 
employ1 & _c recruit & reta91 qualifi$  
d5ti/s1 d5tal hygi5i/s1 & oral surgeons 
9 ! applicable location4  7#i7          
,def9itions ,9 ?is subsection3 7,a7     
,cov]$ vet]an ,! t]m cov]$ vet]an means 
a vet]an enroll$ 9 ! sy/em ( annual     
pati5t enrollm5t ( ! ,dep>tm5t (        
,vet]ans ,affairs e/abli%$ & op]at$ "u  
section #agje7;a7 ( title #ch1 ,unit$   
,/ates ,code1 pursuant to p>agraph 7#a7 
or 7#b7 ( su* section4  7,b7 ,f$]ally   
qualifi$ heal? c5t] ,! t]m ,f$]ally     
,qualifi$ ,heal? ,c5t] means a          
,f$]ally-qualifi$ heal? c5t] z def9$ 9  
section #aije7l77#b77;,b7 ( ! ,social   
,security ,act 7#db ,u4,s4,c4           
#acif;d7l77#b77;,b774  7c7 ,expansion   
7#a7 ,9 g5]al ,aft] ! completion ( phase

 "o1 ! ,secret>y %all exp& ! provision (
 d5tal c>e "u ?is section to all        
vet]ans1 includ+ ?r\gh ! use ( !        
recomm5dations ( ! ,secret>y "u         
subsection 7d77#b77;,f71 z foll[s3 7,a7 
,9 phase two1 :i* %all-- 7i7 comm5ce n  
lat] ?an #ij days aft] ! completion (   
phase "o2 &  7ii7 consi/ ( ! provision (
 d5tal c>e to all vet]ans enroll$ 9 !   
sy/em ( annual pati5t enrollm5t ( !     
,dep>tm5t ( ,vet]ans ,affairs e/abli%$ &
 op]at$ "u section #agje7;a7 ( title    
#ch1 ,unit$ ,/ates ,code1 pursuant to   
p>agraph 7#a71 7#b71 7#c71 or 7#d7 ( su*
 section4  7,b7 ,9 phase ?ree1 :i*      
%all-- 7i7 comm5ce n lat] ?an #ij days  
aft] ! completion ( phase two2 &  7ii7  
consi/ ( ! provision ( d5tal c>e to all 
vet]ans enroll$ 9 su* sy/em pursuant to 
p>agraph 7#a71 7#b71 7#c71 7#d71 7#e71  
or 7#f7 ( su* section4  7,c7 ,9 phase   
f\r1 :i* %all-- 7i7 comm5ce n lat] ?an  
#ij days aft] ! completion ( phase ?ree2
 &  7ii7 consi/ ( ! provision ( d5tal   
c>e to all vet]ans enroll$ 9 su* sy/em4 

7#b7 ,facility expansion ,"u ea* phase  
specifi$ 9 p>agraph 7#a71 ! ,secret>y   
%all exp& ! numb] ( facilities describ$ 
9 subsection 7b77#c7 furni%+ d5tal c>e  
"u ?is section comm5surate to ! numb] ( 
new vet]ans furni%$ c>e "u su* phase1   
includ+ ?r\gh ! use ( any o!r facilities
 to :i* vet]ans h access4  7#c7         
,duration ,ea* phase specifi$ 9 p>agraph
 7#a7 %all be c>ri$ out dur+ a p]iod n  
to exce$ two ye>s & all su* phases1     
includ+ phase "o1 %all be c>ri$ out = a 
p]iod n to exce$ eight ye>s4  7#d7      
,conclusion ,^u ! conclusion ( phase f\r
 specifi$ "u p>agraph 7#a77;,c71 all    
vet]ans enroll$ 9 ! sy/em ( annual      
pati5t enrollm5t ( ! ,dep>tm5t (        
,vet]ans ,affairs e/abli%$ & op]at$ "u  
section #agje7;a7 ( title #ch1 ,unit$   
,/ates ,code1 %all be eligible = d5tal  
c>e f ! ,dep>tm5t4  7d7 ,reports  7#a7  
,9 g5]al ,n lat] ?an #ij days be=e !    
completion ( phase "o1 & n lat] ?an #ahj
 days aft] ! completion ( ea* subsequ5t 
phase "u subsection 7c77#a71 ! ,secret>y

