Title 42The Public Health and WelfareRelease 119-73

§247b–14 Oral health promotion and disease prevention

Title 42 › Chapter CHAPTER 6A— - PUBLIC HEALTH SERVICE › Subchapter SUBCHAPTER II— - GENERAL POWERS AND DUTIES › Part Part B— - Federal-State Cooperation › § 247b–14

Last updated Apr 6, 2026|Official source

Summary

The federal government, through the CDC, can give grants to States and Indian tribes to help expand community water fluoridation. States must use the money to buy fluoridation equipment, train engineers, make educational materials about fluoridation, or keep the systems monitored and working well. The CDC, working with the Indian Health Service, will run a 5-year demonstration project to help small and rural water systems follow the CDC’s 1995 fluoridation engineering guidelines (EARWF). The project must give technical help and training across the 12 Indian Health Service areas, create fluoridation specialist engineer jobs in each Dental Clinical and Preventive Support Center to train tribal water and utility operators, and be evaluated as a model. The evaluation must measure changes in compliance, list the special problems small systems face, create a practical model others can use, and track any increase in Native American and Alaska Native people receiving optimally fluoridated water. The CDC, with the Health Resources and Services Administration, must also give grants to all 50 States and territories and to Indian tribes, tribal organizations, and urban Indian organizations to set up school-based dental sealant programs. States must pass funds to eligible school groups or public K–12 schools so licensed dental professionals can provide dental care and sealants under state law. To get funds, a school must apply and be a public elementary or secondary school that is either in an urban area with more than 50% of students in free or reduced meal programs, or in a rural area where the school district’s median income is at or below 235% of the poverty line. The CDC may also make cooperative agreements with States, territories, and tribes to build oral health leadership, collect and use oral health data, create multi-part delivery systems, and run science-based programs like sealants and fluoridation. Funding was authorized as needed for that cooperative work for fiscal years 2010–2014, and overall funding for carrying out this part was authorized as needed for fiscal years 2001–2005. Definitions: Indian tribe — an Indian tribe or tribal organization as defined in federal law.

Full Legal Text

Title 42, §247b–14

The Public Health and Welfare — Source: USLM XML via OLRC

(a)(1)The Secretary, acting through the Director of the Centers for Disease Control and Prevention, may make grants to States and Indian tribes for the purpose of increasing the resources available for community water fluoridation.
(2)A State shall use amounts provided under a grant under paragraph (1)—
(A)to purchase fluoridation equipment;
(B)to train fluoridation engineers;
(C)to develop educational materials on the benefits of fluoridation; or
(D)to support the infrastructure necessary to monitor and maintain the quality of water fluoridation.
(b)(1)The Secretary, acting through the Director of the Centers for Disease Control and Prevention and in collaboration with the Director of the Indian Health Service, shall establish a demonstration project that is designed to assist rural water systems in successfully implementing the water fluoridation guidelines of the Centers for Disease Control and Prevention that are entitled “Engineering and Administrative Recommendations for Water Fluoridation, 1995” (referred to in this subsection as the “EARWF”).
(2)(A)In collaborating under paragraph (1), the Directors referred to in such paragraph shall ensure that technical assistance and training are provided to tribal programs located in each of the 12 areas of the Indian Health Service. The Director of the Indian Health Service shall provide coordination and administrative support to tribes under this section.
(B)Amounts made available under paragraph (1) shall be used to assist small water systems in improving the effectiveness of water fluoridation and to meet the recommendations of the EARWF.
(C)(i)In carrying out this subsection, the Secretary shall provide for the establishment of fluoridation specialist engineering positions in each of the Dental Clinical and Preventive Support Centers through which technical assistance and training will be provided to tribal water operators, tribal utility operators and other Indian Health Service personnel working directly with fluoridation projects.
(ii)A fluoridation specialist shall serve as the principal technical liaison between the Indian Health Service and the Centers for Disease Control and Prevention with respect to engineering and fluoridation issues.
(iii)The Director of the Centers for Disease Control and Prevention shall appoint individuals to serve as the fluoridation specialists.
(D)The project established under this subsection shall be planned, implemented and evaluated over the 5-year period beginning on the date on which funds are appropriated under this section and shall be designed to serve as a model for improving the effectiveness of water fluoridation systems of small rural communities.
(3)In conducting the ongoing evaluation as provided for in paragraph (2)(D), the Secretary shall ensure that such evaluation includes—
(A)the measurement of changes in water fluoridation compliance levels resulting from assistance provided under this section;
(B)the identification of the administrative, technical and operational challenges that are unique to the fluoridation of small water systems;
(C)the development of a practical model that may be easily utilized by other tribal, State, county or local governments in improving the quality of water fluoridation with emphasis on small water systems; and
(D)the measurement of any increased percentage of Native Americans or Alaskan Natives who receive the benefits of optimally fluoridated water.
(c)(1)The Secretary, acting through the Director of the Centers for Disease Control and Prevention and in collaboration with the Administrator of the Health Resources and Services Administration, shall award a grant to each of the 50 States and territories and to Indians, Indian tribes, tribal organizations and urban Indian organizations (as such terms are defined in section 1603 of title 25) to provide for the development of school-based dental sealant programs to improve the access of children to sealants.
(2)A State shall use amounts received under a grant under paragraph (1) to provide funds to eligible school-based entities or to public elementary or secondary schools to enable such entities or schools to provide children with access to dental care and dental sealant services. Such services shall be provided by licensed dental health professionals in accordance with State practice licensing laws.
(3)To be eligible to receive funds under paragraph (1), an entity shall—
(A)prepare and submit to the State an application at such time, in such manner and containing such information as the State may require; and
(B)be a public elementary or secondary school—
(i)that is located in an urban area in which and 11 So in original. The word “and” probably should not appear. 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 income that is at or below 235 percent of the poverty line, as defined in section 9902(2) of this title.
(d)(1)The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall enter into cooperative agreements with State, territorial, and Indian tribes or tribal organizations (as those terms are defined in section 1603 of title 25) to establish oral health leadership and program guidance, oral health data collection and interpretation,22 So in original. The comma probably should not appear. (including determinants of poor oral health among vulnerable populations), a multi-dimensional delivery system for oral health, and to implement science-based programs (including dental sealants and community water fluoridation) to improve oral health.
(2)There is authorized to be appropriated such sums as necessary to carry out this subsection for fiscal years 2010 through 2014.
(e)For purposes of this section, the term “Indian tribe” means an Indian tribe or tribal organization as defined in section 5304(b) and section 5304(c) 33 See References in Text note below. of title 25.
(f)For the purpose of carrying out this section, there are authorized to be appropriated such sums as may be necessary for each of the fiscal years 2001 through 2005.

Legislative History

Notes & Related Subsidiaries

Editorial Notes

References in Text

Section 5304 of title 25, referred to in subsec. (e), has been amended, and subsecs. (b) and (c) of section 5304 no longer define the terms “Indian tribe” and “tribal organization”. However, such terms are defined elsewhere in that section.

Amendments

2010—Subsec. (c)(1). Pub. L. 111–148, § 4102(b), substituted “shall award a grant to each of the 50 States and territories and to Indians, Indian tribes, tribal organizations and urban Indian organizations (as such terms are defined in section 1603 of title 25)” for “may award grants to States and Indian tribes”. Subsecs. (d) to (f). Pub. L. 111–148, § 4102(c), added subsec. (d) and redesignated former subsecs. (d) and (e) as (e) and (f), respectively.

Reference

Citations & Metadata

Citation

42 U.S.C. § 247b–14

Title 42The Public Health and Welfare

Last Updated

Apr 6, 2026

Release point: 119-73