HOUSE BILL 24-1048
BY REPRESENTATIVE(S) McCormick and Martinez, McLachlan,
Amabile, Bacon, Bird, Boesenecker, Brown, Catlin, Clifford, Epps,
Froelich, Garcia, Hamrick, Jodeh, Kipp, Lindsay, Lindstedt, Lukens, Lynch,
Mauro, Parenti, Ricks, Snyder, Soper, Story, Titone, Valdez, Vigil, Young,
McCluskie, Armagost, English, Herod, Joseph, Lieder, Marshall, Marvin,
Ortiz, Weinberg, Willford;
also SENATOR(S) Ginal and Pelton B., Pelton R., Simpson, Bridges,
Danielson, Hansen, Jaquez Lewis, Kirkmeyer, Kolker, Marchman, Roberts,
Van Winkle, Will.
C
ONCERNING THE PROVISION OF VETERINARY SERVICES THROUGH
TELEHEALTH
.
Be it enacted by the General Assembly of the State of Colorado:
SECTION 1. In Colorado Revised Statutes, 12-315-104, amend
(19) as follows:
12-315-104. Definitions. As used in this article 315, unless the
context otherwise requires:
(19) (a) "Veterinarian-client-patient relationship" means that
THE
NOTE: This bill has been prepared for the signatures of the appropriate legislative
officers and the Governor. To determine whether the Governor has signed the bill
or taken other action on it, please consult the legislative status sheet, the legislative
history, or the Session Laws.
________
Capital letters or bold & italic numbers indicate new material added to existing law; dashes
through words or numbers indicate deletions from existing law and such material is not part of
the act. relationship established when:
(a) (I) The veterinarian has assumed the responsibility for making
medical judgments regarding the health of an animal and the need for
medical treatment, and the owner,
OWNER'S AGENT, or other AUTHORIZED
caretaker has agreed to follow the instruction of the veterinarian;
(b) (II) There is sufficient knowledge of an animal by the
veterinarian to initiate at least a general or preliminary diagnosis of the
medical condition of the animal, which means that the veterinarian has
recently seen and is personally acquainted with the keeping and care of the
animal by virtue of an
IN-PERSON, PHYSICAL examination of the animal or
by medically appropriate and timely visits to the premises where the animal
is kept; and
(c)
(III) The practicing veterinarian is readily available, or has
arranged for emergency coverage, for follow-up evaluation in the event of
adverse reactions or failure of the treatment regimen.
(b) A
VETERINARIAN-CLIENT-PATIENT RELATIONSHIP ESTABLISHED
ACCORDING TO SUBSECTION
(19)(a) OF THIS SECTION MAY EXTEND TO OTHER
LICENSED VETERINARIANS WORKING OUT OF THE SAME PHYSICAL PRACTICE
LOCATION AS THE VETERINARIAN WHO ESTABLISHED THE
VETERINARIAN
-CLIENT-PATIENT RELATIONSHIP IF THE OTHER LICENSED
VETERINARIANS HAVE ACCESS TO AND HAVE REVIEWED THE PATIENT
'S
MEDICAL RECORDS
.
SECTION 2. In Colorado Revised Statutes, 12-315-106, add (9) as
follows:
12-315-106. Board of veterinary medicine - creation - powers -
rules. (9) (a) T
HE BOARD MAY PROMULGATE RULES REGARDING THE USE OF
TELEHEALTH TO PROVIDE VETERINARY SERVICES IN
COLORADO PURSUANT
TO PART
3 OF THIS ARTICLE 315.
(b) I
N DEVELOPING RULES PURSUANT TO SUBSECTION (9)(a) OF THIS
SECTION
, THE BOARD SHALL CONSULT WITH LICENSED VETERINARIANS ,
REGISTERED VETERINARY TECHNICIANS , CLIENTS, AND OTHER RELEVANT
STAKEHOLDERS AS DETERMINED BY THE BOARD
.