 %all submit to ! ,committee on         
,vet]ans' ,affairs & ! ,committee on    
,arm$ ,s]vices ( ! ,s5ate & ! ,committee
 on ,vet]ans' ,affairs & ! ,committee on
 ,arm$ ,s]vices ( ! ,h\se (             
,repres5tatives a report on ! phase ab\t
 to be complet$ & ! plans ( ! ,secret>y 
= implem5tation ( expansion ( !         
provision ( d5tal c>e pursuant to       
subsection 7c74  7#b7 ,cont5ts ,ea*     
report "u p>agraph 7#a7 %all include !  
foll[+3 7,a7 ,a description ( !         
implem5tation & op]ation ( ! phase cov]$
 by ! report4  7,b7 ,! numb] ( vet]ans  
receiv+ d5tal c>e "u su* phase & a      
description ( ! d5tal c>e furni%$ to su*
 vet]ans4  7,c7 ,an analysis ( ! co/s & 
b5efits ( su* phase1 includ+ a comp>ison
 ( co/s & b5efits by location type4     
7,d7 ,an assessm5t ( ! impact ( su*     
phase on appo9tm5ts = c>e1              
prescriptions1 hospitalizations1 em]g5cy
 room visits1 wellness1 employability1 &
 satisfaction ( pati5ts1 & p]ceiv$      
quality ( life ( vet]ans4  7,e7 ,an     

analysis & assessm5t ( ! efficacy (     
mobile cl9ics & home-bas$ d5tal c>e to  
s]vice ! d5tal ne$s ( vet]ans dur+ su*  
phase4  7,f7 ,! f9d+s & conclusions ( ! 
,secret>y ) respect to su* phase4  7,g7 
,a comp>ison ( ! co/s = private sector  
d5tal c>e ) co/ ( furni%+ d5tal c>e f ! 
,dep>tm5t1 brok5 d[n by ea* locality    
includ$ 9 su* phase4  7,h7 ,su*         
recomm5dations = ! expansion ( d5tal c>e
 pursuant to subsection 7c7 z !         
,secret>y consid]s appropriate4  #e4    
,requirem5t ( d5tal cl9ic ( ,dep>tm5t ( 
,vet]ans ,affairs 9 ea* ,/ate  7a7 ,9   
g5]al ,! ,secret>y ( ,vet]ans ,affairs  
%all ensure t ea* ,/ate has a d5tal     
cl9ic ( ! ,dep>tm5t ( ,vet]ans ,affairs 
to s]vice ! ne$s ( ! vet]ans )9 t ,/ate4
  7b7 ,effective date ,?is section %all 
take effect on ! date t is "o ye> aft] !
 date ( ! enactm5t ( ?is ,act4  #f4     
,program on education to promote d5tal  
heal? 9 vet]ans  7a7 ,program requir$ ,!
 ,secret>y ( ,vet]ans ,affairs %all c>ry
 out a program ( education to promote   

d5tal heal? = vet]ans :o are enroll$ 9 !
 sy/em ( annual pati5t enrollm5t ( !    
,dep>tm5t ( ,vet]ans ,affairs e/abli%$ &
 op]at$ "u section #agje7;a7 ( title    
#ch1 ,unit$ ,/ates ,code4  7b7 ,elem5ts 
,! program requir$ by subsection 7a7    
%all provide education = vet]ans on !   
foll[+3 7#a7 ,! association betwe5 d5tal
 heal? & ov]all heal? & well-be+4  7#b7 
,prop] te*niques = d5tal c>e4  7#c7     
,signs & symptoms ( commonly occurr+    
d5tal conditions4  7#d7 ,treatm5t       
options = commonly occurr+ d5tal issues4
  7#e7 ,options = obta9+ access to d5tal
 c>e1 includ+ in=mation on eligibility =
 d5tal c>e ?r\gh ! ,dep>tm5t4  7#f7     
,available & accessible options = obta9+
 l[ or no-co/ d5tal c>e1 includ+ ?r\gh  
d5tal s*ools & ,f$]ally ,qualifi$ ,heal?
 ,c5t]s4  7#g7 ,su* o!r matt]s relat+ to
 d5tal heal? z ! ,secret>y consid]s     
appropriate4  7c7 ,deliv]y ( educational
 mat]ials  7#a7 ,9 g5]al ,! ,secret>y   
%all provide educational mat]ials to    
vet]ans "u ! program requir$ by         

