Second Regular Session
Seventy-fourth General Assembly
STATE OF COLORADO
REENGROSSED
This Version Includes All Amendments
Adopted in the House of Introduction
LLS NO. 24-0363.01 Christopher McMichael x4775
HOUSE BILL 24-1048
House Committees Senate Committees
Agriculture, Water & Natural Resources
A BILL FOR AN ACT
C
ONCERNING THE PROVISION OF VETERI NARY SERVICES THROUGH101
TELEHEALTH.102
Bill Summary
(Note: This summary applies to this bill as introduced and does
not reflect any amendments that may be subsequently adopted. If this bill
passes third reading in the house of introduction, a bill summary that
applies to the reengrossed version of this bill will be available at
http://leg.colorado.gov/
.)
Water Resources and Agriculture Review Committee. The bill
concerns the use of telehealth to provide veterinary services. The bill
defines different types of telehealth tools that can be used in a veterinary
practice.
In current law, one criterion for the establishment of a
veterinarian-client-patient relationship is that the veterinarian has
HOUSE
3rd Reading Unamended
February 12, 2024
HOUSE
Amended 2nd Reading
February 9, 2024
HOUSE SPONSORSHIP
McCormick and Martinez, McLachlan, Amabile, Bacon, Bird, Boesenecker, Brown,
Catlin, Clifford, Epps, Froelich, Garcia, Hamrick, Jodeh, Kipp, Lindsay, Lindstedt, Lukens,
Lynch, Mauro, McCluskie, Parenti, Ricks, Snyder, Soper, Story, Titone, Valdez, Vigil, Young
SENATE SPONSORSHIP
Ginal and Pelton B., Pelton R., Simpson
Shading denotes HOUSE amendment. Double underlining denotes SENATE amendment.
Capital letters or bold & italic numbers indicate new material to be added to existing law.
Dashes through the words or numbers indicate deletions from existing law. conducted an examination of the animal that is the patient. The bill
clarifies that the examination must be an in-person, physical examination.
The bill also extends the veterinarian-client-patient relationship to other
licensed veterinarians who share the same physical premises as the
veterinarian who established the relationship if the other veterinarians
have access to and have reviewed the patient's medical records.
The bill allows a licensed veterinarian who has established a
veterinarian-client-patient relationship to use telehealth to provide
veterinary services to clients and patients in Colorado with the consent of
the client. A licensed veterinarian may also refer a patient to a veterinary
specialist, who may provide veterinary services via telemedicine under
the referring veterinarian's veterinarian-client-patient relationship.
The bill authorizes the state board of veterinary medicine to
establish rules for the use of telehealth to provide veterinary services.
The bill clarifies that only a licensed veterinarian with an
established veterinarian-client-patient relationship may prescribe
medication using telemedicine.
The bill allows a licensed veterinarian who has established a
veterinarian-client-patient relationship to supervise veterinary personnel
who are not located on the same premises using telesupervision if the
veterinarian and the personnel are employees of the same veterinary
practice and the veterinary premises, the veterinary professionals or other
veterinary personnel, and the patient are all located in Colorado.
The bill establishes record-keeping, confidentiality, and privacy
requirements related to the use of telehealth.
