For each meeting of the VMB or the MDC, a CaRVTA Regulatory/Legislative Committee member is in attendance to report back on information that is important to our members, as well as to represent CaRVTA when appropriate.
• Veterinary Medical Board News (VMB)
• Multidisciplinary Advisory Committee News (MDC)
Recent VMB News for RVTs
Possible VMB Alternate Route Changes
Updated May 2013
Alternate Route programs have proliferated in recent years, prompting the VMB to create an approval process for them, as required by law. Discussion on March 12 included whether students in these programs should have to complete some or all of their required work experience prior to enrolling in the program— as well as whether there should be a minimum or maximum number of hours for each of the required subjects.
The current regulation only requires that there be a course in each of the subjects, but does not require minimum or maximum hours. Under consideration were the options: make no change since there doesn't appear to be a problem with the current regulation; consider minimum hours only for the RVT job-related subjects; consider removing a separate requirement for the general education subjects and make them part of the RVT-related courses; or, consider a maximum for the general education subjects.
CaRVTA's position is that there is no need to alter the Alternate Route, as it has been working as intended. In addition, AVMA accredited and California approved RVT schools do not have minimum or maximum hours requirements for their programs. The regulations for these programs require a minimum number of total hours in specific subject areas, just as the Alternate Route does.
Debate on this matter at the first meeting over this matter included a lively discussion, with most of the public in attendance suggesting that no change was required, while several Task Force members advocated for change. Since no consensus was reached, it was agreed to continue the discussion at a future meeting. That meeting has now been set for June 11, in Sacramento.
CaRVTA Board President Allyne Moon attended the April SCVMA meeting to discuss the possibility of obtaining the veterinary association's support in CaRVTA's stance against the VMB's discussed changes to the Alternate Route. Please consider attending this important VMB RVT Task Force meeting and making your voice heard in Sacramento.
The current regulation, which has been in effect since 1994, requires a minimum of 300 hours or 20 semester or 30 quarter units, in specific subject areas, but does not require any minimum or maximum number of hours in any particular subject. Alternate Route candidates have been required to have at least one course in each required subject area, but it is currently left to the candidates to decide how many hours in any particular subject area are appropriate for them.
The RVT Task Force consists of the two members of the RVT Sub-Committee of the Veterinary Medical Board (VMB)—Kim Williams, RVT, and Dr. Cheryl Waterhouse—as well as the two members of the Multidisciplinary Advisory Committee's (MDC) RVT Sub- Committee, David Johnson, RVT, and Dr. Oscar Chavez.
CaRVTA will continue to keep you posted on this important matter.
VMB Sunset Review Update
The VMB came up for Sunset Review in front of a joint meeting of the Senate and
Assembly Business and Professions Committees on March 19. Every agency in the Department
of Consumer Affairs must undergo periodic reviews by the Legislature to determine
if they should continue operation or if their Practice Acts need adjustment. Much of
the discussion at the hearing revolved around why RVT issues were being neglected
or delayed. The VMB stated that they had been short staffed and that other issues
at the MDC took precedence. CVMA testified that they were very happy with how
the MDC was functioning but had problems with delays in processing disciplinary
actions.
Nancy Ehrlich, RVT, CaRVTA's Regulatory/Legislative Liaison, testified that CaRVTA was very disappointed that since the RVTC was sunsetted, RVT issues have not been given sufficient priority. She stated that the goal of the MDC handling RVT issues had not been met, since the MDC had not even discussed RVT issues at all. She promoted CaRVTA's position that the RVT Committee (RVTC) should be reinstated as the only sure method of insuring that RVT issues were handled in a public and timely manner. Ehrlich clarified that a Task Force is for temporary issues and that RVT issues are on-going and need a regular venue for discussion. She also pointed out that the number of RVTs has grown 69% since the last Sunset Review in 2003, while the number of veterinarians has grown only 31% and the number of premises only 7%. Carol Schumacher, RVT, the Chair of the RVTC when it was sunsetted, testified that she was disappointed that RVT issues have been neglected and concurred that a new RVTC was the best solution.
The issue of access to—and the administration of—controlled substances was also discussed. Current law allows assistants to administer controlled substances—and all other drugs—under the direct and indirect supervision of a veterinarian. Assistants with access to controlled drugs must undergo a background check to insure they are free of drug convictions. The plan was to require fingerprinting of assistants with access to controlled drugs once the VMB established a program. Sue Geranen, the Executive Officer of the VMB, testified that the VMB cannot create a fingerprinting program for several years due to computer system limitations. Therefore, the VMB is suggesting that access to the controlled drug central supply be limited to licensees to avoid the need for a fingerprinting program. CaRVTA has previously supported limiting access to the central supply to licensees. It was agreed that stakeholders would meet to come up with a new law that was workable.
