,,ii #aad? ,,congress #a/ ,session ,s4 #aejc ,,9 ,,! ,,s5ate ,,( ,,! ,,unit$ ,,/ates ,june #d1 #bjae ,mr4 ,blum5?al 7= himself1 ,ms4 ,ayotte1 ,mrs4 ,gillibr&1 ,mr4 ,re$1 ,ms4 ,klobu*>1 ,mr4 ,coons1 ,mr4 ,:iteh\se1 ,mr4 ,casey1 & ,mr4 ,s*um]7 introduc$ ! foll[+ bill2 :i* 0 read twice & ref]r$ to ! ,committee on ,heal?1 ,education1 ,labor1 & ,p5sions ,a ,,bill ,to provide = enhanc$ ,f$]al ef=ts conc]n+ ! prev5tion1 education1 treatm5t1 & rese>* activities relat$ to ,lyme disease & o!r tick-borne diseases1 includ+ ! e/abli%m5t ( a ,tick-,borne ,diseases ,advisory ,committee4 #a4 ,%ort title ,?is ,act may be cit$ z ! ,lyme & ,tick-,borne ,disease ,prev5tion1 ,education1 & ,rese>* ,act ( #bjae4 #b4 ,f9d+s ,congress makes ! foll[+ f9d+s3 7#a7 ,lyme disease is a common b frequ5tly misund]/ood illness t1 if n caught e>ly & treat$ prop]ly1 c cause s]i\s heal? problems4 7#b7 ,lyme disease is caus$ by ! bact]ium ,borrelia burgdorf]i1 :i* belongs to ! class ( spiro*aetes1 & is transmitt$ to humans by ! bite ( infect$ ticks4 ,e>ly signs ( infection may include a ra% & flu-l symptoms1 su* z fev]1 muscle a*es1 heada*es1 & fatigue4 7#c7 ,al?\gh ,lyme disease c be treat$ ) antibiotics if caught e>ly1 ! disease (t5 goes undetect$ because x mimics o!r illnesses or may be misdiagnos$4 ,untreat$1 ,lyme disease c lead to sev]e he>t1 neurological1 & jo9t problems because ! bact]ia c affect _m diff]5t organs & organ sy/ems4 7#d7 ,if an individual ) ,lyme disease does n receive treatm5t1 su* individual c develop sev]e he>t1 neurological1 & jo9t problems4 7#e7 ,al?\gh ,lyme disease acc\nts = #ij p]c5t ( all vector-borne disease 9 ! ,unit$ ,/ates1 ! ticks t spread ,lyme disease also spread o!r diseases1 su* z anaplasmosis & babesiosis1 & c>ry o!r /ra9s ( ,borrelia burgdorf]i4 ,o!r tick species1 su* z ! aggressive lone /> tick1 spread ehrli*iosis1 ,rocky ,m\nta9 spott$ fev]1 & s\!rn tick-associat$ ra% illness 7,,/>i74 ,multiple diseases 9 #a pati5t make diagnosis & treatm5t m difficult4 7#f7 ,! ,c5t]s = ,disease ,control & ,prev5tion report$ ov] #cf1jjj confirm$ or probable ,lyme disease cases 9 #bjac & has e/imat$ t ! total numb] ( p diagnos$ ) ,lyme disease annually is r\ghly #aj times high] ?an ! numb] ( cases report$4 7#g7 ,accord+ to ! ,c5t]s = ,disease ,control & ,prev5tion1 f #aiib to #bjjf1 ! incid5ce ( ,lyme disease 0 highe/ among *ildr5 #e to #ad ye>s ( age4 7#h7 ,p]si/5ce ( symptomatology 9 _m pati5ts )\t reliable te/+ makes diagnosis & treatm5t ( pati5ts m difficult4 7#i7 ,9 ! abs5ce ( a safe & effective human vacc9e1 r$uc+ exposure to ticks is ! be/ def5se aga9/ ,lyme disease1 ,rocky ,m\nta9 spott$ fev]1 & o!r tick-borne diseases4 ,entomology-bas$ approa*es to prev5t tick-borne diseases include ! use & developm5t ( insect repell5t1 prompt tick removal1 application ( pe/icides1 & r$uction ( tick habitat4 #c4 ,e/abli%m5t ( a tick-borne diseases advisory committee 7a7 ,e/abli%m5t ,n lat] ?an #ahj days aft] ! date ( ! enactm5t ( ?is ,act1 ! ,secret>y ( ,heal? & ,human ,s]vices 7ref]r$ to 9 ?is ,act z ! ,secret>y7 %all e/abli% )9 ! ,(fice ( ! ,secret>y an advisory committee to be kn[n z ! ,tick-,borne ,diseases ,advisory ,committee 7ref]r$ to 9 ?is section z ! ,committee74 7b7 ,duties ,! ,committee %all-- 7#a7 advise ! ,secret>y & ! ,assi/ant ,secret>y = ,heal? reg>d+ ! mann] 9 :i* su* (ficials c-- 7,a7 ensure int]ag5cy coord9ation & communication & m9imize ov]lap reg>d+ ef=ts to address tick-borne diseases2 7,b7 id5tify opportunities to coord9ate ef=ts ) o!r ,f$]al ag5cies & private organizations address+ su* diseases2 7,c7 ensure int]ag5cy coord9ation & communication ) con/itu5cy gr\ps2 7,d7 ensure t a broad spectrum ( sci5tific viewpo9ts are consid]$ 9 public heal? policy decisions & t in=mation dissem9at$ to ! public & physicians is bas$ on ! be/ available sci5ce & is appropriately balanc$2 & 7,e7 advise relevant ,f$]al ag5cies on priorities relat$ to ,lyme disease & o!r tick-borne diseases2 & 7#b7 9 coord9ation ) relevant ag5cies )9 ! ,dep>tm5t ( ,heal? & ,human ,s]vices1 regul>ly review publi%$ public & private treatm5t guidel9es & evaluate su* guidel9es = effective repres5tation ( a wide div]sity ( views4 7c7 ,memb]%ip 7#a7 ,appo9t$ memb]s 7,a7 ,9 g5]al ,f among individuals :o are n (fic]s or employees ( ! ,f$]al ,gov]nm5t1 ! ,secret>y %all appo9t to ! ,committee1 z vot+ memb]s1 ! foll[+3 7i7 ,n few] ?an #d memb]s f ! sci5tific community repres5t+ ! broad spectrum ( viewpo9ts held )9 ! sci5tific community relat$ to ,lyme disease & o!r tick-borne diseases1 includ+ exp]ts 9 ! areas (-- 7,i7 m$ic9e1 epidemiology1 & public heal?2 7,,ii7 vet]9>y m$ic9e & animal heal?2 7,,iii7 entomology & pe/ managem5t2 & 7,,iv7 microbiology4 7ii7 ,n few] ?an #b repres5tatives ( tick-borne disease volunt>y advocacy organizations1 :i* may include #a repres5tative ( a pati5t-support$ tick-borne disease advocacy organization4 7iii7 ,n few] ?an #b heal? c>e provid]s1 includ+ n few] ?an #a physician involv$ 9 direct pati5t c>e1 ) relevant exp]i5ce provid+ c>e = individuals ) a broad range ( acute & *ronic ,lyme disease & o!r tick-borne diseases4 7iv7 ,n few] ?an #b pati5t repres5tatives :o are individuals :o h be5 diagnos$ ) ,lyme disease or ano!r tick-borne disease or :o h _h an imm$iate family memb] diagnos$ ) su* a disease4 7v7 ,n few] ?an #b repres5tatives ( ,/ate & local heal? dep>tm5ts & national organizations t repres5t ,/ate & local heal? pr(essionals :o inve/igate or treat pati5ts ) ,lyme disease or o!r tick-borne diseases4 7,b7 ,div]sity ,9 appo9t+ memb]s "u ?is p>agraph1 ! ,secret>y %all ensure t su* memb]s1 z a gr\p1 repres5t a div]sity ( sci5tific p]spectives relevant to ! duties ( ! ,committee4 7#b7 ,ex (ficio memb]s ,! ,secret>y %all designate1 z nonvot+1 ex (ficio memb]s ( ! ,committee1 repres5tatives ov]see+ tick-borne disease activities f ea* ( ! foll[+ ,f$]al ag5cies3 7,a7 ,! ,c5t]s = ,disease ,control & ,prev5tion4 7,b7 ,! ,national ,in/itutes ( ,heal?4 7,c7 ,! ,ag5cy = ,heal?c>e ,rese>* & ,quality4 7,d7 ,! ,food & ,drug ,adm9i/ration4 7,e7 ,! ,(fice ( ! ,assi/ant ,secret>y = ,heal?4 7,f7 ,! ,dep>tm5t ( ,agriculture4 7,g7 ,su* additional ,f$]al dep>tm5ts & ag5cies z ! ,secret>y det]m9es appropriate4 7#c7 ,co-*airp]sons ,! ,committee %all be head$ by ! foll[+ co-*airp]sons3 7,a7 ,! ,assi/ant ,secret>y ( ,heal?4 7,b7 ,a public *airp]son appo9t$ by ! memb]s ( ! ,committee1 :o %all s]ve a #b-ye> t]m4 7#d7 ,t]m ( appo9tm5t ,! t]m ( s]vice = ea* memb] ( ! ,committee appo9t$ "u p>agraph 7#a7 %all be #d ye>s4 7#e7 ,vacancy ,a vacancy 9 ! memb]%ip ( ! ,committee %all be fill$ 9 ! same mann] z ! orig9al appo9tm5t4 ,any memb] appo9t$ to fill a vacancy = an unexpir$ t]m %all be appo9t$ = ! rema9d] ( t t]m4 ,memb]s may s]ve aft] ! expiration ( _! t]ms until _! successors h tak5 (fice4 7d7 ,meet+s ,! ,committee %all hold public meet+s aft] provid+ notice to ! public ( su* meet+s1 & %all meet at lea/ twice a ye> ) additional meet+s subject to ! call ( ! co-*airp]sons4 ,ag5da items ) respect to su* meet+s may be add$ at ! reque/ ( ! memb]s ( ! ,committee1 includ+ ! co-*airp]sons4 ,meet+s %all be conduct$1 & records ( ! proce$+s %all be ma9ta9$1 z requir$ by applicable law & by regulations ( ! ,secret>y4 7e7 ,report ,n lat] ?an #a ye> aft] ! date ( enactm5t ( ?is ,act & annually !reaft]1 ! ,committee1 act+ ?r\gh ! memb]s repres5t+ ! ,c5t]s = ,disease ,control & ,prev5tion & ! ,national ,in/itutes ( ,heal?1 %all submit a report to ! ,secret>y4 ,ea* su* report %all conta91 at a m9imum-- 7#a7 a description ( ! ,committee's functions2 7#b7 a li/ ( ! ,committee's memb]s & _! affiliations2 & 7#c7 a summ>y ( ! ,committee's activities & recomm5dations dur+ ! previ\s ye>1 includ+ any significant issues reg>d+ ! function+ ( ! ,committee4 #d4 ,f$]al activities relat$ to ! diagnosis1 surveillance1 prev5tion1 & rese>* ( lyme disease & o!r tick-borne diseases 7a7 ,9 g5]al ,! ,secret>y1 act+1 z appropriate1 ?r\gh ! ,director ( ! ,c5t]s = ,disease ,control & ,prev5tion1 ! ,director ( ! ,national ,in/itutes ( ,heal?1 ! ,commission] ( ,food & ,drugs1 ! ,director ( ! ,ag5cy = ,heal?c>e ,rese>* & ,quality1 ! ,*ief ( ! ,=e/ ,s]vice1 or o!r ,f$]al ag5cies z ! ,secret>y det]m9es appropriate1 & 9 consultation ) ! ,tick-,borne ,diseases ,advisory ,committee1 %all-- 7#a7 conduct or support ! activities describ$ 9 subsection 7b72 & 7#b7 coord9ate all ,f$]al programs & activities relat$ to ,lyme disease & o!r tick-borne diseases4 7b7 ,activities ,! activities describ$ 9 ?is subsection are ! foll[+3 7#a7 ,! developm5t ( diagno/ic te/s1 includ+-- 7,a7 ! developm5t ( s5sitive & m accurate diagno/ic tools & te/s1 includ+ a direct detection te/ = ,lyme disease capable ( di/+ui%+ active infection f pa/ infection2 7,b7 improv+ ! effici5t utilization ( diagno/ic te/s t h be5 adequately validat$ cl9ically available to acc\nt = ! multiple cl9ical manife/ations ( bo? acute & *ronic ,lyme disease2 