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[Congressional Bills 116th Congress]
[From the U.S. Government Publishing Office]
[S. 1657 Reported in Senate (RS)]

<DOC>

                                                       Calendar No. 287
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, Mr. King, Mrs. Capito, Mr. 
 Blumenthal, Mrs. Hyde-Smith, Mr. Murphy, Mr. Boozman, Ms. Hassan, Mr. 
 Braun, and Mr. Sanders) introduced the following bill; which was read 
 twice and referred to the Committee on Health, Education, Labor, and 
                                Pensions

                            November 5, 2019

              Reported by Mr. Alexander, with an amendment
 [Strike out all after the enacting clause and insert the part printed 
                               in italic]

_______________________________________________________________________

                                 A BILL

 
 To provide assistance to combat the escalating burden of Lyme disease 
        and other tick and vector-borne diseases and disorders.

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

<DELETED>SECTION 1. SHORT TITLE.</DELETED>

<DELETED>    This Act may be cited as the ``Ticks: Identify, Control, 
and Knockout Act'' or the ``TICK Act''.</DELETED>

<DELETED>SEC. 2. OFFICE OF OVERSIGHT AND COORDINATION FOR VECTOR-BORNE 
              DISEASE.</DELETED>

<DELETED>    (a) Establishment.--The Secretary of Health and Human 
Services (referred to in this Act as the ``Secretary'') shall establish 
in the Office of the Secretary an Office of Oversight and Coordination 
for Vector-Borne Diseases (referred to in this Act as the ``Office''), 
to be headed by a director to be appointed by the Secretary.</DELETED>
<DELETED>    (b) Duties of the Office.--</DELETED>
        <DELETED>    (1) In general.--The Director of the Office 
        shall--</DELETED>
                <DELETED>    (A) oversee the creation and maintenance 
                of a national strategy to address Lyme disease, and 
                other tick and vector-borne diseases as provided for in 
                paragraph (2); and</DELETED>
                <DELETED>    (B) oversee and coordinate Lyme disease 
                and other tick and vector-borne disease and disorder 
                programs and activities across the agencies and offices 
                of the Department of Health and Human Services and 
                other Federal agencies outside of the Department of 
                Health and Human Services, as appropriate.</DELETED>
        <DELETED>    (2) National strategy.--</DELETED>
                <DELETED>    (A) In general.--The Director of the 
                Office shall provide for the conduct of an annual 
                assessment of the progress of the United States in 
                preparing for the escalating burden of Lyme disease and 
                other tick and vector-borne diseases and disorders, 
                including an assessment of all Federally funded 
                programs and activities related to surveillance, 
                diagnosis, treatment, education, or prevention, as well 
                as implementation steps, and recommendations for 
                priority actions, with appropriate benchmarks to 
                measure progress, based on the assessment.</DELETED>
                <DELETED>    (B) Non-federal perspectives.--In 
                developing the strategy under subparagraph (A), and 
                maintaining it, the Director shall consult with non-
                Federal individuals with appropriate expertise, which 
                may include--</DELETED>
                        <DELETED>    (i) epidemiologists with 
                        experience in surveillance, treatment, 
                        education, or prevention of vector-borne 
                        diseases;</DELETED>
                        <DELETED>    (ii) representatives of national 
                        patient advocacy and research organizations 
                        that focus on vector-borne diseases, and those 
                        that focus specifically on tick-borne disease 
                        and have demonstrated experience in research, 
                        data collection, or patient access to 
                        care;</DELETED>
                        <DELETED>    (iii) health information 
                        technology experts or other information 
                        management specialists;</DELETED>
                        <DELETED>    (iv) clinicians, entomologists, 
                        vector-management professionals, integrated 
                        pest management professionals, public health 
                        professionals, and others with expertise in 
                        vector-borne disease, including Lyme disease or 
                        other tick-borne diseases or disorders; 
                        and</DELETED>
                        <DELETED>    (v) research scientists with 
                        experience conducting translational research or 
                        utilizing surveillance systems for scientific 
                        research purposes.</DELETED>
<DELETED>    (c) Objective of the Office.--In carrying out subsection 
(b), the Director of the Office shall facilitate and work to ensure the 
accomplishment of the following activities:</DELETED>
        <DELETED>    (1) Expansion and enhancement of epidemiological 
        research and basic, translational, and clinical biological and 
        biomedical research.</DELETED>
        <DELETED>    (2) Expansion and improvement of tick 
        surveillance, linking tick surveillance to surveillance of Lyme 
        disease, and reporting of Lyme disease and other tick- and 
        vector-borne diseases, including coinfections with agents of 
        more than one tick or vector-borne diseases.</DELETED>
        <DELETED>    (3) Development of effective diagnostic tests to 
        accurately and timely diagnose Lyme disease and other tick- and 
        vector-borne diseases, including direct detention 
        tests.</DELETED>
        <DELETED>    (4) Development of treatments to cure or improve 
        the lives of those who are infected with Lyme disease or other 
        tick-and vector-borne diseases or who suffer from a tick-
        induced disorder (such as tick PIM programs).</DELETED>
        <DELETED>    (5) Address the quality of patient care, treatment 
        affordability, and public awareness of Lyme disease and other 
        tick or vector-borne diseases.</DELETED>
        <DELETED>    (6) Design and conduct clinical trials of 
        sufficient size and duration to support clinical 
        recommendations.</DELETED>
        <DELETED>    (7) Systematic documentation of the experiences of 
        health care professionals in diagnosing and treating tick- and 
        vector-borne disease, including diagnostic and treatment 
        outcomes.</DELETED>
        <DELETED>    (8) Development and maintenance of one or more 
        registries of patients and their experiences relating to 
        exposure to, diagnosis for, and treatment of tick- and vector-
        borne disease, including outcomes, such that the 
        confidentiality and safety of patient data is 
        protected.</DELETED>
        <DELETED>    (9) Access to data and enable emerging 
        technologies to improve patient care, sharing data with 
        researchers and care providers.</DELETED>
        <DELETED>    (10) Coordination with other Federal departments 
        to address tick- and other vector-borne diseases including the 
        Department of Defense, the Department of Agriculture, the 
        Environmental Protection Agency, the Department of Interior, 
        and the Department of Homeland Security.</DELETED>
        <DELETED>    (11) Coordination with the Tick-Borne Disease 
        Working Group established under section 2062 of the 21st 
        Century Cures Act (42 U.S.C. 284s) to develop and implement 
        recommendations.</DELETED>
        <DELETED>    (12) Coordination with international bodies to 
        integrate and inform the fight against Lyme disease, and other 
        tick- and vector-borne diseases globally.</DELETED>

