Bill Text: PA HB272 | 2011-2012 | Regular Session | Amended

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Bill Title: Establishing a task force on Lyme disease and related maladies; and providing for powers and duties of the task force, the Department of Health, the Department of Conservation and Natural Resources and the Pennsylvania Game Commission to execute prevention and education strategies.

Spectrum: Slight Partisan Bill (Republican 37-19)

Status: (Engrossed - Dead) 2012-10-17 - Referred to RULES [HB272 Detail]

Download: Pennsylvania-2011-HB272-Amended.html

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SENATE AMENDED
PRIOR PRINTER'S NOS. 225, 2895, 4139 PRINTER'S NO. 4222
THE GENERAL ASSEMBLY OF PENNSYLVANIA
HOUSE BILL
No. 272 Session of2011
INTRODUCED BY HESS, BAKER, FLECK, MAJOR, CALTAGIRONE, CARROLL, CAUSER, COHEN, D. COSTA, J. EVANS, GOODMAN, GROVE, HARKINS, HARRIS, KAUFFMAN, M. K. KELLER, KIRKLAND, KORTZ, KOTIK, KULA, MAHONEY, MILLARD, PEIFER, PICKETT, RAPP, SWANGER, TALLMAN, YOUNGBLOOD, MOUL, BENNINGHOFF, MURT, KAVULICH, DENLINGER, BRADFORD, TRUITT, BRIGGS, MILLER, SCAVELLO, WATSON, GABLER, KILLION, FREEMAN, M. SMITH, HORNAMAN, HENNESSEY, R. BROWN, BEAR, PAYNE, CONKLIN, STEVENSON, PERRY, MAHER, ROCK, SAYLOR, HARPER AND BROOKS, JANUARY 27, 2011
SENATOR D. WHITE, BANKING AND INSURANCE, IN SENATE, AS AMENDED, OCTOBER 15, 2012
AN ACT
Establishing a task force on Lyme disease and related maladies; <--
providing for powers and duties of the task force, the
Department of Health, the Department of Conservation and
Natural Resources and the Pennsylvania Game Commission and
for required coverage; and executing prevention and education
strategies.
Establishing a task force on Lyme disease and related maladies; <--
and providing for powers and duties of the task force, the
Department of Health, the Department of Conservation and
Natural Resources and the Pennsylvania Game Commission to
execute prevention and education strategies.
The General Assembly of the Commonwealth of Pennsylvania
hereby enacts as follows:
Section 1. Short title. <--
This act shall be known and may be cited as the Lyme and
Related Tick-Borne Disease Surveillance, Education, Prevention
and Treatment Act.
Section 2. Findings.
The General Assembly finds and declares as follows:
(1) Lyme disease and other tick-borne diseases are
carried primarily by ticks and pose a serious threat to the
health and quality of life of many citizens of this
Commonwealth.
(2) The most common way to acquire Lyme disease is to be
bitten by a tick that carries the spirochete.
(3) In 2009, 5,722 confirmed cases of Lyme disease were
reported in this Commonwealth, the highest number of cases
reported in any state and representing a 76% increase since
2006. In 2011, provisional numbers of 7,484 cases confirm
this ongoing upward trend.
(4) These trends illustrate the World Health
Organization's (WHO) projections through 2010. The WHO states
that Lyme disease will increasingly become a public health
threat in the United States. Pennsylvania needs to be
prepared to deal with this trend, which is already being
observed in Pennsylvania's statistics.
(5) Lyme disease is most prevalent in southeastern
Pennsylvania, but it is found across this Commonwealth.
(6) With proper precautions taken while engaged in
outdoor activities, people can greatly reduce their chances
of tick pathogen transmission by making sure that frequent
tick checks are made and ticks are removed and disposed of
promptly and properly.
(7) The early clinical diagnosis and appropriate
treatment of these tick-borne disorders and diseases can
greatly reduce the risks of continued symptoms which can
affect every system and organ of the human body and often
every aspect of life.
