HB 1266 & SB 0950

2018 Legislation

House Bill 1266

Link to Bill Wording Here

See comments to consider below the bill information. Scroll way down...

Link Here

WORDING BELOW

HOUSE BILL 1266

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CF SB 950

By: Delegates Carey, Beidle, Frush, Krimm, Moon, Rose, and Stein

Introduced and read first time: February 9, 2018

Assigned to: Health and Government Operations

A BILL ENTITLED

AN ACT concerning

1 Health Occupations – Treatment of Lyme Disease and Other Tick – Borne

2 Diseases – Disciplinary Actions

3 FOR the purpose of prohibiting a certain health practitioner from being disciplined under

4 certain circumstances solely because of the health practitioner’s diagnostic

5 evaluation, testing, or treatment of Lyme disease or another tick – borne disease in a

6 patient; authorizing a certain disciplinary body to discipline a certain health

7 practitioner if the body makes a certain determination; prohibiting the use of a

8 certain drug, device, biological product, or method from being the basis for a

9 disciplinary action against a certain health practitioner; prohibiting a certain health

10 practitioner from being found to have violated any record–keeping, billing, or other

11 regulatory requirements for acts or omissions that arise under certain

12 circumstances; requiring, except under certain circumstances, that a certain panel

13 of peer reviewers include at least one reviewer with certain training, competence,

14 and experience; and generally relating to disciplinary actions for treatment of Lyme

15 disease and other tick–borne diseases.

16 BY adding to

17 Article – Health Occupations

18 Section 1 – 224

19 Annotated Code of Maryland

20 (22014 Replacement Volume and 2017 Supplement)

21 BY repealing and reenacting, with amendments,

22 Article – Health Occupations

23 Section 1 – 604

24 Annotated Code of Maryland

25 (22014 Replacement Volume and 2017 Supplement)

26 SECTION 1. BE IT ENACTED BY THE GENERAL ASSEMBLY OF MARYLAND,

27 That the Laws of Maryland read as follows:

28 Article – Health Occupations 1

1 – 224.

2 ( A ) (11) EXCEPT AS PROVIDED IN PARAGRAPH (22) OF THIS SUBSECTION, A

3 HEALTH PRACTITIONER LICENSED UNDER THIS ARTICLE MAY NOT BE DISCIPLINED

4 UNDER THIS ARTICLE SOLELY BECAUSE OF THE HEALTH PRACTITIONER’S

5 DIAGNOSTIC EVALUATION, TESTING, OR TREATMENT OF L YME DISEASE OR

6 ANOTHER TICK–BORNE DISEASE IN A PATIENT IF:

7 ( I ) THE DIAGNOSTIC EVALUATION, TESTING, OR TREATMENT

8 IS:

9 1. INTEGRATIVE;

10 2. COMPLEMENTARY;

11 3. ALTERNATIVE;

12 4. NONTRADITIONAL; OR

13 5. NONCONVENTIONAL;

14 ( II ) THE HEALTH PRACTITIONER DISCLOSES TO THE PATIENT:

15 1. THAT THE DIAGNOSTIC EVALUATION , TESTING , OR

16 TREATMENT IS:

17 A. INTEGRATIVE;

18 B. COMPLEMENTARY;

19 C. ALTERNATIVE;

20 D. NONTRADITIONAL; OR

21 E.. NONCONVENTIONAL;

22 2. THE KNOWN RISKS AND BENEFITS OF THE PROPOSED

23 DIAGNOSTIC EVALUATION, TESTING, OR TREATMENT;

24 3. THE FEDERAL FOOD AND DRUG ADMINISTRATION

25. STATUS OF THE PROPOSED DIAGNOSTIC EVALUATION, TESTING, OR TREATMENT

1. THE EVALUATION, TESTING, OR TREATMENT USES A DRUG, DEVICE, OR BIOLOGICAL

2 PRODUCT;

3. 4. THAT THE PROPOSED DIAGNOSTIC EVALUATION,

TESTING, OR TREATMENT:

