Florida Senate - 2024                          SENATOR AMENDMENT
       Bill No. HB 849
                              LEGISLATIVE ACTION                        
                    Senate             .             House              
                Floor: 1/AD/2R         .            Floor: C            
             03/04/2024 04:09 PM       .      03/06/2024 10:48 AM       

       Senator Bradley moved the following:
    1         Senate Amendment (with title amendment)
    3         Delete everything after the enacting clause
    4  and insert:
    5         Section 1. Subsection (14) is added to section 474.202,
    6  Florida Statutes, to read:
    7         474.202 Definitions.—As used in this chapter:
    8         (14) “Veterinary telehealth” means the use of synchronous
    9  or asynchronous telecommunications technology by a telehealth
   10  provider to provide health care services, including, but not
   11  limited to, assessment, diagnosis, consultation, treatment, and
   12  monitoring of a patient; transfer of medical data; patient and
   13  professional health-related education; public health services;
   14  and health administration.
   15         Section 2. Section 474.2021, Florida Statutes, is created
   16  to read:
   17         474.2021 Veterinary telehealth.—
   18         (1) This section may be cited as the “Providing Equity in
   19  Telehealth Services Act.”
   20         (2) A veterinarian who holds a current license to practice
   21  veterinary medicine in this state may practice veterinary
   22  telehealth.
   23         (3) The board has jurisdiction over a veterinarian
   24  practicing veterinary telehealth, regardless of where the
   25  veterinarian’s physical office is located. The practice of
   26  veterinary medicine is deemed to occur when the veterinarian,
   27  the patient, or both are located within this state at the time
   28  the veterinarian practices veterinary telehealth.
   29         (4) A veterinarian practicing veterinary telehealth:
   30         (a) May not engage in the practice of veterinary telehealth
   31  unless it is within the context of a veterinarian/client/patient
   32  relationship;
   33         (b) Shall practice in a manner consistent with his or her
   34  scope of practice and the prevailing professional standard of
   35  practice for a veterinarian who provides in-person veterinary
   36  services to patients in this state and shall employ sound,
   37  professional judgment to determine whether using veterinary
   38  telehealth is an appropriate method for delivering medical
   39  advice or treatment to the patient;
   40         (c) May use veterinary telehealth to perform an initial
   41  patient evaluation to establish the veterinarian/client/patient
   42  relationship if the evaluation is conducted using synchronous,
   43  audiovisual communication. The evaluation may not be performed
   44  using audio only communications, text messaging, questionnaires,
   45  chatbots, or other similar means. If a veterinarian practicing
   46  telehealth conducts a patient evaluation sufficient to diagnose
   47  and treat the patient, the veterinarian is not required to
   48  research a patient’s medical history or conduct a physical
   49  examination of the patient before using veterinary telehealth to
   50  provide a veterinary health care service to the patient;
   51         (d) If the initial patient evaluation is performed using
   52  veterinary telehealth, must provide the client with a statement
   53  containing the veterinarian’s name, license number, and contact
   54  information and the contact information for at least one
   55  physical veterinary clinic in the vicinity of the patient’s
   56  location and instructions for how to receive patient follow-up
   57  care or assistance if the veterinarian and client are unable to
   58  communicate because of a technological or equipment failure or
   59  if there is an adverse reaction to treatment, and inform the
   60  client that, if medication is prescribed, the client may obtain
   61  a prescription that may be filled at the pharmacy of his or her
   62  choice. The veterinarian shall obtain from the client a signed
   63  and dated statement indicating the client has received the
   64  required information before practicing veterinary telehealth;
   65         (e) Shall prescribe all drugs and medications in accordance
   66  with all federal and state laws and the following requirements:
   67         1. A veterinarian practicing veterinary telehealth may
   68  order, prescribe, or make available medicinal drugs or drugs
   69  specifically approved for use in animals by the United States
   70  Food and Drug Administration, the use of which conforms to the
   71  approved labeling. Prescriptions based solely on a telehealth
   72  evaluation may be issued for up to 1 month for products labeled
   73  solely for flea and tick control and up to 14 days of treatment
   74  for other animal drugs. Prescriptions based solely on a
   75  telehealth evaluation may not be renewed without an in-person
   76  examination.
