BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 969
                                                                  Page  1

          Date of Hearing:   June 26, 2007

                   ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
                                   Mike Eng, Chair
                    SB 969 (Aanestad) - As Amended:  May 30, 2007

           SENATE VOTE  :   39-0
           
          SUBJECT  :   Veterinary medicine.

           SUMMARY  :   Allows a registered veterinarian technician (RVT) or  
          an unregistered assistant (UA) to administer a drug, including  
          controlled substances, under the direct or indirect supervision,  
          as defined, of a licensed veterinarian.  Specifically,  this  
          bill  :   

          1)Allows, until January 1, 2012, a RVT or an UA to administer a  
            drug, except for anesthesia, under the direct or indirect  
            supervision of a licensed veterinarian, when done pursuant to  
            the order, control, and full professional responsibility of a  
            licensed veterinarian.

          2)Defines "drug" and "controlled substance" as specified under  
            the Health and Safety Code.  

          3)Defines "direct supervision" and "indirect supervision" as  
            specified in the California Code of Regulations.   

           EXISTING LAW  :

          1)Provides for the licensing and regulation of approximately  
            11,600 veterinarians and 3,700 RVTs by the Veterinary Medical  
            Board (Board) in the Department of Consumer Affairs.

          2)Prohibits any person not licensed by the Board from practicing  
            veterinary medicine, and provides that an applicant for a  
            license to practice veterinary medicine shall have graduated  
            from a veterinary college, passed a national-administered  
            licensing examination, a Board examination, and an examination  
            on the statutes and regulations of the Veterinary Medical  
            Practice Act.

          3)Requires the Board to adopt regulations establishing animal  
            health care tasks and an appropriate degree of supervision  
            required for those tasks that may be performed only by a RVT,  








                                                                  SB 969
                                                                  Page  2

            or a licensed veterinarian, and allows the Board to adopt  
            regulations for animal health care tasks to be performed by  
            UAs, and the degree to which UAs would be supervised by a RVT  
            or a licensed veterinarian.

          4)Provides that a person practices veterinary medicine when he  
            or she, among other things, administers a drug for prevention,  
            cure, or relief of a wound, fracture, bodily injury, or  
            disease of animals, except where the drug is administered by a  
            RVT or an UA at the direction of and under the direct  
            supervision of a licensed veterinarian.  

          5)Allows a RVT or an UA to administer a drug under the indirect  
            supervision of a licensed veterinarian when done pursuant to  
            the order, control, and full professional responsibility of a  
            licensed veterinarian.

          6)Defines "direct supervision" as meaning the supervisor is  
            physically present at the location where animal health care  
            job tasks are to be preformed and the animal has been examined  
            by a veterinarian at such time as good veterinary medical  
            practices requires, as described.

          7)Defines "indirect supervision" as meaning that the supervisor  
            is not physically present at the location where the animal  
            health care job tasks are to be preformed but has given either  
            written or oral instructions for treatment of the animal  
            patient and the animal has been examined by a veterinarian at  
            such time as good veterinary medical practices requires.

           FISCAL EFFECT  :   Unknown.  This bill is keyed non-fiscal. 

           COMMENTS  :   
           
          Purpose for this bill  .  According to the author's office, "For  
          years, Registered Veterinary Technicians (RVTs) and unregistered  
          assistants (UAs) working in veterinary practices in California  
          and other states have been allowed to administer controlled  
          substances under the indirect supervision of a veterinarian.  A  
          new interpretation of the law by the California Veterinary  
          Medical Board recently opined that this practice is not  
          authorized.  The Veterinary Medical Board promulgated  
          regulations which allow RVTs to administer a controlled  
          substance under indirect supervision.  However, UAs must be  
          directly supervised.  There regulations are contradictory and  








                                                                  SB 969
                                                                  Page  3

          create a problem for veterinarians who do not have RVTs."

           Recent Board regulations relating to supervision of RVTs and UAs  
          in the administration of controlled substances  .  Traditionally,  
          the Board has believed that the authority for the administration  
          of any drug was governed by existing regulations allowing  
          California licensed veterinarians to delegate the administration  
          of controlled substances to RVTs or UAs either under direct or  
          indirect supervision.  The Board, however, on October 18, 2006,  
          promulgated new regulations to deal with this issue based on new  
          information in a legal opinion prepared by the Board's legal  
          counsel, dated April 19, 2006, and a subsequent legal memo to  
          the Board, dated June 29, 2006, outlining the restrictive  
          parameters of the Federal Controlled Substances Act and the  
          Uniform Controlled Substances Act to the delegation of  
          administration of controlled substances.  (The regulations are  
          currently pending review at the Department of Finance.)

