The proposed rule makes structural changes, minor language changes, and telehealth changes as described below.
Structural Changes
— Consolidates the eleven existing rule chapters into three chapters: one for veterinarians, one for veterinary technicians, and one for the professional assistance program. Consolidation makes the rules easier to access quickly.
— Adds a chapter for relevant complaint procedures that did not transfer in the previous rules from DSPS to DATCP.
— States the current fee amounts in rule. Fee amounts do not change.
Minor Language Changes
— Makes changes regarding procedures and processes.
— Removes the word annual from references to the review of colleges and technical schools.
— Expands the temporary veterinary permit process to include applicants who are scheduled to take or are awaiting results from the examination on state laws and rules.
— Clarifies that applicants for licensure who have previously been licensed in Wisconsin or another jurisdiction must apply by endorsement.
— Adds for clarity and consistency a section identifying common situations in which the board may require additional information from an applicant when reviewing an application.
— States more clearly that the board may reprimand the licensee or deny, suspend, limit or revoke a credential for cause, including filing an incomplete or fraudulent application, misrepresenting information on an application, or violating the rule chapter or Wis. Stat. ch. 89. — Makes technical changes and updates.
— Adds the denial of a license to the list of reasons for a temporary veterinary permit to expire.
— Allows applicants to provide proof of graduation through the American Association of Veterinary State Boards (AAVSB), which allows for electronic submissions using the AAVSB online system.
— Adds direction in the rules to assure the requirements for access to health care records required in Wis. Stat. s. 89.075 are clear and consistently applied. — Removes an obsolete provision regarding continuing education auditing of journal articles read. The Board previously eliminated the ability to self-study journal articles and mistakenly did not also eliminate this provision regarding auditing.
— Clarifies the continuing education requirements for persons who have not been credentialed for more than 5 years.
— Adds language to clearly state license exemptions.
— Allows veterinarians to delegate additional veterinary medical acts to certified veterinary technicians and unlicensed assistants.
— Allows veterinarians to delegate the placement of intravenous catheters to unlicensed assistants under the direct supervision of the veterinarian present on the premises, per requests from stakeholders.
— Additional changes to the delegation of veterinary medical acts are included in the telehealth section of this summary.
— Makes changes for consistency and ease of use the places in which rule requirements repeat, or refer to requirements in statute.
— Modifies language regarding unprofessional conduct so that it also refers to Wis. Stat. s. 89.07 (1). — Modifies language regarding prescribing and dispensing a veterinary drug to refer to Wis. Stat. s. 89.068 (1) (c). — Makes a correction to the delegation of rabies vaccinations to reflect Wis. Stat. s. 95.21 (2) (a). — Modifies terminology for clarity and consistency.
— Adds additional definitions and updates existing definitions language for clarity.
— Renames “temporary permit” to “temporary veterinary permit” and renamed “temporary consulting permit” to “veterinary consulting permit.”
— Changes language to use the word “dispense” rather than “sell” to be more consistent with statutory language and definitions to make the language clearer and easier to understand.
— Adds a note clarifying that the board accepts “veterinary nurse” as equivalent to “veterinary technician.”
Telehealth Changes
— Adds definitions related to telehealth.
— Adds definitions related to veterinary consulting and clarifies that a consulting veterinarian or other consultant may not do any of the following:
— Visit the patient or client or communicate directly with the client without the knowledge of the attending veterinarian.
— Take charge of a case or problem without the consent of the attending veterinarian and the client.
— Clarifies that the practice of veterinary medicine takes place where the animal is located at the time of practice, in alignment with Wis. Stat. §§ 89.05 (1) and 89.02 (6). — Clarifies that in order to practice veterinary medicine in Wisconsin a veterinarian must be licensed in Wisconsin and have an established veterinary-client-patient relationship (VCPR) with the client. A VCPR must be established via an in person physical exam, or timely medically appropriate visits to the premises on which the patient is kept. It may not be established by telehealth technologies.
— Clarifies that the VCPR, once established, extends to other veterinarians within the practice, or relief veterinarians within the practice, that have access to, and have reviewed, the medical history and records of the animal.
— Clarifies that records must be kept, regardless of the encounter type.
— Clarifies, in accordance with Wis. Stat. § 89.02(8) (c), that an animal owner must be able to easily seek follow-up care or information from the veterinarian who conducts an encounter while using telehealth technologies. — Expands the delegation of medical services to allow a veterinarian to delegate the following items to a certified veterinary technician (CVT) if the veterinarian is available to communicate via telehealth technologies within five minutes. Under current rules, these items may only be delegated to a CVT if the veterinarian is personally present on the premises.
— Performing diagnostic radiographic awake contrast studies not requiring general anesthesia.
— Sample collection via a cystocentesis procedure.
— Placement of intravenous catheters.
— Suturing of tubes and catheters.
— Fine needle aspirate of a mass.
Summary of, and Comparison with, Existing or Proposed Federal Statutes and Regulations
Pursuant to 9 CFR 160 to 162, a veterinarian must be specifically authorized by the United States Department of Agriculture – Animal and Plant Health Inspection Service to perform animal disease eradication and control functions under federal animal health laws. Licensure requirements to practice veterinary medicine are established by each state and should not be affected by federal requirements.
Summary of Comments Received during Hearing and Comment Periods
Preliminary Public Hearing and Comment Period on the Statement of Scope
The Board held a preliminary hearing on SS 064-20 on August 19, 2020, with a written comment period through August 26, 2020. The Board received three comments. One comment was for information. Two comments expressed support of the scope, both expressed support of including telehealth in the scope, and one also expressed support of including addressing the circumstances under which a veterinarian may dispense a drug for a patient of another veterinarian in the scope. Comment Period on the Economic Impact Analysis
The economic impact analysis was posted for 14 days, with comments accepted through June 21, 2021. One comment was received. The comment noted a typo in the plain language analysis, which has been corrected. The comment also expressed objection to the term “veterinary nurse,” stated that there are objections from the national nursing organization regarding the term, and stated that “nurse” does not adequately encompass the skills and knowledge base of veterinary technicians. The rule draft does not use “veterinary nurse” to refer to veterinary technicians, but does include a note that states that the Board accepts the classification of “veterinary nurse” in other jurisdictions as equivalent to “veterinary technician.” While the Board, and this rule, does not use “veterinary nurse” to refer to veterinary technicians, this note clarifies that the Board accepts the term as equivalent when used by other jurisdictions.
Public Hearing and Comment Period on the Preliminary Rule Draft
The Board held public hearings on the preliminary rule draft on September 9 and 15, 2021, with comments accepted through September 29, 2021. Both hearings offered a combination of in-person access and remote access. The Board sent an email notice to licensees notifying them of the hearing and comment period, in addition to the posting in the Administrative Register. The Board received 3 comments at public hearings and 25 written comments. There were 26 total commenters. Of these 26:
— Nine expressed support of the proposed rule. Of these nine:
— Nine also specified support of the veterinary-client-patient relationship (VCPR) definition
— Eight also specified support of the omission of Assisted Reproductive Technologies (ART) procedures in delegation changes
— Two also expressed that ART procedures should not be delegated to a CVT at all
— One also expressed opposition to delegation without the veterinarian on the premises generally
— Six also expressed support of language regarding veterinarians filling prescriptions for other veterinarians
— Fourteen expressed opposition to the VCPR definition
— One expressed opposition to the omission of ART in delegation changes
— Two did not express a position for/against the proposal
— One expressed concerns about existing rabies provisions
