II 

116TH CONGRESS 

1ST SESSION S. 1657 

To provide assistance to combat the escalating burden of Lyme disease and 

other tick and vector-borne diseases and disorders. 

IN THE SENATE OF THE UNITED STATES 

MAY 23 (legislative day, MAY 22), 2019 

Ms. COLLINS (for herself, Ms. SMITH, and Mr. KING) introduced the following 

bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To provide assistance to combat the escalating burden of 

Lyme disease and other tick and vector-borne diseases 

and disorders. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Ticks: Identify, Con5 trol, and Knockout Act’’ or the ‘‘TICK Act’’. 

6 SEC. 2. OFFICE OF OVERSIGHT AND COORDINATION FOR 

7 VECTOR-BORNE DISEASE. 

8 (a) ESTABLISHMENT.—The Secretary of Health and 

9 Human Services (referred to in this Act as the ‘‘SecVerDate Sep 11 2014 17:18 Jun 05, 2019 Jkt 089200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1657.IS S1657

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1 retary’’) shall establish in the Office of the Secretary an 

2 Office of Oversight and Coordination for Vector-Borne 

3 Diseases (referred to in this Act as the ‘‘Office’’), to be 

4 headed by a director to be appointed by the Secretary. 

5 (b) DUTIES OF THE OFFICE.— 

6 (1) IN GENERAL.—The Director of the Office 

7 shall— 

8 (A) oversee the creation and maintenance 

9 of a national strategy to address Lyme disease, 

10 and other tick and vector-borne diseases as pro11 vided for in paragraph (2); and 

12 (B) oversee and coordinate Lyme disease 

13 and other tick and vector-borne disease and dis14 order programs and activities across the agen15 cies and offices of the Department of Health 

16 and Human Services and other Federal agen17 cies outside of the Department of Health and 

18 Human Services, as appropriate. 

19 (2) NATIONAL STRATEGY.— 

20 (A) IN GENERAL.—The Director of the Of21 fice shall provide for the conduct of an annual 

22 assessment of the progress of the United States 

23 in preparing for the escalating burden of Lyme 

24 disease and other tick and vector-borne diseases 

25 and disorders, including an assessment of all 


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1 Federally funded programs and activities re2 lated to surveillance, diagnosis, treatment, edu3 cation, or prevention, as well as implementation 

4 steps, and recommendations for priority actions, 

5 with appropriate benchmarks to measure 

6 progress, based on the assessment. 

7 (B) NON-FEDERAL PERSPECTIVES.—In de8 veloping the strategy under subparagraph (A), 

9 and maintaining it, the Director shall consult 

10 with non-Federal individuals with appropriate 

11 expertise, which may include— 

12 (i) epidemiologists with experience in 

13 surveillance, treatment, education, or pre14 vention of vector-borne diseases; 

15 (ii) representatives of national patient 

16 advocacy and research organizations that 

17 focus on vector-borne diseases, and those 

18 that focus specifically on tick-borne disease 

19 and have demonstrated experience in re20 search, data collection, or patient access to 

21 care; 

22 (iii) health information technology ex23 perts or other information management 

24 specialists; 


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1 (iv) clinicians, entomologists, vector2 management professionals, integrated pest 

3 management professionals, public health 

4 professionals, and others with expertise in 

5 vector-borne disease, including Lyme dis6 ease or other tick-borne diseases or dis7 orders; and 

8 (v) research scientists with experience 

9 conducting translational research or uti10 lizing surveillance systems for scientific re11 search purposes. 

12 (c) OBJECTIVE OF THE OFFICE.—In carrying out 

13 subsection (b), the Director of the Office shall facilitate 

14 and work to ensure the accomplishment of the following 

15 activities: 

16 (1) Expansion and enhancement of epidemiolog17 ical research and basic, translational, and clinical bi18 ological and biomedical research. 

19 (2) Expansion and improvement of tick surveil20 lance, linking tick surveillance to surveillance of 

21 Lyme disease, and reporting of Lyme disease and 

22 other tick- and vector-borne diseases, including co23 infections with agents of more than one tick or vec24 tor-borne diseases. 


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1 (3) Development of effective diagnostic tests to 

2 accurately and timely diagnose Lyme disease and 

3 other tick- and vector-borne diseases, including di4 rect detention tests. 

