HB563 By Representatives Todd and Sanderford RFD Boards, Agencies and Commissions Rd 1 28-APR-15

SYNOPSIS: Under existing law, the Alabama Veterinary Practice Act governs the practice of veterinary medicine in the state.

This bill would provide further for the definition of the practice of veterinary medicine to prohibit any person, other than a licensed veterinarian, from directly supervising veterinary medical services or making certain decisions relating to the medical or surgical treatment of animals.

This bill would include a spay neuter clinic under the definition of a veterinary facility, and would limit the scope of services offered at a spay neuter clinic.

This bill would exempt licensed veterinarians employed by nonprofit spay neuter clinics from certain prohibitions against practicing veterinary medicine as an employee of a person not licensed by the board.

This bill would subject spay neuter clinics to the same permits and requirements as other veterinary facilities and would require certain records to be maintained.

This bill would also specify that licensed veterinarians continue to exercise the standard of care, professional judgment, and humane treatment of animals required under the practice act as amended.

A BILL TO BE ENTITLED AN ACT

To amend Sections 34-29-61, 34-29-87, and 34-29-88, Code of Alabama 1975, relating to the Alabama Veterinary Practice Act; to provide further for the definition of the practice of veterinary medicine to prohibit any person, other than a licensed veterinarian, from directly supervising veterinary medical services or making certain decisions relating to the medical or surgical treatment of animals; to include a spay neuter clinic under the definition of a veterinary facility, and to limit the scope of services offered at a spay neuter clinic; to exempt licensed veterinarians employed by nonprofit spay neuter clinics from certain prohibitions against practicing veterinary medicine as an employee of a person not licensed by the board; subject spay neuter clinics to the same permits and requirements as other veterinary facilities; to provide certain record-keeping responsibilities; and to specify that licensed veterinarians continue to exercise the standard of care, professional judgment, and humane treatment of animals required under the practice act as amended.

BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:Section 1. Sections 34-29-61, 34-29-87, and 34-29-88 of the Code of Alabama 1975, are amended to read as follows:

§34-29-61.

"For the purposes of this article, the following terms shall have the following meanings ascribed by this section:

"(1) ACCREDITED SCHOOL OF VETERINARY MEDICINE. Any veterinary college or division of a university or college that offers the degree of doctor of veterinary medicine or its equivalent and is accredited by the American Veterinary Medical Association (AVMA).

"(2) ANIMAL. Any animal or mammal other than man, including birds, fish, reptiles, wild or domestic, living or dead.

"(3) APPLICANT. A person who files an application to be licensed to practice veterinary medicine or licensed as a veterinary technician.

"(4) BOARD. Alabama State Board of Veterinary Medical Examiners.

"(5) CONSULTING VETERINARIAN. A veterinarian licensed in another state who gives advice or demonstrates techniques to a licensed Alabama veterinarian or group of licensed Alabama veterinarians. A consulting veterinarian shall not utilize this privilege to circumvent the law.

"(6) DIRECT SUPERVISION. The supervising veterinarian has initially examined the animal and will examine at other times as acceptable veterinary medical practice requires, consistent with the particular delegated animal health care task. The supervising veterinarian is on the premises and is quickly and easily available.

"(7) EMERGENCY. The animal has been placed in a life threatening condition and immediate treatment is necessary to sustain life.

"(8) FOREIGN VETERINARY GRADUATE, EXCLUDING CANADA. Any person, including a foreign national or an American citizen, who has received a professional veterinarian medical degree from an American Veterinary Medical Association listed veterinary college that is not accredited by the American Veterinary Medical Association.

"(9) IMMEDIATE SUPERVISION. The supervising veterinarian is on the premises and in audible or visual range of the animal patient and the person treating the patient.

"(10) INDIRECT SUPERVISION. The supervising veterinarian has examined the animal and has given written or oral instructions for the treatment of the animal while the supervising veterinarian is away from the premises.

"(11) LICENSE. Any permit, approval, registration, or certificate of qualification issued by the board.

"(12) LICENSED VETERINARIAN. A person who is validly and currently licensed to practice veterinary medicine in Alabama.

"(13) LICENSED VETERINARY TECHNICIAN. A person who is validly and currently licensed to practice as a veterinary technician in Alabama.

"(14) PERSON. Any individual, firm, partnership, association, joint venture, cooperative, or corporation or any other group or combination acting in concert; and whether or not acting as a principal, trustee, fiduciary, receiver, or as any kind of legal or personal representative, or as the successor in interest, assigning agent, factor, servant, employee, director, officer, or any other representative of such person.