subsection 7a7 ?r\gh a v>iety (         
me*anisms1 includ+ ! foll[+3 7,a7 ,!    
availability & di/ribution ( pr9t       
mat]ials at facilities ( ! ,dep>tm5t    
7includ+ at m$ical c5t]s1 cl9ics1 ,vet  
,c5t]s1 & readju/m5t c\nsel+ c5t]s7 & to
 provid]s 7includ+ memb]s ( ,pati5t     
,align$ ,c>e ,teams74  7,b7 ,!          
availability & di/ribution ( mat]ials   
ov] ! int]net1 includ+ ?r\gh web9>s1 ,my
 ,healthe,vet1 & ,,va4gov4  7,c7        
,pres5tations by ! d5tal program (fice (
 ! ,dep>tm5t ( in=mation1 includ+ bo?   
small gr\p & l>ge gr\p pres5tations1 &  
di/ribution ( su* in=mation to all      
locations 9 :i* ! program is be+ c>ri$  
out4  7#b7 ,selection ( me*anisms ,9    
select+ me*anisms "u p>agraph 7#a71 !   
,secret>y %all select me*anisms design$ 
to maximize ! numb] ( vet]ans :o receive
 education "u ! program4  7d7           
,con/ruction ,no?+ 9 ?is section %all be
 con/ru$ to alt] or revise ! eligibility
 ( any vet]an = d5tal c>e "u ! laws     
adm9i/]$ by ! ,secret>y4  7e7           

,def9itions ,9 ?is section-- 7#a7       
,f$]ally qualifi$ heal? c5t] ,! t]m     
,f$]ally ,qualifi$ ,heal? ,c5t] means a 
,f$]ally-qualifi$ heal? c5t] z def9$ 9  
section #aije7l77#b77;,b7 ( ! ,social   
,security ,act 7#db ,u4,s4,c4           
#acif;d7l77#b77;,b774  7#b7 ,vet ,c5t]  
,! t]m ,vet ,c5t] has ! mean+ giv5 t t]m
 9 section #agab;,a7h7 ( title #ch1     
,unit$ ,/ates ,code4  7f7 ,effective    
date ,?is section %all take effect on ! 
date t is "o ye> aft] ! date ( !        
enactm5t ( ?is ,act4  #g4 ,/ud5t loan   
repaym5t program to inc5tivize d5tal    
tra9+ & ensure ! d5tal work=ce ( !      
,dep>tm5t ( ,vet]ans ,affairs  7a7      
,program requir$ ,! ,secret>y ( ,vet]ans
 ,affairs1 to ensure t ! ,dep>tm5t (    
,vet]ans ,affairs has suffici5t /aff to 
provide d5tal s]vice to vet]ans1 %all   
implem5t a loan reimbursem5t program =  
qualifi$ d5ti/s1 d5tal hygi5i/s1 & oral 
surgeons :o agree-- 7#a7 to be appo9t$  
by ! ,secret>y z a d5ti/1 d5tal hygi5i/1
 or oral surgeon1 z ! case may be1 "u   

section #gdja ( title #ch1 ,unit$ ,/ates
 ,code2 &  7#b7 to s]ve z a d5ti/1 d5tal
 hygi5i/1 or oral surgeon1 z ! case may 
be1 ( ! ,dep>tm5t pursuant to su*       
appo9tm5t at a d5tal cl9ic ( ! ,dep>tm5t
 = a p]iod ( n less ?an five ye>s4  7b7 
,maximum am\nt ,! ,secret>y may         
reimburse n m ?an-- 7#a7 #ge1jjj = ea*  
d5ti/ p>ticipat+ 9 ! program "u         
subsection 7a72  7#b7 #aj1jjj = ea*     
d5tal hygi5i/ p>ticipat+ 9 su* program2 
&  7#c7 #bj1jjj = ea* oral surgeon      
p>ticipat+ 9 su* program4  7c7          
,selection ( locations ,! ,secret>y %all
 monitor dem& among vet]ans = d5tal c>e 
& require p>ticipants 9 ! program "u    
subsection 7a7 to *oose f d5tal cl9ics (
 ! ,dep>tm5t ) ! greate/ ne$ = d5ti/s1  
d5tal hygi5i/s1 or oral surgeons1 z !   
case may be1 accord+ to facility        
enrollm5t & pati5t dem&4  #h4           
,educational & tra9+ p>tn]%ips = d5ti/s1
 d5tal hygi5i/s1 & oral surgeons ,!     
,secret>y ( ,vet]ans ,affairs %all ent] 
into educational & tra9+ p>tn]%ips )    

d5tal s*ools to provide tra9+ &         
employm5t opportunities = d5ti/s1 d5tal 
hygi5i/s1 & oral surgeons4  #i4         
,au?orization ( appropriations  7a7 ,9  
g5]al ,!re is au?oriz$ to be appropriat$
 = ! ,dep>tm5t ( ,vet]ans ,affairs =    
fiscal ye> #bjba su* sums z may be      
necess>y to c>ry out ?is ,act & !       
am5dm5ts made by ?is ,act4  7b7         
,availability ,! am\nt au?oriz$ to be   
appropriat$ "u subsection 7a7 %all be   
available = obligation = ! eight-ye>    
p]iod beg9n+ on ! date t is "o ye> aft] 
! date ( ! enactm5t ( ?is ,act4