4 A. MAY NOT BE WIDELY RECOGNIZED WITHIN THE

5 MEDICAL PROFESSION; OR

6 B. MAY BE SUBJECT TO DISAGREEMENT AMONG

7 QUALIFIED MEDICAL EXPERTS;

8 5. THE HEALTH PRACTITIONER’S EDUCATION,

9 EXPERIENCE, AND CREDENTIALS IN PERFORMING THE PROPOSED DIAGNOSTIC

10 EVALUATION, TESTING, OR TREATMENT; AND

11 6. A. THE MEDICAL SPECIALTIES THAT MAY

12 PROVIDE THE PATIENT WITH OTHER OPTIONS IF THE PATIENT HAS A POTENTIALLY

13 SIGNIFICANT CONDITION AND THE PATIENT HAS NOT YET BEEN PROVIDED WITH A

14 CONVENTIONAL DIAGNOSIS OR TREATMENT BY THE PHYSICIAN OR A SPECIALIST

15 FOR THE PATIENT’S CONDITION; AND

16 B. THE SIGNIFICANT KNOWN RISKS OF DEFERRING

17 WIDELY ACCEPTED TREATMENTS, IF ANY, FOR THE PATIENT’S CONDITION; AND

18 ( III ) THE HEALTH CARE PRACTITIONER INCLUDES IN THE

19 PATIENT’S MEDICAL RECORD DOCUMENTATION OF THE DISCLOSURE MADE UNDER

20 ITEM ( II ) OF THIS PARAGRAPH AND ANY WRITTEN CONSENT OF THE PATIENT

21 REGARDING THE DIAGNOSTIC EVALUATION, TESTING, OR TREATMENT.

22 (22) A HEALTH OCCUPATIONS BOARD UNDER THIS ARTICLE MAY

23 DISCIPLINE A HEALTH PRACTITIONER WHO OTHERWISE WOULD BE EXEMPT FROM

24 DISCIPLINE UNDER PARAGRAPH (11) OF THIS SUBSECTION IF THE HEALTH

25 OCCUPATIONS BOARD DETERMINES:

26 ( I ) THAT THE DIAGNOSTIC EVALUATION, TESTING, OR

27 TREATMENT HAS A SIGNIFICANT SAFETY RISK GREATER THAN THE CONVENTIONAL

28 METHODS; AND

29 ( II ) THAT THE RISK IS NOT OUTWEIGHED BY THE POTENTIAL

30 BENEFITS OF THE EVALUATION, TESTING, OR TREATMENT.

31 ( B ) HAS NOT BEEN APPROVED BY THE FEDERAL FOOD AND DRUG ADMINISTRATION

1 MAY NOT BE A BASIS FOR A DISCIPLINARY ACTION AGAINST A HEALTH

2 PRACTITIONER WHO IS EXEMPT FROM DISCIPLINE UNDER SUBSECTION ( A )(11) OF

3 THIS SECTION.

4 ( C ) A HEALTH PRACTITIONER WHO IS EXEMPT FROM DISCIPLINE UNDER

5 SUBSECTION ( A )(11) OF THIS SECTION MAY NOT BE FOUND TO HAVE VIOLATED ANY

6 RECORD – KEEPING, BILLING, OR OTHER REGULATORY REQUIREMENTS FOR ACTS OR

7 OMISSIONS THAT ARISE FROM PROFESSIONAL DIFFERENCES OF OPINION IF THE

8 HEALTH PRACTITIONER HAS ACTED IN GOOD FAITH TO COMPLY WITH THE INTENT

9 OF THE REQUIREMENTS .

10 1 – 604.

11 (aa) If a statute authorizes a health occupations board to use a system of peer

12 review in standard of care cases and the peer reviewer or peer reviewers determine that

13 there has been a violation of a standard of care, the board shall provide the licensee or

14 certificate holder under investigation with an opportunity to review the final peer review

15 report and provide the board with a written response within 10 business days after the

16 report was sent to the licensee or certificate holder.

17 (bb) If a health occupations board receives a written response to a final peer review

18 report, the board shall consider both the report and response before taking any action.