"(15) PRACTICE OF VETERINARY MEDICINE:

"a. To diagnose, treat, correct, change, relieve, or prevent animal disease, deformity, defect, injury, or other physical or mental condition; including the prescription or administration of any drug, medicine, biologic, apparatus, application, anesthesia, or other therapeutic or diagnostic substance or technique on any animal including but not limited to acupuncture, dentistry, animal psychology, animal chiropractic, theriogenology, surgery, including cosmetic surgery, any manual, mechanical, biological, or chemical procedure for testing for pregnancy or for correcting sterility or infertility, or to render service or recommendations with regard to any of the above.

"b. To represent directly or indirectly, publicly or privately, an ability and willingness to do any act described in paragraph a.

"c. To use any title, words, abbreviations, or letters in a manner or under circumstances which induce the belief that the person using them is qualified to do any act described in paragraph a. Such use shall be prima facie evidence of the intention to represent oneself as engaged in the practice of veterinary medicine.

"d. Collects To collect blood or other samples for the purpose of diagnosing disease or other conditions. This paragraph shall not apply to unlicensed personnel employed by the United States Department of Agriculture or the Alabama Department of Agriculture who are engaged in the Brucellosis eradication program or external parasite control program pursuant to Section 2-15-192.

"e. To remove any embryo from a food animal or companion animal for the purpose of transplanting the embryo into another female animal or for the purpose of cryopreserving the embryo, or to implant the embryo into a food or companion animal. It shall not be considered the practice of veterinary medicine for a person or his or her full-time employees to remove an embryo from the food or companion animal of the person for the purpose of transplanting or cryopreserving the embryo, or to implant an embryo into the food or companion animal of the person, provided ownership of the food or companion animal shall not be transferred or employment of the person shall not be changed for the purpose of circumventing this article.

"f. To provide veterinary medical services to a client or patient in this state, through telephonic, electronic, or other means, regardless of the location of the veterinarian, shall constitute the practice of veterinary medicine in this state and shall require licensure within this state and a veterinarian-client-patient relationship must be established.

"g. It shall be unlawful for any person, other than a licensed veterinarian, to undertake the direct supervision of the veterinary medical services or to make any policy or decision relating to the medical or surgical treatment of animals including, but not limited to, the number of surgical procedures to be performed per day per veterinarian or the number of auxiliary veterinary medical personnel, including licensed veterinary technicians and unlicensed veterinary assistants, necessary to provide adequate outpatient surgery services.

"(16) SUPERVISING VETERINARIAN. A veterinarian who assumes responsibility for the professional care given to an animal by a person working under his or her direction.

"(17) TEMPORARY LICENSE. Temporary permission to practice veterinary medicine issued by the board pursuant to this article.

"(18) UNLICENSED ASSISTANT. Any individual who is not a licensed veterinary technician or veterinarian and is employed by a licensed veterinarian.

"(19) VETERINARIAN-CLIENT-PATIENT RELATIONSHIP (VCPR). A relationship when the veterinarian has assumed responsibility for making medical judgments regarding the health of the animal or animals and the need for medical treatment and is created by actual examination by the veterinarian of the animal or a representative segment of a consignment or herd.

"(20) VETERINARIAN, DOCTOR OF VETERINARY MEDICINE, DVM, VMD, or EQUIVALENT TITLE. A person who has received a doctor's degree in veterinary medicine from an accredited school of veterinary medicine or holds an Educational Commission for Foreign Veterinary Graduates (ECFVG) certificate issued by the American Veterinary Medical Association (AVMA).

"(21) VETERINARY FACILITIES. Any place or unit from which the practice of veterinary medicine is conducted. The following are types of veterinary facilities:

"a. Veterinary or Animal Hospital or Clinic. Meets or exceeds all mandatory requirements as listed in the administrative code of the board for veterinary facilities. In doing so, it provides quality examination, diagnostic, and health maintenance services for medical and surgical treatment of animals and is equipped to provide housing and nursing care for the animals during illness or convalescence.

"b. Specialty Practice or Clinic. Provides complete specialty service by a veterinarian who has advanced training in that specialty and is a diplomat of an approved specialty college. It meets all minimum standards that are applicable to that specialty.

"c. Central Hospital. Shall meet all requirements of paragraph a., as well as provide specialized care including 24-hour nursing care and specialty consultation on a permanent or on-call basis. It is mainly utilized on referral from area veterinary hospitals or clinics.

