BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                      



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          |SENATE RULES COMMITTEE            |                  AB 1839|
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                                 THIRD READING


          Bill No:  AB 1839
          Author:   Ma (D)
          Amended:  6/26/12 in Senate
          Vote:     21

           
           SENATE BUSINESS, PROF. & ECON. DEV. COMM.  :  9-0, 6/11/12
          AYES:  Price, Emmerson, Corbett, Correa, Hernandez, Negrete 
            McLeod, Strickland, Vargas, Wyland
           
          SENATE APPROPRIATIONS COMMITTEE  :  Senate Rule 28.8
           
          ASSEMBLY FLOOR  :  74-0, 4/26/12 (Consent) - See last page 
            for vote


           SUBJECT  :    Veterinary medicine:  veterinary assistants

            SOURCE  :     California Registered Veterinarian Technician 
                      Association California Veterinary Medical 
                      Association 


           DIGEST  :    This bill authorizes registered veterinary 
          technicians (RVTs) and unregistered veterinary assistants 
          to administer a controlled substance pursuant to "direct" 
          or "indirect" supervision if specified requirements are 
          satisfied, including undergoing a background check, but 
          authorizes the Veterinary Medical Board (Board) to restrict 
          access to a dangerous drug by an unregistered veterinary 
          assistant if the drug is identified as having a pattern of 
          being diverted.

                                                           CONTINUED





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           ANALYSIS  :    

          Existing law:

          1. Provides for the licensing and regulation of 
             approximately 15,200 veterinarians and 8,100 RVTs by the 
             Board in the Department of Consumer Affairs.

          2. Provides that the Board may adopt regulations 
             establishing animal health care tasks performed by an 
             unregistered assistant (UA) as well as by a RVT or a 
             licensed veterinarian; and provides that the Board shall 
             establish an appropriate degree of supervision by a RVT 
             or a licensed veterinarian over a UA for any tasks 
             established by regulation and the degree of supervision 
             for any of those tasks shall be higher than, or equal 
             to, the degree of supervision required when a RVT 
             performs the task.  (Business and Professions Code (BPC) 
             Section 4836)

          3. Provides that a RVT or a UA may administer a drug, 
             including, but not limited to, a drug that is a 
             controlled substance, 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.  (BPC Section 
             4836.1)

          4. Defines "direct supervision" as:  (a) the supervisor is 
             physically present at the location where animal health 
             care job tasks are to be performed and is quickly and 
             easily available; and (b) the animal has been examined 
             by a veterinarian at such time as good veterinary 
             medical practice requires consistent with the particular 
             delegated animal health care job task.  (Title 16 of the 
             California Code of Regulations (CCR) Section 2034 (e)) 

          5. Defines "indirect supervision" as:  (a) the supervisor 
             is not physically present at the location where the 
             animal health care job talks are to be performed, but 
             has given either written or oral instructions ("direct 
             orders") for treatment of the animal patient; and (b) 
             the animal has been examined by a veterinarian at such 
             times as good veterinary medical practice requires, 







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             consistent with the particular delegated animal health 
             care task and the animal is not anesthetized, as 
             defined.  (Title 16, CCR Section 2034 (f)) 

          6. Repeals on January 1, 2013, the authorization in Item #3 
             above, for RVTs or UAs to administer a drug that is a 
             controlled substance pursuant to direct or indirect 
             supervision of a licensed veterinarian.  (BPC Section 
             4836.1 (c))

          This bill:

          1. Replaces and updates references to "UAs" with the term, 
             "veterinary assistant."

          2. Limits access to controlled substances by veterinary 
             assistants who have undergoing a background check and 
             who, to the best of the managing licensee's knowledge, 
             do not have any drug or alcohol related felony 
             convictions.

          3. Authorizes the Board to restrict access by veterinary 
             assistants to any drug identified as a dangerous drug in 
             consultation with the Board of Pharmacy (BOP), and that 
             has an established pattern of being diverted.

