PRINTER'S NO. 200
THE GENERAL ASSEMBLY OF PENNSYLVANIA
SENATE BILL
No.
233
Session of
2023
INTRODUCED BY BROOKS, BREWSTER, KANE, COSTA, LANGERHOLC, STREET,
J. WARD, COMITTA, MASTRIANO AND ROBINSON, JANUARY 31, 2023
REFERRED TO CONSUMER PROTECTION AND PROFESSIONAL LICENSURE,
JANUARY 31, 2023
AN ACT
Providing for continuing education in Lyme disease and related
tick-borne diseases for health care professionals.
The General Assembly finds and declares as follows:
(1) This Commonwealth has ranked the highest in the
country in the number of confirmed cases of Lyme disease in
prior years and in 2017 reported 11,900 new cases of Lyme
disease.
(2) Between 2000 and 2016, cases jumped in this
Commonwealth from 2,271 to 11,443, according to the
Department of Health, accounting for approximately 40% of the
nation's cases.
(3) Because cases may be under-reported by a factor of
10, cases may actually exceed 110,000, as estimated by the
Centers for Disease Control and Prevention.
(4) The Department of Environmental Protection published
a study in 2015 that confirmed a high risk of Lyme disease in
every county of this Commonwealth and found all 67 counties
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
had the blacklegged tick.
(5) The early clinical diagnosis and appropriate
treatment of these tick-borne disorders and diseases can
greatly reduce the risks of continued, diverse and chronic
symptoms that can affect every system and organ of the human
body and often every aspect of an individual's life.
(6) Residents of this Commonwealth should be aware of
early disseminated and persistent symptoms and should know
that a negative Lyme test cannot rule out Lyme disease.
(7) Scientific understanding of these complex tick-borne
illnesses is expected to evolve rapidly in the next decade,
including diagnosis and treatment options.
(8) The high burden of tick-borne diseases in this
Commonwealth requires an urgent and ongoing response. Health
care practitioner education is a specific strategy
recommended.
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 Disease
and Related Tick-Borne Disease Continuing Education Act.
Section 2. 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:
"Licensee." A physician, physician assistant or nurse
practitioner.
"Licensing board." The State Board of Medicine or the State
Board of Nursing.
"Lyme disease." Signs or symptoms compatible with acute,
20230SB0233PN0200 - 2 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
late-stage, persistent infection with Borrelia burgdorferi or
complications related to the infection or with other strains of
Borrelia, including B. miyamotoi, B. mayonii, B. garinii and B.
afzelii, that are recognized by the Centers for Disease Control
and Prevention as a cause of Lyme disease. The term includes
infection that meets the surveillance criteria established by
the Centers for Disease Control and Prevention and other acute
and persistent manifestations of the infection as determined by
a health care practitioner.
"Related tick-borne disease." The presence of signs or
symptoms compatible with infection with bartonella,
babesiosis/piroplasmosis, anaplasmosis, ehrlichiosis, Rocky
Mountain spotted fever, rickettsiosis, Powassan or other tick-
transmissible illness or complications related to the
infections. The term does not include Lyme disease.
Section 3. Continuing education requirement.
(a) General rule.--A licensing board shall require that a
licensee complete at least two hours of continuing education in
the assessment and diagnosis of and treatment options for Lyme
disease and other related tick-borne diseases as a portion of
the total continuing education required for license renewal.
(b) Content.--A licensing board shall establish the content
of continuing medical education required under this section. The
content shall address, at a minimum, the most current, evidence-
based research on tick data/pathogens Statewide, patient profile
and symptom presentation in regards to assessment and diagnosis,
current diagnostic options and current treatment options and
prevention.
(c) Input.--In establishing the content required for
continuing medical education required under this section, the
20230SB0233PN0200 - 3 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
20
21
22
23
24
25
26
27
28
29
30
licensing board shall seek input from persons with knowledge
about Lyme disease or related tick-borne diseases, including
universities involved in the research of Lyme disease and
related tick-borne diseases. To ensure quality and balanced
medical education, the licensing board shall consider the
philosophies of the Centers for Disease Control and Prevention,
the guidelines established by the National Institutes of Health,
the International Lyme and Associated Diseases Society and the
Infectious Diseases Society of America, as well as the latest
scientific evidence and research.
Section 4. Construction.
Nothing in this act shall be construed to provide treatment
recommendations for Lyme disease or related tick-borne disease.
Section 5. Regulations.
Not later than 18 months after the effective date of this
section, the licensing board shall promulgate regulations
necessary to effectuate this act.
Section 6. Effective date.
This act shall take effect immediately.
20230SB0233PN0200 - 4 -
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19