18VAC150-20 Regulations Governing the Practice of Veterinary Medicine

REGULATIONS

Vol. 32 Iss. 7 - November 30, 2015

TITLE 18. PROFESSIONAL AND OCCUPATIONAL LICENSING

BOARD OF VETERINARY MEDICINE

Chapter 20

Proposed Regulation

Title of Regulation: 18VAC150-20. Regulations Governing the Practice of Veterinary Medicine (amending 18VAC150-20-10, 18VAC150-20-140).

Statutory Authority: § 54.1-2400 of the Code of Virginia.

Public Hearing Information:

December 2, 2015 - 9 a.m. - Department of Health Professions, Perimeter Center, 9960 Mayland Drive, 2nd Floor Conference Center, Hearing Room 1, Henrico, VA

Public Comment Deadline: January 29, 2016.

Agency Contact: Leslie L. Knachel, Executive Director, Board of Veterinary Medicine, 9960 Mayland Drive, Suite 300, Richmond, VA 23233, telephone [phone], FAX [phone], or email [e-mail].

Basis: Subdivision 6 of § 54.1-2400 of the Code of Virginia establishes the general powers and duties of health regulatory boards, including the Board of Veterinary Medicine, and includes the responsibility to promulgate regulations. Subdivision 5 of § 54.1-3807 of the Code of Virginia grants the board authority to take disciplinary action based on a finding of unprofessional conduct as defined by regulation.

Purpose: This proposed regulatory action is in response to a petition for rulemaking. The purpose of the amendments is to prevent misrepresentation to the public in the use of the term "specialist" or "specialty" for an individual licensee or in the name of an establishment. The proposed action will protect consumers who may choose veterinary care based on a claim by the veterinarian or the establishment of being a "specialist" or having a "specialty" when in fact there is no justification for such a claim. By defining the term "specialist," the board can assure that those who advertise or represent themselves as such have met the requirements of the American Board of Veterinary Specialties of the American Veterinary Medical Association for board certification. Misrepresentation or fraudulent advertising is already a cause for a finding of unprofessional conduct; this proposed regulation expands on the intent of the current regulation, which is to protect the health, welfare, and safety of animals that come under the care of a veterinarian or veterinary establishment.

Substance: The amendments (i) define a specialist as a veterinarian who has completed the requirements to become a diplomate of a specialty organization recognized by the American Board of Veterinary Specialties of the American Veterinary Medical Association, or any other organization approved by the board, and (ii) provide that representing oneself as a "specialist" without meeting that definition or representing a practice as a "specialty" practice without having a "specialist" on staff is unprofessional conduct.

Issues: The primary advantage to the public is assurance that specialty care by a veterinarian is being provided by someone who has obtained such designation by a recognized specialty board or organization. This is public protection for the consumer. There are no disadvantages to the public. There are no advantages or disadvantages to the agency or the Commonwealth.

Department of Planning and Budget's Economic Impact Analysis:

Summary of the Proposed Amendments to Regulation. The Board of Veterinary Medicine (Board) proposes to: 1) define "specialist" as "a veterinarian who has completed the requirements to become a diplomate of a specialty organization recognized by the American Board of Veterinary Specialties of the American Veterinary Medical Association, or any other organization approved by the board," and 2) add to the list of acts constituting unprofessional conduct: "representing oneself as a 'specialist' without meeting the above definition, or using the words 'specialist' or 'specialty' in the name of a veterinary establishment without a veterinarian on staff who meets the above definition."

Result of Analysis. The benefits likely exceed the costs for all proposed changes.

Estimated Economic Impact. The Board's proposal to restrict the use of the term "specialist" is similar to the existing rules for human medicine and dentistry. The proposal does not alter the work that may be performed by veterinarians. It helps inform the public as to which veterinarians have obtained expertise in the specialty in question as judged by the American Board of Veterinary Specialties of the American Veterinary Medical Association.¹ Thus the proposal would produce a net benefit in that animal owners would be able to objectively make better-informed decisions concerning choosing specific veterinarians and veterinary practices for specific veterinary services, while not changing what services veterinarians may offer.