PAGE 2-HOUSE BILL 24-1048 SECTION 3. In Colorado Revised Statutes, add part 3 to article
315 of title 12 as follows:
PART 3
USE OF TELEHEALTH TO PROVIDE
VETERINARY SERVICES
12-315-301. Definitions - rules. A
S USED IN THIS PART 3, UNLESS
THE CONTEXT OTHERWISE REQUIRES
:
(1) "T
ELE-ADVICE" MEANS THE PROVISION OF ANY HEALTH
INFORMATION
, OPINION, OR GUIDANCE BY A VETERINARY PROFESSIONAL
THAT IS NOT INTENDED TO DIAGNOSE
, TREAT, OR ISSUE PROGNOSES OF AN
ANIMAL
'S, OR GROUP OF ANIMALS', PHYSICAL OR BEHAVIORAL ILLNESS OR
INJURY
. A VETERINARIAN-CLIENT-PATIENT RELATIONSHIP IS NOT REQUIRED
TO PROVIDE TELE
-ADVICE.
(2) "T
ELECONSULTING" MEANS A VETERINARIAN WHO
COMMUNICATES WITH A VETERINARY SPECIALIST OR OTHER QUALIFIED
EXPERT USING TELECOMMUNICATIONS TECHNOLOGY TO GAIN INSIGHT OR
ADVICE REGARDING THE CARE OF A PATIENT
.
(3) "T
ELE-EDUCATION" MEANS THE USE OF INFORMATION AND
TELECOMMUNICATIONS TECHNOLOGY FOR DISTANCE LEARNING
.
(4) (a) "T
ELEHEALTH" MEANS THE USE OF TELECOMMUNICATIONS
TECHNOLOGY TO PROVIDE VETERINARY SERVICES OR TO COLLECT AND
DELIVER VETERINARY HEALTH INFORMATION OR EDUCATION VIRTUALLY
AND CAN ENCOMPASS GENERAL V ETERINARY SERVICES OR PATIENT
-SPECIFIC
VETERINARY SERVICES
.
(b) "T
ELEHEALTH" MAY INCLUDE TELE-ADVICE, TELECONSULTING,
TELE-EDUCATION, TELEMEDICINE, TELEMONITORING, TELEREFERRAL,
TELESUPERVISION, TELETRIAGE, AND OTHER TOOLS THAT HELP VETERINARY
PROFESSIONALS DELIVER VETERINARY EDUCATION AND SERVICES
VIRTUALLY
.
(5) "T
ELEMEDICINE" MEANS THE REMOTE PRACTICE OF VETERINARY
MEDICINE THROUGH THE USE OF TELECOMMUNICATIONS TECHNOLOGY THAT
ALLOWS A LICENSED VETERINARIAN WITH AN ESTABLISHED
PAGE 3-HOUSE BILL 24-1048 VETERINARIAN-CLIENT-PATIENT RELATIONSHIP TO EVALUATE , DIAGNOSE,
AND TREAT A PATIENT VIRTUALLY.
(6) "T
ELEMONITORING" MEANS THE USE OF TELECOMMUNICATIONS
TECHNOLOGY TO AUGMENT VETERINARY SERVICES BY COLLECTING AND
DELIVERING HEALTH INFORMATION FROM A PATIENT
.
(7) "T
ELEREFERRAL" MEANS A VETERINARIAN WITH AN ESTABLISHED
VETERINARIAN
-CLIENT-PATIENT RELATIONSHIP WHO REFERS THE CLIENT TO
A VETERINARY SPECIALIST TO PROVIDE VETERINARY SERVICES USING
TELECOMMUNICATIONS TECHNOLOGY UNDER THE ESTABLISHED
VETERINARIAN
-CLIENT-PATIENT RELATIONSHIP.
