BILL ANALYSIS                                                                                                                                                                                                    

        |Hearing Date:April 29, 2013        |Bill No:SB                         |
        |                                   |307                                |

                               AND ECONOMIC DEVELOPMENT
                          Senator Curren D. Price, Jr., Chair

                          Bill No:        SB 307Author:Price
                     As Amended:April 24, 2013          Fiscal:Yes

        SUBJECT:  Healing arts: Veterinary Medical Board.
        SUMMARY:  Extends until January 1, 2016, the provisions establishing  
        the Veterinary Medical Board (VMB) and the term of the executive  
        officer of the VMB.  Makes other changes regarding the inspection  
        authority of the VMB as it pertains to veterinary premises, the  
        membership and responsibility of the Multidisciplinary Committee of  
        the VMB, and the requirements for veterinary assistants regarding  
        access to controlled substances.   

        Existing law:
        1)Provides for the licensing and regulation of approximately 9,800  
          veterinarians and 4,300 registered veterinary technicians by the  
          Veterinary Medical Board (VMB) within the Department of Consumer  
          Affairs (DCA).  (Business and Professions Code (BPC)  4800 et seq.)

        2)Specifies that the VMB shall consist of 8 members, 4 of whom are  
          licensed veterinarians, 1 of whom is a registered veterinary  
          technician (RVT) and 3 of whom are public members, and that VMB  
          shall remain in effect until January 1, 2014, and that the VMB is  
          subject to review by the Legislature.  (BPC  4800) 

        3)Authorizes the VMB to appoint a person exempt from civil service who  
          shall be designated as an executive officer and who shall exercise  
          the powers and perform the duties delegated by the Board;  provides  
          that this authority shall remain in effect only until January 1,  
        (BPC  4804.5)


                                                                         SB 307
                                                                         Page 2

        4)Provides that the VMB may at any time inspect the premises in which  
          veterinary medicine, veterinary dentistry, veterinary surgery is  
          being practiced.  (BPC  4809.5)

        5)Requires the VMB to establish a regular inspection program which  
          will provide for random, unannounced inspections.  (BPC  4809.7)

        6)Provides that the VMB shall establish an advisory committee to  
          assist, advise, and make recommendations for the implementation of  
          rules and regulations necessary to ensure proper administration and  
          enforcement of the Veterinary Practice Act and to assist the VMB in  
          its examination, licensure, and registration programs.  This  
          committee shall be known as the Veterinary Medicine  
          Multidisciplinary Advisory Committee (MDC).  (BPC  4809.8 (a))

        7)Provides that members of the MDC shall be appointed by the VMB and  
          shall consist of  
        7 members;  4 licensed veterinarians, 2 RVTs, and 1 public member.   
          Members shall represent a sufficient cross section of the interests  
          in veterinary medicine in order to address the issues before it, as  
          determined by the VMB, including veterinarians, RVTs and members of  
          the public.  (BPC  id.)

        8)Provides for terms of the membership of the MDC.  (BPC  4809.8 (b))

        9)Authorizes a RVT or a veterinary assistant to 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   
          4836.1 (a))

        10)Limits access to controlled substances to persons who have  
          undergone a background check and who, to the best of the licensee  
          manager's knowledge, do not have any drug or alcohol related felony  
          convictions.  (BPC  4836.1 (b)) 

        This bill:

        1) Extends the establishment of the VMB and the authorization for the  
           appointment of an executive officer to January 1, 2016.

        2) Specifies that veterinary premises to be inspected by the VMB shall  
           not include nonprofit animal rescue or adoption centers.

        3) Provides that the VMB shall make every effort to inspect at least  


                                                                         SB 307
                                                                         Page 3

           20 percent of veterinary premises on an annual basis.

        4) Changes the membership of the MDC so that it shall consist of 9  
        4 licensed veterinarians, 2 RVTs, 1 public member, and a veterinarian  
           and RVT of the VMB.
        Provides that board members shall serve concurrent with their term of  

        5) States the intent of the Legislature that the MDC shall give  
           specific consideration to issues pertaining to the practice of  

        6) Requires a valid permit issued by the VMB to a veterinary assistant  
           before the veterinary assistant would be able to have access to  
           controlled substances on the veterinary premises.  

        7) Requires that as part of the application for a permit of the  
           veterinary assistant, the VMB shall require an applicant to furnish  
           a full set of fingerprints for purposes of conducting a criminal  
           history record check and that the fingerprints furnished shall be  
           submitted in an electronic format if readily available.  Requires  
           the VMB to use the fingerprints furnished to obtain criminal  
           history information on the applicant from the Department of Justice  
           and the Federal Bureau of Investigation and for the VMB to obtain  
           any subsequent arrest information that is available.