19 ( C ) (11)) E XCEPT AS PROVIDED UNDER PARAGRAPH (22) OF THIS

20 SUBSECTION, IF A STATUTE AUTHORIZES A HEALTH OCCUPATIONS BOARD TO USE A

21 SYSTEM OF PEER REVIEW IN STANDARD OF CARE CASES AND THE BOARD USES A

22 PANEL OF PEER REVIEWERS TO DETERMINE WHETHER A LICENSEE OR CERTIFICATE

23 HOLDER HAS VIOLATED THE STANDARD OF CARE IN THE TREATMENT OF A PATIENT

24 WITH LYME DISEASE OR ANOTHER TICK – BORNE DISEASE, THE PANEL SHALL

25 INCLUDE AT LEAST ONE REVIEWER WITH DEMONSTRATED TRAINING , COMPETENCE, 26 AND EXPERIENCE IN THE SAME METHODS USED BY THE LICENSEE OR CERTIFICATE

27 HOLDER UNDER REVIEW.

28 (22) THE REQUIREMENT UNDER PARAGRAPH (11) OF THIS SUBSECTION

29 DOES NOT APPLY IF, AFTER A GOOD FAITH INQUIRY, THE HEALTH OCCUPATIONS

30 BOARD FINDS THAT THE METHODS OF THE LICENSEE OR CERTIFICATE HOLDER

31 UNDER REVIEW HAVE NOT BEEN ADOPTED BY:

32 ( I ) ANY PROFESSIONAL ORGANIZATION;

33 ( II ) A CATEGORY 1 CONTINUING MEDICAL EDUCATION

34 PROGRAM ; OR

35 ( III ) ANY OTHER MINORITY COMMUNITY OF PHYSICIANS.

1 SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect

2 October 1, 2018.

3

Maryland Board of Physicians- Current News

2/3/18 Members of Board Ordered To Pay Millions For Poor Treatment of Maryland Physician (vaccine issues)- Article, Link Here Case Law- Link Here

Maryland Governor Signs Bill To License Naturopathic Physicians- Link Here

Damage Control- Restrictions on Naturopaths- Link Here

SB 0950

Bill Wording- Link Here

Link Here- http://mgaleg.maryland.gov/webmga/frmMain.aspx?pid=billpage&tab=subject3&id=sb0950&stab=01&ys=2018RS

Bill Wording- http://mgaleg.maryland.gov/2018RS/bills/sb/sb0950F.pdf

COMMENTS- OPINIONS

I look at the technical aspects of the Lyme related bills that come before me and so far all of them have. Anything that might be harmful to patients is my main concern.

I've spent the last 20 years reviewing, drafting, deciphering, supporting, killing and reporting on Lyme related bills and others. I am not an expert on Lyme bills, no one is actually. I just call it as I see it and continue each day trying to make the best of a really bad Lyme disease situation for those who suffer.

I love this bill, its intentions and those who are trying to make it better for patients and doctors in our state.

In fact, I think this concept- doctors and patients being allowed to chose the treatment they want to use (after full disclosure)- should be a "given" already, just as we are allowed to chose where we eat supper, where we buy a bed or sofa and where we work.

The fact we are trying to dictate and pass laws about what should be our "right" makes this a sad situation.

BUT....

This well-intended bill asks for blanket immunity for anyone and everyone (doctors) diagnosing and treating Lyme and TBDs in any way, shape or form. If some sort of charges against a doctor were to sneak through, IF this bill passed (and it won't), that were not covered in the wording, the bill requires the "Board" to be altered with someone that is qualified to treat Lyme & TBDs in the same manner as the accused; however, it states they must be "qualified" and there is no such thing.

Unfortunately, there are no certifications or credentials given to a health care professionals that distinguishes them, apart from the rest, as an "expert" on any or all modes of diagnosing or treating Lyme & TBDs. Or distinguishes them as an expert in treating Lyme with hyperbaric, for example. Or an expert in prescribing 6 months of combo antibiotics and/or steroids for Lyme and tick borne diseases.

In fact, there may be little to no scientific support for any treatment modalities. Not to say certain ones aren't successful, some may be. But this needs to be proven, documented and accepted for it to be a valid stance. (Their rules, not mine. Don't kill the messenger.)

