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 vaccine that is licensed 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 may shall not 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 which that contains all the
  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), vaccine to an
  112  animal as authorized required under 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.
  143  Pursuant 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 electronically seen the
  152  animal or has made medically appropriate and timely visits to
  153  the premises where the animal is kept.
  154         2. Be available or provide for follow-up followup care 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.