Review of Michigan Bills- 2019
Review of Michigan Bills- 2019
Before reviewing the bills and comments below it would be to your advantage
To know more about the chronic stages of Lyme disease.
Chronic Lyme Disease Definition
Embedded Files
HB 4603- Opposed
Summary- Requires health care professionals to reports cases of Lyme disease.
Position- Reporting of Lyme disease has been ongoing on a yearly basis since 1990. It is already required by the Michigan health departments and Centers for Disease Control (CDC). We do not need a bill to make Lyme disease reporting mandatory. It already is a reportable disease.
The bill requires those who don't report a case of Lyme disease within 24 hours of the diagnosis to pay a fine ($10 - $100). Aside from being unreasonable and unnecessary, the law is not able to be enforced and there is no accountability.
Map of reported cases. Michigan stats from 1990 to 2017.
https://lymediseaseassociation.org/LDA_Apps/content/Maps/index.html#
Link to Bill
http://www.legislature.mi.gov/documents/2019-2020/billintroduced/House/htm/2019-HIB-4603.htm
Text of HB4603 Relating to Lyme disease.
(4) THE DEPARTMENT SHALL ESTABLISH BY RULE REQUIREMENTS FOR REPORTING AND OTHER SURVEILLANCE METHODS FOR MEASURING THE OCCURRENCE OF LYME DISEASE.
RULES PROMULGATED UNDER THIS SUBSECTION MUST REQUIRE A LICENSED HEALTH PROFESSIONAL OR HEALTH FACILITY TO SUBMIT TO THE DEPARTMENT OR A LOCAL HEALTH DEPARTMENT, ON A FORM PROVIDED BY THE DEPARTMENT, A REPORT OF AN INDIVIDUAL WHO HAS BEEN DIAGNOSED WITH LYME DISEASE.
THE RULES PROMULGATED UNDER THIS SUBSECTION MUST REQUIRE A REPORT TO BE SUBMITTED TO THE DEPARTMENT NOT MORE THAN 24 HOURS AFTER A LICENSED HEALTH PROFESSIONAL OR HEALTH FACILITY DETERMINES THAT AN INDIVIDUAL HAS LYME DISEASE.
IF THE DEPARTMENT DETERMINES THAT A PERSON HAS VIOLATED A RULE PROMULGATED UNDER THIS SUBSECTION, THE DEPARTMENT MAY ISSUE A NOTICE TO THE PERSON WARNING THE PERSON OF THE VIOLATION.
UPON A SECOND OR SUBSEQUENT VIOLATION, THE DEPARTMENT SHALL ASSESS A CIVIL FINE OF NOT LESS THAN $10.00 OR NOT MORE THAN $100.00, AS DETERMINED BY THE DEPARTMENT.
HB 4604- Insurance Coverage- OPPOSED
Summary- Insurance Coverage
Sponsor claims the bill is to have Medicare & Medicaid cover Lyme related bills. Since those programs are federally based, not state, the bill would not apply in those cases. As for other insurers, it simply states insurers are to "provide coverage for Lyme disease treatment".
It doesn't specify what kind of treatment, prescribed by whom, or for how long, nor does it cover the diagnosis process.
Insurers typically do cover some treatment and the diagnositc costs for Lyme disease, so the bill is redundent. It also contains too many loop holes and not enough specifics to be effective.
Bill Text
A bill to amend 1956 PA 218, entitled "The insurance code of 1956,"
(MCL 500.100 to 500.8302) by adding section 3406u.
THE PEOPLE OF THE STATE OF MICHIGAN ENACT:
SEC. 3406U. AN INSURER THAT DELIVERS, ISSUES FOR DELIVERY, OR RENEWS IN THIS STATE A HEALTH INSURANCE POLICY SHALL PROVIDE COVERAGE FOR LYME DISEASE TREATMENT.
Enacting section 1. This amendatory act applies to policies, certificates, and contracts delivered, executed, issued, amended, adjusted, or renewed in this state, or outside of this state if covering residents of this state, beginning 90 days after the date this amendatory act is enacted into law.
