[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1254 Introduced in House (IH)]
107th CONGRESS
1st Session
H. R. 1254
To establish a program to provide for a reduction in the incidence and
prevalence of Lyme disease.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
March 27, 2001
Mr. Smith of New Jersey (for himself, Mr. Pitts, Mr. Maloney of
Connecticut, Mr. Gilman, Mrs. Morella, Mr. Hinchey, Mr. Delahunt, Mr.
Traficant, Mr. Wolf, Mr. Towns, and Mr. Saxton) introduced the
following bill; which was referred to the Committee on Energy and
Commerce, and in addition to the Committees on Armed Services,
Resources, and Agriculture, for a period to be subsequently determined
by the Speaker, in each case for consideration of such provisions as
fall within the jurisdiction of the committee concerned
_______________________________________________________________________
A BILL
To establish a program to provide for a reduction in the incidence and
prevalence of Lyme disease.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Lyme Disease Initiative of 2001''.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) The incidence of Lyme disease in the United States is
increasing rapidly. The Centers for Disease Control and
Prevention (``CDC'') has determined that, since 1982, there has
been a 25-fold increase in reported cases.
(2) In 1999, a total of 16,273 cases of Lyme disease were
reported to CDC by 50 States and the District of Columbia (the
overall incidence was 4.67 per 100,000), representing a 27
percent increase from the 12,807 cases reported in 1997.
(3) There is no reliable standardized diagnostic test for
chronic Lyme disease, and the test for acute Lyme disease
should be improved. As a result, the disease is underreported
or misreported by as much as 10 or 12 fold, according to some
studies, because the symptoms of Lyme disease mimic other
health conditions. Thus, precise figures on the incidence of
Lyme disease are difficult to develop.
(4) Lyme disease costs our Nation between $1,000,000,000
and $2,000,000,000 in medical costs annually, according to
studies. Lost productivity annually per person from Lyme
disease has been estimated at 5 to 37 days.
(5) Many health care providers lack the necessary knowledge
and expertise--particularly in non-endemic areas--to accurately
diagnose and prevent Lyme disease. As a result, patients often
visit multiple doctors before obtaining a diagnosis of the
disease, resulting in prolonged pain and suffering, unnecessary
tests, and costly, delayed, or futile treatments.
(6) Due to scientific uncertainties about the diagnosis of
acute and chronic Lyme disease, and the proper course and
length of treatment, many patients have encountered
difficulties in obtaining needed insurance coverage for Lyme
disease.
(7) Most Lyme disease infections are thought to result from
periresidential exposure to infected ticks during property
maintenance, recreation, and leisure activities. Thus,
individuals who live or work in residential areas surrounded by
woods or overgrown brush infested by vector ticks are at risk
of Lyme disease. In addition, persons who participate in
recreational activities away from home (such as hiking,
camping, fishing and hunting in tick habitat) and persons who
engage in outdoor occupations (such as landscaping, brush
clearing, forestry, military service, and wildlife and parks
management in endemic areas) may also be at risk of Lyme
disease. Some estimates indicate outdoor workers have a four-
to-six fold elevation in risk of Lyme disease.
SEC. 3. PUBLIC HEALTH GOALS; FIVE-YEAR PLAN.
(a) In General.--The Secretary of Health and Human Services (acting
as appropriate through the Director of the Centers for Disease Control
and Prevention, the Director of the National Institutes of Health, and
the Commissioner of Food and Drugs), the Secretary of Agriculture, the
Secretary of the Interior, and the Secretary of Defense (in this Act
referred to collectively as the ``Secretaries'') shall collaborate to
carry out the following:
(1) The Secretaries shall establish the goals described in
subsections (c) through (g) relating to activities to provide
for a reduction in the incidence and prevalence of Lyme disease
and related tick-borne infectious diseases.
(2) The Secretaries shall carry out activities toward
achieving the goals, which may include activities carried out
directly by the Secretaries and activities carried out through
awards of grants or contracts to public or nonprofit private
entities.
(3) In carrying out paragraph (2), the Secretaries shall
give priority--
(A) first, to achieving the goal under subsection
(c);
(B) second, to achieving the goal under subsection
(d);
(C) third, to achieving the goal under subsection
(e);
(D) fourth, to achieving the goal under subsection
(f); and
(E) fifth, to achieving the goal under subsection
(g).
(b) Five-Year Plan.--In carrying out subsection (a), the
Secretaries shall establish a plan that, for the five fiscal years
following the date of the enactment of this Act, provides for the
activities to be carried out during such fiscal years toward achieving
the goals under subsections (c) through (g). The plan shall, as
appropriate to such goals, provide for the coordination of programs and
activities regarding Lyme disease that are conducted or supported by
the Federal Government.
(c) First Goal: Detection Test.--For purposes of subsection (a),
the goal described in this subsection is the development of novel and
more sensitive, specific, and reproducible diagnostic tests and
procedures (or the improvement or refinement of existing tests) that--
(1) can accurately determine whether an individual has
acute or chronic Lyme disease;
(2) can accurately determine the activity of acute or
chronic Lyme disease infection or both;
(3) can accurately distinguish acute or chronic Lyme
disease or both from other related, tick-borne, coinfectious
diseases; and
(4) can accurately measure the responsiveness of acute or
chronic Lyme disease infection or both to treatment.