20110HB0272PN4222 - 2 -
(8) Left untreated, Lyme disease can cause a number of
signs and symptoms which can become quite severe.
Section 3. Legislative intent.
It is the intent of the General Assembly:
(1) To provide the public with information and education
to create greater public awareness of the dangers of and
measures available to prevent, diagnose and treat Lyme
disease and related maladies.
(2) To ensure that:
(i) Licensees, insurers, patients and governmental
agencies are educated about treatment options.
(ii) Licensees provide patients with sufficient
information about treatment options to enable patients to
make an informed choice as part of informed consent and
respect the autonomy of that choice.
(iii) Pennsylvania government agencies provide
unbiased information regarding treatment options.
Section 4. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Board." The Pennsylvania State Board of Medicine, the State
Board of Osteopathic Medicine and the State Board of Nursing.
"Department." The Department of Health of the Commonwealth.
"Licensee." A licensed physician, a physician's assistant or
certified registered nurse practitioner or other licensed health
care professional.
"Long-term antibiotic or antimicrobial therapy."
Administration of oral, intramuscular or intravenous antibiotics
or antimicrobial medications, singly or in combination, for
20110HB0272PN4222 - 3 -
periods of more than four weeks.
"Lyme disease." The clinical diagnosis of a patient by a
licensed physician or certified registered nurse practitioner of
the presence of signs or symptoms compatible with acute, late-
stage, persistent infection with Borrelia burgdorferi or
complications related to such infection or with such other
strains of Borrelia that are recognized by the Centers for
Disease Control and Prevention as a cause of Lyme disease. The
term includes infection which meets the surveillance criteria
set forth by the Centers for Disease Control and Prevention and
other acute and persistent manifestations of such an infection
as determined by a physician.
"Related tick-borne illnesses." Cases of Bartonellosis,
Babesiosis/Piroplasmosis, Anaplasmosis, Ehrlichiosis and other
tick-transmissible illnesses as may be empirically associated
with Lyme disease.
"Secretary." The Secretary of Health of the Commonwealth.
"State officials." The term includes the Secretary of
Environmental Protection.
"Task force." The task force established by this act.
"Therapeutic purpose." The use of antibiotics to control a
patient's symptoms or signs determined by a physician as
reasonably related to Lyme disease and its sequelae or related
tick-borne illnesses.
Section 5. Task force.
(a) Establishment.--The department shall establish a task
force on Lyme disease and related tick-borne diseases.
(b) Purpose.--The task force shall investigate and make
recommendations to the department regarding:
(1) The surveillance and prevention of Lyme disease and
20110HB0272PN4222 - 4 -
related tick-borne illnesses in this Commonwealth.
(2) Raising awareness about the long-term effects of the
misdiagnosis of Lyme disease.
(3) The development of a program of general public and
health care professional information and education regarding
Lyme disease which shall include the broad spectrum of
scientific and treatment options regarding all stages of Lyme
disease and related tick-borne illnesses.
(4) Cooperation with the Pennsylvania Game Commission to
disseminate the information required under paragraph (3) to
licensees of the commission and the general public.
(5) Cooperation with the Department of Conservation and
Natural Resources to disseminate the information required
under paragraph (3) to the general public and visitors of
State parks and lands.
(6) Cooperation with the Department of Environmental
Protection to test ticks and provide results and to publish
on its publicly accessible Internet website.
(7) Cooperation with the Department of Education to:
(i) Disseminate the information required under
paragraph (3) to school administrators, faculty, staff,
parents, guardians and students.
(ii) Determine the role schools may play in the
prevention of Lyme disease, including, but not limited
to, prompt removal and reporting of tick removals to
State officials.
(iii) Update policies to recognize signs or symptoms
of Lyme disease and related tick-borne illnesses as
health impairments potentially requiring accommodations.
