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Health Department Seeks Dental Expansion, Ryan White Support and Funds for Rural Health Transformation
Summary
The Department of Health requested $24.2M non‑recurring to continue the Healthy Smiles dental pilot, proposed $18M to sustain Ryan White insurance assistance, and described a $27M federal award for rural‑health transformation to be matched by proposed state shared‑savings capital funding.
Commissioner of Health presented a multi‑part FY27 request to the House Finance Committee that emphasizes dental access, HIV insurance continuity and a federal rural‑health transformation award that the department intends to layer with state shared‑savings capital.
Dental access: Commissioner Dunn asked for $24.2 million non‑recurring to continue a five‑year Healthy Smiles initiative that combines training expansions at the University of Tennessee and Meharry with direct service delivery through local health departments and specialty programs (Smile 65+ and Smile180). Dunn told the committee that UT expanded dental class sizes and that, since July 2024, TDH hired seven new dentists who are now providing regular service in counties that previously lacked full‑time clinical dental staffing. The department said the program mixes workforce pipeline incentives (loan repayment) with rotating student clinics and direct hired dentists to increase capacity.
Ryan White insurance assistance: Health asked for roughly $18 million to pair with federal Ryan‑White resources and maintain coverage for about 7,700 low‑income Tennesseans living with HIV. Dunn said the request will help avoid mid‑year coverage disruptions if marketplace premiums rise.
Opioid and harm‑reduction investments: The department proposed a $5 million appropriation from the state’s opioid abatement fund to support the governor’s billion‑pill pledge and a recurring naloxone purchase to target high‑need areas and save lives.
Rural health transformation: Dunn described a successful CMS award of $27 million (five‑year project) and a governor’s proposed $125 million state shared‑savings capital commitment. The administration’s plan includes a rural center of excellence (COE) run with UT Health Science Center, competitive planning and implementation grants, a rural training pipeline, specialty‑care e‑consults and capital projects (16 new local health department builds and multiple renovations). Dunn emphasized that state funds tied to shared savings will be awarded competitively and that the department intends not to create unsustainable state obligations after federal funds expire.
Committee members asked for accounting and timeline details—particularly how previously authorized capital and ARPA funds have been obligated and how the department will manage the larger federal award’s implementation and reporting requirements.
What happens next: The committee will review the Health Department’s requests, including dental continuation funding and proposed state contributions to rural‑health capital initiatives. Health committed to provide further detail on ARPA and shared‑savings obligation schedules and program metrics.
Representative quote: Commissioner Dunn cited workforce signals in dental training surveys: "One hundred thirty of 350 respondents indicated plans to practice general dentistry in Tennessee," which she offered as evidence the training pipeline is generating local commitments.