        8) Provides that the requirement for a permit is contingent on the VMB  
           receiving sufficient staffing and a fee to cover costs to implement  
           the permit requirement and that the requirement for the permit  
           shall become effective on January 1, 2015.

        FISCAL EFFECT:  Unknown.  This bill has been keyed "fiscal" by  
        Legislative Counsel.
        1.Purpose. This bill is one of six "sunset review bills" authored by  
          the Chair of this Committee.  Unless legislation is carried this  
          year to extend the sunset dates for the VMB and its executive  
          director they will be repealed on January 1, 2014.  This bill makes  
          a number of legislative changes recommended by the VMB as well as  
          recommendations made in the Committee's background paper. 


                                                                         SB 307
                                                                         Page 4

        2.Oversight Hearings and Sunset Review of Licensing Boards and  
          Commission of DCA.  In 2013, this Committee conducted oversight  
          hearings to review 14 regulatory boards within the DCA.  The  
          Committee began its review of these licensing agencies in March and  
          conducted two days of hearings.  This bill, and the accompanying  
          sunset bills, is intended to implement legislative changes as  
          recommended in the Committee's Background/Issue Papers for all of  
          the agencies reviewed by the Committee this year.  

        3.Review of the Veterinary Medical Board, Issues Identified and  
          Recommended Changes.  The following are some of the major issues  
          pertaining to the VMB, or areas of concern reviewed and discussed by  
          the Committee during the review of the VMB, along with background  
          information concerning each particular issue.  Recommendations were  
          made by Committee staff and members regarding the particular issues  
          or problem areas which needed to be addressed.

            a)   Issue  :  Delay and Lack of Addressing RVT Issues.  

            Background  :  According to those representing the RVT profession,  
             there have been several issues which either the MDC or the VMB  
             have not addressed or have delayed action in resolving.  Examples  
             given were: (1) regulations to define the parameters for a  
             student exemption allowing them to perform restricted RVT job  
             tasks; (2) a regulation to clarify the VMB's authority over RVT  
             schools which took two and half years to go to public hearing  
             after approved by the VMB; (3) the transitioning from using the  
             state RVT examination to using a national RVT exam.

             A little history regarding the RVT profession and RVT committees,  
             and RVT input on VMB matters may be appropriate at this point.   
             In 1975, the profession of Animal Health Technician (AHT) was  
             created by the Legislature in response to the desire by the  
             veterinary profession to have a well-trained and reliable work  
             force.  The AHT Examining Committee (AHTEC) was created as an  
             independent committee with a separate budget to assist the VMB  
             with issues related to the new profession.  In 1994, the title  
             "Animal Health Technician" was changed to RVT and the committee  
             was called the Registered Veterinary Technician Examining  
             Committee (RVTEC).   In 1998, the original independent RVTEC was  
             to sunset, and a new committee of the VMB, the Registered  
             Veterinary Technicians Committee (RVTC), was created.  The  
             Legislature gave the new committee the statutory authority to  
             advise the VMB on issues pertaining to the practice of RVTs,  
             assist the VMB with RVT examinations, CE and approval of RVT  
             schools.  The Legislature also specifically stated in the law  


                                                                         SB 307
                                                                         Page 5

             that its intent was that the VMB would give specific  
             consideration to the recommendations of the RVTC.  In 2004, the  
             JLSRC was concerned that the RVTC had no independent authority  
             over issues within its jurisdiction, e.g., examinations,  
             eligibility categories, establishing criteria for and approving  
             RVT school programs.  In 2006, the duties of the RVTC were  
             expanded to include assisting the VMB in developing regulations  
             to define procedures for citations and fines.  In 2010, the  
             Legislature added an RVT to the VMB for the first time,  
             increasing the VMB composition to a total of 8 members:  4  
             veterinarians, 1 RVT and 3 public members.  At the same time the  
             RVTC was allowed to sunset upon appointment of the RVT.  The  
             newly created MDC also had the following make-up of members:  4  
             veterinarians, 2 RVTs and 1 public member.