Link To Bill
https://www.legislature.mi.gov/documents/2019-2020/billintroduced/House/htm/2019-HIB-4604.htm
HB 4605- OPPOSED
Summary- Doctor Protection
This will be a highly contested bill and should be. The medical board has an obligation to protect Michigan residents from doctors who run-a-muck and provide dangerous treatments, the wrong treatments, or no treatments for certain conditions.
The bill is loosely worded, opening the door for snake oil salesmen to take advantage of patients with no oversight or consequences for doing so. Reasons for opposing this bill are deeper than that of course, but that is the main point- it doesn't protect patients.
Example of wording problems- An ob/gyn treating her Lyme patients or a dermatologist treating patients, for example, would be considered to be treating out of their “scope of practice” and left venerable.
Also, the line "DISPENSES A LONG-TERM ANTIBIOTIC FOR THE TREATMENT OF LYME DISEASE”...
“A” long term antibiotic would not necessarily cover antimicrobials (all bills should use antimicrobial rather than antibiotic in the wording), or Mepron, or two or more antibiotic combos, supplemental herbs, etc. It also doesn't cover monitoring the use of the antibiotic, testing and additional diagnostics and safe guards as needed. That leaves Lyme treating health care professionals open for legal actions if they use more than "an antibiotic" or practice medicine as required.
Refer to ILADS Lyme Guidelines to review treatment protocols calling for more than one antimicrobial in some instances and multiple studies from Johns Hopkins (Zhang, et. al.) indicating the current treatment protocols are failing to eliminate all forms of the Lyme spirochete (Borrelia burgdorferi) and multiple antimicrobials are necessary.
ILADS Guidelines
https://www.tandfonline.com/doi/full/10.1586/14787210.2014.940900
Zhang's Studies
And, who determines what “gross negligence” actually is today? If you have doctors who are unfamiliar and inexperienced on the medical boards or reviewing the medical records, their reports, as we've learned from years of experience, can be interpreted differently than if you have trained, experienced chronic Lyme treating physicians reviewing the records and making decisions.
And “long-term"- it is also not seen the same way by various specialties. That is a fine line that has been a problem in the past. Is it more than 2 weeks, more than 4 weeks, more than 3 months or a year or more?
The bill is not specific and is riddle with loop holes. Possibly it is the worst example of a doctor protection bill ever written.
Link To Bill
https://www.legislature.mi.gov/documents/2019-2020/billintroduced/House/pdf/2019-HIB-4605.pdf
Bill Text
SEC. 162 21C . (11) EXCEPT IN THE CASE OF GROSS NEGLIGENCE OR WILLFUL MISCONDUCT AS DETERMINED BY THE DEPARTMENT, A LICENSEE OR REGISTRANT WHO PRESCRIBES , ADMINISTERS , OR DISPENSES A LONG - TERM ANTIBIOTIC FOR THE TREATMENT OF LYME DISEASE IN A HUMAN PATIENT IN ACCORDANCE WITH THE LICENSEE'S OR REGISTRANT'S SCOPE OF PRACTICE IS NOT SUBJECT TO ADMINISTRATIVE ACTION UNDER THIS ARTICLE .
(2) AS USED IN THIS SECTION::
(A) "GROSS NEGLIGENCE" MEANS CONDUCT SO RECKLESS AS TO DEMONSTRATE A SUBSTANTIAL LACK OF CONCERN FOR WHETHER AN INJURY RESULTS .
(B) "WILLFUL MISCONDUCT" MEAN S CONDUCT COMMITTED WITH AN INTENTIONAL OR RECKLESS DISREGARD FOR TH E SAFETY OF OTHERS, AS BY FAILING TO EXERCISE REASONABLE CARE TO PREVENT A KNOWN DANGER
Enacting section 1. This amendatory act takes effect 90 days after the date it is enacted into law.