(c) Composition.--The task force shall be composed of the
20110HB0272PN4222 - 5 -
following individuals:
(1) The Secretary of Health or a designee.
(2) The Insurance Commissioner or a designee.
(3) The Secretary of Education or a designee.
(4) The Deputy Secretary for Parks and Forestry in the
Department of Conservation and Natural Resources or a
designee.
(5) The Director of the Bureau of Information and
Education of the Pennsylvania Game Commission or a designee.
(6) Two physicians licensed in this Commonwealth, who
are knowledgeable concerning treatment of Lyme disease and
related tick-borne illnesses and who are members of the
International Lyme and Associated Diseases Society.
(7) Two physicians licensed in this Commonwealth who are
knowledgeable concerning treatment of Lyme disease and
related tick-borne illnesses who are members of the
Infectious Disease Society of America.
(8) An epidemiologist licensed in this Commonwealth
having expertise in spirochetes and related infectious
diseases.
(9) Two individuals representing Lyme disease patient
groups who may be a Lyme disease patient of a family member
of a Lyme disease patient.
(10) One individual who is a Lyme disease patient or a
family member of a Lyme disease patient.
(11) Two registered nurses licensed in this
Commonwealth, one of which should be a certified registered
nurse practitioner and both of whom are knowledgeable
concerning Lyme disease and related tick-borne illnesses.
(12) The Director of Vector Management of the Department
20110HB0272PN4222 - 6 -
of Environmental Protection.
(13) An entomologist with the Department of Entomology
of The Pennsylvania State University who has experience in
tick identification and tick-borne diseases.
(14) A registered school nurse licensed in this
Commonwealth who is knowledgeable concerning Lyme disease and
tick-borne illnesses.
(15) Two veterinarians licensed in this Commonwealth, at
least one of whom is a veterinary epidemiologist and both of
whom are knowledgeable concerning Lyme disease and related
tick-borne illnesses.
(d) Meetings.--
(1) Within 45 days of the effective date of this act,
the Secretary of Health shall appoint the members of the task
force. The Secretary of Health shall appoint a chairman of
the task force.
(2) The task force shall convene within 90 days of the
effective date of this act and shall meet quarterly.
(3) The task force shall issue a report with
recommendations to the Secretary of Health within one year of
its first meeting. The report shall also be transmitted to
the relevant committees of the Senate and the House of
Representatives. Nothing in this act shall prohibit the task
force from making interim reports, taking agreed-upon
immediate actions or responding to requests for such reports.
(e) Compensation and expenses.--The members of the task
force shall receive no compensation for their services but shall
be reimbursed for actual and necessary expenses incurred in
performance of their duties. Reimbursement shall be provided by
the department.
20110HB0272PN4222 - 7 -
(f) Department.--The department shall:
(1) Develop a program of general public and health care
professional information and education regarding Lyme disease
which shall include the broad spectrum of scientific and
treating options regarding all stages of Lyme disease and
related tick-borne illnesses.
(2) Develop an active tick collection, testing and
surveillance program in cooperation with the Department of
Environmental Protection to provide a better understanding
of, including, but not limited to, the full range of tick-
borne diseases, geographic hot spots and levels of
infectivity to be used in targeting prevention and education
efforts. This effort may include veterinary data on tick-
borne disease prevention, specifically dogs and horses and
other animals as the Centers for Disease Control and
Prevention have recommended.
(3) Cooperate with the Pennsylvania Game Commission to
disseminate the information required under paragraph (1) to
licensees of the Pennsylvania Game Commission and the general
public.
(4) Cooperate with the Department of Conservation and
Natural Resources to disseminate the information required
under paragraph (1) to the general public and visitors of
State parks and lands.
(5) Cooperate with the professional associations of
health care professionals to provide the education program
for professionals required under paragraph (1).
(6) Cooperate with the Department of Education to:
(i) Disseminate the information under paragraph (1)
to school administrators, school nurses, faculty and
20110HB0272PN4222 - 8 -
staff, parents, guardians and students.
