BILL ANALYSIS                                                                                                                                                                                                    







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        |Hearing Date:June 8, 2009          |Bill No:AB                         |
        |                                   |107                                |
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                     SENATE COMMITTEE ON BUSINESS, PROFESSIONS AND
                                 ECONOMIC DEVELOPMENT
                         Senator Gloria Negrete McLeod, Chair

                         Bill No:        AB 107Author:Galgiani
                        As Amended:June 1, 2009  Fiscal:    Yes

        
        SUBJECT:   Veterinarians and registered veterinary technicians. 
        
        SUMMARY:  Clarifies the appointment of members to the Veterinary  
        Medical Board (VMB) by the Governor; requires the VMB to offer  
        both a written and practical  examination at least twice a year  
        until January 1, 2011, and after that date, to offer a national  
        examination and a state specific examination on animal health care  
        tasks; makes other changes related to reciprocity and temporary  
        licensing requirements for out-of-state veterinarians; clarifies  
        the enforcement actions that may be taken against a registered  
        veterinarian technician; and makes other technical and conforming  
        changes to the Veterinary Medicine Practice Act.

        Existing law:

        1)Provides for the examination, licensing, and regulation of  
          approximately 9,800 veterinarians and 4,300 registered  
          veterinary technicians by the VMB in the Department of Consumer  
          Affairs.

        2)Establishes the VMB which consists of seven members, three of  
          whom are public members and four of whom are licensed  
          veterinarians, and requires the Governor to appoint the four  
          licensed veterinarians and the Senate Committee on Rules and the  
          Speaker of the Assembly to each appoint a public member.

        3)Requires that the VMB shall, by means of examination, ascertain  
          the professional qualifications of all applicants for licensure  
          to practice veterinary medicine in this state and shall issue a  
          license to every person whom it finds to be qualified.






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        4)Requires the examination for veterinarians to consist of a  
          licensing examination that is administered on a national basis,  
          a state board examination, and an examination concerning the  
          statutes and regulations of the Veterinary Medicine Practice Act  
          (VMP Act) administered by the VMB.

        5)Specifies that a registered veterinary technician means a person  
          who is registered by the VMB if they have passed a written and  
          practical examination and have met the following requirements:

           a)   Be at least 18 years of age.

           b)   Furnish satisfactory evidence of graduation from a  
             postsecondary institution approved by the VMB, and if a  
             private postsecondary institution, also approved by the  
             Bureau of Private Postsecondary and Vocational Education.

           c)   Completed the equivalent of education and clinical  
             experience as determined by the VMB.

        6)Provides that the examination for registered veterinary  
          technicians shall be held at least once a year at the times and  
          places designated by VMB.

        6)Provides that the VMB may waive the examination requirements as  
          specified and issue a  temporary   license  valid for one year to an  
          applicant to practice veterinary medicine under the supervision  
          of another licensed California veterinarian if the applicant  
          meets the following requirements: 

           6)   Holds a current valid license from another state and has  
             practiced clinical veterinary medicine for a minimum of four  
             years.

           6)   Is not under investigation nor been charged with an  
             offense or subject to administrative disciplinary action by  
             an agency or been subject to a judgment that the VMB  
             determines constitutes evidence of incompetence or  
             negligence.

           6)   Has no physical or mental impairment related to drugs or  
             alcohol and has not been found mentally incompetent.

           6)   Has passed the national licensing examination.

           6)   Graduated from a veterinary college recognized by the VMB.





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           f)   Passes an examination concerning the statutes and  
             regulations of the VMP Act administered by the VMB.

           g)   Agrees to complete an approved educational curriculum, as  
             specified, on regionally specific and important diseases and  
             conditions during the period of temporary licensure. 

        5)Requires that the complete examination (the state board  
          examination) shall be given at least  once  each year and shall  
          include all such subjects as are included in the curricula of  
          veterinary colleges and may include such other subjects as the  
          VMB may by rule authorize and direct.

        9)Provides that the VMB shall issue a temporary license valid for  
          one year to an applicant accepted into a qualifying internship  
          or residency program that meets specified requirements including  
          graduation from a veterinary college or possess a certificate  
          issued by the Educational Commission for Foreign Veterinary  
          Graduates.


