Pennsylvania Bill HB 272

Helping Our Neighbors in Pennsylvania

Plan A. Please see the instructions below and take action immediately to help our neighbors in Pennsylvania. Estimated time to do this task is 2-3 minutes tops.

Or ...

Plan B. Get a lot of lumber, nails, hammers and a large crew together to start building a fence so Pennsylvania ticks don't cross the borders into Virginia or other nearby states and bite you! Estimated time to do this task is 15-20 years easy.

IT'S YOUR CHOICE!

The House passed this very well written Lyme and tick borne disease bill that was introduced by Representative Dick Hess on October 2, 2012. Now we need to keep it moving forward, but ONLY if it keeps the original wording in tact!

In other words, NO CHANGES!!!

HB 272

PRIOR PRINTER'S NOS. 225, 2895 PRINTER'S NO. 4139

THE GENERAL ASSEMBLY OF PENNSYLVANIA

HOUSE BILL

No. 272

Session of

2011

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

AS AMENDED ON SECOND CONSIDERATION, HOUSE OF REPRESENTATIVES,

OCTOBER 1, 2012

AN ACT

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 and for required coverage; AND EXECUTING 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.

(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 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 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 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 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.

(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 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 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.

THE END.

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