             The RVT committee has basically gone from an autonomous,  
             semi-autonomous to a non-existent committee.  However, it appears  
             that both veterinarians and RVTs believed that both  
             representation on the VMB by an RVT and providing for RVTs on the  
             MDC would allow for issues regarding the RVT profession to be  
             adequately addressed.  It appears, however, that this may not be  
             the case.  The VMB seemed to realize this oversight at its  
             September 5, 2012 meeting as it discussed the role of its  
             committees and a structure for the committees that might be best  
             to address the issues of the VMB.  It appears that one of the  
             problems may be that the VMB has no direct input during MDC  
             meetings or oversight of matters brought before the MDC, or has  
             not given clear direction to the MDC to address important issues  
             brought before the VMB or that must be resolved.  The VMB has  
             also allowed RVT matters to be splintered between different  
             subcommittees.  There is one RVT subcommittee of the VMB made up  
             of two board members and another subcommittee of the MDC made up  
             of one RVT and one veterinarian.  Section 4809.8 of the Business  
             and Professions Code was clear that the role of the MDC was to  
             assist, advise and make recommendations for the implementation of  
             rules and regulations necessary for the proper administration and  
             enforcement of the Veterinary Medicine Practice Act and to assist  
             the VMB in its examination, licensure, and registration programs.  
              The MDC was intended to be inclusive of all issues regarding the  
             veterinarian profession, and the VMB must do the same.
             Recommendation  :  Committee staff recommended that to assure the  
             VMB has direct input and oversight of matters related to the MDC,  
             there should be one veterinarian member of the VMB that sits on  
             the MDC, and the RVT member of the VMB should also sit on the  
             MDC.  They would not act as a liaison to the MDC but rather as  


                                                                         SB 307
                                                                         Page 6

             actual participants of the MDC.  The VMB should eliminate its RVT  
             subcommittee and the MDC RVT subcommittee and deal with RVT  
             issues directly and not delay implementation of important RVT  
             matters.  Section 4832(b) of the Business and Professions Code of  
             2005 should be reinstated and included within Section 4809.8 to  
             assure that the VMB will give specific consideration to the  
             recommendations of the MDC regarding RVT matters.  [The current  
             language in this measure reflects these recommended changes.]   
           b)     Issue  :  Slow Response to Issues and Recommendations of Joint  

              Background  :  The Board has been slow to deal with the issues and  
             recommendations made by the previous Joint Legislative Sunset  
             Review Committee (JLSRC) during its sunset review in 2004, and  
             other issues which may have been brought before the VMB over the  
             past 8 years.  The following are some examples:
                         Transitioning to the RVT National Examination.
                         Appropriate oversight of RVT schools.
                         Allowing students to perform limited RVT job tasks.
                         Providing information to consumers about the use (or  
                  misuse) of specialty titles of veterinarians.
                         Making its Diversion Program self-supporting.
                         Only recently planning to increase the number of  
                  inspections of veterinary premises.
                         Only recently putting forth regulations to increase  
                  its fine authority.
                         Only recently updating its Disciplinary Guidelines.
                         Posting Disciplinary Actions taken by the Board on  
                  its Website.
                         Only recently putting forth regulations to deal with  
                  illegal animal dentistry.
                         Adoption of Uniform Substance Abuse Standards for  
                  its Diversion Program.
                         Adoption of CPEI SB 1111 regulations similar to  
                  other health related boards.
                         Lack of a consumer satisfaction survey.

              Recommendation  :  During the review of the VMB, the Chairs of the  
             respective Committees were concerned about the issues which had  
             not been addressed by the VMB and also the problem of the VMB in  
             addressing RVT issues.  To assure that the VMB will move ahead  
             more expeditiously to implement these necessary changes and  
             address RVT issues and provide continued oversight of the VMB, it  
             was recommended that this Board receive a two-year extension of  
             its sunset date rather than a four-year extension.  It will not  


                                                                         SB 307
                                                                         Page 7

             be necessary for the VMB to provide a detailed report in two  
             years, but rather provide the respective Committees with an  
             update on the progress it has made regarding these issues. [The  
             current language in this measure reflects this recommended  
            a)   Issue  :  Prioritize Veterinary Premises and Facilities to be  
              Background  :  It came to the attention of the Committee that the  
             VMB may be inspecting non-veterinarian premises, including  
             501(c)(3) animal rescue groups, and providing an "inspection  
             report" and possibly issuing citations and fines.  The Committee  
             was concerned that this may not be a reasonable use of resources  
             for the VMB especially in light of the problems it is having  
             maintaining its own inspection program over those facilities and  
             hospitals that provide direct veterinary services.  There may  
             also be some confusion in the law regarding the VMB's  
             jurisdiction over these types of "premises" and that should be  
             clarified.  There does not appear to be any need for the VMB to  
             be involved in inspecting nonprofit animal rescue or adoption  
             centers unless of course the VMB has probable cause to believe  
             that such facility is involved in unlicensed activity.  However,  
             the VMB should only pursue action based on unlicensed activity,  
              not  pursuant to its inspection authority.  The scope of VMB  
             authority over humane society facilities needs to be clarified so  
             that resources are not being expended on low-priority activities  
             while higher priorities are suffering.  Local jurisdictions,  
             either pursuant to health and safety violations or complaints  
             received, may be able to deal with these other entities more  