          4. Deletes the January 1, 2013 sunset for provisions 
             authorizing RVTs and UAs to administer controlled 
             substances under specified circumstances, thereby 
             extending these provisions and authorization 
             indefinitely.

           Background
           
          As indicated, in 2007, the Board's attorney interpreted a 
          section of law pertaining to who can administer controlled 
          substances in a veterinary office under the "indirect 
          supervision" of a veterinarian.  The interpretation was 
          inconsistent with application of this law in veterinary 
          practices, and as such an Legislative Counsel (LC) opinion 
          was sought for clarification.  The LC opinion found that 
          the current practice was appropriate, and in compliance 
          with the federal Controlled Substances Act, but recommended 
          legislative clarification.  LC stated, "Thus, it is our 







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          opinion, that an amendment to California law authorizing 
          those persons to administer controlled substances under the 
          indirect supervision of a licensed veterinarian would not 
          violate the federal Controlled Substances Act, provided 
          that the supervising licensed veterinarian is properly 
          registered."  In response, California Veterinary Medical 
          Association (CVMA) and the Board sponsored SB 969 
          (Aanestad), Chapter 83, Statutes of 2007, which provided 
          that RVTs and UAs could administer drugs under the indirect 
          supervision of a licensed veterinarian until January 1, 
          2012.  This sunset date was extended for one year by SB 943 
          (Senate Business, Professions and Economic Development 
          Committee), Chapter 350, Statutes of 2011. 

          Concerns were raised by the California Registered 
          Veterinarian Technician Association (CRVTA) that the 
          current law did not go far enough in providing the 
          appropriate oversight of UAs and assuring that UAs, who had 
          access to controlled substances, had proper background 
          checks and that drugs being abused or diverted could be 
          prevented from being used by unlicensed and unregistered 
          persons working within veterinary offices, clinics or 
          hospitals.  The CRVTA did not believe the sunset date 
          should be lifted until these additional protections were 
          provided.  Both CRVTA and the CVMA reached agreement to 
          include a requirement for fingerprinting of veterinary 
          assistants which provides a criminal background check and 
          to authorize the Board, in consultation with the BOP, to 
          identify a drug that has an established pattern of being 
          diverted and to restrict access to that drug by veterinary 
          assistants.  With these changes, CRVTA agreed with CVMA to 
          eliminate the sunset date making permanent the authority 
          for RVTs and UA's to administer controlled substances under 
          specified circumstances.  It was also decided to update the 
          term "UA" to "veterinary assistant."

           Prior Legislation
           
          AB 1980 (Hayashi), Chapter 538, Statutes of 2010, changed 
          the composition of the Board; made permanent the 
          "multidisciplinary committee" of the Board and provided for 
          additional duties of the committee; eliminated the 
          Registered Veterinary Technician Committee; specified that 
          the practice of veterinary medicine also includes physical 







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          rehabilitation or musculoskeletal manipulation upon an 
          animal, unless otherwise authorized by regulation of the 
          Board; prohibited the use of the title "registered 
          veterinary technician" unless registered with the Board; 
          required training for an "unregistered assistant" in the 
          use of radiation safety and techniques before they may 
          operate radiographic equipment; clarified the reporting 
          requirement for veterinarians who must report any animal 
          injuries which occurred at a rodeo event; allowed students 
          in their final year of study in a veterinary technology 
          program to perform tasks of a registered veterinary 
          technician; exempted from liability veterinarians or 
          registered veterinarians who provide services during any 
          state of war emergency, a state of emergency, or local 
          emergency.

          SB 943 (Senate Business, Professions and Economic 
          Development Committee), Chapter 350, Statutes of 2011, 
          extended the sunset date authorizing RVTs and UAs to 
          administer drugs under the indirect supervision of a 
          licensed veterinarian to January 1, 2013.

          SB 969 (Aanestad), Chapter 83, Statutes of 2007, provided 
          that RVTs and UAs can administer drugs under the indirect 
          supervision of a licensed veterinarian.