HB 4606- OPPOSED
Re: Blood, Tissue & Organ Testing
The words "Lyme disease" were added to an HIV bill as a second thought. The bill is not only poorly written for use in Lyme disease situations, but is problematic.
Common sense and rules and regulations already in force require people to be notified if they have a positive HIV test. Additional testing results are also reported to the patient or caregiver as directed.
If donated blood, tissue or organs are infected with bacteria, parasites (example- Babesia sp.), or other foreign material or unsafe organisms they would not be used in a transplant or transfusion situation. Hence, no reason to have a bill addressing the situation.
The FDA recently (2018) approved testing donated blood for Babesia (tick borne disease). The blood is to go through a two step testing process before being utilized.
https://www.jwatch.org/fw113935/2018/03/08/fda-approves-tests-screen-blood-donations-babesia
The Red Cross, FDA, CDC and others have been reviewing the data and various modes of transmission for other tick borne diseases to determine the best way to screen for potentially transmitable diseases, including Lyme disease.
There have been NO reported cases of Lyme being transfused from one person to another through a blood donation, or tissue or organ transplants.
Additional concerns:
1.) There is no funding in the bill to cover the costs of testing which could easily run in the millions annually.
2.) There is no accountablity or oversight specified to monitor this situation.
3.) The tests to be used for HIV are specified in the bill. (See text below.)
4.) The methods for testing for Lyme disease are not specified.
5.) Lyme tests approved by the CDC have been shown to miss 74.9% of those infected.*
6.) Standard testing for Lyme disease is not an accurate way to determine if blood, tissues, or organs are infected.
*Lyme Test Study- Compared to HIV Testing. https://sites.google.com/view/marylandlyme/lab-tests/are-lyme-tests-accurate-no?authuser=0
Selected section of bill text, to be used as an example.
(6) A person, including, but not limited to, a licensee under article15 or article 17 who orders or performs, or both, a test for HIV, or an antibody to HIV, OR LYME DISEASE under this section shall, if the test result is positive, inform the donor of the positive test result.
For purposes of this subsection, a positive test result FOR HIV OR AN ANTIBODY TO HIV is a double positive enzyme - linked immunosorbent assay test, combined with a positive western blot assay test, or a positive result under an HIV test that is considered reliable by the federal centers for disease control CENTERS FOR DISEASE CONTROL and is approved by the department.
Link to Bill
https://www.legislature.mi.gov/documents/2019-2020/billintroduced/House/pdf/2019-HIB-4606.pdf
HB 4607- OPPOSED
Summary- Requires health care professionals to perform an ELISA and Western Blot for Lyme disease after explaining about details about testing, treament options and complications. It also requires doctors to provide a list of (unknown, unspecified?) doctors to see for treatment. It requires all doctors to provide a written statement that the tests for Lyme can be false positive or false negative.
It is repetative, redundent, full of loop holes, unreasonable for health care providers, dangerous for patients and should not be supported.
Link To Bill
https://www.legislature.mi.gov/documents/2019-2020/billintroduced/House/pdf/2019-HIB-4607.pdf
Bill Text & Comments
THE PRESENCE OF LYME DISEASE IN A HUMAN PATIENT SHALL ORDER AN ENZYME - LINKED IMMUNOSORBENT ASSAY TEST AND A WESTERN BLOT ASSAY
(First, that is what the labs are now being forced to do already, so it isn’t needed- redundent. And that specified process that would become a law goes against what we know would be most helpful and cost effective, which is a WB only in most cases.)
... TEST AND SHALL PROVIDE THE PATIENT OR HIS OR HER LEGAL REPRESENTATIVE WITH WRITTEN MATERIALS ON LYME DISEASE AND TESTING FOR LYME DISEASE BEFORE THE TESTS ARE PERFORMED . THE WRITTEN MATERIALS MUST INCLUDE, BUT ARE NOT LIMITED TO, ALL OF THE FOLLOWING:
( i ) AVAILABLE TREATMENT OPTIONS FOR LYME DISEASE .