(ii) Determine what role schools may play in the
prevention of Lyme disease, including, but not limited
to, prompt removal and reporting of tick removals to
State officials.
(iii) Update policies to recognize signs or symptoms
of Lyme disease and related tick-borne illnesses as
health conditions potentially requiring accommodations.
(7) Cooperate with the Department of Environmental
Protection to publish and make available on its publicly
accessible Internet website the information developed under
paragraph (2) to health care professionals and the general
public.
(8) Cooperate with The Pennsylvania State University,
Department of Entomology, Cooperative Extension Program for
Integrated Pest Management, to disseminate educational
resources about ticks, related diseases and integrated pest
management for disease prevention as required under paragraph
(1) to health care professionals and the general public.
(9) Identify and apply for public and private funding in
order to carry out the provisions of this act.
Section 6. Required coverage.
(a) Tick-borne illnesses.--Except as provided in subsection
(b), every health care policy which is delivered, issued for
delivery, renewed, extended or modified in this Commonwealth by
a health insurer must cover prescribed treatment for Lyme
disease or related tick-borne illnesses if the diagnosis and
treatment plan are documented in the patient's medical record,
and it is documented in the patient's medical record that the
patient has been properly informed of multiple standards of
20110HB0272PN4222 - 9 -
care, risks and benefits and able to exercise informed consent.
Such treatment plans may include long-term therapies, long-term
antibiotic or antimicrobial therapy and treatment as prescribed
by the patient's attending physician.
(b) Exception.--Subsection (a) shall not apply to any of the
following types of insurance:
(1) Hospital indemnity.
(2) Accident.
(3) Specified disease.
(4) Disability income.
(5) Dental.
(6) Vision.
(7) Civilian Health and Medical Program of the Uniformed
Services (CHAMPUS) supplement.
(8) Medicare supplement.
(9) Long-term care.
(10) Other limited insurance benefit plans.
Section 7. Effective date.
This act shall take effect July 1, 2013.
Section 1. Short title. <--
This act shall be known and may be cited as the Lyme and
Related Tick-Borne Disease Surveillance, Education, Prevention
and Treatment Act.
Section 2. Findings.
The General Assembly finds that:
(1) Lyme disease and other tick-borne diseases are
carried primarily by ticks and pose a serious threat to the
health and quality of life of many citizens of this
Commonwealth.
(2) The most common way to acquire Lyme disease is to be
20110HB0272PN4222 - 10 -
bitten by a tick that carries the spirochete.
(3) In 2009, 5,722 cases of Lyme disease were reported
in this Commonwealth, the highest number of cases reported in
any state, and representing a 76% increase since 2006. In
2010, provisional numbers of 6,277 cases, confirm this
ongoing upward trend.
(4) These trends illustrate the World Health
Organization's (WHO) projections through 2100. The WHO states
that Lyme disease will increasingly become a public health
threat in the United States. Pennsylvania needs to be
prepared to deal with this trend, which is already being
observed in Pennsylvania's statistics.
(5) Lyme disease is most prevalent in Southeastern
Pennsylvania, but it is found across this Commonwealth.
(6) With proper precautions taken while engaged in
outdoor activities, people can greatly reduce their chances
of tick pathogen transmission by making sure that frequent
tick checks are made and ticks are removed and disposed of
promptly and properly.
(7) The early clinical diagnosis and appropriate
treatment of these tick-borne disorders and diseases can
greatly reduce the risks of continued symptoms which can
affect every system and organ of the human body and often
every aspect of life.
(8) Left untreated, Lyme disease can cause a number of
signs and symptoms which can become quite severe.
Section 3. Legislative intent.
It is the intent of the General Assembly:
(1) To provide the public with information and education
to create greater public awareness of the dangers of and
20110HB0272PN4222 - 11 -
measures available to prevent, diagnose and treat Lyme
disease and related maladies.