Be it enacted by the General Assembly of the State of Colorado:1
SECTION 1. In Colorado Revised Statutes, 12-315-104, amend2
(19) as follows:3
12-315-104. Definitions. As used in this article 315, unless the4
context otherwise requires:5
(19) (a) "Veterinarian-client-patient relationship" means that
THE6
relationship established when:7
(a) (I) The veterinarian has assumed the responsibility for making8
medical judgments regarding the health of an animal and the need for9
medical treatment, and the owner, OWNER'S AGENT, or other AUTHORIZED10
caretaker has agreed to follow the instruction of the veterinarian;11
1048-2- (b) (II) There is sufficient knowledge of an animal by the1
veterinarian to initiate at least a general or preliminary diagnosis of the2
medical condition of the animal, which means that the veterinarian has3
recently seen and is personally acquainted with the keeping and care of4
the animal by virtue of an
IN-PERSON, PHYSICAL examination of the5
animal or by medically appropriate and timely visits to the premises6
where the animal is kept; and7
(c)
(III) The practicing veterinarian is readily available, or has8
arranged for emergency coverage, for follow-up evaluation in the event9
of adverse reactions or failure of the treatment regimen.10
(b) A
VETERINARIAN-CLIENT-PATIENT RELATIONSHIP ESTABLISHED11
ACCORDING TO SUBSECTION (19)(a) OF THIS SECTION MAY EXTEND TO12
OTHER LICENSED VETERINARIANS
WORKING OUT OF THE SAME PHYSICAL13
PRACTICE LOCATION AS THE VETERINARIAN WHO ESTABLISHED THE14
VETERINARIAN-CLIENT-PATIENT RELATIONSHIP IF THE OTHER LICENSED15
VETERINARIANS HAVE ACCESS TO AND HAVE REVIEWED THE PATIENT 'S16
MEDICAL RECORDS.17
SECTION 2. In Colorado Revised Statutes, 12-315-106, add (9)18
as follows:19
12-315-106. Board of veterinary medicine - creation - powers20
- rules. (9) (a) THE BOARD MAY PROMULGATE RULES REGARDING THE USE21
OF TELEHEALTH TO PROVIDE VETERINARY SERVICES IN COLORADO22
PURSUANT TO PART 3 OF THIS ARTICLE 315.23
(b) IN DEVELOPING RULES PURSUANT TO SUBSECTION (9)(a) OF24
THIS SECTION, THE BOARD SHALL CONSULT WITH LICENSED25
VETERINARIANS, REGISTERED VETERINARY TECHNICIANS, CLIENTS, AND26
OTHER RELEVANT STAKE HOLDERS AS DETERMINED BY THE BOARD .27
1048
-3- SECTION 3. In Colorado Revised Statutes, add part 3 to article1
315 of title 12 as follows:2
PART 33
USE OF TELEHEALTH TO PROVIDE4
VETERINARY SERVICES5
12-315-301. Definitions - rules. A
S USED IN THIS PART 3, UNLESS6
THE CONTEXT OTHERWISE REQUIRES :7
(1) "T
ELE-ADVICE" MEANS THE PROVISION OF ANY HEALTH8
INFORMATION, OPINION, OR GUIDANCE BY A VETERINARY PROFESSIONAL9
THAT IS NOT SPECIFIC TO A PARTICULAR ANIMAL'S, OR GROUP OF ANIMALS',10
HEALTH, ILLNESS, OR INJURY AND THAT IS NOT INTENDED TO DIAGNOSE ,11