<DELETED>SEC. 3. REGIONAL CENTERS OF EXCELLENCE IN TICK AND VECTOR-
              BORNE DISEASES.</DELETED>

<DELETED>    (a) In General.--The Secretary, in coordination with the 
Director of the Centers for Disease Control and Prevention and the 
heads of other agencies as appropriate, shall award grants, contracts, 
or cooperative agreements to eligible entities (such as institutions of 
higher education, State, tribal, and local health departments, 
associations, or other appropriate entities) for the establishment or 
support of Regional Centers of Excellence in Tick and Vector-Borne 
Diseases. Such Regional Centers shall be designed to address Lyme 
disease and other tick and vector-borne diseases by--</DELETED>
        <DELETED>    (1) building collaboration between academia and 
        public health agencies for surveillance, prevention and 
        response to Lyme disease and other tick and vector-borne 
        diseases;</DELETED>
        <DELETED>    (2) providing training for public health 
        entomologists to deal with Lyme disease and other tick and 
        vector-borne diseases; and</DELETED>
        <DELETED>    (3) conducting applied research to develop and 
        validate prevention and control tools and methods, and to 
        anticipate and respond to outbreaks of Lyme disease and other 
        tick and vector-borne diseases.</DELETED>
<DELETED>    (b) Eligibility.--To be eligible to receive a grant, 
contract, or cooperative agreement under this section, an entity shall 
prepare and submit to the Secretary an application at such time, in 
such manner, and containing such agreements and information as the 
Secretary may require, including a description of how the entity will--
</DELETED>
        <DELETED>    (1) coordinate, as applicable, with existing 
        Federal, State, and tribal programs related to Lyme disease and 
        other vector-borne diseases;</DELETED>
        <DELETED>    (2) examine, evaluate, and promote evidence-based 
        interventions for individuals with Lyme disease and other tick- 
        and vector-borne diseases, including those in rural and 
        underserved populations, and those who provide care for such 
        individuals; and</DELETED>
        <DELETED>    (3) prioritize activities relating to--</DELETED>
                <DELETED>    (A) expanding efforts, as appropriate, to 
                implement evidence-based practices to address Lyme 
                disease and other tick- and vector-borne diseases, 
                including through the training of State, local, and 
                tribal public health officials and other health 
                professionals on such practices;</DELETED>
                <DELETED>    (B) supporting surveillance of vectors, 
                and early detection and diagnosis of Lyme and other 
                tick- and vector-borne diseases, including improving 
                the quality and reliability of diagnostic tools at all 
                stages of disease progression, and developing a Lyme 
                disease test capable of distinguishing between past and 
                active infections;</DELETED>
                <DELETED>    (C) improving the safety and efficacy of 
                any new, renewed, or modified human vaccine for Lyme 
                disease, other tick- and vector-borne diseases, or a 
                combination of such diseases;</DELETED>
                <DELETED>    (D) developing a standardized screening 
                protocol for Lyme disease and other tick- and vector-
                borne diseases;</DELETED>
                <DELETED>    (E) enhancing studies and activities on 
                tick biology, disease ecology, and surveillance, and 
                tick management; and</DELETED>
                <DELETED>    (F) supporting other relevant activities 
                identified by the Secretary or the Director of the 
                Centers for Disease Control and Prevention, as 
                appropriate.</DELETED>
<DELETED>    (c) Considerations.--In awarding grants, contracts, and 
cooperative agreements under this section, the Secretary shall 
consider, among other factors, whether the entity--</DELETED>