Businesses and Entities Affected. The proposed amendments apply to and potentially affect the 4214 licensed veterinarians and 1089 licensed veterinary establishments in the Commonwealth.² Most and perhaps all of the veterinary establishments would qualify as small businesses.

Localities Particularly Affected. The proposed amendments do not disproportionately affect particular localities.

Projected Impact on Employment. The proposed amendments do not significantly affect employment.

Effects on the Use and Value of Private Property. The proposed amendments may affect which veterinary practices some owners choose for their animals. In that respect, the quantity of business and consequently practice value may rise for some veterinary establishments with specialty diplomates and may decline for some veterinary establishments without specialty diplomates.

Real Estate Development Costs. The proposed amendments do not affect real estate development costs.

Small Businesses:

Definition. Pursuant to § 2.2-4007.04 of the Code of Virginia, small business is defined as "a business entity, including its affiliates, that (i) is independently owned and operated and (ii) employs fewer than 500 full-time employees or has gross annual sales of less than $6 million."

Costs and Other Effects. The proposed amendments do not increase costs for small businesses.

Alternative Method that Minimizes Adverse Impact. In aggregate, the proposed amendments do not adversely affect small businesses.

Adverse Impacts:

Businesses: In aggregate, the proposed amendments do not adversely affect businesses.

Localities: The proposed amendments will not adversely affect localities.

Other Entities: The proposed amendments will not adversely affect other entities.

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¹Or by an equivalent organization as determined by the Board of Veterinary Medicine

²Source: Department of Health Professions' website accessed on September 17, 2015 (https://dhp.virginiainteractive.org/Lookup/Index)

Agency's Response to Economic Impact Analysis: The Board of Veterinary Medicine concurs with the economic impact analysis of the Department of Planning and Budget.

Summary:

The proposed amendments (i) define a specialist as a veterinarian who has completed the requirements to become a diplomate of a specialty organization recognized by the American Board of Veterinary Specialties of the American Veterinary Medical Association, or any other organization approved by the board, and (ii) provide that representing oneself as a specialist without meeting that definition or representing a practice as a specialty practice without having a specialist on staff is unprofessional conduct.

Part I
General Provisions

18VAC150-20-10. Definitions.

The following words and terms when used in this chapter shall have the following meanings unless the context clearly indicates otherwise:

"Animal shelter" means a facility, other than a private residential dwelling and its surrounding grounds, that is used to house or contain animals and that is owned, operated, or maintained by a nongovernmental entity including, but not limited to, a humane society, animal welfare organization, society for the prevention of cruelty to animals, or any other organization operating for the purpose of finding permanent adoptive homes for animals.

"Automatic emergency lighting" is lighting that is powered by battery, generator, or alternate power source other than electrical power, is activated automatically by electrical power failure, and provides sufficient light to complete surgery or to stabilize the animal until surgery can be continued or the animal moved to another establishment.

"AVMA" means the American Veterinary Medical Association.

"Board" means the Virginia Board of Veterinary Medicine.

"Companion animal" means any dog, cat, horse, nonhuman primate, guinea pig, hamster, rabbit not raised for human food or fiber, exotic or native animal, reptile, exotic or native bird, or any feral animal or animal under the care, custody or ownership of a person or any animal that is bought, sold, traded, or bartered by any person. Agricultural animals, game species, or any animals regulated under federal law as research animals shall not be considered companion animals for the purposes of this chapter.

"CVMA" means the Canadian Veterinary Medical Association.

"Full-service establishment" means a stationary or ambulatory facility that provides surgery and encompasses all aspects of health care for small or large animals, or both.

"Immediate and direct supervision" means that the licensed veterinarian is immediately available to the licensed veterinary technician or assistant, either electronically or in person, and provides a specific order based on observation and diagnosis of the patient within the last 36 hours.

"Owner" means any person who (i) has a right of property in an animal; (ii) keeps or harbors an animal; (iii) has an animal in his care; or (iv) acts as a custodian of an animal.

