HOUSE BILL NO. 4200 A bill to amend 1978 PA 368, entitled "Public health code," by amending sections 16287, 18811, and 18814 (MCL 333.16287, 333.18811, and 333.18814), section 16287 as amended by 2017 PA 22 and section 18811 as amended by 2006 PA 406, and by adding section 18818. the people of the state of michigan enact: Sec. 16287. (1) The department, in consultation with a board, shall promulgate rules to implement sections 16284 and 16285. (2) Rules promulgated by the department in consultation with the Michigan board of veterinary medicine under this section are subject to section 18818. Sec. 18811. (1) A person Subject to section 18818, an individual shall not engage in the practice of veterinary medicine unless licensed or otherwise authorized by this article. (2) After July 1, 1979, an An individual shall not practice as a veterinary technician without a license. (3) A veterinary technician shall not diagnose animal diseases, prescribe medical or surgical treatment, or perform as a surgeon. (4) The following words, titles, or letters or a combination thereof, of words, titles, or letters, with or without qualifying words or phrases, are restricted in use only to those persons individuals authorized under this part to use the terms and in a way prescribed in this part: "veterinary", "veterinarian", "veterinary doctor", "veterinary surgeon", "doctor of veterinary medicine", "v.m.d.", "d.v.m.", "animal technician", or "animal technologist"."licensed veterinary technician", or "licensed veterinary technologist". Sec. 18814. An individual is not engaging in the practice of veterinary medicine in this state who meets any of the following: (a) Administers to livestock owned by that individual, except when the title is vested in him or her the individual for the purpose of circumventing this act. (b) Conducts experimentation and scientific research in the development of methods, techniques, or treatments directly or indirectly applicable to the problems of medicine and who in connection therewith uses animals. (c) Conducts routine vaccination and pullorum testing of poultry under supervision of the national poultry improvement plan National Poultry Improvement Plan as administered by the official state agency and the United States department of agriculture.Department of Agriculture. (d) Is a regularly employed veterinarian of the United States department of agriculture Department of Agriculture or a full-time veterinary food inspector while engaged in the inspection of animals as food for human consumption. (e) Conducts sample collection and activities as directed through the Certified Swine Sample Collector Program or the United States Swine Health Improvement Plan. Sec. 18818. (1) Except as otherwise provided in this section, a veterinarian shall not engage in the practice of veterinary medicine unless it is within the context of a veterinarian-client-patient relationship. Subject to federal law, all of the following requirements must be met to establish a veterinarian-client-patient relationship: (a) The veterinarian must assume responsibility for making clinical judgments regarding the health of the animal and the need for medical treatment and the animal's owner must have agreed to follow the veterinarian's instructions. (b) The veterinarian must have current knowledge of the animal to initiate, at a minimum, a general or preliminary diagnosis of the medical condition of the animal. A veterinarian may obtain current knowledge of an animal for purposes of this subdivision through any of the following means: (i) Conducting an in-person examination of the animal. (ii) Making a medically appropriate and timely visit to the premises where the animal is kept or where a group of animals of the owner is kept. (2) Subject to this subsection and subsection (3) and except as otherwise provided in this section, once a veterinarian-client-patient relationship is established, a veterinarian may conduct a consultation for an animal through telemedicine using real-time interactive audio and visual electronic technology. All of the following apply for purposes of a consultation through telemedicine under this subsection: (a) The veterinarian shall not conduct a consultation for an animal through telemedicine if any of the following apply: (i) The animal is not a companion animal, unless the veterinarian has current knowledge of the animal through a medically appropriate and timely visit described in subsection (1)(b). (ii) The veterinarian is conducting the consultation to issue an interstate certificate of veterinary inspection or a pet health certificate. (b) If the veterinarian uses any instrumentation or diagnostic equipment in conducting the consultation, the instrumentation and diagnostic equipment must be capable of electronically transmitting any image and medical record. (c) The veterinarian shall be readily available, or arrange for emergency coverage, if the animal experiences an adverse reaction or the treatment regimen for the animal fails. (d) The owner of the animal may request an in-person follow-up evaluation with the veterinarian. If the veterinarian cannot perform an in-person follow-up evaluation of the animal, the veterinarian shall provide the owner with a list of other veterinarians who are geographically accessible to the owner. (e) The veterinarian shall annually conduct at least 1 in-person examination of the animal. (3) If a veterinarian conducts a consultation for an animal under subsection (2), the veterinarian may prescribe the animal that was the subject of the consultation a drug under all of the following conditions: (a) The veterinarian shall not prescribe the animal more than a 14-day supply of the drug with no refills. The veterinarian may prescribe