              Recommendation  :  Committee staff recommended that existing law  
             should be clarified so that the VMB is not inspecting these  
             non-veterinarian premises so that it can better target their use  
             of scarce enforcement (inspection) resources and staff.  [The  
             current language in this measure reflects this recommended  
            b)   Issue  :  Inspect More Veterinary Premises and Facilities. 
              Background  :  California Code of Regulations Section 2030 sets the  
             minimum standards for fixed veterinary premises where veterinary  
             medicine is practiced, as well as all instruments, apparatus, and  
             apparel used in connection with those practices.  The method the  
             VMB has selected to enforce such standards is the inspection of  


                                                                         SB 307
                                                                         Page 8

             veterinary premises.  During the sunset review of the VMB in  
             2004, the VMB inspected an average of 300 registered veterinary  
             facilities that were selected from a master list, and an average  
             of 31 facilities in response to complaints it received.  The vast  
             majority of these inspections were unannounced.  From 1996 to  
             2003 the VMB had completed 2,616 inspections, including 211  
             complaint-related ones.  The average rate for annual routine  
             hospital inspections during those years was 13 percent, with a  
             slight improvement during 2001/02 to 18 percent and 16 percent in  
             2002/03.  In its report to the JLSRC at the time, the VMB  
             indicated that all new veterinary premises were inspected within  
             the first 6 to 12 months of operation and that its goal was to  
             have all premises inspected within a 5-year period.

             The VMB further indicated to the JLSRC at the time that when it  
             "randomly" selects premises to inspect, it eliminates from  
             selection those premises with the most recent inspection dates.   
             Thus, it appears that once facilities are inspected, they enjoy  
             "safe harbors" from random inspections for an extended period of  
             time, perhaps as long as 6 or more years.  To accomplish these  
             inspections, the VMB contracted with private veterinarians who  
             hold current California licenses and have at least 5 years of  
             clinical practice experience.  However, the VMB was at the time  
             considering expanding the pool of prospective inspectors to  
             include RVTs as well.

             The Committee did not receive any current information regarding  
             the VMB's inspection program of veterinary premises.  The VMB  
             only indicated that it hired three new inspectors for the 2012/13  
             fiscal year to begin in September 2012, with a goal of increasing  
             the actual number of inspections each year to 500, or 16%.  The  
             VMB also changed the method of hiring inspectors from the Request  
             for Proposal process to establishing a pool of qualified experts  
             and hiring via the streamlined contract process implemented by  
             DCA last year.  This has greatly improved the pool of qualified  
             Recommendation  :  The Committee requested that the VMB update the  
             Committee on its inspection program for the past 8 years and  
             indicate if it has adequate staff to increase the number of  
             actual inspections and what percentage of veterinary premises  
             does it believe it will be able to inspect on an annual basis. It  
             would appear, based on the past number of inspections conducted  
             by the VMB on an annual basis that the VMB should try to at least  
             conduct inspections of 20% of veterinary premises.  [The current  
             language in this measure reflects this recommended change.]   


                                                                         SB 307
                                                                         Page 9

            c)   Issue  :  Veterinarian Assistants Access to Controlled  
             Background  :  For many years the RVTs and veterinarian assistants  
             who assisted veterinarians in practice were allowed to administer  
             drugs under indirect supervision of a veterinarian, by the  
             veterinarian's order, control, and full professional  
             responsibility.  However, in 2007, the VMB's legal counsel  
             questioned the language in existing law regarding who can  
             administer drugs to animals in a veterinary practice setting.   
             The California Veterinary Medical Association (CVMA) disagreed  
             with the VMB's interpretation of the law and subsequently sought  
             a Legislative Counsel (LC) opinion.  The LC opinion confirmed  
             CVMA's position and it further validated current practice as it  
             pertains to federal drug laws.