(8) "T
ELESUPERVISION" MEANS THE SUPERVISION OF INDIVIDUALS
PROVIDING VETERINARY SERVICES USING MEDIA SUCH AS AUDIO
,
AUDIO-VISUAL CONFERENCING , TEXT MESSAGING, E-MAIL, OR OTHER
VIRTUAL OR DIGITAL TECHNOLOGIES
.
(9) "T
ELETRIAGE" MEANS THE SAFE, APPROPRIATE, AND TIMELY
ASSESSMENT OF AN ANIMAL
, OR A GROUP OF ANIMALS, UNDER CONDITIONS
OF UNCERTAINTY AND URGENCY
, AND THE POSSIBLE REFERRAL TO A
LICENSED VETERINARIAN
, AFTER DISCUSSION WITH THE INDIVIDUAL
RESPONSIBLE FOR THE ANIMAL OR GROUP OF ANIMALS
, USING
TELECOMMUNICATIONS TECHNOLOGY
. A VETERINARIAN-CLIENT-PATIENT
RELATIONSHIP IS NOT REQUIRED FOR SUCH AN ASSESSMENT OR REFERRAL
.
"T
ELETRIAGE" DOES NOT INCLUDE THE RENDERING OF A DIAGNOSIS BUT MAY
INCLUDE THE PROVISION OF TELE
-ADVICE.
(10) "V
ETERINARY SPECIALIST" MEANS A VETERINARIAN WHO IS
FORMALLY RECOGNIZED AS A SPECIALIST FROM A SPECIALTY ORGANIZATION
THAT IS RECOGNIZED BY THE
AMERICAN VETERINARY MEDICAL
ASSOCIATION'S AMERICAN BOARD OF VETERINARY SPECIALTIES, OR ITS
SUCCESSOR ORGANIZATION
, OR ANOTHER ASSOCIATION THAT REC OGNIZES
VETERINARY SPECIALISTS THAT THE STATE BOARD OF V ETERINARY MEDICINE
HAS APPROVED BY RULE
.
12-315-302. Veterinarian-client-patient relationship -
telemedicine. (1) O
NLY A LICENSED VETERINARIAN MAY ESTABLISH A
VETERINARIAN
-CLIENT-PATIENT RELATIONSHIP IN THIS STATE.
PAGE 4-HOUSE BILL 24-1048 (2) (a) A VETERINARIAN-CLIENT-PATIENT RELATIONSHIP MUST BE
ESTABLISHED BY AN IN
-PERSON, PHYSICAL EXAMINATION OF THE ANIMAL OR
TIMELY VISITS TO THE PREMISES WHERE THE ANIMAL IS KEPT
.
(b) A
VETERINARY SPECIALIST MAY USE TELECOMMUNICATIONS
TECHNOLOGY TO SEE A PATIENT UNDER ANOTHER VETERINARIAN
'S
PREVIOUSLY ESTABLISHED VETERINARIAN
-CLIENT-PATIENT RELATIONSHIP
PURSUANT TO SECTION
12-315-306.
(3) A
N ESTABLISHED VETERINARIAN-CLIENT-PATIENT RELATIONSHIP
MAY BE MAINTAINED THROUGH EXAMINATIONS THAT OCCUR USING
TELECOMMUNICATIONS TECHNOLOGY IN BETWEEN APPROPRIATE IN
-PERSON,
PHYSICAL EXAMINATIONS OR VISITS TO THE PREMISES WHERE THE PATIENT
IS KEPT
.
12-315-303. Treatment of patients using telehealth - telemedicine
- licensure - technology - consent. (1) (a) A
PERSON MUST BE LICENSED TO
PRACTICE VETERINARY MEDICINE IN
COLORADO IN ORDER TO PRACTICE
TELEMEDICINE IN
COLORADO.