Ms. Ehrlich also promoted CaRVTA's position that the legislature consider requiring all veterinary personnel to wear name tags with their official designation so that clients know who is treating their animals.
May 9 Update: SB 307, the bill that reauthorizes the Veterinary Medical Board, was heard in the Senate Business & Professions Committee on April 29. At the end of the Sunset hearing on March 19, Assembly B&P Committee Chair Richard Gordon noted the committee was considering reducing the time between sunset reviews from 4 years to 2 years for the VMB to insure that RVT issues were properly handled. The bill has been amended to include that 2-year sunset review.
SB307 also includes a provision requiring veterinary assistants who have access to controlled substances to be fingerprinted starting in 2015. The fingerprinting program would be instituted only if the VMB receives sufficient funding and staff to implement the program. The VMB has indicated that it may not be able to comply if its computer system is not upgraded. The bill has been re-referred to the Senate Appropriation Committee.
VMB RVT Task Force Discusses VTNE Transistion
At the April 2013 meeting, the VMB reviewed proposed language for regulations regarding the transition to the national RVT exam (VTNE), which is expected to go into effect in January 2014. Nancy Ehrlich, CaRVTA Board member and Regulatory Liaison, brought up the matter of the greatly increased costs to RVT candidates once the transition goes into effect. The current costs include the $125 application fee and a $175 exam fee. The new regulation requires a $125 application fee and a $125 fee for the California RVT (law) exam. Candidates will also have to pay the $300 to take the VTNE. This translates into an increase from $300 to $550. If a candidate passes either the California RVT (law) exam or the VTNE but fails the other exam, he/she will have to pay an additional $125 application fee to re-take the failed exam, which could bring the tot al to $675. After considerable discussion, the VMB agreed to look into the cost of the California RVT (law) exam to be sure that the State is not charging any more than the minimum to cover expenses. The VMB agreed to ask the American Association of Veterinary State Boards, which administers the VTNE, to review the cost of its exam. The regulations were approved with minor amendments and will be on the agenda for Public Hearing in July.
Earlier in 2013, the VMB RVT Task Force discussed the VTNE Reciprocity. The items under discussion included the regulations necessary to make the switch from a California only licensing exam to the national RVT exam (VTNE) plus a supplement on California law. One of the proposals would make it easier for RVTs from other states to become licensed in California. The proposal would allow RVTs who have taken the VTNE, are currently licensed and in good standing, and whose employers sign them off on the Task List and document at least 4416 hours of employment as an RVT, to take just the California law exam regardless of when they had taken the VTNE. This regulation would create a true reciprocity program for out-of-state RVTs. Candidates who have taken the VTNE out-of-state but have not become licensed would have to take the California law exam within 5 years of passing the VTNE, just as will be required of in-state candidates.
There was also discussion about the content of the new law exam. It was agreed that since California does not have control over the content of the VTNE, it was advisable to maintain the option to add content to the exam about the RVT specific job tasks. Although the exam will consist of only questions about California law for now, it was decided that it should be called the California RVT Exam in the regulations to allow for other content in the future.
RVT School Regulation Updates
Updated Feb. 18, 2013
A public hearing was held on the proposed regulations regarding California-approved RVT schools. The proposal was approved with a few minor amendments. A 15-day notice will be sent out regarding the amendments. Assuming there are no objections to the amendments, the regulation will take 6-9 months to work its way through the various state agencies before going into effect. The primary effect of the regulations is to clarify that AVMA-accredited RVT schools in California must also be approved by the VMB, although they will be exempt from many of the requirements as long as they maintain their AVMA accreditation. However, if the schools fail to comply with the California regulations, they can be put on probation or lose their California approval.
Other VMB News Items
Updated May 9, 2013
The VMB met on April 24 in Newport Beach. Board members reviewed their proposed regulation on Animal Rehabilitation (AR), which would restrict the delegation of AR to licensed Physical Therapists (PT) or to RVTs under the Direct Supervision of a veterinarian. It was announced that the proposed regulation would be on the VMB's agenda for Public Hearing in January. Quite a few PTs and their clients spoke in opposition to the proposal. They generally agreed that Direct Supervision was unnecessary and too costly. Most felt that PTs are capable of reading physical cues and could tell when an animal was in distress. Some PTs pointed out that they work on young children and disabled people who cannot speak, which requires similar skills to working on non-verbal animals. Sue Geranen, the Executive Officer of the VMB, pointed out that it is the opinion of the VMB's legal counsel that AR is included in the definition of veterinary medicine and cannot, therefore, be performed by anyone unless they are under the supervision of a veterinarian.
The VMB also announced that the new Minimum Standards regulations that include an upgraded definition of dental operation, required an additional 15-day notice, but that they have been granted an extension so the regulation can proceed. They also announced that the Animal Control Tranquilizer Manual will be presented at the July meeting. Previous legislation allows Animal Control Officers who receive training as defined by the VMB may utilize certain controlled substances as an alternative to lethal force.
