Florida Senate - 2022 SB 448 By Senator Brodeur 9-00429C-22 2022448__ 1 A bill to be entitled 2 An act relating to veterinary telehealth; providing a 3 short title; amending s. 474.202, F.S.; defining the 4 term “telemedicine”; creating s. 474.2021, F.S.; 5 authorizing veterinarians to practice telemedicine; 6 requiring veterinarians using telemedicine to 7 establish a veterinarian/client/patient relationship 8 and meet certain professional standards; prohibiting 9 such veterinarians from prescribing controlled 10 substances under certain circumstances; providing an 11 exception; providing licensure requirements to 12 practice telemedicine; providing jurisdiction of the 13 Florida Board of Veterinary Medicine; providing 14 construction; amending s. 828.30, F.S.; authorizing 15 employees, agents, or contractors of animal control 16 authorities to administer rabies vaccinations under 17 certain circumstances; providing that a supervising 18 veterinarian assumes responsibility for any person 19 vaccinating animals at the supervising veterinarian’s 20 discretion or under his or her supervision; defining 21 the term “indirect supervision”; authorizing a 22 veterinarian who indirectly supervises the 23 administration of the rabies vaccination to affix his 24 or her signature stamp on a rabies vaccination 25 certificate; amending ss. 474.203 and 474.214, F.S.; 26 conforming provisions to changes made by the act; 27 providing an effective date. 28 29 Be It Enacted by the Legislature of the State of Florida: 30 31 Section 1. This act may be cited as the “Providing Equity 32 in Telemedicine Services (PETS) Act.” 33 Section 2. Present subsections (11), (12), and (13) of 34 section 474.202, Florida Statutes, are redesignated as 35 subsections (12), (13), and (14), respectively, and a new 36 subsection (11) is added to that section, to read: 37 474.202 Definitions.—As used in this chapter: 38 (11) “Telemedicine” means the practice of veterinary 39 medicine, including diagnosis, consultation, evaluation, 40 treatment, or transfer of medical data, by means of a two-way, 41 real-time interactive communication between a client and patient 42 and a veterinarian who has access to and the ability to review 43 the patient’s relevant information before the telemedicine 44 visit. 45 Section 3. Section 474.2021, Florida Statutes, is created 46 to read: 47 474.2021 Veterinary telemedicine.— 48 (1) A veterinarian may practice telemedicine. 49 (2) A veterinarian who uses telemedicine: 50 (a) Shall take appropriate steps to establish a 51 veterinarian/client/patient relationship and conduct all 52 appropriate evaluations and collect appropriate histories of the 53 patient, consistent with prevailing professional standards of 54 care for the specific patient presentation. 55 (b) May not prescribe controlled substances if he or she 56 has not previously performed an in-person physical examination 57 or made medically appropriate and timely visits to the premises 58 where the animal is kept. However, a consulting veterinarian 59 using telemedicine may prescribe controlled substances for a 60 terminal patient transferred to the consulting veterinarian for 61 hospice care from a veterinarian who performed an in-person 62 physical examination of the patient and provided medical records 63 to the consulting veterinarian. 64 (c) Must hold a current license to practice veterinary 65 medicine in this state. The practice of medicine occurs where 66 the veterinarian or the patient, or both, are located at the 67 time the veterinarian practices telemedicine. 68 (3) The board has jurisdiction over a veterinarian 69 practicing telemedicine in this state, regardless of where the 70 veterinarian’s physical offices are located. The practice of 71 telemedicine in accordance with this section is not a standard 72 of care violation, and a veterinarian may not be disciplined 73 solely for practicing telemedicine. 74 Section 4. Subsections (1) and (3) of section 828.30, 75 Florida Statutes, are amended to read: 76 828.30 Rabies vaccination of dogs, cats, and ferrets.— 77 (1)(a) All dogs, cats, and ferrets 4 months of age or older 78 must be vaccinated by a licensed veterinarian or, in the case of 79 impounded animals, a person authorized under paragraph (b), 80 against rabies with a vaccinethat islicensed by the United 81 States Department of Agriculture for use in those species. 