(d) Second Goal: Improved Surveillance and Reporting System.--
(1) In general.--For purposes of subsection (a), the goal
described in this subsection is to assess the medical, social,
and economic burden of Lyme disease in the United States. This
assessment shall include a review of the system in the United
States for surveillance and reporting with respect to Lyme
disease and a determination of whether and in what manner the
system can be improved.
(2) Certain activities.--In carrying out activities toward
the goal described in paragraph (1), the Secretaries shall--
(A) consult with the States, the Conference of
State and Territorial Epidemiologists, units of local
government, physicians and health providers, patients
with Lyme disease, and organizations representing such
patients;
(B) consider whether uniform formats should be
developed for the reporting by physicians and
laboratories of cases of Lyme disease to public health
officials; and
(C) with respect to health conditions that are
reported by physicians as cases of Lyme disease but do
not meet the surveillance criteria established by the
Director of the Centers for Disease Control and
Prevention to be counted as such cases, consider
whether data on such health conditions should be
maintained and analyzed to assist in understanding the
circumstances in which Lyme disease is being diagnosed
and the manner in which it is being treated.
(e) Third Goal: Lyme Disease Prevention; Development of
Indicators.--For purposes of subsection (a), the goal described in this
subsection is to reduce, through the use of effective public health
education, prevention, and tick population reduction techniques, the
incidence of Lyme disease in the 10 highest endemic States by 33
percent by the date that is five years after the date of the enactment
of this Act. In carrying out activities toward such goal, the
Secretaries shall carry out each of the following:
(1) Establish a baseline incidence rate of Lyme disease in
the 10 highest endemic States. The establishment of this
baseline must take into consideration the surveillance criteria
review specified in subsection (d).
(2) Encourage the use of natural and nonpesticidal methods
to control and reduce tick populations, where appropriate.
(3) Reduce the risks of Lyme disease at all federally owned
lands located in endemic States and regions, as well as at
locations known or suspected to pose a risk of Lyme disease to
patrons and employees, through the following:
(A) The development of standardized, periodic (not
less than one per year) Lyme disease risk assessments
that test and then categorize the overall level of risk
of Lyme disease at federally owned lands in endemic
States and regions. The Lyme disease risk assessments
shall be made available to the public in appropriate
forms, and may include such factors as--
(i) whether any human cases of Lyme disease
have been diagnosed and treated on, or in areas
adjacent to, the federally owned lands;
(ii) whether vectors capable of
transmitting Lyme disease to humans are known
to inhabit the federally owned land;
(iii) whether any such vectors present on
the federally owned land are known to actually
be infected with Lyme disease; and
(iv) the geographic distribution of Lyme
disease risk within the federally owned land;
(B) The development and coordination of public
awareness programs to educate patrons, employees, and
health professionals at federally owned lands about:
the risks of Lyme disease, all appropriate prevention
methods that can be used to reduce these risks, and
information about the symptoms and nature of the
disease.
(C) The use of appropriate habitat management and
integrated pest-control techniques to reduce the number
of tick-borne Lyme disease vectors in areas where
humans work or recreate.
(f) Fourth Goal: Prevention of Tick-Borne Diseases Other Than
Lyme.--For purposes of subsection (a), the goal described in this
subsection is to develop the capabilities at the Centers for Disease
Control and Prevention, within the Department of Defense, and in State
and local health departments to implement adequate surveillance,
improved diagnosis, and effective strategies for the prevention and
control of tick-borne diseases other than Lyme disease. Such diseases
may include Lyme-like illness, ehrlichiosis, babesiosis, other
bacterial, viral and rickettsial diseases such as tularemia, tick-borne
encephalitis, and Rocky Mountain Spotted Fever, respectively.
(g) Fifth Goal: Improved Public and Physician Education.--For
purposes of subsection (a), the goal described in this subsection is to
improve the knowledge of physicians, health care providers, and the
public regarding the best and most effective methods to prevent,
diagnose, and treat Lyme disease and related tick-borne diseases.
SEC. 4. LYME DISEASE TASKFORCE.
(a) In General.--Not later than 120 days after the date of
enactment of this Act, there shall be established in accordance with
this section an advisory committee to be known as the Lyme Disease
Taskforce (in this section referred to as the ``Task Force'').
(b) Duties.--The Task Force shall provide advice to the Secretaries
with respect to achieving the goals under section 3, including advice
on the plan under subsection (b) of such section. Nothing in this
section may be construed as interfering with or undermining the peer
review process for research programs and grants, and the Task Force
shall take care that its activities complement existing interagency
relationships and interdepartmental working groups to the maximum
extent practicable.
(c) Membership.--
(1) Ex officio members.--The following officials (or their
designees) shall serve as ex officio members of the Task Force:
(A) The Director of the National Institute of
Allergy and Infectious Diseases.