(You can't provide treatment options until all of the test results have been reported. Coinfections, patient history, etc. allergies, all need to be considered. Additionally, this is stepping on the toes of health care professionals state wide and will not be taken kindly.)
( ii ) A LIST OF PHYSICIANS WITH EXPERTISE IN TREATING LYME DISEASE .
(What list of physicians with expertise in treating Lyme disease? A list of infectious disease doctors? That would be a total disaster for Lyme patients. A list of trained health care professionals specializing and certified to treat Lyme disease? Certification does not exist. Some doctors do not want to be on a list, yet are very versed in treating Lyme disease.
Who compiles the list? Who keeps up with changes on the list? Who copies and distributes the list to all Michigan health care professionals across the State?
This plan has not been thought through, is unreasonable and is inappropriate.)
( iii ) THE SYMPTOMS AND COMPLICATIONS THAT AN INDIVIDUAL WHO IS DIAGNOSED WITH LYME DISEASE MAY EXPERIENCE .
(This makes no sense and it would be almost impossible to have a list prepared with over 1,000 documented symptoms that could be experienced. And since the treatment protocol would not be established until all test results are in, you can not predict in advance what complications any prescribed medications may cause.
Documented Symptoms
https://sites.google.com/view/symptoms-of-lyme/home
Why would you tell (scare) someone you suspect may have Lyme disease or one of many other conditions all of this detailed information about Lyme disease (and nothing else) before TESTING them and evaluating all of the test results and considering their history and other factors?
This is dictating to doctors how to handle and treat their patients and will not be seen as a good thing.
Additional Consideration- Whatever would be distributed by the Michigan DOH would by default become the law of the land in Michigan- good or bad for doctors and patients. The sanctioning by the DOH of certain procedures and treatment protocols they sanction could be used by medical boards against all of us.)
(B) A NOTICE IN SUBSTANTIALLY THE FOLLOW ING FORM: "YOUR HEALTH CARE PROVIDER HAS ORDERED A LABORA TORY TEST FOR THE PRESENCE OF LYME DISEASE FOR YOU. CURRENT LABORATORY TEST ING FOR LYME DISEASE CAN BE PROBLEMATIC AND STANDARD LABORATORY TESTS OFTEN RESULT IN FALS E NEGATIVE AND FALSE POSITIVE RESULTS.. IF TESTED TOO EARLY, YOU MAY NOT HAVE PRODUCED ENOUGH ANTIBODIES TO BE CONSIDERED POSITIVE BECAUSE YOUR IMMUNE RESPONSE REQUIRES TIME TO DEVELOP ANTIBODIES. IF YOU ARE TESTED FOR LYME DISEASE AND THE RESULTS ARE NEGATIVE , THIS DOES NOT NECESSARILY MEAN THAT YOU DO NOT HAVE LYME DISEASE. IF YOU CONTINUE TO EXPER IENCE UNEXPLAINED SYMPTOMS, YOU SHOULD CONTACT YOUR HEALTH CARE PROVIDER AND INQUIRE ABOUT THE APPROPRIATENESS OF RETESTING OR INITIAL OR ADDITIONAL TREATMENT."
(This is from a total do-nothing bill that is being ignored by those required to perform this action, and couldn’t be enforced in the states where it was passed (Maryland, Virginia).
The bill promoters tried to go back the following year (Virginia) and have another bill requiring monetary sanctions be placed on those who didn’t follow the law and that bill wasn’t even brought out of committee- total failure.
The only thing the original bill did was cause mainstream doctors and medical societies to go MORE on the defensive. It stirred them up into a frenzy, and got them to hate Lyme patients more. Today, still, I’ve yet to hear of anyone in VA or MD that got this note from their doctor, and I’ve been asking around about it.
If we are going to ask Santa (legislators) for something- we need to ask for something that will actually help us and be effective, not something as insignificant as a stick of bubble gum, or something as dangerous as a loaded gun with no safety.)