5 (4) Development of treatments to cure or im6 prove the lives of those who are infected with Lyme 

7 disease or other tick-and vector-borne diseases or 

8 who suffer from a tick-induced disorder (such as tick 

9 PIM programs). 

10 (5) Address the quality of patient care, treat11 ment affordability, and public awareness of Lyme 

12 disease and other tick or vector-borne diseases. 

13 (6) Design and conduct clinical trials of suffi14 cient size and duration to support clinical rec15 ommendations. 

16 (7) Systematic documentation of the experi17 ences of health care professionals in diagnosing and 

18 treating tick- and vector-borne disease, including di19 agnostic and treatment outcomes. 

20 (8) Development and maintenance of one or 

21 more registries of patients and their experiences re22 lating to exposure to, diagnosis for, and treatment 

23 of tick- and vector-borne disease, including out24 comes, such that the confidentiality and safety of 

25 patient data is protected. 


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1 (9) Access to data and enable emerging tech2 nologies to improve patient care, sharing data with 

3 researchers and care providers. 

4 (10) Coordination with other Federal depart5 ments to address tick- and other vector-borne dis6 eases including the Department of Defense, the De7 partment of Agriculture, the Environmental Protec8 tion Agency, the Department of Interior, and the 

9 Department of Homeland Security. 

10 (11) Coordination with the Tick-Borne Disease 

11 Working Group established under section 2062 of 

12 the 21st Century Cures Act (42 U.S.C. 284s) to de13 velop and implement recommendations. 

14 (12) Coordination with international bodies to 

15 integrate and inform the fight against Lyme disease, 

16 and other tick- and vector-borne diseases globally. 

17 SEC. 3. REGIONAL CENTERS OF EXCELLENCE IN TICK AND 

18 VECTOR-BORNE DISEASES. 

19 (a) IN GENERAL.—The Secretary, in coordination 

20 with the Director of the Centers for Disease Control and 

21 Prevention and the heads of other agencies as appropriate, 

22 shall award grants, contracts, or cooperative agreements 

23 to eligible entities (such as institutions of higher edu24 cation, State, tribal, and local health departments, asso25 ciations, or other appropriate entities) for the establishVerDate Sep 11 2014 17:18 Jun 05, 2019 Jkt 089200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1657.IS S1657

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1 ment or support of Regional Centers of Excellence in Tick 

2 and Vector-Borne Diseases. Such Regional Centers shall 

3 be designed to address Lyme disease and other tick and 

4 vector-borne diseases by— 

5 (1) building collaboration between academia 

6 and public health agencies for surveillance, preven7 tion and response to Lyme disease and other tick 

8 and vector-borne diseases; 

9 (2) providing training for public health ento10 mologists to deal with Lyme disease and other tick 

11 and vector-borne diseases; and 

12 (3) conducting applied research to develop and 

13 validate prevention and control tools and methods, 

14 and to anticipate and respond to outbreaks of Lyme 

15 disease and other tick and vector-borne diseases. 

16 (b) ELIGIBILITY.—To be eligible to receive a grant, 

17 contract, or cooperative agreement under this section, an 

18 entity shall prepare and submit to the Secretary an appli19 cation at such time, in such manner, and containing such 

20 agreements and information as the Secretary may require, 

21 including a description of how the entity will— 

22 (1) coordinate, as applicable, with existing Fed23 eral, State, and tribal programs related to Lyme dis24 ease and other vector-borne diseases; 


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1 (2) examine, evaluate, and promote evidence2 based interventions for individuals with Lyme dis3 ease and other tick- and vector-borne diseases, in4 cluding those in rural and underserved populations, 

5 and those who provide care for such individuals; and 

6 (3) prioritize activities relating to— 

7 (A) expanding efforts, as appropriate, to 

8 implement evidence-based practices to address 

9 Lyme disease and other tick- and vector-borne 

10 diseases, including through the training of 

11 State, local, and tribal public health officials 

12 and other health professionals on such prac13 tices; 

14 (B) supporting surveillance of vectors, and 

15 early detection and diagnosis of Lyme and 

16 other tick- and vector-borne diseases, including 

17 improving the quality and reliability of diag18 nostic tools at all stages of disease progression, 

19 and developing a Lyme disease test capable of 

20 distinguishing between past and active infec21 tions; 

22 (C) improving the safety and efficacy of 

23 any new, renewed, or modified human vaccine 

24 for Lyme disease, other tick- and vector-borne 

25 diseases, or a combination of such diseases; 


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1 (D) developing a standardized screening 

2 protocol for Lyme disease and other tick- and 

3 vector-borne diseases; 

4 (E) enhancing studies and activities on 

5 tick biology, disease ecology, and surveillance, 

6 and tick management; and 

7 (F) supporting other relevant activities 

8 identified by the Secretary or the Director of 

9 the Centers for Disease Control and Prevention, 

10 as appropriate. 

