BILL ANALYSIS �
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|Hearing Date:June 11, 2012 |Bill No:AB |
| |1839 |
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SENATE COMMITTEE ON BUSINESS, PROFESSIONS
AND ECONOMIC DEVELOPMENT
Senator Curren D. Price, Jr., Chair
Bill No: AB 1839Author:Ma
As Introduced: February 22, 2012 Fiscal: Yes
SUBJECT: Veterinary medicine: veterinary assistants.
SUMMARY: Authorizes registered veterinary technicians and
unregistered veterinary assistants to administer a controlled
substance pursuant to "direct" or "indirect" supervision if specified
requirements are satisfied, including completion of a fingerprinting
background check, but authorizes the Veterinary Medical 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.
Existing law:
1) Provides for the licensing and regulation of approximately 15,200
veterinarians and 8,100 registered veterinary technicians (RVTs) by
the Veterinary Medical Board (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) � 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
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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)
4) Defines "direct supervision" as: (1) 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
(2) 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 (CCRs) � 2034 (e))
5) Defines "indirect supervision" as: (1) 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 (2) 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 � 2034 (f))
6) Would repeal 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 � 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 completed a state and federal fingerprinting background check
and who do not have any drug or alcohol related felony convictions.
3) Requires the employer to retain the results of the background check
in his or her personnel records and make them available to the
Board and the Department of Justice, upon request.
4) 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.
5) Deletes the January 1, 2013, sunset for provisions authorizing
registered veterinary technicians (RVTs) and unregistered
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assistants (UAs) to administer controlled substances under
specified circumstances, thereby extending these provisions and
authorization indefinitely.
FISCAL EFFECT: According to the Assembly Committee on Appropriations
analysis dated April 18, 2012, "any costs associated with this
legislation would be minor and absorbable within existing resources."
COMMENTS:
1. Purpose. According to the Author, for many years the RVTs and UAs
who assist veterinarians in practice have been allowed to
administer drugs under indirect supervision of a veterinarian, by
the veterinarian's order, control, and full professional
responsibility. However, in 2007, Board'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 Board's
interpretation of the law and subsequently sought a Legislative
Counsel (LC) opinion, requested by then Assemblyman Greg
Aghazarian. The LC opinion confirmed CVMA's position and it
further validated current practice as it pertains to federal drug
laws.
As the Author further explains, ultimately however, the Board
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, Senator Sam Aanestad carried
SB 969 for CVMA 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.
With the assistance of the Senate Business, Professions and
Economic Development Committee last year, CVMA and the VMB were
able to secure a temporary one-year extension to the sunset,
through January 1, 2013. (Committee omnibus bill, SB 943, 2011.)
During the interim, CVMA, the Board and representatives from the
Registered Veterinary Technician community met to determine if
other changes were necessary in the law to assure that unregistered
assistants who had access to controlled substances had appropriate
oversight and had no criminal history.
2. Background. As indicated, in 2007, the Board's attorney
interpreted a section of law pertaining to who can administer
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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 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, 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
(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 Board of
Pharmacy, 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."
3. Previous 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 rehabilitation or
musculoskeletal manipulation upon an animal, unless otherwise
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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 (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 VMB in conjunction with BOP to enforce
the existing statutes of the Pharmacy Law regarding prescribing and
dispensing of dangerous drugs or devices.
4. 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 �Board] 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 �Board] 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
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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 measure 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. "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 �Board] regarding the ability to have lower level
employees receive a background check prior to their ability to
handle drugs in a veterinary office."
SUPPORT AND OPPOSITION:
Support:
California Veterinary Medical Association (Co-Sponsor)
California Registered Veterinarian Technician Association (Co-Sponsor)
California Veterinary Medical Board
Paw Pac (California Political Action Committee for Animals)
Opposition:
None on file as of June 6, 2012.
Consultant: Bill Gage