TREAT, OR ISSUE PROGNOSES OF AN ANIMAL 'S, OR GROUP OF ANIMALS',12
PHYSICAL OR BEHAVIORAL ILLNESS OR INJURY . A13
VETERINARIAN-CLIENT-PATIENT RELATIONSHIP IS NOT REQUIRED TO14
PROVIDE TELE-ADVICE.15
(2) "T
ELECONSULTING" MEANS A VETERINARIAN WHO16
COMMUNICATES WITH A VETERINARY SPECIALIST OR OTHER QUALIFIED17
EXPERT USING TELECOMMUNICATIONS TECHNOLOGY TO GAIN INSIGHT OR18
ADVICE REGARDING THE CARE OF A PATIENT .19
(3) "T
ELE-EDUCATION" MEANS THE USE OF INFORMATION AND20
TELECOMMUNICATIONS TECHNOLOGY FOR DISTANCE LEARNING .21
(4) (a) "T
ELEHEALTH" MEANS THE USE OF TELECOMMUNICATIONS22
TECHNOLOGY TO PROVIDE VETERINARY SERVICES OR TO COLLECT AND23
DELIVER VETERINARY HEALTH INFORMATION OR EDUCATION VIRTUALLY24
AND CAN ENCOMPASS GENERAL VETERINARY SERVICES OR25
PATIENT-SPECIFIC VETERINARY SERVICES.26
(b) "T
ELEHEALTH" MAY INCLUDE TELE-ADVICE, TELECONSULTING,27
1048
-4- TELE-EDUCATION, TELEMEDICINE, TELEMONITORING, TELEREFERRAL,1
TELESUPERVISION, TELETRIAGE, AND OTHER TOOLS THAT HELP2
VETERINARY PROFESSIONALS DELI VER VETERINARY EDUCATION AND3
SERVICES VIRTUALLY.4
(5) "T
ELEMEDICINE" MEANS THE REMOTE PRACTICE OF5
VETERINARY MEDICINE THROUGH THE USE OF TELECOMMUNICATIONS6
TECHNOLOGY THAT ALLOWS A LICENSED VETERINARIAN WITH AN7
ESTABLISHED VETERINARIAN -CLIENT-PATIENT RELATIONSHIP TO8
EVALUATE, DIAGNOSE, AND TREAT A PATIENT VIRTUALLY.9
(6) "T
ELEMONITORING" MEANS THE USE OF TELECOMMUNICATIONS10
TECHNOLOGY TO AUGMENT VETERINARY SERVICES BY COLLECTING AND11
DELIVERING HEALTH INFORMATION FROM A PATIENT .12
(7) "T
ELEREFERRAL" MEANS A VETERINARIAN WITH AN13
ESTABLISHED VETERINARIAN-CLIENT-PATIENT RELATIONSHIP WHO REFERS14
THE CLIENT TO A VETERINARY SPECIALIST TO PROVIDE VETERINARY15
SERVICES USING TELECOMMUNICATIONS TECHNOLOGY UNDER THE16
ESTABLISHED VETERINARIAN-CLIENT-PATIENT RELATIONSHIP.17
(8) "T
ELESUPERVISION" MEANS THE SUPERVISION OF INDIVIDUALS18
PROVIDING VETERINARY SERVICES USING MEDIA SUCH AS AUDIO ,19
AUDIO-VISUAL CONFERENCING, TEXT MESSAGING, E-MAIL, OR OTHER20
VIRTUAL OR DIGITAL TECHNOLOGIES .21
(9) "T
ELETRIAGE" MEANS THE SAFE, APPROPRIATE, AND TIMELY22
ASSESSMENT OF AN ANIMAL, OR A GROUP OF ANIMALS, UNDER CONDITIONS23
OF UNCERTAINTY AND URGENCY , AND THE POSSIBLE REFERRAL TO A24
LICENSED VETERINARIAN, AFTER DISCUSSION WITH THE INDIVIDUAL25
RESPONSIBLE FOR THE ANIMAL OR GROUP OF ANIMALS , USING26
TELECOMMUNICATIONS TECHNOLOGY . A VETERINARIAN-CLIENT-PATIENT27
1048
-5- RELATIONSHIP IS NOT REQUIRED FOR SUCH AN ASSESSMENT OR REFERRAL .1
"T
ELETRIAGE" DOES NOT INCLUDE THE RENDERING OF A DIAGNOSIS .2
(10) "V
ETERINARY SPECIALIST" MEANS A VETERINARIAN WHO IS3
FORMALLY RECOGNIZED AS A SPECIALIST FROM A SPECIALTY4
