Pediatric Dentistry Title VII Funding Increased to $14 million

There was positive news from the United State House of Representatives concerning FY 2022 appropriations legislation related to Labor-Health and Human Services- Education. On July 12, 2021 the Appropriations Labor-HHS-Education Committee approved the legislation, followed by approval of the full Appropriations Committee on July 15, 2021 by a 33-25 vote. On July 14, 2021, the House Appropriations released the committee report[1] accompanying the FY 2022 Labor-HHS-Education appropriation bill. Among other provisions, the bill would provide Title VII Health Professions and Title VIII Nursing Workforce Development Programs with a total of $979.88 million, a $227.87 million increase (30%) from FY 2021 enacted levels.  

The House report language on Title VII oral health funding was as follows: 

“Oral Health Training.- The Committee includes $42,673,000 for Oral Health Training, $2,000,000 above the fiscal year 2021 enacted level and the fiscal year 2022 budget request. Within the total, the Committee includes not less than $14,000,000 for Pediatric Dentistry Programs, an increase of $2,000,000 above the fiscal year 2021 enacted level. The Committee directs HRSA to provide continuation funding for section 748 post-doctoral training grants initially awarded in fiscal year 2020 and dental faculty loan repayment program (DFLRP) grants initially awarded in fiscal years 2018 and 2021. The Committee directs HRSA to initiate a new pre-doctoral grant cycle, and to initiate a new DFLRP grant cycle with a preference for pediatric dentistry faculty supervising dental students or residents and providing clinical services in dental clinics located in dental schools, hospitals, and community-based affiliated sites. “ (p. 51)

The AAPD requested $14 million for pediatric dentistry and $46 million overall. It is noteworthy that only pediatric dentistry was targeted for an increase in the oral health training area. The AAPD also appreciates the continued preference for pediatric dentistry faculty under the DFLRP, as was advocated. The AAPD thanks all of those advocates who attended the virtual Pediatric Oral Health Advocacy Conference in March 2021, which included advocacy for this program. The AAPD also thanks ADA, ADEA, and AADR for their collaborative advocacy efforts on FY 2022 appropriations for important oral health programs. 

Some of the other House report language related to oral health that was recommended and supported by the AAPD-ADA-ADEA-AADR  included the following:

 HRSA
“HRSA Chief Dental Officer.—The Committee is disturbed to learn that despite its directive in House Report (116–450) to have HRSA ensure that the Chief Dental Officer (CDO) is functioning at an executive level authority with resources and staff to oversee and lead all oral health programs and initiatives across HRSA, no such authority has been delegated. The Committee directs HRSA to restore the authority of HRSA CDO with executive level authority and resources to oversee and lead HRSA dental programs and initiatives as well as have a role within oral health across the agency. The CDO is also expected to serve as the agency representative on oral health issues to international, national, State, and/or local government agencies, universities, and oral health stakeholder organizations. The Committee requests an update as part of the fiscal year 2023 Congressional Budget Justification on how the CDO is serving as the agency representative on oral health issues to international, national, State and/or local government agencies, universities, and oral health stakeholder organizations.” (p. 70) 

CMS
“Medicaid Dental Audits.—The Committee has previously raised concerns that failure to use professional guidelines or established state Medicaid manual parameters in the auditing process can result in inaccurate Medicaid dental audits, negatively impacting dentist participation in the program and impeding patient access to care. While State Medicaid agencies (SMA) have significant responsibility in managing provider audits, the Committee believes that as part of CMS oversight of the Medicaid program it is appropriate to issue guidance to SMAs concerning best practices in dental audits and offer training in such practices. The Committee again urges CMS to develop such guidance for SMAs and report within 90 days of enactment of this Act on steps taken to develop such guidance.” (p. 195)

“Oral Health Services.—The Committee is pleased that CMS is moving forward to fill the Chief Dental Officer position, which has been vacant since October 2017. This left a significant gap of clinical oral health expertise within CMS. Medicaid provides oral health services to millions of people, including vulnerable populations such as children (including those with special health care needs), pregnant women, and disabled adults. The Committee notes that States have flexibility to determine dental benefits for adult Medicaid enrollees and while most States provide at least emergency dental services for adults, less than half currently provide comprehensive dental care. The Committee urges the Chief Dental Officer to examine opportunities within existing statutory authority to expand Medicare coverage of dental services. The Committee also urges CMS to provide recommendations no later than one year after enactment of this Act regarding policies to increase coverage of, and access to, comprehensive dental benefits for adults in State Medicaid programs.” (pp. 197-198

NIDCR
“SARS–CoV–2.—The Committee thanks NIDCR for its commitment to prioritizing research to answer critical research questions related to the novel coronavirus. The Institute’s research into high impact areas such as transmission risk in dental environments is critical for the nation to continue fighting COVID–19 and to ensure everyone is as safe as possible.” (p. 118)

“Report on Oral Health in America.—The Committee greatly appreciates NIDCR’s leadership on the upcoming Report ‘‘Oral Health in America: Advances and Challenges’’. The Committee anticipates the final release of the report and encourages NIDCR to utilize the findings of the 2021 Report to identify research gaps across dental, oral, and craniofacial research and to pursue research opportunities to fill those gaps.” (pp. 118-119)

For further information, please contact AAPD Chief Operating Officer and General Counsel C. Scott Litch at slitch@aapd.org.