(2) A LICENSEE WHO PRESCRIBES, ADMINISTE RS, OR DISPENSES ANY OF THE FOLLOWING FOR THE TREATMENT OF LYME DISEASE IN A HUMAN PATIENT IS NOT SUBJECT TO ADMINISTRATIVE ACTION UNDER SECTIONS 2116221 AND 16226:
(A) AN ORAL LONG - TERM ANTIBIOTIC.
(Again, with the “an antibiotic”. It isn’t helping us with those words, and can hurt us by restricting treatment options.)
(B) AN INTRAVENOUS ANTIBIOTIC ADMINISTERED THROUGH A VASCULAR ACCESS DEVICE.
^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^^
Michigan Legislator- Second Attempt
August 16, 2019- In the meantime, the CDC issued a report- Updated CDC Recommendation for the Serological Diagnosis of Lyme Disease.
QUOTE- "On July 29, 2019, the Food and Drug Administration (FDA) cleared several Lyme disease serologic assays with new indications for use, allowing for an EIA rather than western immunoblot assay as the second test in a Lyme disease testing algorithm. ...
The modified methodology uses a second EIA in place of a western immunoblot assay. Clearance by FDA of the new Lyme disease assays indicates that test performance has been evaluated and is “substantially equivalent to or better than” a legally marketed predicate test."
https://www.cdc.gov/mmwr/volumes/68/wr/mm6832a4.htm?s_cid=mm6832a4_w
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List of Symptoms Documentation- Over 1,000
https://sites.google.com/view/symptoms-of-lyme/home
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List of Treatment Options- An Entire Website Dedicated To Treatment Options
https://sites.google.com/view/treating-lyme-related-diseases/home
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Lyme Test Notice- One of Many Bills Not Working
Virginia- 2019 Bill- Lab Test Notice to be provided by labs
https://legiscan.com/VA/text/HB2731/2019
Virginia Bill- Test Notifications- HB 1933- (The bill has an expiration date of July 1, 2018.)
Virginia Fix-it bill
https://legiscan.com/VA/text/HB962/2016
Maine Bill
Maryland Bill- NatCapLyme
Rhode Island- Move On Petition
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HB 4608- OPPOSED
Summary- This bill makes it mandatory for the Michigan DOH to determine the best way to diagnose and treat Lyme disease and to inform health care providers how to treat Lyme patients.
Link To Bill
https://www.legislature.mi.gov/documents/2019-2020/billintroduced/House/htm/2019-HIB-4608.htm
Needless to say this bill, if passed, would be a total disaster.
It actually makes it a law that the DOH (CDC) and the Michigan Board of Medicine the ability to decide how to diagnose and treat Lyme disease.
It is possible upon reading this bill that not only will it negatively affect patients in a severe manner, but the Michigan Medical Society and others heads will explode.
There is no doubnt the new IDSA Lyme guidelines (in publication process now) will be the law in Michigan and doctors and patients will not be afforded any choices. If anyone strays from the IDSA protocols they can be investigated and charged.
1st argument- The people on the committee that would be formed won’t all be medical doctors and it isn’t up to untrained people to determine diagnosis and treatment protocols for licensed doctors to follow, especially when the main DOH division working with this project will be a veterinarian led and focused group. The group will be responsible for developing...
A STANDARDIZED PROCEDURE FOR THE DIAGNOSIS AND TREATMENT OF LYME DISEASE AND OTHER TICK-BORNE DISEASES THAT ARE IDENTIFIED BY THE DEPARTMENT.
THE PROCEDURES MUST INCLUDE, BUT ARE NOT LIMITED TO, PROVIDING GUIDANCE TO HEALTH CARE PROVIDERS IF THE RESULT OF A SEROLOGICAL TEST FOR LYME DISEASE OR ANOTHER TICK-BORNE DISEASE IS NEGATIVE BUT A SYMPTOM OF LYME DISEASE OR ANOTHER TICK-BORNE DISEASE PERSISTS.
(This is already dictated by the CDC and IDSA. And it says move along this person doesn’t need testing or treatment. No use in adding to our misery.)