ORGANIZATION THAT IS RECOGNIZED BY THE AMERICAN VETERINARY5
M
EDICAL ASSOCIATION'S AMERICAN BOARD OF VETERINARY6
S
PECIALTIES, OR ITS SUCCESSOR ORGANIZATION , OR ANOTHER7
ASSOCIATION THAT RECOGNIZES V ETERINARY SPECIALISTS THAT THE8
STATE BOARD OF VETERINARY MEDICINE HAS APPROVED BY RULE .9
12-315-302. Veterinarian-client-patient relationship -10
telemedicine. (1) O
NLY A LICENSED VETERINARIAN MAY ESTABLISH A11
VETERINARIAN-CLIENT-PATIENT RELATIONSHIP IN THIS STATE.12
(2) (a) A
VETERINARIAN-CLIENT-PATIENT RELATIONSHIP MUST BE13
ESTABLISHED BY AN IN-PERSON, PHYSICAL EXAMINATION OF THE ANIMAL14
OR TIMELY VISITS TO THE PREMISES WHERE THE ANIMAL IS KEPT .15
(b) A
VETERINARY SPECIALIST MAY USE TELECOMMUNICATIONS16
TECHNOLOGY TO SEE A PATIENT UNDER ANOTHER VETERINARIAN 'S17
PREVIOUSLY ESTABLISHED VETERINARIAN -CLIENT-PATIENT RELATIONSHIP18
PURSUANT TO SECTION 12-315-306.19
(3) A
N ESTABLISHED VETERINARIAN -CLIENT-PATIENT20
RELATIONSHIP MAY BE MAINTAINED THROUGH EXAMINATIONS THAT21
OCCUR USING TELECOMMUNICATIONS TECHNOLOGY IN BETWEEN22
APPROPRIATE IN-PERSON, PHYSICAL EXAMINATIONS OR VISITS TO THE23
PREMISES WHERE THE PATIENT IS KEPT.24
12-315-303. Treatment of patients using telehealth -25
telemedicine - licensure - technology - consent. (1) (a) A
PERSON MUST26
BE LICENSED TO PRACTICE VETERINARY MEDICINE IN COLORADO IN ORDER27
1048
-6- TO PRACTICE TELEMEDICINE IN COLORADO.1
(b) A
PERSON WHO IS NOT A LICENSED VETERINARIAN IN2
C
OLORADO AND WHO USES TELEMEDICINE TO PROVIDE VETERINARY3
SERVICES TO ANIMALS AND INDIVIDUALS RESPONSIBLE FOR THE ANIMALS4
ENGAGES IN THE UNAUTHORIZED PRACTICE OF VETERINARY MEDICINE .5
S
UCH PERSON IS SUBJECT TO PENALTIES FOR THE UNAUTHORIZED PRACTICE6
OF VETERINARY MEDICINE PURSUANT TO SECTION 12-315-114.7
(2) A
LICENSED VETERINARIAN SHALL EMPLOY SOUND ,8
PROFESSIONAL JUDGMENT WHEN DETERMINING WHETHER TO PROVIDE9
VETERINARY SERVICES TO A PATIENT THROUGH TELEMEDICINE AND SHALL10
USE TELEMEDICINE ONLY WHEN SUCH USE IS MEDICALLY APPROPRIATE11
BASED ON THE PATIENT'S CONDITION.12
(3) A
VETERINARY PROFESSIONAL SHALL ENSURE THAT THE13
TECHNOLOGY USED WHEN PROVIDING VETERINARY SERVICES THROUGH14
TELEHEALTH IS OF APPROPRIATE QUALITY TO ENSURE :15
(a) A
CCURACY OF THE REMOTE ASSESSMENT OF THE PATIENT 'S16
CONDITION OR BEHAVIOR;17
(b) C
LEAR COMMUNICATION WITH CLIENTS ; AND18
(c) C
OMPLIANCE WITH ALL RELEVANT PRIVACY AND19
CONFIDENTIALITY REQUIREMENTS .20
(4) (a) A
VETERINARY PROFESSIONAL SHALL OBTAIN CONSENT21
FROM THE CLIENT BEFORE PROVIDING VETERINARY SERVICES THROUGH22
TELEHEALTH AND SHALL RECORD THE CLIENT 'S CONSENT IN THE PATIENT'S23
MEDICAL RECORD.24
(b) A
VETERINARY PROFESSIONAL USING TELEHEALTH TO PROVIDE25
VETERINARY SERVICES SHALL INFORM THE CLIENT , OR THE CLIENT'S26