        
        This bill:

        1)Clarifies that the Governor actually appoints  five  members to the  
          VMB, and that one of those members shall be a public member.

        2)Provides that the examinations for a registered veterinary  
          technician shall be a written and practical examination until  
          January 1, 2011, and then after that date, the examinations for  
          registered veterinary technicians shall consist of a national  
          examination and a state specific examination on animal health care  
          tasks.

        3)Provides that the examinations may be given at the same time or at  
          different times as determined by the VMB and that the VMB, for  
          examination purposes, may make contractual arrangements on a  sole   
           source   basis  with organizations furnishing examination material as  
          it may deem desirable and shall be exempt from the requirements for  
          services contracts of state agencies to meet statewide participation  
          goals (Section 10115 of the Public Contract Code).

        4)Provides, however, that the national licensing examination shall  
          only be provided upon the availability of the computerized  
          examination on or after January 1, 2011.





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        5)Changes one of the requirements as specified in item #7 above, so  
          that an applicant in good standing shall within three years  
          preceding filing an application for licensure have practiced  
          clinical veterinary medicine for a minimum of two years and  
          completed a minimum of 2,944 hours of clinical practice, rather than  
          having practiced clinical veterinary medicine for a minimum of four  
          years full time. Provides also that an applicant can also possess a  
          certificate issued by the Program for the Assessment of Veterinary  
          Education Equivalency (PAVE) to meet the requirements as a graduate  
          from a veterinary college.

        6)Provides for  purposes   of   reciprocity  , that the VMB shall waive the  
          examination requirements if an applicant for a license meets all of  
          the requirements as specified in item # 7 and #5 above, and shall  
          issue a license once the approved educational curriculum on  
          regionally specific and important diseases and conditions is  
          completed. 

        7)Requires the VMB to issue a temporary   license  valid for one year to  
          practice veterinary medicine under the supervision of another  
          California-licensed veterinarian in good standing if the applicant  
          satisfies all of the requirements as specified in item #7 above, and  
          would not be denied issuance of a license under any other provision  
          of law, and agrees to complete the approved curriculum as specified  
          above during the period of temporary licensure.

        8)Specifies that upon completion of the required educational  
          curriculum, a temporary licensee shall submit an application for  
          full licensure accompanied by verification of completion of that  
          curriculum and all applicable fees.

        9)Provides that applicants accepted into a qualifying internship or  
          residency program can also possess a certificate issued by PAVE to  
          receive a temporary license. 

        10)Provides that the state board examination shall be given at least  
           twice  each year rather than only once.

        7)Clarifies when the VMB may place on probation, revoke or suspend  
          the registration of a veterinary technician or take other  
          enforcement action as necessary against a registered veterinary  
          technician, including a citation and fine.

        12)Makes other various technical and conforming changes. 






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        FISCAL EFFECT:  According to the Assembly Appropriations Committee  
        analysis of 
        April 1, 2009:

        1)Costs associated with computer programming changes and workload  
          increases would be approximately $110,000 from the Veterinary  
          Medical Board Contingent Fund for 2009-10 with an on-going  
          annual cost of $70,000 from the same fund.

        2)This bill would increase licensing revenue by approximately  
          $25,000 in the first year and second years, growing to $50,000  
          in 2011-12, and continue to grow by $25,000 a year as 100 new  
          veterinarians are licensed each year.

        3)The Department of Consumer Affairs estimates this measure will  
          result in an increase of 100 veterinarians in California each  
          year.  Currently, approximately 12% of veterinarians treat farm  
          animals.  If the purpose of this bill is to attract more  
          agricultural veterinarians, this legislation would result in  
          approximately 12 more of these veterinarians in the state each  
          year with a net annual cost of $3,750 per newly licensed  
          agricultural veterinarian.


        COMMENTS:
        
        1.Purpose.  The Sponsors of this measure are the  Western United  
          Dairymen  and the  California Cattlemen's Association  .  As  
          explained by the Sponsors, currently California cattle producers  
          are experiencing a shortage of food animal veterinarians, which  
          is felt in many ways.  Some are experiencing delays in  
          scheduling routine services such as pregnancy checks.  Others  
          have trouble getting routine health testing, which must be  
          completed by veterinarians while other may be experiencing  
          delays in other types of treatment areas.  The Sponsors argue  
          that this bill would help alleviate this pressure by  
          streamlining the process by which veterinarians are able to  
          become licensed to practice in California.