(b) A
PERSON WHO IS NOT A LICENSED VETERINARIAN IN COLORADO
AND WHO USES TELEMEDICINE TO PROVIDE VETERINARY SERVICES TO
ANIMALS AND INDIVIDUALS RESPONSIBLE FOR THE ANIMALS ENGAGES IN THE
UNAUTHORIZED PRACTICE OF VETERINARY MEDICINE
. SUCH PERSON IS
SUBJECT TO PENALTIES FOR THE UNAUTHORIZED PRACTICE OF VETERINARY
MEDICINE PURSUANT TO SECTION
12-315-114.
(2) A
LICENSED VETERINARIAN SHALL EMPLOY SOUND ,
PROFESSIONAL JUDGMENT WHEN DETERMINING WHETHER TO PROVIDE
VETERINARY SERVICES TO A PATIENT THROUGH TELEMEDICINE AND SHALL
USE TELEMEDICINE ONLY WHEN SUCH USE IS MEDICALLY APPROPRIATE
BASED ON THE PATIENT
'S CONDITION.
(3) A
VETERINARY PROFESSIONAL SHALL ENSURE THAT THE
TECHNOLOGY USED WHEN PROVIDING VETERINARY SERVICES THROUGH
TELEHEALTH IS OF APPROPRIATE QUALITY TO ENSURE
:
(a) A
CCURACY OF THE REMOTE ASSESSMENT OF THE PATIENT 'S
CONDITION OR BEHAVIOR
;
PAGE 5-HOUSE BILL 24-1048 (b) CLEAR COMMUNICATION WITH CLIENTS ; AND
(c) COMPLIANCE WITH ALL RELEVANT PRIVACY AND
CONFIDENTIALITY REQUIREMENTS
.
(4) (a) A
VETERINARY PROFESSIONAL SHALL OBTAIN CONSENT FROM
THE CLIENT BEFORE PROVIDING VETERINARY SERVICES THROUGH
TELEHEALTH AND SHALL RECORD THE CLIENT
'S CONSENT IN THE PATIENT'S
MEDICAL RECORD
.
(b) A
VETERINARY PROFESSIONAL USING TELEHEALTH TO PROVIDE
VETERINARY SERVICES SHALL INFORM THE CLIENT
, OR THE CLIENT'S
AUTHORIZED REPRESENTATIVE
, OF:
(I) T
HE VETERINARY PROFESSIONAL 'S NAME, LOCATION, AND, IF
APPLICABLE
, LICENSE NUMBER AND LICENSURE STATUS ;
(II) W
HETHER, IN THE VETERINARIAN'S PROFESSIONAL OPINION, THE
PATIENT
'S CONDITION CAN BE ACCURATELY DIAGNOSED OR TREATED USING
TELEMEDICINE
; AND
(III) THE DIAGNOSIS, PROGNOSIS, AND TREATMENT OPTIONS FOR THE
PATIENT
.
12-315-304. Standard of care. (1) A
LICENSED VETERINARIAN
USING TELEHEALTH TO PROVIDE VETERINARY SERVICES SHALL C ONDUCT ALL
NECESSARY PATIENT EVALUATIONS AND TREATMENT USING THE APPLICABLE
STANDARD OF CARE FOR THOSE EVALUATIONS AND TREATMENTS
.
(2) A
LICENSED VETERINARIAN SHALL NOT RECOMMEND TREATMENT
OR CARE FOR AN ANIMAL BASED SOLELY ON A CLIENT
'S RESPONSES TO AN
ONLINE QUESTIONNAIRE
.
12-315-305. Prescribing medication through telemedicine.
(1) (a) E
XCEPT AS PROVIDED IN SUBSECTION (3) OF THIS SECTION, ONLY A
LICENSED VETERINARIAN WITH AN ESTABLISHED
VETERINARIAN
-CLIENT-PATIENT RELATIONSHIP MAY PRESCRIBE MEDICATION
THROUGH TELEMEDICINE
.