AUTHORIZED REPRESENTATIVE , OF:27
1048
-7- (I) THE VETERINARY PROFESSIONAL 'S NAME, LOCATION, AND, IF1
APPLICABLE, LICENSE NUMBER AND LICENSURE STATUS ;2
(II) W
HETHER, IN THE VETERINARIAN'S PROFESSIONAL OPINION,3
THE PATIENT'S CONDITION CAN BE ACCURATELY DIAGNOSED OR TREATED4
USING TELEMEDICINE; AND5
(III) T
HE DIAGNOSIS, PROGNOSIS, AND TREATMENT OPTIONS FOR6
THE PATIENT.7
12-315-304. Standard of care. (1) A
LICENSED VETERINARIAN8
USING TELEHEALTH TO PROVIDE VETERINARY SERVICES SHALL CONDUCT9
ALL NECESSARY PATIENT EVALUATIONS AND TREATMENT USING THE10
APPLICABLE STANDARD OF CARE FOR THOSE EVALUATIONS AND11
TREATMENTS.12
(2) A
LICENSED VETERINARIAN SHALL NOT RECOMMEND13
TREATMENT OR CARE FOR AN ANIMAL BASED SOLELY ON A CLIENT 'S14
RESPONSES TO AN ONLINE QUESTIONNAIRE .15
12-315-305. Prescribing medication through telemedicine.16
(1) (a) O
NLY A LICENSED VETERINARIAN WITH AN ESTABLISHED17
VETERINARIAN-CLIENT-PATIENT RELATIONSHIP MAY PRESCRIBE18
MEDICATION THROUGH TELEMEDICINE .19
(b) A
LICENSED VETERINARIAN SHALL USE PROFESSI ONAL20
JUDGMENT WHEN DETERMINING IF IT IS APPROPRIATE TO PRESCRIBE21
MEDICATION THROUGH TELEMEDICINE .22
(2) A
LICENSED VETERINARIAN WHO PRESCRIBES MEDICATION23
THROUGH TELEMEDICINE IS SUBJECT TO THE LIMITATIONS ON24
PRESCRIPTIONS SPECIFIED IN SECTION 12-30-109.25
12-315-306. Telereferral. (1) A
VETERINARIAN WITH AN26
ESTABLISHED VETERINARIAN-CLIENT-PATIENT RELATIONSHIP MAY REFER27
1048
-8- A PATIENT TO A VETERINARY SPECIALIST.1
(2) A
VETERINARY SPECIALIST TO WHOM A PATIENT IS REFERRED2
MAY PROVIDE VETERINARY SERVICES USING TELECOMMUNICATIONS3
TECHNOLOGY FOR THE PATIENT AND CLIENT UNDER THE REFERRING4
VETERINARIAN'S VETERINARIAN-CLIENT-PATIENT RELATIONSHIP.5
(3) A
VETERINARY SPECIALIST TO WHOM A PATIENT IS REFERRED6
SHALL PROVIDE THE REFERRING VETERINARIAN WITH INFORMATION7
RELATED TO THE DIAGNOSIS, TREATMENT, AND PROGRESS OF THE PATIENT.8
(4) (a) A
VETERINARY SPECIALIST TO WHOM A PATIENT IS9
REFERRED SHALL NOT PRESCRIBE MEDICATIONS TO THE PATIENT UNLESS10
THE VETERINARY SPECIALIST ESTABLISHES A11
VETERINARIAN-CLIENT-PATIENT RELATIONSHIP THROUGH AN IN -PERSON,12
PHYSICAL EXAMINATION OF THE PATIENT .13
(b) T
HE LICENSED VETERINARIAN WITH THE ESTABLISHED14
VETERINARIAN-CLIENT-PATIENT RELATIONSHIP MAY PRESCRIBE15
MEDICATIONS TO THE PATIENT AFTER CONSULTATION WITH THE16
VETERINARY SPECIALIST TO WHOM THE PATIENT WAS REFERRED .17
12-315-307. Telesupervision. (1) A
LICENSED VETERINARIAN18
MAY PROVIDE, AT THE VETERINARIAN'S DISCRETION, TELESUPERVISION
OF19
REGISTERED VETERINARY TECHNICIANS FOR TASKS THAT DO NOT REQUIRE20
DIRECT OR IMMEDIATE SUPERVISION, PURSUANT TO BOARD RULES.21
(2) A
SUPERVISING LICENSED VETERINARIAN WHO HAS AN22