        According to the Sponsors, the food animal veterinarian shortage  
          not only has a direct impact in livestock production, but it  
          also impacts state and federal agencies.  Both the California  
          Department of Food and Agriculture and the United States  
          Department of Agriculture hires food animal veterinarians to  
          work in their food safety and inspection programs.  The Sponsors  





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          state that this bill is also an important first step in ensuring  
          we have the necessary food animal veterinarians needed to  
          perform vital services.  As indicated by the Sponsors, food  
          animal veterinarians play an important role and it is critical  
          we work to alleviate the shortage in California to ensure good  
          animal and related health care. 


        The Author points out that this bill would authorize the VMB to  
          offer the licensing examination at least twice a year, which  
          would allow a greater number of candidates to test for their  
          license.  The bill would also provide different paths for  
          licensed veterinarians from other states to receive reciprocity.  
           There are those veterinarians who could apply for a license in  
          California and continue to practice in their state of origin and  
          then once they met all requirements, including educational  
          curriculum on regionally specific and important diseases of  
          California, they would qualify for full licensure.  Others who  
          wish to practice immediately in California would still be able  
          to obtain a temporary license and practice under the supervision  
          of a California licensed veterinarian while they are meeting the  
          educational curriculum requirements.

        2.Background.  

           2)   Veterinarian Shortage.  According to the Author, there is  
             a current veterinarian shortage in California, particularly  
             affecting the agricultural communities.  According to the  
              California Veterinary Medical Association  , there are 7,500  
             practicing veterinarians in California, with another 222  
             graduating from veterinary school.  As the Author explains,  
             part of the shortage problem is the fact that current law  
             only requires the VMB to offer the licensing examination once  
             a year, thus driving otherwise qualified veterinarians to  
             leave the state in order to test for their license and find  
             employment.  The Author also argues that current law is also  
             very cumbersome to practicing veterinarians in other states  
             who would like to practice in California.  The current  
             national shortfall of at least 1,500 veterinarians could grow  
             to 15,000 or more over the next 20 years.  The shortage is  
             especially dire in California where there are about 17  
             veterinarians for every 100,000 people, which is far below  
             the national average of 27 per 100,000.  Further, as the  
             Author states, this current lack of licensed veterinarians  
             has a direct effect on the safety of our food supply.  While  
             the demand for "food supply veterinarians" (Farm Animal  





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             Veterinarians) is predicted to increase 12 to 13 percent in  
             the next eight years, research shows that there will most  
             likely be a 4 to 5 percent decrease of these types of  
             veterinarians obtaining jobs in our agricultural and farming  
             communities.  

           Another reason for fewer food supply veterinarians is that most  
             veterinarians gravitate toward treating small animals for  
             various reasons.  Primarily, small animal veterinarians  
             generally make more money from pet owners that are willing to  
             pay for expensive treatments for sick or injured animals.   
             Ranchers, on the other hand, will tend to choose to slaughter  
             a sick or injured animal rather than invest in costly  
             veterinary care.  For veterinarians with large student loans,  
             the ability to make a larger income to pay off those loans  
             could become a necessity.  In addition to the higher earning  
             potential, working with small animals can be less physically  
             demanding for a veterinarian.  Treating animals that weigh  
             over 1,000 pounds day in and day out can take a significant  
             toll on a veterinarian's health.

           The shortage of food supply veterinarians could also directly  
             affect the safety of the nation's food supply because it is  
             veterinarians that are responsible for monitoring the health  
             of livestock.  The recent recall of 143 million pounds of  
             beef from Hallmark/Weston Meat Packing Company in San  
             Bernardino County has greatly increased the awareness of the  
             vulnerability of the food supply and the need for increased  
             oversight and for more veterinarians willing to provide the  
             care and oversight of these animals.