(2) To ensure that:
(i) Licensees, insurers, patients and governmental
agencies are educated about treatment options.
(ii) Licensees provide patients with sufficient
information about treatment options to enable patients to
make an informed choice as part of informed consent and
to respect the autonomy of that choice.
(iii) Pennsylvania government agencies provide
unbiased information regarding treatment options.
Section 4. Definitions.
The following words and phrases when used in this act shall
have the meanings given to them in this section unless the
context clearly indicates otherwise:
"Department." The Department of Health of the Commonwealth.
"Licensee." A licensed physician, a physician's assistant, a
certified registered nurse practitioner or other licensed health
care professional.
"Lyme disease." The clinical diagnosis of a patient by a
licensed physician or certified registered nurse practitioner of
the presence of signs or symptoms compatible with acute, late-
stage, persistent infection with Borrelia burgdorferi or
complications related to such infection or with such other
strains of Borrelia that are recognized by the Centers for
Disease Control and Prevention as a cause of Lyme disease. The
term includes infection that meets the surveillance criteria
established by the Centers for Disease Control and Prevention
and other acute and persistent manifestations of such an
infection as determined by a physician.
20110HB0272PN4222 - 12 -
"Related tick-borne illness." A case of Bartonella,
babesiosis/piroplasmosis, anaplasmosis, ehrlichiosis or other
tick-transmissible illness. The term does not include Lyme
disease.
"Secretary." The Secretary of Health of the Commonwealth.
"State officials." The term includes the Secretary of
Environmental Protection of the Commonwealth.
"Task force." The task force established by this act.
Section 5. Task force.
(a) Establishment.--The department shall establish a task
force on Lyme disease and related tick-borne diseases.
(b) Purpose.--The task force shall investigate and make
recommendations to the department regarding:
(1) The surveillance and prevention of Lyme disease and
related tick-borne illnesses in this Commonwealth.
(2) Raising awareness about the long-term effects of the
misdiagnosis of Lyme disease.
(3) Development of a program of general public and
health care professional information and education regarding
Lyme disease which shall include the broad spectrum of
scientific and treatment options regarding all stages of Lyme
disease and related tick-borne illnesses.
(4) Cooperation with the Pennsylvania Game Commission to
disseminate the information required under paragraph (3) to
licensees of the commission and the general public.
(5) Cooperation with the Department of Conservation and
Natural Resources to disseminate the information required
under paragraph (3) to the general public and visitors of
State parks and lands.
(6) Cooperation with the Department of Education to:
20110HB0272PN4222 - 13 -
(i) Disseminate the information required under
paragraph (3) to school administrators, faculty and
staff, parents, guardians and students.
(ii) Determine what role schools may play in the
prevention of Lyme disease, including, but not limited
to, prompt removal and reporting of tick removals to
State officials.
(iii) Update policies to recognize signs or symptoms
of Lyme disease and related tick-borne illnesses as
health conditions potentially requiring accommodations.
(7) Cooperation of the Department of Environmental
Protection to test ticks and provide results and to publish
infection rates on its publicly accessible Internet website.
(c) Composition.--The task force shall be composed of the
following individuals:
(1) The secretary or a designee.
(2) The Secretary of the Commonwealth or a designee.
(3) The Secretary of Education or a designee.
(4) The Deputy Secretary for Parks and Forestry in the
Department of Conservation and Natural Resources or a
designee.
(5) The Director of the Bureau of Information and
Education of the Pennsylvania Game Commission or a designee.
(6) Two physicians licensed in this Commonwealth who are
knowledgeable concerning treatment of Lyme disease and
related tick-borne illness and who are members of the
International Lyme and Associated Diseases Society.
(7) Two physicians licensed in this Commonwealth who are
knowledgeable concerning treatment of Lyme disease and
related tick-borne illness and who are members of the
20110HB0272PN4222 - 14 -
Infectious Diseases Society of America.