ESTABLISHED VETERINARIAN -CLIENT-PATIENT RELATIONSHIP MAY USE23
TELESUPERVISION TO SUPERVISE
REGISTERED VETERINARY TECHNICIANS24
WHO ARE NOT LOCATED ON THE SAME PREMISES AS THE SUPERVISING25
VETERINARIAN IF:26
(a) T
HE SUPERVISING LICENSED VETERINARIAN AND THE27
1048
-9- REGISTERED VETERINARY TECHNICIANS ARE EMPLOYEES OF THE SAME1
VETERINARY PRACTICE LOCATION; AND2
(b) THE VETERINARY PROFESSIONALS ARE REGISTERED OR3
LICENSED IN COLORADO AND THE PATIENT IS LOCATED IN COLORADO.4
12-315-308. Emergency care - continuity of care. (1) A5
LICENSED VETERINARIAN WHO PRACTICES VETERINARY MEDICINE6
THROUGH TELEMEDICINE SHALL BE AVAILABLE IN PERSON AT A7
VETERINARY PREMISES THAT IS ACCE SSIBLE TO THE CLIENT AND PATIENT8
OR SHALL ARRANGE FOR ANOTHER LICENSED VETERINARIAN IN COLORADO9
TO BE AT A VETERINARY PREMISES THAT IS ACCESSIBLE TO THE CLIENT10
AND PATIENT IN CASE OF AN EMERGENCY OR FOR NECESSARY FOLLOW -UP11
EVALUATIONS.12
(2) A
LICENSED VETERINARIAN SHALL PROVIDE THE CLIENT WITH13
A PLAN FOR EMERGENCY OR FOLLOW -UP CARE WHEN PROVIDING14
VETERINARY SERVICES THROUGH TELEMEDICINE .15
12-315-309. Medical records - definition. (1) A
S USED IN THIS16
SECTION, UNLESS THE CONTEXT OTHERWISE REQUIRES , "ANIMAL CARE17
PROVIDER" HAS THE MEANING SET FORTH IN SECTION 12-315-119 (1).18
(2) A
N ANIMAL CARE PROVIDER THAT USES TELEHEALTH TO19
PROVIDE VETERINARY SERVICES SHALL MAINTAIN MEDICAL RECORDS20
PURSUANT TO SECTION 12-315-119.21
(3) A
N ANIMAL CARE PROVIDER THAT CREATES MEDICAL RECORDS22
DURING THE PROVISION OF VETERINARY SERVICES , INCLUDING THE23
CLIENT'S CONSENT TO TELEHEALTH SERVICES , SHALL INCLUDE THE24
RECORDS IN THE PATIENT'S MEDICAL RECORD AND MAKE THE RECORDS25
ACCESSIBLE TO BOTH THE CLIENT AND THE ANIMAL CARE PROVIDER .26
12-315-310. Confidentiality and privacy. A
LICENSED27
1048
-10- VETERINARIAN SHALL ENSURE THAT A CLIENT 'S PRIVACY AND1
CONFIDENTIALITY ARE PROTECTED WHEN THE VETERINARIAN IS PROVIDING2
VETERINARY SERVICES USING TELEHEALTH PURSUANT TO THE3
VETERINARIAN'S PROFESSIONAL AND LEGAL OBLIGATIONS .4
SECTION 4. Act subject to petition - effective date. This act5
takes effect at 12:01 a.m. on the day following the expiration of the6
ninety-day period after final adjournment of the general assembly; except7
that, if a referendum petition is filed pursuant to section 1 (3) of article V8
of the state constitution against this act or an item, section, or part of this9
act within such period, then the act, item, section, or part will not take10
effect unless approved by the people at the general election to be held in11
November 2024 and, in such case, will take effect on the date of the12
official declaration of the vote thereon by the governor.13
1048
-11-