           2)   Other State's Legislation.   Currently, 8 states  
             (including Ohio and Pennsylvania) are attempting to address  
             the shortage of agricultural veterinarians by offering  
             student loan forgiveness programs and 8 other states are  
             considering similar legislation to provide easier  
             reciprocity.

           c)   Previous Similar Legislation.  This bill is almost  
             identical to  AB 1760  (Galgiani) from 2008, that was vetoed  
             due to the late passage of the 2008-2009 Budget.  In the  
             message the Governor wrote, "I am only signing bills that are  
             the highest priority for California.  This bill does not meet  
             this standard and I cannot sign it at this time."   

            SB 1205  (Aanestad) would have established an advisory committee  





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             to the Veterinary Medical Board (VMB) to make recommendations  
             to the VMB regarding the implementation of rules and  
             regulations by the VMB; make changes to the registered  
             veterinary technicians committee; clarify that the equivalent  
             of education considered by the VMB must be educational or a  
             combination of education and clinical experience; prioritized  
             cases handled by the VMB for purposes of investigation and  
             prosecution; provided reasonable opportunity for a  
             veterinarian to comply with any deficiencies found during the  
             VMB's inspection of their premises; and, allowed the VMB to  
             cite for minor infractions, rather than for negligence when a  
             minor violation occurred.  This measure failed passage in  
             this Committee on April 14, 2008.   

            SB 1584  (Padilla, Chapter 529, Statutes of 2008) included  
             language similar to 
           SB 1205 (Aanestad) and also allowed for an increase in the  
             maximum amounts that the VMB may set for certain specified  
             fees; deleted the provision of existing law requiring the VMB  
             to set and collect a fee for the national licensing  
             examination; required an application fee to be paid by a  
             school or institution seeking approval of RVT curriculum. 

            SB 969  (Aanestad, 2007) provided similar changes related to  
             reciprocity and temporary licensing requirements for  
             out-of-state veterinarians.  This language was removed from  
             the measure in Senate Appropriations Committee.  There was  
             concern over a fee increase for the examination and the  
             temporary license which would be necessary to cover the  
             workload of the VMB.

            SB 2003  (Knight, Chapter 1070, Statutes of 1998) required the  
             VMB to issue a temporary license to practice veterinary  
             medicine, changed the requirements for the examination of  
             applicants, required and authorized the VMB to set and  
             appropriate the examination and licensing fees, and created a  
             one-year temporary license for applicants accepted into a  
             qualifying internship or residency programs.  
            
        3.Arguments in Support.  The  Veterinary Medical Board  (VMB)  
          supports the changes in this measure to require the state  
          board's licensing examination to be given twice each year, to  
          update the reciprocity licensing requirements and to include  
          updates on various other sections of the VMP Act, including the  
          VMB's enforcement provisions.






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        The  California Veterinary Medical Association  is in support of  
          this measure and believes that this bill will provide more  
          opportunities for students at UC Davis and Western University of  
          Veterinary Medicine in Southern California to take the VMB's  
          examination closer to graduation from veterinary school by  
          providing the exam at least twice annually.  The CVMA also  
          believes that  lowering the clinical experience requirement to  
          two years with a minimum of 2,944 hours of clinical practice  
          versus the current four-year requirement, will remove an  
          additional barrier for veterinarians wanting to practice in  
          California.

        The  California Farm Bureau  (CFB) is in support of this measure and  
          also indicates from their standpoint that there is a growing  
          shortage of veterinarians in production agriculture, academia,  
          and regulatory medicine throughout the U.S. and that the CFB  
          believes this bill can be a piece towards helping solve the  
          growing shortage of veterinarians.  According to the CFB,  
          veterinarians are critical for preventative herd health medicine  
          and for treatment of sick and injured livestock; they not only  
          handle diseases that affect animals but also deal with diseases  
          that are transferable between humans and animals.  Veterinarians  
          are also critical in detecting and in responding to emerging  
          infectious disease outbreaks such as West Nile Virus and Avian  
          Influenza.  With this in mind, as CFB states, the current  
          veterinarian shortage is even more alarming.

        
        SUPPORT AND OPPOSITION:
        
         Support:  

        California Cattlemen's Association (Co-Sponsor)
        Western United Dairyman (Co-Sponsor)
        California Farm Bureau Federation
        California Veterinary Medical Board
        California Veterinary Medical Association

         Opposition:  

        None on file as of June 3, 2009.



        Consultant:Bill Gage





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