A STANDARDIZED NOTIFICATION FORM TO BE DISTRIBUTED BY HEALTH CARE PROVIDERS TO INDIVIDUALS WHO ARE BEING TESTED FOR LYME
(Again, not needed, comes from bad bills in other states, and has been unsuccessful in obtaining its goals.)
ANY OTHER INFORMATION THAT THE DEPARTMENT CONSIDERS RELEVANT.
(That’s like giving those working against us a signed check to do with as they please.)
THE DEPARTMENT SHALL DISTRIBUTE THE PROCEDURES AND NOTIFICATION FORM DESCRIBED IN SUBSECTION (1) TO HEALTH CARE PROVIDERS.
(VERY dangerous. That means what they distribute is the law of the land, no exceptions. No doctor will have a chance against a medical board if this happens and patients won’t have a choice in their treatment options. This tactic was also tried in the form of a bill in another state when the 2006 IDSA guidelines had just come out. Bad mojo! Run, don’t walk to your nearest exit.)
"INTERESTED PERSONS” MEANS
(Even if you have 10 people who aren't supporting the IDSA guidelines on that deciding group, they will out number you as fast as possible. It is not specified how many people or what position they hold, so if you are not IDSA, you don’t stand a chance. Been there, done that many times.)
HB 4609- OPPOSED
Summary- A person with Lyme can be treated in a hospital. This bill focuses on payments for services provided by health care professionals for many conditions. It appears one line about Lyme disease was added in as an afterthought (?).
Link To Bill
https://www.legislature.mi.gov/documents/2019-2020/billintroduced/House/htm/2019-HIB-4609.htm
(I) AN ELIGIBLE INDIVIDUAL MAY RECEIVE DIAGNOSTIC AND TREATMENT SERVICES FOR LYME DISEASE OR OTHER RELATED TICKBORNE ILLNESSES.
This is a strange one. First of all, we already recieve treatment if we are in a hospital. Insurance typically pays and if no insurance, then often the Medicaid or charitable organizations assist.
This bill does not specify what type of diagnostics or treatment.
It appears, and I am not versed in this and it doesn’t make much sense to me, they are setting prices (by percentages) for various treatments for various conditions. I don’t want to interfere with what doctors can get or not in the way of payment.
It might be best to refer this bill to a doctor to review? I don’t know all the implications here, sorry.
EDIT- This bill was shared with a practicing doctor and they don't understand it either.
HB 4659- Park Signs
Summary- Placement of tick warning signs in all of the Michigan state parks- at trail entrances and in campgrounds. No funding for this costly endeavor (millions of dollars) has been provided.
https://www.legislature.mi.gov/documents/2019-2020/billintroduced/House/htm/2019-HIB-4659.htm
No funding. No description of signs to be used. Experience tells us that metal signs should be used (no others last and need replacing too often). The signs should be secured in cement with metal poles.
To accomplish this requirement there would need to be new staff to plan, design, transport and install the signs. Material and labor costs have not been factored in to the bill.
Before introducing the bill someone should have checked with the parks first to see if they want to add signs. (My note and the communications at the bottom of this email explains that parks don’t want more signs and why.)
Also, one year to complete the project is not reasonable. Need time to design and make signs, and there is no extra staff waiting around to take on the project and complete the physical work needed to install them.
Some park areas are closed in winter months and are inaccessible so working conditions may not be conducive to installing signs for possibly six or more months of the year.
Using NY as an example for costs involved...
To put ONE sign per park entrance in Michigan, and one on each trail and at each campground (this bill calls for more), it would cost approximately $11,400,000.
Additionally….
NY spent an enormous amount of money for installing their “I Love NY” signs.
QUOTE- "In all, 514 signs were installed statewide [NY] -- meaning the state spent an average of more than $15,000 per sign for materials and installation costs.”
QUOTE- "ALBANY - New York paid about $8.1 million to print and install "I Love NY" highway signs across the state, despite being warned they violate federal law."