(b) A
LICENSED VETERINARIAN SHALL USE PROFESSIONAL JUDGMENT
PAGE 6-HOUSE BILL 24-1048 WHEN DETERMINING IF IT IS APPROPRIATE TO PRESCRIBE MEDICATION
THROUGH TELEMEDICINE
.
(2) A
LICENSED VETERINARIAN WHO PRESCRIBES MEDICATION
THROUGH TELEMEDICINE IS SUBJECT TO THE LIMITATIONS ON PRESCRIPTIONS
SPECIFIED IN SECTION
12-30-109.
(3) I
N ACCORDANCE WITH SECTION 12-315-105 (2)(b), A LICENSED
VETERINARIAN WHO DOES NOT HAVE AN ESTABLISHED
VETERINARIAN
-CLIENT-PATIENT RELATIONSHIP WITH AN ANIMAL AND ITS
OWNER MAY USE TELEMEDICINE TO ADMINISTER
, DISTRIBUTE, OR DISPENSE
A PRESCRIPTION DRUG THAT HAS BEEN PRESCRIBED BY ANOTHER LICENSED
VETERINARIAN WHO HAS AN ESTABLISHED VETERINARIAN
-CLIENT-PATIENT
RELATIONSHIP
.
12-315-306. Telereferral. (1) A
VETERINARIAN WITH AN
ESTABLISHED VETERINARIAN
-CLIENT-PATIENT RELATIONSHIP MAY REFER A
PATIENT TO A VETERINARY SPECIALIST
.
(2) A
VETERINARY SPECIALIST TO WHOM A PATIENT IS REFERRED
MAY PROVIDE VETERINARY SERVICES USING TELECOMMUNICATIONS
TECHNOLOGY FOR THE PATIENT AND CLIENT UNDER THE REFERRING
VETERINARIAN
'S VETERINARIAN-CLIENT-PATIENT RELATIONSHIP.
(3) A
VETERINARY SPECIALIST TO WHOM A PATIENT IS REFERRED
SHALL PROVIDE THE REFERRING VETERINARIAN WITH INFORMATION RELATED
TO THE DIAGNOSIS
, TREATMENT, AND PROGRESS OF THE PATIENT.
(4) (a) A
VETERINARY SPECIALIST TO WHOM A PATIENT IS REFERRED
SHALL NOT PRESCRIBE MEDICATIONS TO THE PATIENT UNLESS THE
VETERINARY SPECIALIST ESTABLISHES A VETERINARIAN
-CLIENT-PATIENT
RELATIONSHIP THROUGH AN IN
-PERSON, PHYSICAL EXAMINATION OF THE
PATIENT
.
(b) T
HE LICENSED VETERINARIAN WITH THE ESTABLISHED
VETERINARIAN
-CLIENT-PATIENT RELATIONSHIP MAY PRESCRIBE
MEDICATIONS TO THE PATIENT AFTER CONSULTATION WITH THE VETERINARY
SPECIALIST TO WHOM THE PATIENT WAS REFERRED
.
12-315-307. Telesupervision. (1) A
LICENSED VETERINARIAN MAY
PAGE 7-HOUSE BILL 24-1048 PROVIDE, AT THE VETERINARIAN 'S DISCRETION, TELESUPERVISION OF
REGISTERED VETERINARY TECHNICIANS FOR TASKS THAT DO NOT REQUIRE
DIRECT OR IMMEDIATE SUPERVISION
, PURSUANT TO BOARD RULES.
(2) A
SUPERVISING LICENSED VETERINARIAN WHO HAS AN
ESTABLISHED VETERINARIAN
-CLIENT-PATIENT RELATIONSHIP MAY USE
TELESUPERVISION TO SUPERVISE REGISTERED VETERINARY TECHNICIANS
WHO ARE NOT LOCATED ON THE SAME PREMISES AS THE SUPERVISING
VETERINARIAN IF
:
(a) T
HE SUPERVISING LICENSED VETERINARIAN AND THE REGISTERED
VETERINARY TECHNICIANS ARE EMPLOYEES OF THE SAME VETERINARY
PRACTICE LOCATION
; AND
(b) THE VETERINARY PROFESSIONALS ARE REGISTERED OR LICENSED
IN
COLORADO AND THE PATIENT IS LOCATED IN COLORADO.