82 (b) An employee, an agent, or a contractor of an animal 83 control authority acting under the indirect supervision of a 84 veterinarian may vaccinate impounded dogs, cats, and ferrets 85 that will be transferred, rescued, fostered, adopted, or 86 reclaimed by the owner. The supervising veterinarian assumes 87 responsibility for any person vaccinating animals at his or her 88 direction or under his or her supervision. As used in this 89 paragraph, the term “indirect supervision” means that the 90 supervising veterinarian is required to be available for 91 consultation through telecommunications but is not required to 92 be physically present during such consultation. 93 (c) The owner of every dog, cat, and ferret shall have the 94 animal revaccinated 12 months after the initial vaccination. 95 Thereafter, the interval between vaccinations shall conform to 96 the vaccine manufacturer’s directions. The cost of vaccination 97 must be borne by the animal’s owner. Evidence of circulating 98 rabies virus neutralizing antibodies mayshallnot be used as a 99 substitute for current vaccination in managing rabies exposure 100 or determining the need for booster vaccinations. 101 (3) Upon vaccination against rabies, the licensed 102 veterinarian shall provide the animal’s owner and the animal 103 control authority with a rabies vaccination certificate. Each 104 animal control authority and veterinarian shall use the “Rabies 105 Vaccination Certificate” of the National Association of State 106 Public Health Veterinarians (NASPHV) or an equivalent form 107 approved by the local government whichthatcontainsallthe 108 information required by the NASPHV Rabies Vaccination 109 Certificate. The veterinarian who administers the rabies 110 vaccination, or who supervises the administration of the rabies 111 vaccination as provided in paragraph (1)(b),vaccineto an 112 animal as authorizedrequiredunder this section may affix his 113 or her signature stamp in lieu of an actual signature. 114 Section 5. Paragraph (a) of subsection (5) of section 115 474.203, Florida Statutes, is amended to read: 116 474.203 Exemptions.—This chapter does not apply to: 117 (5)(a) Any person, or the person’s regular employee, 118 administering to the ills or injuries of her or his own animals, 119 including, but not limited to, castration, spaying, and 120 dehorning of herd animals, unless title is transferred or 121 employment provided for the purpose of circumventing this law. 122 This exemption does not apply to any person licensed as a 123 veterinarian in another state or foreign jurisdiction and 124 practicing temporarily in this state. However, except as 125 provided in s. 828.30, only a veterinarian may immunize or treat 126 an animal for diseases that are communicable to humans and that 127 are of public health significance. 128 129 For the purposes of chapters 465 and 893, persons exempt 130 pursuant to subsection (1), subsection (2), or subsection (4) 131 are deemed to be duly licensed practitioners authorized by the 132 laws of this state to prescribe drugs or medicinal supplies. 133 Section 6. Paragraph (y) of subsection (1) of section 134 474.214, Florida Statutes, is amended to read: 135 474.214 Disciplinary proceedings.— 136 (1) The following acts shall constitute grounds for which 137 the disciplinary actions in subsection (2) may be taken: 138 (y) Using the privilege of ordering, prescribing, or making 139 available medicinal drugs or drugs as defined in chapter 465, or 140 controlled substances as defined in chapter 893, for use other 141 than for the specific treatment of animal patients for which 142 there is a documented veterinarian/client/patient relationship. 143Pursuant thereto,The veterinarian shall: 144 1. Have sufficient knowledge of the animal to initiate at 145 least a general or preliminary diagnosis of the medical 146 condition of the animal, which means that the veterinarian is 147 personally acquainted with the keeping and caring of the animal 148 and has recently performed an examination of the animal or group 149 of animals either physically in person or by the use of 150 instrumentation and diagnostic equipment through which images 151 and medical records may be transmitted electronicallyseen the152animalor has made medically appropriate and timely visits to 153 the premises where the animal is kept. 154 2. Be available or provide for follow-upfollowupcare and 155 treatment in case of adverse reactions or failure of the regimen 156 of therapy. 157 3. Maintain records which document patient visits, 158 diagnosis, treatment, and other relevant information required 159 under this chapter. 160 Section 7. This act shall take effect July 1, 2022.