        <DELETED>    (1) provides services to rural areas or other 
        underserved populations;</DELETED>
        <DELETED>    (2) is able to build on an existing infrastructure 
        of services and public health research;</DELETED>
        <DELETED>    (3) is located in an area with a high prevalence, 
        or in any area predicted to have a high prevalence, of Lyme 
        disease or other tick- and vector-borne diseases; and</DELETED>
        <DELETED>    (4) has experience with conducting research 
        related to Lyme disease and other tick- and vector-borne 
        diseases.</DELETED>
<DELETED>    (d) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be appropriated 
$10,000,000 for each of fiscal years from 2021 through 2026. Amounts 
appropriated shall be allocated under this section to diseases in a 
manner that proportionately matches the disease burden of those 
diseases in the United States, which shall be reassessed and adjusted 
annually.</DELETED>

<DELETED>SEC. 4. COOPERATIVE AGREEMENTS WITH THE CENTERS FOR DISEASE 
              CONTROL AND PREVENTION.</DELETED>

<DELETED>    (a) In General.--The Secretary, in coordination with the 
Director of the Centers for Disease Control and Prevention and the 
heads of other agencies, as appropriate, shall enter into cooperative 
agreements between the Centers for Disease Control and Prevention and 
health departments of States, political subdivisions of States, and 
Indian tribes and tribal organizations, to address Lyme Disease and 
other tick- and vector-borne diseases, and to support the development 
and implementation of evidence-based research, interventions, and 
treatment with respect to--</DELETED>
        <DELETED>    (1) educating and informing the public, based on 
        evidence-based public health research and data, about Lyme 
        Disease and other vector-borne diseases;</DELETED>
        <DELETED>    (2) supporting early detection and 
        diagnosis;</DELETED>
        <DELETED>    (3) supporting prevention;</DELETED>
        <DELETED>    (4) improving treatment;</DELETED>
        <DELETED>    (5) supporting care planning and management for 
        individuals with Lyme disease and other tick- and vector-borne 
        diseases; and</DELETED>
        <DELETED>    (6) supporting other relevant activities 
        identified by the Secretary or the Director of the Centers for 
        Disease Control and Prevention, as appropriate.</DELETED>
<DELETED>    (b) Eligibility.--To be eligible to enter into a 
cooperative agreement under this section, an entity described in 
subsection (a) shall prepare and submit to the Secretary an application 
at such time, in such manner, and containing such information as the 
Secretary may require, including a plan that describes--</DELETED>
        <DELETED>    (1) how the applicant proposes to develop or 
        expand programs to educate individuals through partnership 
        engagement, workforce development, guidance and support for 
        programmatic efforts, and evaluation with respect to Lyme 
        disease and other tick- or vector-borne diseases, and how the 
        applicant proposes to support other relevant activities 
        identified by the Secretary or the Director of the Centers for 
        Disease Control and Prevention, as appropriate;</DELETED>
        <DELETED>    (2) the manner in which the applicant will 
        coordinate with Federal, tribal, and State programs related to 
        Lyme Disease and other vector-borne diseases, and appropriate 
        State, tribal, and local agencies, as well as other relevant 
        public and private organizations or agencies; and</DELETED>
        <DELETED>    (3) the manner in which the applicant will 
        evaluate the effectiveness of any program carried out under the 
        cooperative agreement.</DELETED>
<DELETED>    (c) Authorization of Appropriations.--For the purpose of 
carrying out this section, there are authorized to be appropriated 
$20,000,000 for each of fiscal years from (2021 through 2026). Amounts 
appropriated shall be allocated under this section to diseases in a 
manner that proportionately matches the disease burden of those 
diseases in the United States, which shall be reassessed and adjusted 
annually.</DELETED>