So when the bill asks for a qualified person to review a doctor's records and/or weigh in on the charges against him, the only truly qualified person, according to the officials overseeing a Lyme disease case, the CDC, the Maryland DHMH, etc., would be an infectious disease doctor. That is as close as it gets.

And when you have dip-sticks in Maryland like Paul Auwaerter at Hopkins fighting us every step of the way, publishing with other undesirables and making life miserable for so many, the way this bill is set up, finding a "qualified" person will be difficult if not impossible.

The Bill...

Opinions on the technical issues

1. Inadvertently gives (allots) the Board some of the same powers it already has, so this doesn't need to be re-stated.

2. It exempts certain Lyme treating providers (physicians only- not therapists, assistants, hyperbaric oxygen owners, etc.) from the rules that all other medical professionals from any field that practices in Maryland must abide by.

The Board (and most likely the legislators if and hopefully they are paying attention) will not allow this to happen, as the Board's mission is to protect the public. Their rules were set up to cover ALL practitioners, not just some, and to protect ALL of the public, not just Lyme patients IF this bill really will protect them and I feel it definitely won't in some circumstances.

3. The bill permits/forces a last minute change in Board membership- something that no other field of medicine enjoys. The Board already has its working members in place, many who are currently responsible for paying millions out-of-pocket for tormenting a physician (and other offenses). Sound familiar?

Finding a volunteer for the Board at this time, until that case goes through the appeals or higher courts again, will be difficult if not impossible.

If Board members aren't protected from personal liability and can be fined for their actions, in my estimation getting new members to serve will be a really hard sell.

Additionally, according to the bill no one has been specified to fill that Lyme friendly position the bill requires, so it could end up being an ID doctor since there is no official state or federal certification to credential a LLMD. That would be a disaster.

Also, no one was specified to chose who that person would be (the Board or the accused picks someone? Heaven forbid it would be the Attorney General's office.) If it is the Board that choses, well, good luck with that too.

4. As bills go it is too complex and it attempts to cover all possibilities. It is certainly what we need to help us get patients treated, however, it goes too far.

In the process of helping us it severely infringes on the mission and purpose of the Board. Might as well not have a Board if doctors are allowed to do anything and everything they want that may or may not have scientific value or support.

5. Again, important to remember- the bill's wording allows physicians treating Lyme disease patients (but, no other doctors) to be exempt from nearly all rules set up by the State in advance- rules that were designed to protect the public.

6. It appears to expect ILADS as an organization, or its members or its guidelines to support the position of someone who is charged. (Example- 4 months oral triple combo antibiotic regimen, three months of hyperbaric sessions, colloidal silver treatments, and various supplements.)

Even ILADS guidelines don't cover most of the treatment dispensed today by good, well meaning and experienced health care professionals. ILADS (as an organization) has not been willing in the past to publicly support doctors who are charged in this kind of situation. (This is not in the ILADS mission statement and could risk its 501 (C) 3 status? I don't know for sure, need to check on that.)

7. Bill wording demands that the Board overlook violations in standard record keeping, billing and other regulatory requirements for Lyme treating health care professionals, but no one else practicing medicine in Maryland would be exempt. This could place patients in danger by way of omissions, depending only the memory of a busy doctor, malpractice suits, emergency situations, etc.

True, Lyme treating doctors who have been targeted have more recently been bogusly charged by the medical boards for paperwork mistakes as opposed to "over diagnosing and over treating Lyme disease", although that is still included in some cases. The Board reviewers specifically check for and often finds the doctor has not been keeping adequate records (ridiculous as they may seem sometimes), but this is their job.

Doctors have been charged for example, for "mistakes"- for example- not saying a patient had or didn’t have a tick bite in an endemic area, not saying if there was a rash, not sending patient’s to other health care professionals for consults or treatment (such as infectious disease doctors or neurologists), not running tests or running too many tests, or not listing and/or eliminating the differential diagnoses.