(8) An epidemiologist licensed in this Commonwealth who
has expertise in spirochetes and related infectious diseases.
(9) Two individuals who represent Lyme disease patient
groups who may be a Lyme disease patient or a family member
of a Lyme disease patient.
(10) One individual who is a Lyme disease patient or
family member of a Lyme disease patient.
(11) Two registered nurses licensed in this
Commonwealth, one of whom is a certified registered nurse
practitioner and both of whom are knowledgeable concerning
Lyme disease and related tick-borne illness.
(12) The Director of Vector Management of the
Department of Environmental Protection.
(13) An entomologist with the Department of Entomology
of The Pennsylvania State University who has experience in
tick identification and tick borne diseases.
(14) A registered school nurse licensed in this
Commonwealth who is knowledgeable concerning Lyme disease and
related tick-borne illness.
(15) Two veterinarians licensed in this Commonwealth, at
least one of whom is a veterinary epidemiologist and both of
whom are knowledgeable concerning Lyme disease and related
tick-borne illness.
(d) Meetings.--
(1) Within 45 days of the effective date of this
section, the secretary shall appoint the members of the task
force. The secretary shall appoint a chairman of the task
force.
(2) The task force shall convene within 90 days of the
20110HB0272PN4222 - 15 -
effective date of this section and shall meet at least
quarterly.
(3) The task force shall issue a report with
recommendations to the secretary within one year of its first
meeting. The report shall also be transmitted to the Public
Health and Welfare Committee of the Senate and the Health
Committee of the House of Representatives.
(4) Nothing in this act shall be construed to prohibit
the task force from making interim reports.
(e) Compensation and expenses.--The members of the task
force shall receive no compensation for their services but shall
be allowed their actual and necessary expenses incurred in
performance of their duties. Reimbursement shall be provided by
the department.
(f) Duties of department.--The department shall:
(1) Develop a program of general public information and
education regarding Lyme disease which shall include the
broad spectrum of scientific and treating options regarding
all stages of Lyme disease and related tick-borne illnesses.
(2) Cooperate with the Pennsylvania Game Commission to
disseminate the information required under paragraph (1) to
licensees of the Pennsylvania Game Commission and the general
public.
(3) Cooperate with the Department of Conservation and
Natural Resources to disseminate the information required
under paragraph (1) to the general public and visitors of
State parks and lands.
(4) Cooperate with the Department of Education to:
(i) Disseminate the information required under
paragraph (1) to school administrators, school nurses,
20110HB0272PN4222 - 16 -
faculty and staff, parents, guardians and students.
(ii) Determine what role schools may play in the
prevention of Lyme disease, including, but not limited
to, prompt removal and reporting of tick removals to
State officials.
(iii) Update policies to recognize signs or symptoms
of Lyme disease and related tick-borne illnesses as
health conditions potentially requiring accommodations.
(5) Cooperate with professional associations of health
care professionals to provide the education program for
professionals required under paragraph (1).
(6) Cooperate with the Department of Environmental
Protection to disseminate tick infection information required
under paragraph (1) to health care professionals and the
general public.
(7) Cooperate with the Pennsylvania State University,
Department of Entomology, cooperative extension program for
integrated pest management, to disseminate educational
resources about ticks, related diseases and integrated pest
management for disease prevention as required under paragraph
(1) to health care professionals and the general public.
(g) Tick collection and testing program.--The department may
develop an active tick collection and testing program in
cooperation with the Department of Environmental Protection.
This effort may include a tick surveillance program to provide a
better understanding of, including, but not limited to, the full
range of tick-borne diseases, geographic hot spots and levels of
infectivity to be used in targeting prevention and education
efforts and veterinary data on tick-borne disease prevention,
specifically dogs and horses and other animals as the Centers
20110HB0272PN4222 - 17 -
for Disease Control and Prevention have recommended.
Section 6. Effective date.
This act shall take effect immediately.
20110HB0272PN4222 - 18 -