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Kay Hagan Tick Act''.

SEC. 2. COMBATING VECTOR-BORNE DISEASES.

    Title III of the Public Health Service Act is amended by inserting 
after section 317T (42 U.S.C. 247b-22) the following:

``SEC. 317U. NATIONAL STRATEGY AND REGIONAL CENTERS OF EXCELLENCE IN 
              VECTOR-BORNE DISEASES.

    ``(a) In General.--The Secretary, acting through the Assistant 
Secretary for Health, shall--
            ``(1) ensure the development and implementation of a 
        national strategy to address vector-borne diseases, including 
        tick-borne diseases, consistent with subsection (b); and
            ``(2) coordinate programs and activities, including related 
        to data collection, research, and the development of 
        diagnostics, treatments, vaccines, and other related 
        activities, to address vector-borne diseases, including tick-
        borne diseases, across the Department of Health and Human 
        Services and with other Federal agencies or departments, as 
        appropriate.
    ``(b) Strategy.--
            ``(1) In general.--The Secretary, in coordination with the 
        Secretary of Defense, the Secretary of Agriculture, the 
        Administrator of the Environmental Protection Agency, the 
        Secretary of the Interior, the Secretary of Veterans Affairs, 
        the Secretary of Homeland Security, and others, as appropriate, 
        shall develop a strategy to address gaps in Federal programs, 
        and assess the progress of the United States in, addressing 
        vector-borne diseases, including tick-borne diseases. Such 
        strategy shall--
                    ``(A) assess gaps and unnecessary duplication in 
                federally funded programs and activities related to 
                surveillance, diagnosis, treatment, education, 
                pathogenesis, or prevention of vector-borne diseases, 
                including tick-borne diseases, which may include taking 
                into consideration relevant strategic plans made by 
                other agencies;
                    ``(B) identify gaps and unnecessary duplication 
                with respect to--
                            ``(i) epidemiological, basic, 
                        translational, and clinical research on vector-
                        borne diseases, including tick-borne diseases; 
                        and
                            ``(ii) vector surveillance, registries, and 
                        disease monitoring, including coinfections with 
                        agents of more than one vector-borne disease;
                    ``(C) identify strategic goals related to 
                addressing vector-borne diseases, including tick-borne 
                diseases, including goals related to the development of 
                diagnostics, treatments, vaccines, and other related 
                measures, as appropriate, and benchmarks to measure 
                progress;
                    ``(D) identify ways to improve the care and 
                treatment of individuals with vector-borne diseases, 
                including tick-borne diseases, and to improve public 
                awareness of such diseases; and
                    ``(E) update such strategy biennially.
            ``(2) Non-federal perspectives.--In developing and 
        updating, as applicable, the strategy under paragraph (1), the 
        Secretary shall--
                    ``(A) coordinate with the Tick-Borne Disease 
                Working Group established under section 2062 of the 
                21st Century Cures Act (42 U.S.C. 284s), as 
                appropriate; and
                    ``(B) consult with non-Federal individuals with 
                appropriate expertise, which may include--
                            ``(i) epidemiologists with experience in 
                        vector-borne diseases, including tick-borne 
                        diseases;
                            ``(ii) representatives of patient advocacy 
                        and research organizations that focus on 
                        vector-borne diseases, including those that 
                        focus specifically on tick-borne diseases and 
                        have demonstrated experience in related 
                        research, public health, data collection, or 
                        patient access to care;
                            ``(iii) health information technology 
                        experts or other information management 
                        specialists;
                            ``(iv) clinicians, entomologists, vector 
                        management professionals, public health 
                        professionals, and others with expertise in 
                        vector-borne diseases, including tick-borne 
                        diseases; and
                            ``(v) researchers, including researchers 
                        with experience conducting translational 
                        research.
    ``(c) Centers of Excellence.--The Secretary, in coordination with 
the Director of the Centers for Disease Control and Prevention and the 
heads of other agencies, as appropriate, shall award grants, contracts, 
or cooperative agreements to institutions of higher education for the 
establishment or continued support of regional centers of excellence in 
vector-borne diseases to address vector-borne diseases, including tick-
borne diseases, by--
            ``(1) facilitating collaboration between academia and 
        public health organizations for public health surveillance, 
        prevention, and response activities related to vector-borne 
        diseases, including tick-borne diseases;
            ``(2) providing training for public health entomologists 
        and other health care professionals, as appropriate, to address 
        vector-borne diseases, including tick-borne diseases;
            ``(3) conducting research to develop and validate 
        prevention and control tools and methods, including evidence-
        based and innovative, evidence-informed tools and methods to 
        anticipate and respond to disease outbreaks; or
            ``(4) preparing for and responding to outbreaks of vector-
        borne diseases, including tick-borne diseases.
    ``(d) Eligibility.--To be eligible to receive a grant, contract, or 
cooperative agreement under subsection (c), an entity shall submit to 
the Secretary an application at such time, in such manner, and 
containing such information as the Secretary may require, including a 
description of how the entity will conduct the activities described in 
such subsection.
    ``(e) Reports.--
            ``(1) Program summary.--An entity receiving an award under 
        subsection (c) shall, not later than one year after receiving 
        such award, and annually thereafter, submit to the Secretary a 
        summary of programs and activities funded under the award.
            ``(2) Progress report.--Not later than 4 years after the 
        date of enactment of this section, the Secretary shall submit 
        to the Committee on Health, Education, Labor, and Pensions of 
        the Senate and the Committee on Energy and Commerce of the 
        House of Representatives, a report on the progress made in 
        addressing vector-borne diseases, including tick-borne 
        diseases, through activities carried out under this section.
    ``(f) Authorization of Appropriations.--For the purpose of carrying 
out this section, there are authorized to be appropriated $10,000,000 
for each of fiscal years 2021 through 2025.''.