7,c7 provid+ = ! timely evaluation ( promis+ em]g+ diagno/ic me?ods2 & 7,d7 ! developm5t ( quantitative assays = ! detection ( tick-borne pa?og5s 9 ticks4 7#b7 ,surveillance & report+ ( ,lyme disease & o!r tick-borne diseases-- 7,a7 to accurately det]m9e ! incid5ce ( ,lyme disease & o!r tick-borne diseases2 7,b7 to evaluate ! feasibility ( develop+ a report+ sy/em = ! collection ( data on cases ( ,lyme disease t d n meet ! surveillance crit]ia ( ! ,c5t]s = ,disease ,control & ,prev5tion 9 ord] to m accurately gauge disease incid5ce2 7,c7 to evaluate ! feasibility ( creat+ a national uni=m report+ sy/em includ+ requir$ report+ by laboratories 9 ea* ,/ate2 & 7,d7 to evaluate ! feasibility ( creat+ a national monitor+ sy/em = tick populations4 7#c7 ,prev5tion activities1 includ+-- 7,a7 ! provision & promotion ( access to a compreh5sive1 up-to-date cle>+h\se ( pe]-review$ in=mation on ,lyme disease & o!r tick-borne diseases2 7,b7 increas$ public education relat$ to ,lyme disease & o!r tick-borne diseases ?r\gh ! expansion ( ! ,community ,bas$ ,education ,programs ( ! ,c5t]s = ,disease ,control & ,prev5tion to include expansion ( in=mation access po9ts to ! public2 7,c7 ! creation ( a physician education program t includes ! full spectrum ( sci5tific rese>* relat$ to ! id5tification ( symptoms associat$ )1 & ! diagnosis (1 ,lyme disease & o!r tick-borne diseases1 &1 9 coord9ation ) ! ,tick-,borne ,diseases ,advisory ,committee e/abli%$ "u section #c1 ! publication ( an annual report t evaluates publi%$ guidel9es & curr5t rese>* available on ,lyme disease1 9 ord] to be/ educate heal? pr(essionals on ! late/ rese>* & div]sity ( treatm5t options = ,lyme disease2 7,d7 rese>* to und]/& me*anisms ( tick repell5ts & to develop new *emical & non-*emical /rategies = ! control ( ticks2 & 7,e7 explor+ ! utility & pot5tial = ! developm5t ( a safe & effective vacc9e aga9/ ,lyme disease & o!r tick-borne diseases4 7#d7 ,sponsor+ sci5tific conf]5ces on ,lyme disease & o!r tick-borne diseases1 includ+ report+ 9 accordance ) subsection 7c7 & consid]ation ( ! full spectrum ( cl9ically bas$ k1 ) ! fir/ ( su* conf]5ces to be held n lat] ?an #b ye>s aft] ! date ( enactm5t ( ?is ,act4 7#e7 ,cl9ical outcomes rese>*1 includ+-- 7,a7 ! e/abli%m5t ( epidemiological rese>* objectives to det]m9e ! long-t]m c\rse ( illness = ,lyme disease2 & 7,b7 det]m9ation ( ! effectiv5ess ( diff]5t treatm5t modalities by e/abli%+ treatm5t outcome objectives4 7c7 ,sci5tific conf]5ces 7#a7 ,s5se ( ,congress ,x is ! s5se ( ,congress t p>ticipation 9 or sponsor%ip ( sci5tific conf]5ces & meet+s is ess5tial to ! mission ( ! ,dep>tm5t ( ,heal? & ,human ,s]vices 9 address+ ,lyme disease & o!r tick-borne diseases4 7#b7 ,conf]5ce report+ 7,a7 ,9 g5]al ,! ,secret>y %all submit to ,congress an annual report reg>d+ ! co/s & contract+ proc$ures relat$ to conf]5ces ) respect to address+ ,lyme disease & o!r tick-borne diseases t are organiz$ by ! ,f$]al ,gov]nm5t or att5d$ by repres5tatives ( ! ,f$]al ,gov]nm5t1 = :i* ! co/ to ! ,f$]al ,gov]nm5t 0 m ?an #ajj1jjj4 7,b7 ,cont5ts ,ea* report submitt$ "u subp>agraph 7,a7 %all include1 ) respect to ea* su* conf]5ce held dur+ ! applicable p]iod-- 7i7 a description ( ! purpose ( ! conf]5ce2 7ii7 ! numb] ( p>ticipants att5d+2 7iii7 a detail$ /atem5t ( ! co/s to ! ,f$]al ,gov]nm5t1 includ+-- 7,i7 ! co/ ( any food or bev]ages2 7,,ii7 ! co/ ( any audio-visual s]vices2 7,,iii7 ! co/ ( employee or contractor travel to & f ! conf]5ce2 & 7,,iv7 a discussion ( ! me?odology us$ to det]m9e :i* co/s relate to ! conf]5ce2 & 7iv7 a description ( ! contract+ proc$ures us$ 9 coord9at+ ! conf]5ce1 includ+-- 7,i7 :e!r contracts 7 aw>d$ on a competitive basis2 & 7,,ii7 a discussion ( any co/ comp>ison conduct$ by ! dep>tm5tal compon5t or (fice 9 evaluat+ pot5tial contractors = ! conf]5ce4 #e4 ,reports on lyme disease & o!r tick-borne diseases 7a7 ,9 g5]al ,n lat] ?an #ah mon?s aft] ! date ( enactm5t ( ?is ,act & annually !reaft]1 ! ,secret>y %all submit to ,congress a report on ! activities c>ri$ out "u ?is ,act4 7b7 ,cont5t ,reports "u subsection 7a7 %all include-- 7#a7 in=mation relat+ to significant activities or developm5ts relat$ to ! surveillance1 diagnosis1 treatm5t1 education1 or prev5tion ( ,lyme disease or o!r tick-borne diseases1 includ+ sugge/ions = fur!r rese>* & education2 7#b7 a sci5tifically qualifi$ assessm5t ( ,lyme disease & o!r tick-borne diseases1 includ+ bo? acute & *ronic in/ances1 relat$ to ! broad spectrum ( cl9ical evid5ce ( treat+ physicians involv$ 9 direct pati5t c>e1 z well z publi%$ pe] review$ data1 t %all include recomm5dations = address+ int]ag5cy rese>* gaps 9 tick biology & tick managem5t1 & ! diagnosis1 transmission1 & treatm5t ( ,lyme disease & o!r tick-borne diseases1 & an evaluation ( treatm5t guidel9es & ! utilization ( su* guidel9es2 7#c7 details reg>d+ progress 9 ! developm5t ( accurate diagno/ic tools t are m useful 9 ! cl9ical sett+ = bo? acute & *ronic disease2 7#d7 in=mation relat+ to ! promotion ( public aw>5ess & physician education initiatives to improve ! k ( heal? c>e provid]s & ! public reg>d+ cl9ical & surveillance practices = ,lyme disease & o!r tick-borne diseases2 & 7#e7 a copy ( ! mo/ rec5t annual report ( ! ,tick-,borne ,diseases ,advisory ,committee issu$ "u section #c7;e71 & an assessm5t ( progress 9 a*iev+ ! recomm5dations includ$ 9 su* report4 #f4 ,appropriations ,funds = ! purpose ( c>ry+ out ?is ,act may be d]iv$ f am\nts appropriat$ to ! ,dep>tm5t ( ,heal? & ,human ,s]vices & o!rwise available = obligation & exp5diture = ea* ( ! fiscal ye>s #bjaf ?r\gh #bjbj4 ,am\nts appropriat$ "u ! prec$+ s5t5ce %all be us$ = ! exp5ses & p] diem co/s incurr$ by ! ,tick-,borne ,diseases ,advisory ,committee e/abli%$ "u section #c 9 accordance ) ! ,f$]al ,advisory ,committee ,act 7#e ,u4,s4,c4 ,app471 except t no vot+ memb] ( ! ,tick-,borne ,diseases ,advisory ,committee %all be a p]man5t sal>i$ employee4