QUOTE- "The dispute [over the signs] could threaten a portion of the more than $1 billion in federal highway funding sent to New York each year, which the Federal Highway Administration can withhold if the state doesn't comply."
Michigan Parks, Campgrounds & Trails- Total760
http://www.michigandnr.com/parksandtrails/#list
Map http://www.michigandnr.com/parksandtrails/#map-tab
Many diseases & vectors are found in Michigan State Parks. This only addresses a small number of them. It doesn’t include warning signs about the dangers of snakes, bears, rats, etc.
Zoonotic Diseases Michigan- TBD Info Included for Michigan 2013-2017
https://www.michigan.gov/documents/emergingdiseases/2017_Annual_Summary_final_636841_7.pdf
EXAMPLE Bill Indicating Funds Would Be Needed- Virginia 2016 Session- HB 962
https://lis.virginia.gov/cgi-bin/legp604.exe?161+sum+HB962Virginia
1. That §54.1-2963.2 of the Code of Virginia is amended and reenacted and that the Code of Virginia is amended by adding a section numbered 10.1-202.3 as follows:
§ 10.1-202.3. Lyme Disease Educational Signage Fund.
There is hereby created in the state treasury a special nonreverting fund to be known as the Lyme Disease Educational Signage Fund, referred to in this section as "the Fund."
The Fund shall be established on the books of the Comptroller. All civil penalties assessed pursuant to §54.1-2963.2 and any funds appropriated for such purpose and any gifts, donations, grants, bequests, and other funds received on its behalf shall be paid into the state treasury and credited to the Fund. Interest earned on moneys in the Fund shall remain in the Fund and be credited to it.
Any moneys remaining in the Fund, including interest thereon, at the end of each fiscal year shall not revert to the general fund but shall remain in the Fund.
Moneys in the Fund shall be used solely for the purposes of providing Lyme disease educational signage for placement in Virginia State Parks. [See Note Below] Expenditures and disbursements from the Fund shall be made by the State Treasurer on warrants issued by the Comptroller upon written request signed by the Director.
https://lis.virginia.gov/cgi-bin/legp604.exe?161+sum+HB962
Before you create a bill stating something like:
"Moneys in the Fund shall be used solely for the purposes of providing Lyme disease educational signage for placement in Virginia State Parks."
You need to check with the Virginia State Parks FIRST!
Had someone bothered to check FIRST- they would have known the Parks don't want signs. See what the Virginia State Park official had to say about putting up signs after reviewing the bill....
QUOTE- "Unfortunately signs would not be particularly effective. There are many things that could possibly cause danger in a park experience and if we posted signs about all of them, that’s all you would see. We have drastically reduced signage in our parks even about rules and regulations as we found they were ineffective in changing visitor behavior...." Virginia Department of Conservation and Recreation (email communication)
https://sites.google.com/site/lymelegislation/other-states-actions/virginia
The Virginia park sign bill died and it was set up for having funding.
Status: 01/12/16 House: Prefiled and ordered printed; offered 01/13/16 16102111D
01/12/16 House: Referred to Committee on Health, Welfare and Institutions
01/20/16 House: Assigned HWI sub: Subcommittee #3
02/04/16 House: Subcommittee recommends striking from docket by voice vote
02/16/16 House: Left in Health, Welfare and Institutions
House Concurrent Resolution No. 7- Not Opposed
Summary- Encouraging, by way of delivering this document to the CDC and Michigan Department of Health, to to do a better job than they have been doing as related to Lyme disease.
Response- This action could be handled by way of a letter.
Link To Resolution
Rep. Whitsett offered the following concurrent resolution:
House Concurrent Resolution No. 7.
A concurrent resolution to urge the Centers for Disease Control and Prevention and the Michigan Department of Health and Human Services to protect the people of Michigan from Lyme disease by improving efforts to prevent, monitor, diagnose, and treat the disease.