"d. Satellite, Outpatient, or Mobile Small Animal Clinics. A supportive facility owned by or associated with, or both, and has ready access to, within a reasonable distance, a full-service veterinary hospital or clinic or a central hospital providing all mandatory services and meeting all minimum standards. The public shall be informed of the limitation of services by way of a posted notice in plain view and easily readable or by notice provided to the client by flyer or card which clearly specifies those mandatory veterinary medical services which are not provided. In addition, the main location and telephone number of the veterinary hospital or clinic providing the required service, as well as the signed agreement with the veterinary hospital or clinic shall also be posted in plain view and be easily readable. A veterinarian associated with this veterinary hospital or clinic shall be on call during and after operation of the satellite, outpatient, or mobile clinic to render aid if necessary. The personnel of satellite, outpatient, or mobile clinics shall consist of one or more veterinarians and auxiliary personnel necessary to provide adequate outpatient service. Operation of any satellite, outpatient, or mobile clinic shall be under the direct supervision of a licensed veterinarian who remains on the premises during the entire time of operation.

"e. Large Animal Mobile Clinic. Must provide examination, diagnostic, and preventive medicine, and minor surgical services for large animals not requiring confinement or hospitalization. Emergency service and radiology service shall be provided by that veterinarian or by written agreement with another veterinarian or group of veterinarians in practice in that locale. These clinics shall provide a degree of veterinary care compatible with the level of standards considered adequate to the practice of veterinary medicine currently available in the area. Complete hospital facilities may be provided by the nearest large animal hospital or veterinary school.

"f. Emergency Clinic. A facility established to receive patients and to treat illnesses and injuries of an emergency nature requiring treatment. The clinic shall provide professional diagnostic and emergency treatment during hours when local veterinary hospitals are normally closed. Emergency clinics shall meet all mandatory requirements of a veterinary hospital or clinic.

"g. Spay Neuter Clinic. A limited service veterinary clinic providing spay and neuter services, where no patient shall be allowed on the premises for more than 36 hours. Services provided by a spay neuter clinic shall be limited to spay and neuters. One-year rabies vaccinations and treatment of intestinal and external parasites may be administered only at the time of the surgery. A spay neuter clinic shall meet or exceed all physical requirements and minimum standards established by this article, and the rules of the board, for veterinary facilities providing limited services on an outpatient basis. Service contracts with a full-service veterinary facility that provides emergency and after-hour care shall be required for after-hour emergencies.

"(22) VETERINARY INTERN. A person who is working towards completion of an ECFVG certificate and who is working under the direct or indirect supervision of a board approved licensed veterinarian in any state to complete the practical experience internship required for licensing in Alabama.

"(23) VETERINARY MEDICINE. Includes veterinary surgery, theriogenology, dentistry, acupuncture, animal psychology, chiropractic, and all other branches or specialties of veterinary practice.

"(24) VETERINARY STUDENT PRECEPTEE. A person who is pursuing a veterinary degree in an accredited school of veterinary medicine which has a preceptor or extern program and who has completed the academic requirements of the program.

"(25) VETERINARY TECHNICIAN STUDENT. Any person enrolled in an AVMA accredited veterinary technology program; gaining clinical experience under the supervision of a licensed veterinarian or licensed veterinary technician in a clinical setting.

"(26) VETERINARY TECHNOLOGY. The skills and knowledge accrued in a post-high school course of study, accredited by the AVMA Committee on Education (COE) or the board, in the area of care and treatment of animals. It embodies limited skills, responsibility, and minimal exercise of independent judgment in the treatment of patients of veterinarians while under direct, indirect, or immediate supervision of a veterinarian.

"(27) WHOLESALE VETERINARY DRUG DISTRIBUTOR. A person engaged in the business of distributing veterinary drugs and medicines for resale to veterinary practitioners and other veterinary wholesalers and possesses a current permit issued by the Alabama Board of Pharmacy to engage in the selling of veterinary drugs or medicines in the State of Alabama.

§34-29-87.

"(a) Whenever the practice of veterinary medicine is carried on by a partnership, all partners shall be either licensed or holders of temporary licenses to practice veterinary medicine in the State of Alabama.

"(b) It shall be unlawful for any licensed veterinarian to practice veterinary medicine as an employee of any person or other entity not engaged primarily in the practice of veterinary medicine or for any person that is the owner or owners of an active veterinary practice to be other than a veterinarian or veterinarians duly licensed in the State of Alabama.

"(c) The following shall be exempt from this section:

"(1) A veterinarian employed by a person treating his or her employer's animals.

"(2) A veterinarian employed by an official agency of the federal or state government or any subdivision thereof.