   77         2. A veterinarian practicing veterinary telehealth may not
   78  order, prescribe, or make available medicinal drugs or drugs as
   79  defined in s. 465.003 approved by the United States Food and
   80  Drug Administration for human use or compounded antibacterial,
   81  antifungal, antiviral, or antiparasitic medications, unless the
   82  veterinarian has conducted an in-person physical examination of
   83  the animal or made medically appropriate and timely visits to
   84  the premises where the animal is kept.
   85         3. A veterinarian may not use veterinary telehealth to
   86  prescribe a controlled substance as defined in chapter 893
   87  unless the veterinarian has conducted an in-person physical
   88  examination of the animal or made medically appropriate and
   89  timely visits within the past year to the premises where the
   90  animal is kept.
   91         4. A veterinarian practicing veterinary telehealth may not
   92  prescribe a drug or other medication for use on a horse engaged
   93  in racing or training at a facility under the jurisdiction of
   94  the Florida Gaming Control Commission or on a horse that is a
   95  covered horse as defined in the federal Horseracing Integrity
   96  and Safety Act, 15 U.S.C. ss. 3051 et seq.;
   97         (f) Shall be familiar with available veterinary resources,
   98  including emergency resources, near the patient’s location and
   99  be able to provide the client with a list of nearby
  100  veterinarians who may be able to see the patient in person upon
  101  the request of the client;
  102         (g) Shall keep, maintain, and make available a summary of
  103  the patient record as provided in s. 474.2165; and
  104         (h) May not use veterinary telehealth to issue an
  105  international or interstate travel certificate or a certificate
  106  of veterinary inspection.
  107         (5) A veterinarian personally acquainted with the caring
  108  and keeping of an animal or group of animals on food-producing
  109  animal operations on land classified as agricultural pursuant to
  110  s. 193.461 who has recently seen the animal or group of animals
  111  or has made medically appropriate and timely visits to the
  112  premises where the animal or group of animals is kept may
  113  practice veterinary telehealth for animals on such operations.
  114         Section 3. Subsection (1) of section 474.2165, Florida
  115  Statutes, is amended to read:
  116         474.2165 Ownership and control of veterinary medical
  117  patient records; report or copies of records to be furnished.—
  118         (1) As used in this section, the term “records owner” means
  119  any veterinarian who generates a medical record after making an
  120  a physical examination of, or administering treatment or
  121  dispensing legend drugs to, any patient; any veterinarian to
  122  whom records are transferred by a previous records owner; or any
  123  veterinarian’s employer, provided the employment contract or
  124  agreement between the employer and the veterinarian designates
  125  the employer as the records owner.
  126         Section 4. This act shall take effect July 1, 2024.
  128  ================= T I T L E  A M E N D M E N T ================
  129  And the title is amended as follows:
  130         Delete everything before the enacting clause
  131  and insert:
  132                        A bill to be entitled                      
  133         An act relating to veterinary practices; amending s.
  134         474.202, F.S.; defining the term “veterinary
  135         telehealth”; creating s. 474.2021, F.S.; providing a
  136         short title; authorizing licensed veterinarians to
  137         practice veterinary telehealth in accordance with
  138         specified criteria; specifying the powers of the Board
  139         of Veterinary Medicine related to the practice of
  140         telehealth; providing that the practice of veterinary
  141         medicine is deemed to occur under specified
  142         circumstances; specifying the conditions under which a
  143         veterinarian may practice veterinary telehealth;
  144         specifying the drugs that a veterinarian practicing
  145         telehealth may not provide unless specified conditions
  146         are met; providing specific authorizations for cases
  147         in which the patient is a food-producing species;
  148         amending s. 474.2165, F.S.; conforming a provision to
  149         changes made by the act; providing an effective date.