Updated Feb. 19, 2013
Nancy Ehrlich, RVT, CaRVTA's Regulatory Liaison, brought up the issue of out-of- state RVTs who want to move to California. CaRVTA receives approximately one inquiry per week from interested out-of-state RVTs. The current regulations were written when California used its own licensing exam and are not clear about how to handle those RVTs who have already taken the VTNE in another state. Susan Geranen, the Executive Officer of the VMB, stated that Section 2068.1 should be clarified to state that out-of-state RVTs would be eligible to take the California RVT law exam if they have already passed the VTNE.
VMB Member Kim Williams, RVT, reported on the VMB's RVT Sub- Committee. She reported that she has been working with the Office of Professional Exam Services to define the parameters of the new California RVT Law Exam that is scheduled to be administered to applicants along with the national RVT Exam (VTNE) starting in January 2014. he also reported that the VTNE has a new test plan that is available on their web site, www.aavsb.org, and that the exam has been reduced to 150 questions.
Dr. Dick Sullivan raised the issue of epidural injections and who may administer them. The consensus of opinion at the meeting was that if an anesthetic drug is being administered, a veterinarian may only delegate that task to an RVT under direct supervision. If a non-anesthetic drug is being administered, a veterinarian may delegate the task to either an RVT or a veterinary assistant under direct or indirect supervision. The VMB voted to send further discussion of the issue to the Multidisciplinary Advisory Committee (MDC). The issue was given high priority.
The VMB discussed Section 2027—the regulation that permits junior and senior veterinary students and graduates of recognized veterinary schools to function as RVTs. At issue is the potential problem of unlicensed veterinary school graduates possibly exceeding the scope of an RVT and performing tasks reserved for veterinarians. Since these individuals are not licensed, the VMB has limited options for discipline. Staff was directed to look into whether this is a problem requiring some action.
The VMB approved regulations for the Pet Lovers' License Plate program. The VMB is the agency that controls the funding for the program, but an independent non-profit group will be administering the program. The regulations that set standards for the program will go to public hearing in April.
CE Audits
Going forward, the VMB will send notices to licensees 90-120 days prior to their relicensure dates, notifying individuals that they have been selected for a CE audit. This procedure is intended to give licensees enough time to acquire the CE if they don’t already have it. Approximately 10% of licensees are audited each year. RVTs should keep their CE certificates on file and not send them in with their license renewals, unless they have been notified that they are being audited.
Unlicensed Veterinary Activity
When the VMB receives a complaint about unlicensed activity, it first investigates the complaint. Second, it sends a Cease & Desist letter to the individual, giving them an opportunity to explain whether or not they are actually engaged in the unlicensed activity. If they are performing the activity and do not desist, they are issued a citation and fine. They may also be referred to the local District Attorney for criminal prosecution. The VMB has passed a motion to direct its legal counsel to investigate further enforcement options. For information about how to file a complaint, go to www.vmb.ca.gov/consumers/comp_inf.shtml. If you prefer, you can contact CaRVTA's Regulatory/Legislative Liaison by sending an email to: rvtregs@carvta.org or calling (916) 244-2494 ext 210.
MultiDisciplinary Advisory Committee (MDAC) News
Cite & Fine Update
Updated Feb. 18, 2013
The VMB approved the Cite & Fine Guidelines as proposed. A public hearing will be scheduled for some time after April.
Animal Rehabilitation & Physical Therapists
Feb. 18, 2013
The MDC has presented a proposal for Animal Rehabilitation (AR). The proposal recommends that a veterinarian may delegate the performance of AR (the veterinary term for physical therapy) to a licensed Physical Therapist (PT) under Direct Supervision. The proposal did not include RVTs or veterinary assistants, as the MDC intended to continue to allow RVTs and assistants to be able to perform AR under the Direct or Indirect supervision of a veterinarian. After discussion that this proposal limited licensed Physical Therapists more than unlicensed veterinary assistants, the VMB approved a motion that a veterinarian could delegate the performance of AR only to a licensed PT or RVT under Direct Supervision. They also included a 3-year sunset date so that they would be required to review the effectiveness of the regulation after it had some time to be implemented. A date for public hearing on this proposal has not been set.
In previous VMB/MDC meetings, several veterinarians who specialize in animal rehabilitation stated that in their opinion, PTs need to work under the direct supervision of a veterinarian, due to the unique requirements of animal patients who age more rapidly than humans and who cannot speak for themselves. Shela Barker, legal counsel to the VMB, clarified that under the Veterinary Practice Act, PTs are considered unregistered assistants and that it would require legislation to allow PTs to operate independently of veterinarians. She also explained that by law, unregistered assistants are allowed to perform animal health care tasks at the same or higher level of supervision than RVTs. It also follows that an RVT may perform the tasks allowed to unregistered assistants at the same or lower level of supervision.