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,
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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
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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
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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
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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