11 (c) CONSIDERATIONS.—In awarding grants, con12 tracts, and cooperative agreements under this section, the 

13 Secretary shall consider, among other factors, whether the 

14 entity— 

15 (1) provides services to rural areas or other un16 derserved populations; 

17 (2) is able to build on an existing infrastructure 

18 of services and public health research; 

19 (3) is located in an area with a high prevalence, 

20 or in any area predicted to have a high prevalence, 

21 of Lyme disease or other tick- and vector-borne dis22 eases; and 

23 (4) has experience with conducting research re24 lated to Lyme disease and other tick- and vector25 borne diseases. 


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1 (d) AUTHORIZATION OF APPROPRIATIONS.—For the 

2 purpose of carrying out this section, there are authorized 

3 to be appropriated $10,000,000 for each of fiscal years 

4 from 2021 through 2026. Amounts appropriated shall be 

5 allocated under this section to diseases in a manner that 

6 proportionately matches the disease burden of those dis7 eases in the United States, which shall be reassessed and 

8 adjusted annually. 

9 SEC. 4. COOPERATIVE AGREEMENTS WITH THE CENTERS 

10 FOR DISEASE CONTROL AND PREVENTION. 

11 (a) IN GENERAL.—The Secretary, in coordination 

12 with the Director of the Centers for Disease Control and 

13 Prevention and the heads of other agencies, as appro14 priate, shall enter into cooperative agreements between the 

15 Centers for Disease Control and Prevention and health de16 partments of States, political subdivisions of States, and 

17 Indian tribes and tribal organizations, to address Lyme 

18 Disease and other tick- and vector-borne diseases, and to 

19 support the development and implementation of evidence20 based research, interventions, and treatment with respect 

21 to— 

22 (1) educating and informing the public, based 

23 on evidence-based public health research and data, 

24 about Lyme Disease and other vector-borne diseases; 

25 (2) supporting early detection and diagnosis; 


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1 (3) supporting prevention; 

2 (4) improving treatment; 

3 (5) supporting care planning and management 

4 for individuals with Lyme disease and other tick5 and vector-borne diseases; and 

6 (6) supporting other relevant activities identi7 fied by the Secretary or the Director of the Centers 

8 for Disease Control and Prevention, as appropriate. 

9 (b) ELIGIBILITY.—To be eligible to enter into a coop10 erative agreement under this section, an entity described 

11 in subsection (a) shall prepare and submit to the Secretary 

12 an application at such time, in such manner, and con13 taining such information as the Secretary may require, in14 cluding a plan that describes— 

15 (1) how the applicant proposes to develop or ex16 pand programs to educate individuals through part17 nership engagement, workforce development, guid18 ance and support for programmatic efforts, and 

19 evaluation with respect to Lyme disease and other 

20 tick- or vector-borne diseases, and how the applicant 

21 proposes to support other relevant activities identi22 fied by the Secretary or the Director of the Centers 

23 for Disease Control and Prevention, as appropriate; 

24 (2) the manner in which the applicant will co25 ordinate with Federal, tribal, and State programs 


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1 related to Lyme Disease and other vector-borne dis2 eases, and appropriate State, tribal, and local agen3 cies, as well as other relevant public and private or4 ganizations or agencies; and 

5 (3) the manner in which the applicant will 

6 evaluate the effectiveness of any program carried out 

7 under the cooperative agreement. 

8 (c) AUTHORIZATION OF APPROPRIATIONS.—For the 

9 purpose of carrying out this section, there are authorized 

10 to be appropriated $20,000,000 for each of fiscal years 

11 from (2021 through 2026). Amounts appropriated shall 

12 be allocated under this section to diseases in a manner 

13 that proportionately matches the disease burden of those 

14 diseases in the United States, which shall be reassessed 

15 and adjusted annually. 

Æ 


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