(B) The Director of the National Institute of
Arthritis and Musculoskeletal and Skin Diseases.
(C) The Director of the National Institute of
Neurological Disorders and Stroke.
(D) The Director of the National Center for
Infectious Diseases.
(E) The Director of the Epidemiology Program
Office.
(F) The Director of the Public Health Practice
Program Office.
(G) The Commander of the United States Army Medical
Command.
(H) The Commander of the United States Army Center
for Health Promotion and Preventative Medicine.
(I) The Director of the Center for Biologics
Evaluation and Research.
(J) The Administrator of the Agricultural Research
Service.
(K) The Director of the National Park Service.
(L) The Director of the Fish and Wildlife Service.
(M) The Director of the Indian Health Service.
(N) The Chief Biologist of the Biological Resources
Division, United States Geological Survey.
(2) Appointed members.--Appointments to the Task Force
shall be made in accordance with the following:
(A) Two members shall be research scientists with
demonstrated achievements in research related to Lyme
disease and related tick-borne diseases. The scientists
shall be appointed by the Secretary of Health and Human
Services (in this paragraph referred to as the
``Secretary'') in consultation with the National
Academy of Sciences.
(B) Four members shall be representatives of
organizations whose primary emphasis is on research and
public education into Lyme disease and related tick-
borne diseases. One representative from each of such
organizations shall be appointed by the Secretary in
consultation with the National Academy of Sciences.
(C) Two members shall be clinicians with extensive
experience in the treatment of individuals with chronic
Lyme disease and related tick-borne diseases. The
clinicians shall be appointed by the Secretary in
consultation with the Institute of Medicine and the
National Academy of Sciences.
(D) Two members shall be individuals who are the
parents, spouse, or legal guardians of a person or
persons that have contracted Lyme disease or a related
tick-borne disease. The individuals shall be appointed
by the Secretary in consultation with the ex officio
members under paragraph (1) and the four organizations
referred to in subparagraph (B).
(E) One member shall be a representative of the
Council of State and Territorial Epidemiologists.
(F) One member shall be a representative of the
National Association of County and City Health
Officials.
(G) One member shall be an epidemiologist of
demonstrated achievements in the field of epidemiology.
The epidemiologist shall be appointed by the Secretary
in consultation with the National Academy of Sciences.
(d) Administrative Support; Terms of Service; Other Provisions.--
The following apply with respect to the Task Force:
(1) The Task Force shall receive necessary and appropriate
administrative support from the Department of Health and Human
Services.
(2) Members of the Task Force shall be appointed for the
duration of the Task Force.
(3) From among the members appointed under subsection
(c)(2), the Task Force shall designate an individual to serve
as the chair of the Task Force.
(4) The Task Force shall meet no less than two times per
year.
(5) Members of the Task Force shall not receive additional
compensation for their service. Such members may receive
reimbursement for appropriate and additional expenses that are
incurred through service on the Task Force which would not have
incurred had they not been a member of the Task Force.
(6) Any vacancy in the membership of the Task Force shall
be filled in the manner in which the original appointment was
made and does not affect the power of the remaining members to
carry out the duties of the Task Force.
SEC. 5. ANNUAL REPORTS.
The Secretaries shall submit to the Congress periodic reports on
the activities carried out under this Act and the extent of progress
being made toward the goals established under section 3. The first such
report shall be submitted not later than 18 months after the date of
the enactment of this Act, and subsequent reports shall be submitted
annually thereafter until the goals are met.
SEC. 6. AUTHORIZATION OF APPROPRIATIONS.
(a) National Institutes of Health.--In addition to other
authorizations of appropriations that are available for carrying out
the purposes described in this Act and that are established for the
National Institutes of Health, there are authorized to be appropriated
to the Director of such Institutes for such purposes $8,000,000 for
each of the fiscal years 2002 through 2006.
(b) Centers for Disease Control and Prevention.--In addition to
other authorizations of appropriations that are available for carrying
out the purposes described in this Act and that are established for the
Centers for Disease Control and Prevention, there are authorized to be
appropriated to the Director of such Centers for such purposes
$8,000,000 for each of the fiscal years 2002 through 2006.
(c) Department of Defense.--In addition to other authorizations of
appropriations that are available for carrying out the purposes
described in this Act and that are established for the Department of
Defense, there are authorized to be appropriated to the Secretary of
Defense for such purposes $6,000,000 for each of the fiscal years 2002
through 2006.
(d) Department of Agriculture.--In addition to other authorizations
of appropriations that are available for carrying out the purposes
described in this Act and that are established for the Department of
Agriculture, there are authorized to be appropriated to the Secretary
of Agriculture for such purposes $1,500,000 for each of the fiscal
years 2002 through 2006.
(e) Department of Interior.--In addition to other authorizations of
appropriations that are available for carrying out the purposes
described in this Act and that are established for the Department of
the Interior, there are authorized to be appropriated to the Secretary
of the Interior for such purposes $1,500,000 million for each of the
fiscal years 2002 through 2006.
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