          SB 175 (Kuehl), Chapter 250, Statutes of 2003, modified the 
          definition of "dangerous drug" or "dangerous device" to 
          clarify that BOP has the authority to regulate all 
          dangerous prescription drugs or devices regardless of 
          whether or not they are for human or animal treatment.  
          Authorized the Board in conjunction with BOP to enforce the 
          existing statutes of the Pharmacy Law regarding prescribing 
          and dispensing of dangerous drugs or devices.

           FISCAL EFFECT  :    Appropriation:  No   Fiscal Com.:  Yes   
          Local:  No

           SUPPORT  :   (Verified  7/2/12)

          California Registered Veterinarian Technician Association 
          (co-source)
          California Veterinary Medical Association (co-source)
          California Veterinary Medical Board







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           ARGUMENTS IN SUPPORT  :    The CRVTA is one of the 
          co-sponsors of this bill, and indicates that the previous, 
          temporary bills that concerned the administration of 
          controlled substances by unlicensed veterinary personnel 
          did not require fingerprinting or background checking of 
          these individuals.  CRVTA believes strongly that:

             ?by adding this requirement, our patients and the public 
             are being protected from potential harm.  This bill also 
             returns the ability of the ÝBoard] to regulate the 
             delegation of the administration of drugs that have been 
             determined to have a pattern of being diverted.  We 
             believe this is a very important feature, since the 
             previous legislation did not allow the ÝBoard] to 
             restrict the administration of any drugs, even those 
             that were known to be diverted."

             We also support the change in title from 'UA' to 
             'veterinary assistant'.  This trend exists on a national 
             level precisely because no one actually used the title 
             'UA', which lead to all veterinary staff being called 
             technicians.  Now that we have title protection for the 
             term RVT, we feel that it is in the interest of the 
             public that they be aware of the distinction between 
             licensed technicians and unlicensed veterinary 
             assistants.

          The CVMA is the other co-sponsor of this bill and believes 
          that this bill will put in place some important safeguards 
          for the handling of these drugs, such as requiring the 
          fingerprinting of veterinary assistant staff.  CVMA states, 
          "AB 1839-Ma reaffirms the current, accepted practice in a 
          veterinarian's office relative to the administration of 
          drugs, provides necessary quick veterinary care to sick or 
          injured animals, and offers an appropriate check and 
          balance for the ÝBoard] regarding the ability to have lower 
          level employees receive a background check prior to their 
          ability to handle drugs in a veterinary office."


           ASSEMBLY FLOOR  :  74-0, 4/26/12
          AYES:  Achadjian, Alejo, Allen, Ammiano, Atkins, Beall, 
            Bill Berryhill, Block, Blumenfield, Bonilla, Bradford, 







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            Brownley, Buchanan, Butler, Charles Calderon, Campos, 
            Carter, Chesbro, Conway, Cook, Davis, Dickinson, 
            Donnelly, Eng, Feuer, Fletcher, Fong, Fuentes, Beth 
            Gaines, Galgiani, Garrick, Gatto, Gordon, Gorell, Grove, 
            Hagman, Hall, Hayashi, Roger Hernández, Hill, Huber, 
            Hueso, Huffman, Jeffries, Knight, Lara, Logue, Bonnie 
            Lowenthal, Ma, Mansoor, Mendoza, Miller, Mitchell, 
            Monning, Morrell, Nestande, Nielsen, Norby, Olsen, Pan, 
            Perea, V. Manuel Pérez, Portantino, Silva, Skinner, 
            Solorio, Swanson, Torres, Valadao, Wagner, Wieckowski, 
            Williams, Yamada, John A. Pérez
          NO VOTE RECORDED:  Cedillo, Furutani, Halderman, Harkey, 
            Jones, Smyth


          JJA:k  7/3/12   Senate Floor Analyses 

                         SUPPORT/OPPOSITION:  SEE ABOVE

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