"(3) A veterinarian employed by any licensed research facility.

"(4) An heir or heirs inheriting under the terms of a will or by intestate succession for a period of two five years following the death of the licensee.

"(5) A licensed veterinarian employed by a spay neuter clinic owned and operated by a nonprofit, tax exempt entity, as defined under Section 501(c)(3) of the Internal Revenue Code. Each licensed veterinarian employed by a 501(c)(3) spay neuter clinic shall be subject to the standards of care for veterinary medicine as established in this article, rules promulgated by the board pursuant to this article, and the standards of care for veterinary medicine and surgery as established in this article and by rule of the board.

§34-29-88.

"(a) Any facility, including mobile clinics, spay neuter clinics, or any other premises where a licensed veterinarian practices shall have a premise permit issued by the board. Upon application and payment of a premise permit fee and an inspection fee, if necessary to cover the cost of inspection, the board shall cause a facility to be inspected. A premise permit shall be issued if the facility meets minimum standards to be adopted by the administrative code of the board as to sanitary conditions and physical plant. In lieu of the above procedure, the board may issue a premise permit to any premise which is accredited by a recognized organization whose standards meet or exceed minimum board standards as established by the administrative code of the board.

"(b) Each application for premise permit shall set forth the names of all licensed veterinarians who shall be responsible for the management of the premises.

"(c) The premise permit may be revoked, suspended, or denied when inspection reveals that the premises do not meet the standards set by the administrative code of the board or when the license of the responsible veterinarian or veterinarians has been suspended or revoked.

"(d) The board may cause the closure of a facility and impose a penalty against any owner, operator, or responsible veterinarian of any premises operating without a premise permit in violation of this section or in violation of the administrative code of the board. No penalties so imposed shall exceed one thousand dollars ($1,000) for each count or separate offense. In order that the board and the executive director may determine whether or not a danger to the public or to animals exists, the executive director or investigators employed by the board may conduct inspections or investigations of premises suspected of being in violation of any rule of the board. If a violation is found in conducting an inspection which is determined to be a hazard and a danger to the public or to animals, the executive director may suspend that premise permit until further notice.

"(e) All premise permits shall be renewed yearly by payment of a fee to the board.

"(f) Veterinary facilities shall be reinspected periodically as determined by the board.

"(g) Premise permits issued to satellite, outpatient, spay neuter clinics, or mobile small animal clinics shall state the name of the full service veterinary facility in that locale providing emergency and after hours service. Premise permits issued to mobile large animal clinics shall state the name of the full service veterinary facility in that locale providing radiology, emergency, and after hours service. Mobile clinics operating in more than one locale, i.e. city, shall have a premise permit for each locale. If the agreement between the outpatient, satellite, mobile large animal clinic, mobile small animal clinic, spay neuter clinic, and the full service veterinary clinic providing back-up service ceases, the board shall be notified immediately and a new agreement for back-up service shall be provided before the issuance of a new premise permit."

Section 2. Up-to-date individual veterinary medical records on all veterinary patients pertaining to any and all treatments and procedures rendered shall be properly maintained and remain at the spay-neuter clinic for inspection and audit by the board. Upon the discharge of an animal patient, a spay-neuter clinic shall provide all of the following to the owner:

(1) Contact information for the full service veterinary facility with which the spay-neuter clinic has contracted to provide emergency and after hours services.

(2) A copy of the patient medical records.

(3) Discharge instructions.

Section 3. (a) Nothing in Sections 34-29-61, 34-29-87, and 34-29-88, Code of Alabama 1975, as amended by this act, shall restrict a licensed veterinarian from doing all of the following:

(1) Exercising the same degree of care, skill, and diligence in treating patients as are ordinarily used in the same or similar circumstances by members of the veterinary medical profession in good standing in the locality or community in which he or she practices, or in similar communities.

(2) Deciding what employment he or she will accept in his or her professional capacity and what course of treatment will be followed once he or she has accepted employment.

(3) Treating all animals entrusted to him or her by his or her clients in keeping with the veterinary medical professional standards of humane treatment and care.

(b) Nothing in Sections 34-29-61, 34-29-87, and 34-29-88, Code of Alabama 1975, as amended by this act, shall be construed to allow a spay neuter clinic to operate a full service veterinary clinic.

Section 4. This act shall become effective on the first day of the third month following its passage and approval by the Governor, or its otherwise becoming law.

Veterinarians

Spay Neuter Clinics

Animals

Business and Profession

Nonprofit Organizations

Code Amended