BILL ANALYSIS Ó ------------------------------------------------------------ |SENATE RULES COMMITTEE | AB 1839| |Office of Senate Floor Analyses | | |1020 N Street, Suite 524 | | |(916) 651-1520 Fax: (916) | | |327-4478 | | ------------------------------------------------------------ THIRD READING Bill No: AB 1839 Author: Ma (D) Amended: 8/6/12 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, until January 1, 2015, 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 AB 1839 Page 2 Senate Floor Amendments of 8/6/12 make a technical correction for term "managing licensee's" and extends to January 1, 2015 the current sunset date of the provisions of the Veterinary Medicine Act which allows RVTs and veterinary assistants to administer drugs, including controlled substances, to animals. 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)) CONTINUED AB 1839 Page 3 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, 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 licensee manager'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. Extends, from January 1, 2013 to January 1, 2015, the 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 CONTINUED AB 1839 Page 4 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 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 CONTINUED AB 1839 Page 5 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 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 CONTINUED AB 1839 Page 6 SUPPORT : (Verified 8/6/12) California Registered Veterinarian Technician Association (co-source) California Veterinary Medical Association (co-source) California Veterinary Medical Board 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 CONTINUED AB 1839 Page 7 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, 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 8/7/12 Senate Floor Analyses SUPPORT/OPPOSITION: SEE ABOVE **** END **** CONTINUED