Yes, this is a nit-picky way the IDSA, Hopkins, and Maryland State has to bring down Lyme treating doctors indirectly (their goal) and should never be allowed, but you can not exempt Lyme treating doctors from doing the basics and following regulations that were set up to protect patients and ultimately, themselves.

Recent Maryland Example of Shameful Attacks on Lyme Treating Doctors

https://www.mbp.state.md.us/bpqapp/Charges/D3313804.225.PDF

More Maryland Examples

https://sites.google.com/site/lymelegislation/dr-jaller/charges-against-doctors

8. Mentions "standard of care". What standard? Whose standard? Maryland specifically, due to NatCaps & doctors interference several years ago, has Maryland strangled under a stinking policy that mirrors the IDSA standard of care when once, after years of working on it, we enjoyed the freedom to choose.

When the new IDSA/neurology/rheumatology, etc. Lyme guidelines are published they will have the "force" in our little world and will be "THE standard of care" over ILADS (as it has been since ILADS guidelines were originally published).

And what happens if ILADS once again lets their guidelines lapse (expire) so patients and doctors have nothing to cover them? Loophole alert!

9. What diagnostic methods and treatments are safe and effective for Lyme patients, and who decides what they are? This bill will expose patients to any and all treatments, quack or not.

Examples of diagnostic methods (and the bill says they don't need to be FDA approved)... How about back porch microscopy at Uncle Billy's place, PCR as an end-all determinant, test kits distributed by Tom, Joe and Larry, etc. That's not fair to patients. You can't take a patient's money, or insurers money for tests (and treat them based on the results) that don't conform to some sort of standard.

Examples of treatments used by some health care professionals treating Lyme & TBD patients that may or may not be successful, but have little if any scientific support- Bismuth IV (bismacine), rife machines, surgery, steroids, bee venom, injecting malaria tainted blood (malariotherapy), magnets, herbs, ozone, enemas, cholestyramine, saunas, hyperbaric chamber treatments, cortisone, essential oils, urotherapies (drink urine), colloidal silver, salt treatments, morphine, stem-cell therapy, radiation based therapy, oxygen therapy, chelation, etc. As the little lady in the commercials use to say... WHERE'S THE BEEF?

10. Consider this point- Paul Auwaerter (Hopkins) has done some of the Lyme reviews for the Board and a vengeful, wicked little man he is. But, he is currently the IDSA President, is stationed in Maryland and sits on an FDA panel that approves blood tests (and other things).

None of the current Board members, who are now being ordered by the court to pay millions out-of-pocket for damages to a Maryland physician for tormenting him, etc. (and are probably in a really bad mood already), are in a field of medicine that would typically know or treat Lyme disease or CHRONIC Lyme disease. Plus, who are you going to get that is willing to go up against Johns Hopkins or Auwaerter's vengeful buddies, and what credentials will they have, if any?

11. Again, the bill mentions a "qualified medical expert". Who would this be since there is no speciality field or certification for treating Lyme & TBD. The next best thing would be an infectious disease doctor. YULK!

12. Section 6A ???

13. Page 3, Section B. III Line 20 ???

14. The bill mentions experience, education and credentials. Who is it that has certified or verifiable education, experience and official expertise in Lyme & TBD other than an ID doctor? ILADS methods aren't recognized by the State, as has been seen in Board hearings in the past in Maryland and other states.

15. How popular would this bill be if you changed "Lyme" to "Cancer" and allowed any doctor who decided he/she wanted to treat cancer to do whatever they want with no restrictions or accountability?

More to think about- Would this practice outlined in the bill cause problems with your malpractice and other insurances you may need or are required to have?

16. Page 3- 4A. treatment methods "not widely recognized by the medical community". What prevents someone from giving patients a poisonous mushroom as a cure for example? And then getting away with it? NOT a good thing for patients.

17. How is Lyme to be diagnosed? Clinically, or by test results? This bill is unintentionally trapping doctors into the unknown, leaving it up for interpretation.

18. See #9 above. Who are the "qualified medical experts" in those fields?

19. Page 3, line 19 III. Already required.

20. Is a form with all of these agreements patients must sign attached to the bill or on file with the State? How will it be distributed to health care professionals across the state? Who will pay for its distribution?