"Pound" means a facility operated by the state or a locality for the purpose of impounding or harboring seized, stray, homeless, abandoned, or unwanted animals; or a facility operated for the same purpose under a contract with a locality or an incorporated society for the prevention of cruelty to animals.

"Preceptorship or externship" means a formal arrangement between an AVMA accredited college of veterinary medicine or an AVMA accredited veterinary technology program and a veterinarian who is licensed by the board and responsible for the practice of the preceptee. A preceptorship or externship shall be overseen by faculty of the college or program.

"Professional judgment" includes any decision or conduct in the practice of veterinary medicine, as defined by § 54.1-3800 of the Code of Virginia.

"Restricted service establishment" means a stationary or ambulatory facility which does not meet the requirements of a full-service establishment.

"Specialist" means a veterinarian who has completed the requirements to become a diplomate of a specialty organization recognized by the American Board of Veterinary Specialties of the American Veterinary Medical Association, or any other organization approved by the board.

"Surgery" means treatment through revision, destruction, incision or other structural alteration of animal tissue. Surgery does not include dental extractions of single-rooted teeth or skin closures performed by a licensed veterinary technician upon a diagnosis and pursuant to direct orders from a veterinarian.

"Veterinarian in charge" means a veterinarian who holds an active license in Virginia and who is responsible for maintaining a veterinary establishment within the standards set by this chapter, for complying with federal and state laws and regulations, and for notifying the board of the establishment's closure.

"Veterinary establishment" means any fixed or mobile practice, veterinary hospital, animal hospital or premises wherein or out of which veterinary medicine is being conducted.

Part III
Unprofessional Conduct

18VAC150-20-140. Unprofessional conduct.

Unprofessional conduct as referenced in subdivision 5 of § 54.1-3807(5) of the Code of Virginia shall include the following:

1. Representing conflicting interests except by express consent of all concerned given after a full disclosure of the facts. Acceptance of a fee from both the buyer and the seller is prima facie evidence of a conflict of interest.

2. Practicing veterinary medicine or equine dentistry where an unlicensed person has the authority to control the professional judgment of the licensed veterinarian or the equine dental technician.

3. Issuing a certificate of health unless he shall know of his own knowledge by actual inspection and appropriate tests of the animals that the animals meet the requirements for the issuance of such certificate on the day issued.

4. Revealing confidences gained in the course of providing veterinary services to a client, unless required by law or necessary to protect the health, safety or welfare of other persons or animals.

5. Advertising in a manner which is false, deceptive, or misleading or which makes subjective claims of superiority.

6. Violating any state law, federal law, or board regulation pertaining to the practice of veterinary medicine, veterinary technology or equine dentistry.

7. Practicing veterinary medicine or as an equine dental technician in such a manner as to endanger the health and welfare of his patients or the public, or being unable to practice veterinary medicine or as an equine dental technician with reasonable skill and safety.

8. Performing surgery on animals in an unregistered veterinary establishment or not in accordance with the establishment permit or with accepted standards of practice.

9. Refusing the board or its agent the right to inspect an establishment at reasonable hours.

10. Allowing unlicensed persons to perform acts restricted to the practice of veterinary medicine, veterinary technology or an equine dental technician including any invasive procedure on a patient or delegation of tasks to persons who are not properly trained or authorized to perform such tasks.

11. Failing to provide immediate and direct supervision to a licensed veterinary technician or an assistant in his employ.

12. Refusing to release a copy of a valid prescription upon request from a client.

13. Misrepresenting or falsifying information on an application or renewal form.

14. Failing to report suspected animal cruelty to the appropriate authorities.

15. Failing to release patient records when requested by the owner; a law-enforcement entity; or a federal, state, or local health regulatory agency.

16. Committing an act constituting fraud, deceit, or misrepresentation in dealing with the board or in the veterinarian-client-patient relationship.

17. Representing oneself as a "specialist" without meeting the definition set forth in 18VAC150-20-10 or using the words "specialist" or "specialty" in the name of a veterinary establishment unless there is a veterinarian on staff who meets the definition of a "specialist."

VA.R. Doc. No. R15-16; Filed November 9, 2015, 9:09 a.m.