SEC. 3. ENHANCING CAPACITY TO ADDRESS VECTOR-BORNE DISEASES.

    (a) Enhanced Support.--Subtitle C of title XXVIII of the Public 
Health Service Act (42 U.S.C. 300hh-31 et seq.) is amended by adding at 
the end the following:

``SEC. 2822. ENHANCED SUPPORT TO ASSIST HEALTH DEPARTMENTS IN 
              ADDRESSING VECTOR-BORNE DISEASES.

    ``(a) In General.--The Secretary, acting through the Director of 
the Centers for Disease Control and Prevention, may enter into 
cooperative agreements with health departments of States, political 
subdivisions of States, and Indian Tribes and Tribal organizations in 
areas at high risk of vector-borne diseases in order to increase 
capacity to identify, report, prevent, and respond to such diseases and 
related outbreaks.
    ``(b) Eligibility.--To be eligible to enter into a cooperative 
agreement under this section, an entity described in subsection (a) 
shall prepare and submit to the Secretary an application at such time, 
in such manner, and containing such information as the Secretary may 
require, including a plan that describes--
            ``(1) how the applicant proposes to develop or expand 
        programs to address vector-borne diseases risks, including 
        through--
                    ``(A) related training and workforce development;
                    ``(B) programmatic efforts to improve capacity to 
                identify, report, prevent, and respond to such disease 
                and related outbreaks; and
                    ``(C) other relevant activities identified by the 
                Director of the Centers for Disease Control and 
                Prevention, as appropriate;
            ``(2) the manner in which the applicant will coordinate 
        with other Federal, Tribal, and State agencies and programs, as 
        applicable, related to vector-borne diseases, as well as other 
        relevant public and private organizations or agencies; and
            ``(3) the manner in which the applicant will evaluate the 
        effectiveness of any program carried out under the cooperative 
        agreement.
    ``(c) Authorization of Appropriations.--For the purposes of 
carrying out this section, there are authorized to be appropriated 
$20,000,000 for each of fiscal years 2021 through 2025.''.
                                                       Calendar No. 287

116th CONGRESS

  1st Session

                                S. 1657

_______________________________________________________________________

                                 A BILL

 To provide assistance to combat the escalating burden of Lyme disease 
        and other tick and vector-borne diseases and disorders.

_______________________________________________________________________

                            November 5, 2019

                       Reported with an amendment
```