21. Page 3 Line 27. Can that be proven? 2 weeks of antibiotics can "officially" be considered "fairly" safe for most Lyme patients (not effective, but safe). Is hydrogen peroxide therapy safe for Lyme patients? Hyperbaric chambers? If so, by whom has it been proven to be safe and successful? Are they recognized by Maryland State or the CDC in that capacity? If you are facing charges they need to be.

22. Page 4, top section. NOT approved by FDA. This could include treatment with scrambled eggs topped with turmeric powder, or only IV vitamins with a double shot of gin. This practice is not safe for patients.

23. Page 4, line 12. Not allowed already?

24. Page 4, line 29. READ the ILADS guidelines. Love them, love them, love them, but... ILADS guidelines approve a few weeks extra of antibiotic therapy if patient still has symptoms after treatment. As is stated in the guidelines, treatment beyond the standard one month or so can in some cases be followed by a "re-treatment" (no particulars recommended and evidence they state is "weak" at best).

This is basically what the IDSA guidelines state too. So where is the documentation proving long-term and/or multiple antibiotics are safe and successful in treating Lyme & TBD? Or pulse therapy? Again, may be successful, but it is weak, at best.

25. Page 4, line 33. Guidelines- ILADS vs. IDSA that has neurologists, rheumatologists, etc. on their list of evil-doers. Organizations listed on their new guidelines, so which, in a hostile Board environment, will carry more weight? ILADS or IDSA, et. al? To date IDSA generally rules in Board cases as we've seen many times before.

26. Page 4, line 34. Do continuing education programs cover herbs, supplements, hyperbaric, 6 months of combo antibiotics, pulse therapy, etc. in its recommended or approved protocols section? I don't know, never took the course, but I kinda doubt it. Please check.

27. No sunset clause! If bill is taken from its original form and is re-written, as ALL Lyme bills have been, and the results are not good for patients and/or doctors, you need to be able to end it in a year or two, or ASAP.

And don't think you have that "covered". Bless their hearts, but it's a rare, super rare legislator who will kill their own bill or work to have it reversed after it passes, even if they say they will and they have been known to make those promises many times in the past. I've seen them back down to many times and let the bad take over even after promising us this wouldn't happen.

28. Add repeal and re-enact sections.

29. No mention of "CAMS". ?? This is being used by traditional medicine providers and has some science behind it. Reason for not using this terminology? Just curious.

30. Those trying to reduce the use of antibiotics in the country- many IDSA doctors- may be all over this bill for allowing unproven treatments to be administered to patients when there is little to no supporting science to back it.

Patients may also have a problem with it, especially if they are not cured after all of their money is gone, and/or they are hurt by the treatment provided.

31. Check out the restrictions put on naturopaths in Maryland. What this bill requires goes far beyond what they are allowed to do in the State.

In lieu of a bill...

1. Approach the Board of Physicians and the Maryland Department of Health and Mental Hygiene and discuss getting the same doctor protection and written commitment we previously enjoyed in Maryland before NatCap Lyme, Barbara Buckman of ILADS, Susan Green and a handful of misguided doctors interfered and that protection was tossed out the window and a new IDSA-based standard of care policy was adopted in the state. Information Here

2. Have the latest policy (see #1. above) by the Maryland Board of Physicians and the Maryland DHMH rescinded and a new one adopted (see #3 below). More Information Here

3. Have a statement/agreement drawn up by the Board of Physicians and the Maryland DHMH stating all published standards of care for diagnosing and treating Lyme and tick borne diseases are available for use by patients and their doctors. This allows more leeway for all.

4. NatCap Lyme, Barbara Buckman of ILADS, attorney Susan Green and the doctors who mistakenly listened to them should have taken action immediately once the ruckus they caused and the pushing and insisting they did forced the Board to rewrite the previously good and working Lyme disease policy, which ended up being to the patients and physicians detriment.