Whereas, Lyme disease is a serious, tick-borne illness caused by the bacterium Borrelia burgdorferi, resulting in symptoms including headache, fatigue, fever, and the characteristic bullseye rash. If left untreated, the disease can spread throughout the body to joints, the heart, and the nervous system causing arthritis, pain, heart palpitations, and even facial paralysis; and
Whereas, Previously rare in Michigan, Lyme disease is now a growing concern for Michigan residents. The prevalence of Lyme disease in Michigan has expanded rapidly in the past two decades with more than ten times as many cases reported in 2017 than in the early 2000s; and
Whereas, The Centers for Disease Control and Prevention’s (CDC) definitions of Lyme disease symptoms and recommendations for diagnosing and treating the disease are outdated and need to be updated to improve the ability of health professionals to detect and treat the disease. The misdiagnosis and delayed treatment of Lyme disease have serious consequences for those affected; and
Whereas, A lack of federal funding for Lyme disease research and monitoring hampers Michigan’s ability to prevent and cure the disease. Nearly 80 percent of the conditions and diseases that receive annual funding from the National Institutes of Health receive more than Lyme disease. Additional funding to improve the accuracy and precision of laboratory testing methods would significantly enhance the early detection of Lyme disease in humans; and
Whereas, Additional education and outreach efforts by the Michigan Department of Health and Human Services are necessary to better protect the public from the consequences of this disease. It is imperative that health professionals and the public recognize the symptoms of Lyme disease to ensure timely and proper treatment; and
Whereas, A lack of reporting makes it challenging to effectively monitor and address Lyme disease. Since 1991, state and local health departments have been required to report disease cases to the CDC, but of an estimated 300,000 people annually diagnosed, only 30,000 cases are reported; now, therefore, be it
Resolved by the House of Representatives (the Senate concurring), That we urge the Centers for Disease Control and Prevention to update its definition of Lyme disease symptoms, reconsider standards and best practices for diagnosing and treating the disease, increase funding to prevent and cure the disease, and provide the means for improved laboratory testing to detect Lyme disease; and be it further
Resolved, That we urge the Michigan Department of Health and Human Services to improve the techniques that state and local health departments use to report Lyme disease and to provide more resources to educate health professionals and the general public about Lyme disease to support prevention, diagnosis, and treatment; and be it further
Resolved, That copies of this resolution be transmitted to the Director of the Centers for Disease Control and Prevention and the Director of the Michigan Department of Health and Human Services.
Summary- It appears the bills were thrown together and were not designed with the best interests of the Lyme Community at heart.
Supporting them in this form or even with minor changes would not be advised.
These bills can have amendments added on at any time throughout the process by anyone- including IDSA, CDC, Medical Boards and Insurers.
These bills are not worth the risk of being moved forward.
Find Your Michigan Legislator
http://house.michigan.gov/mhrpublic/frmFindaRep.aspx
List of Michigan Legislators & Contact Information
http://house.michigan.gov/mhrpublic/frmRepListMilenia.aspx?all=true
Find Your Michigan Senator- With Contact Information
http://www.senate.michigan.gov/fysbyaddress.html
Find Bills- Michigan Bill Search
http://www.legislature.mi.gov/(S(iaheoo123fn144vybpxmjxln))/mileg.aspx?page=home
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SEE GUIDELINE DISCLAIMER & DESCRIPTION BELOW
You can't have a "standardized procedure as a foundation for the diagnosis and treatment of post-treatment Lyme disease syndrome". The IDSA/ACR/AAN have combined forces and stated more than half of the patients diagnosed with Lyme actually had other disorders.
Page 64- https://view.protectedpdf.com/ad6GFZ
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ILADS Guidelines
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4196523/
IDSA/ACR/AAN Guidelines
https://view.protectedpdf.com/ad6GFZ
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House Concurrent Resolution- Refer to the T.I.C.K. ACT- federal bill addressing all of the concerns outlined in this proposed resolution.
https://www.govtrack.us/congress/bills/116/hr3073/text
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Bills aren't keeping up with the science as it is advancing.
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Two Standards of Care Article
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