12-315-308. Emergency care - continuity of care. (1) A
LICENSED
VETERINARIAN WHO PRACTICES VETERINARY MEDICINE THROUGH
TELEMEDICINE SHALL BE AVAILABLE IN PERSON AT A VETERINARY PREMISES
THAT IS ACCESSIBLE TO THE CLIENT AND PATIENT OR SHALL ARRANGE FOR
ANOTHER LICENSED VETERINARIAN IN
COLORADO TO BE AT A VETERINARY
PREMISES THAT IS ACCESSIBLE TO THE CLIENT AND PATIENT IN CASE OF AN
EMERGENCY OR FOR NECESSARY FOLLOW
-UP EVALUATIONS.
(2) A
LICENSED VETERINARIAN SHALL PROVIDE THE CLIENT WITH A
PLAN FOR EMERGENCY OR FOLLOW
-UP CARE WHEN PROVIDING VETERINARY
SERVICES THROUGH TELEMEDICINE
.
12-315-309. Medical records - definition. (1) A
S USED IN THIS
SECTION
, UNLESS THE CONTEXT OTHERWISE REQUIRES , "ANIMAL CARE
PROVIDER
" HAS THE MEANING SET FORTH IN SECTION 12-315-119 (1).
(2) A
N ANIMAL CARE PROVIDER THAT USES TELEHEALTH TO PROVIDE
VETERINARY SERVICES SHALL MAINTAIN MEDICAL RECORDS PURSUANT TO
SECTION
12-315-119.
(3) A
N ANIMAL CARE PROVIDER THAT CREATES MEDICAL RECORDS
DURING THE PROVISION OF VETERINARY SERVICES
, INCLUDING THE CLIENT'S
CONSENT TO TELEHEALTH SERVICES
, SHALL INCLUDE THE RECORDS IN THE
PAGE 8-HOUSE BILL 24-1048 PATIENT'S MEDICAL RECORD AND MAKE THE RECORDS ACCESSIBLE TO BOTH
THE CLIENT AND THE ANIMAL CARE PROVIDER
.
12-315-310. Confidentiality and privacy. A
LICENSED
VETERINARIAN SHALL ENSURE THAT A CLIENT
'S PRIVACY AND
CONFIDENTIALITY ARE PROTECTED WHEN THE VETERINARIAN IS PROVIDING
VETERINARY SERVICES USING TELEHEALTH PURSUANT TO THE
VETERINARIAN
'S PROFESSIONAL AND LEGAL OBLIGATIONS .
SECTION 4. Act subject to petition - effective date. This act
takes effect at 12:01 a.m. on the day following the expiration of the
ninety-day period after final adjournment of the general assembly; except
that, if a referendum petition is filed pursuant to section 1 (3) of article V
of the state constitution against this act or an item, section, or part of this act
within such period, then the act, item, section, or part will not take effect
unless approved by the people at the general election to be held in
PAGE 9-HOUSE BILL 24-1048 November 2024 and, in such case, will take effect on the date of the official
declaration of the vote thereon by the governor.
____________________________ ____________________________
Julie McCluskie Steve Fenberg
SPEAKER OF THE HOUSE PRESIDENT OF
OF REPRESENTATIVES THE SENATE
____________________________ ____________________________
Robin Jones Cindi L. Markwell
CHIEF CLERK OF THE HOUSE SECRETARY OF
OF REPRESENTATIVES THE SENATE
APPROVED________________________________________
(Date and Time)
_________________________________________
Jared S. Polis
GOVERNOR OF THE STATE OF COLORADO
PAGE 10-HOUSE BILL 24-1048