Instead, when they learned of the problems they had caused they simply walked away and as predicted about a dozen Lyme treating health care professionals were investigated and/or charged. Today, seven years later, Lyme treating health care professionals are still under threat if they treat outside the new NatCap Lyme initiated IDSA-based standard of care set for the State of Maryland. More Information Here

Hearing Notes

3/7/18

Sorry to say, this bill, in my opinion, has about a 5% chance of passing (as is, or at all).

HB 1266

Testimony by a number of patients, attorney and a few doctors.

Video of Hearing- HERE

(Start at Time 4:48:00)

SB 950

Last hearing of the day. Some people left, some stayed to testify.

Video of Hearing- HERE

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3/13/18

Note to supporters on bill progress...

Good afternoon all!

I communicated with Senate & House offices today on bills currently awaiting a vote in their respective committees. To sum it up and respond to questions I’ve gotten from our side on the topic please see info below. My opinions are marked as such- the rest is what I’ve gleaned from the legislators. BTW- I was asked by one of the offices, forgot which one- Senate I believe- to share this info with you all so everyone is updated. They are super busy and will stay that way till a couple weeks after the session ends.

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Another amendment was introduced (by those requesting the bill) to remove the word “solely” from the bill.

OPINION/Suggestion- That makes 3 amendments so far, so please watch for others to be submitted. The fact the other side hasn’t submitted even one amendment for consideration yet leads me to believe they are not going to be willing to compromise or make adjustments so it can pass, and are counting on the bills to die in committee. Yes, I could be wrong. Let’s hope so.

This week is what is referred to as "cross over" week. Bills must be voted on in their committees and shared with the opposite side by the 19th if they have a chance to move forward. If they are voted "unfavorable” before the 19th they die in committee. If they aren’t “crossed over” by the 19th they die in committee. End of story.

The opposition is strong, however, neither office had the opposition's written testimony to refer to in order to answer my questions, such as who objected and why? I asked (very nicely) that they please get these documents and review them so they can let you know what the objections are so supporters can be better educated and prepared. They both agreed.

Legislator Hill and the other doctor (in committee- name escapes me at the moment) have sincere concerns, some of which they shared at the hearings, and I spoke to you all about before the hearings.

OPINION- The fact these two legislators are doctors generally makes their opinions stronger in committee on these types of bills. Based on what I absorbed during the hearings, they may recommend an unfavorable vote. At first I was encouraged by Legislator Hill’s asking about compromise (what could be done to fix them), however, she didn’t take it any further as she sometimes does, so my personal feeling is there may not be a chance to “work it out” and although they agree there is a problem they may want you to find a different solution.

The Board of Physicians initial reaction to the bills was not good. We all figured that, of course. There has been no further communications between the Board and the legislators offices (other than possible written testimony submitted for the hearings that neither office has checked on yet, and is what I asked they do).

OPINION- Possibly the same strong objections they’ve had in the past when this topic was brought up before.

Bill sponsors said Lyme patient’s stories are believable and were plentiful, which was very good. Both offices said no more letters or comments are needed at this time because the committee members are already convinced there is a problem. With past testimony and current testimony they’ve all heard enough Lyme patient stories. They did mention that the testimony itself was excellent. (You done good!) ~smile~

Right now the bills are in a "wait and see" mode and/or a fix-the-bills to make them workable with the other side, IF that is going to be possible. Doubtful, they said, that the bills will pass thru committee with the current language and major overhauls MAY be necessary, IF you are even offered that option.

MY SUGGESTION- Those following the bills need to be prepared, with written testimony in hand, to KILL THE BILLS in the event they are changed in a way that will go against the original intent and are passed out of committee and onto the floor. ALL Maryland legislators (House and Senate) emails must be ready to share with others (in easy format) at a moments notice, and a plea to kill the bills (with examples of what patients can say) needs to be ready to send out to get the bill killed. The time period to do this is short and very stressful, but is absolutely necessary or we will be stuck with something that our future generations will suffer under.

We should know the status of the bills once cross-over week is over, unless voted favorable or unfavorable in the meantime.

I am presently advising on 6 (possibly 7) Lyme related bills in 3 states and have little time to do more. So, keep on trucking and good luck!

LB