          According to the legal opinion, the Federal Substances Act  
          (FCSA) restricts the administration of controlled substances to  
          licensed veterinarians and limits delegation to support staff to  
          only supervision (in the physical presence of the veterinarian);  
          unless or until such time that the Board implements regulations  
          to permit otherwise.  However, these regulations are further  
          constrained by the FCSA in that unknown persons (lay staff such  
          as UAs) cannot be authorized to administer controlled substances  
          under indirect supervision unless legislation is pursued to  
          allow otherwise. 

          The Board indicated in its rationale for the regulations that it  
          supports the restriction of the administration of controlled  
          substances due to the high potential for harm associated with  
          and/or the diversion of controlled substance drugs and believes  
          that it is essential to restrict their use and define the  
          specific levels of supervision for times when the supervising  
          veterinarian is not present.  However, the Board also believed  
          that the federal standard of immediate supervision is too  
          restrictive and that indirect supervision for RVTs and direct  
          supervision for UAs is a sufficient safeguard for administration  
          of controlled substances, since the ultimate responsibility for  
          the drugs falls upon the supervisor, a California licensed  
          veterinarian.  The Board was concerned that conforming to a  
          strict interpretation of the laws in the FCSA for "immediate  
          supervision" only would create an emergency staff shortage  
          situation in California leading to a severe lack of available  








                                                                  SB 969
                                                                  Page  4

          staff to administer controlled substances that would cause  
          increased pain and endanger the majority of animals currently  
          under care and leading, in many cases, to possible death.  

          The Board explained that  indirect supervision  means the  
          veterinarian supervisor is not physically present at the  
          location where the drugs are being administered but the  
          veterinarian has previously examined the animal and has given  
          either written or oral instructions (direct orders) for  
          treatment of the animal patient.  Indirect supervision is  
          sufficient for RVTs because they are educated and tested by the  
          State in the calculation of drug dosages, pharmacology,  
          controlled drug handling and regulations.  They also undergo  
          state and federal background checks before being registered in  
          California.  

          The Board further explained that  direct supervision  means that  
          the animal has been examined previously by the veterinarian and  
          that the veterinarian or RVT is physically present and easily  
          available at the location where the drugs are administered.   
          Direct supervision is required for unregistered assistants  
          because they are not tested (known) by the state; therefore, the  
          state cannot assure the public that they have the skills  
          necessary to perform the administration of controlled substances  
          without direct supervision.

          As argued by the Board, with the increased awareness of the need  
          for pain control and pain medication in veterinary medicine over  
          the past 25 years, there is a greatly increased and growing use  
          of controlled drugs in veterinary medicine.  Allowing RVTs under  
          indirect supervision and lay personnel under direct supervision  
          to administer controlled drugs provides the animal patient with  
          the needed pain control while protecting both patient and public  
          safety. 

           Recent Legislative Counsel opinion on the degree of supervision  
          for RVTs and UAs  .  A recent Legislative Counsel Opinion was  
          issued to Assemblymember Aghazarian on April 12, 2007.  The  
          first question asked was whether the term "drug" as used in the  
          Veterinary Medicine Practice Act includes drugs that are  
          controlled substances, as defined in the California Controlled  
          Substances Act (CCSA).  Counsel opined that the term "drug" is  
          broad enough to include a drug that is a "controlled substance,"  
          as that term is defined in the CCSA.  The next question was  
          whether RVTs and UAs could administer controlled substances for  








                                                                  SB 969
                                                                  Page  5

          the prevention, cure, or relief of a wound, fracture, bodily  
          injury, or disease of animals.  Counsel opined that a RVT and UA  
          could administer controlled substances but only at the direction  
          of and under the direct supervision of a licensed veterinarian.   
          The next question was whether the Federal Controlled Substances  
          Act prohibits a RVT or an UA from administering drugs that are  
          controlled substances under the direct supervision of a licensed  
          veterinarian.  Counsel opined that under the Code of Federal  
          Regulations, RVTs and UAs may administer drugs that are  
          controlled substances to the extent permitted by California law  
          and under the direct supervision of the licensed veterinarian.   
          Finally, Counsel was asked whether an amendment to the  
          Veterinary Medicine Practice Act authorizing a RVT or an UA to  
          administer drugs, including, but not limited to, controlled  
          substances, under indirect supervision would violate the FCSA.   
          Counsel opined that both RVTs and UAs are considered as  
          "practitioners" under the Code of Federal Regulations and  
          therefore as practitioners could be authorized under California  
          law to administer controlled substances under the indirect  
          supervision of a licensed veterinarian and would not violate the  
          FCSA. 


           REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          California Veterinary Medical Association (sponsor)
           
            Opposition 
           
          None on file.

           Analysis Prepared by  :    Tracy Rhine / B. & P. / (916) 319-3301