             Ultimately, however, the CVMA determined that temporary  
             regulations, designed to rectify the confusion in the law, could  
             only go so far, and that a statutory change would be necessary.   
             In 2007, CVMA carried SB 969 to make the statutory changes  
             necessary to clarify those persons who could provide controlled  
             substances in a veterinary office or clinic and under what level  
             of supervision.  This measure was signed into law, but contained  
             a sunset provision.  The purpose for the sunset provision was to  
             assure that there were no problems or complaints received by the  
             VMB regarding the access to controlled substances by veterinary  
             assistants.  The sunset provision was extended to January 1,  
             2013, pursuant to SB 943 of 2011.  During the interim, the DCA,  
             CVMA, the VMB and representatives from the RVT community met to  
             determine if other changes were necessary in the law to assure  
             that veterinary assistants who had access to controlled  
             substances had appropriate oversight and had no criminal history.  
              Discussions centered around the requirement for the  
             fingerprinting of veterinary assistants who would have access to  
                           controlled substances within the veterinary facility.  However,  
             the Department of Justice (DOJ) indicated that they would be  
             unable to provide criminal background information on veterinarian  
             assistants to the VMB unless they were under the authority of the  
             VMB.  Therefore, the VMB would have to at least require  
             veterinary assistants to obtain a permit from the VMB to be  
             allowed access to controlled substances so that the VMB could  
             then request fingerprints of the veterinarian assistant that  
             would be provided to DOJ.  The VMB could then be provided with  
             the criminal background information from DOJ before they granted  
             a permit.  


                                                                         SB 307
                                                                         Page 10

             Recommendation  :  It was recommended that the VMB should establish  
             a permitting process for veterinary assistants who will have  
             access to controlled substances, both under direct and indirect  
             supervision of a veterinarian, so that the VMB can require  
             fingerprints of veterinarian assistants and obtain criminal  
             history information from DOJ.  The requirement for a permit  
             should begin by 2015.  However, the VMB should be provided  
             adequate staffing to implement this new program to be paid from  
             fees collected pursuant to the permit requirement.  [The current  
             language in this measure reflects these recommended changes.]

        5. Current Related Legislation.   SB 304  (Price, 2013).  Makes various  
           changes to the Medical Practice Act and to the Medical Board of  
           California. (  Note  : This bill will also be heard before the BP&ED  
           Committee during today's hearing)  
            SB 305  (Price, 2013).  Extends until January 1, 2018, the  
           provisions establishing the Naturopathic Medicine Committee and the  
           Respiratory Care Board of California, and extends the term of the  
           executive officers of the Respiratory Care Board of California and  
           the California State Board of Optometry.  Specifies that the  
           Osteopathic Medical Board of California is subject to review by the  
           appropriate policy committees of the Legislature.  Exempts  
           individuals who have performed pulmonary function tests in Los  
           Angeles County facilities for at least 15 years, from licensure as  
           a respiratory care therapist.  Specifies that any board under the  
           Department of Consumer Affairs is authorized to receive certified  
           records from a local or state agency to complete an applicant or  
           licensee investigation and authorizes them to provide those records  
           to the board. (  Note  : This bill will also be heard before the BP&ED  
           Committee during today's hearing)

            SB 306  (Price, 2013).  Extends until January 1, 2018, the  
           provisions establishing the State Board of Chiropractic Examiners,  
           Speech-Language Pathology and Audiology and Hearing Aid Dispensers  
           Board, the Physical Therapy Board of California and the California  
           Board of Occupational Therapy and extends the terms of the  
           executive officers of the Physical Therapy Board of California and  
           the Speech-Language Pathology and Audiology and Hearing Aid  
           Dispensers Board.  This bill also subjects the boards to be  
           reviewed by the appropriate policy committees of the Legislature.   
           (  Note  : This bill will also be heard before the BP&ED Committee  
           during today's hearing)

            SB 308  (Price, 2013).  Extends, until January 1, 2018, the term of  


                                                                         SB 307
                                                                         Page 11

           the Interior Design Law.  Specifies that a certified interior  
           designer provides plans and documents that collaborates with other  
           design professionals.  Requires a certified interior designer to  
           use a written contract when contracting to provide interior design  
           services to a client.  Extends, until January 1, 2018, the State  
           Board of Guide Dogs for the Blind and extends an arbitration  
           procedure for the purpose of resolving disputes between a guide dog  
           user and a licensed guide dog school.  Extends until January 1,  
           2018, the State Board of Barbering and Cosmetology and requires a  
           school to be approved by the board before it is approved by the  
           Bureau for Private Postsecondary Education.  The bill would also  
           authorize the board to revoke, suspend, or deny its approval of a  
           school on specified grounds. 
           (  Note  : This bill will also be heard before the BP&ED Committee  
           during today's hearing)

            SB 309  (Price, 2013).  Extends the term of the State Athletic  
           Commission, which is responsible for licensing and regulating  
           boxing, kickboxing, and martial arts matches and is required to  
           appoint an executive officer until January 1, 2018.  (  Note  : This  
           bill will also be heard before the BP&ED Committee during today's  


        None on file as of April 24, 2013.


        None on file as of April 24, 2013.

        Consultant:Bill Gage