the animal 1 additional 14-day supply of the drug if the veterinarian conducts another consultation under subsection (2) for the animal. The veterinarian shall not issue any additional renewals of the prescription for the animal unless the veterinarian conducts an in-person examination of the animal. (b) The veterinarian may notify the owner of the animal that some prescription drugs may be available at a pharmacy and, on the request of the animal's owner, send a prescription to a pharmacy of the owner's choice. (c) The veterinarian shall not prescribe a controlled substance for the animal unless the veterinarian also performs an in-person examination of the animal or makes a medically appropriate and timely visit to the premises where the animal is kept. (d) The veterinarian shall comply with federal law and any laws of this state for the prescribing of the drug, including, but not limited to, section 16285. (4) A veterinarian or an animal's owner may terminate a veterinarian-client-patient relationship. A veterinarian may terminate a veterinarian-patient-client relationship by notifying the animal's owner that the veterinarian no longer wants to serve the animal and the animal's owner. If a veterinarian terminates the veterinarian-patient-client relationship when an animal that is the subject of the relationship has an ongoing medical or surgical condition, the veterinarian shall refer the animal's owner to another veterinarian for the diagnosis, care, and treatment of the animal and the veterinarian shall continue to provide lifesaving support to the animal, as needed, for a reasonable amount of time or until a new veterinarian-client-patient relationship is established, whichever occurs first. (5) In an emergency, a veterinarian may engage in the practice of veterinary medicine through telemedicine without a veterinarian-client-patient relationship until the animal can be seen in person by a veterinarian. However, the veterinarian shall make a good-faith effort to arrange an in-person visit as soon as practicable to establish a veterinarian-client-patient relationship. (6) A veterinarian may engage in the practice of veterinary medicine through telemedicine without a veterinarian-client-patient relationship if any of the following apply: (a) The veterinarian renders or attempts to render, in good faith, emergency or urgent care to an animal when its owner cannot be identified. (b) The animal is in the care or custody of an animal control shelter or animal protection shelter regulated under 1969 PA 287, MCL 287.331 to 287.340, and its owner cannot be identified. (7) As used in this section: (a) "Companion animal" means that term as defined in section 50b of the Michigan penal code, 1931 PA 328, MCL 750.50b. (b) "Pet health certificate" means that term as defined in section 1 of 1969 PA 287, MCL 287.331. (c) "Telemedicine" means that term as defined in section 16283. (d) "Veterinarian-client-patient relationship" means the relationship meeting the requirements described in subsection (1).
HOUSE BILL NO. 4200
A bill to amend 1978 PA 368, entitled
"Public health code,"
by amending sections 16287, 18811, and 18814 (MCL 333.16287, 333.18811, and 333.18814), section 16287 as amended by 2017 PA 22 and section 18811 as amended by 2006 PA 406, and by adding section 18818.
the people of the state of michigan enact:
Sec. 16287. (1) The department, in consultation with a board, shall promulgate rules to implement sections 16284 and 16285.
(2) Rules promulgated by the department in consultation with the Michigan board of veterinary medicine under this section are subject to section 18818.
Sec. 18811. (1) A person Subject to section 18818, an individual shall not engage in the practice of veterinary medicine unless licensed or otherwise authorized by this article.
(2) After July 1, 1979, an An individual shall not practice as a veterinary technician without a license.
(3) A veterinary technician shall not diagnose animal diseases, prescribe medical or surgical treatment, or perform as a surgeon.
(4) The following words, titles, or letters or a combination thereof, of words, titles, or letters, with or without qualifying words or phrases, are restricted in use only to those persons individuals authorized under this part to use the terms and in a way prescribed in this part: "veterinary", "veterinarian", "veterinary doctor", "veterinary surgeon", "doctor of veterinary medicine", "v.m.d.", "d.v.m.", "animal technician", or "animal technologist"."licensed veterinary technician", or "licensed veterinary technologist".
Sec. 18814. An individual is not engaging in the practice of veterinary medicine in this state who meets any of the following:
(a) Administers to livestock owned by that individual, except when the title is vested in him or her the individual for the purpose of circumventing this act.
(b) Conducts experimentation and scientific research in the development of methods, techniques, or treatments directly or indirectly applicable to the problems of medicine and who in connection therewith uses animals.
(c) Conducts routine vaccination and pullorum testing of poultry under supervision of the national poultry improvement plan National Poultry Improvement Plan as administered by the official state agency and the United States department of agriculture.Department of Agriculture.
(d) Is a regularly employed veterinarian of the United States department of agriculture Department of Agriculture or a full-time veterinary food inspector while engaged in the inspection of animals as food for human consumption.
(e) Conducts sample collection and activities as directed through the Certified Swine Sample Collector Program or the United States Swine Health Improvement Plan.
Sec. 18818. (1) Except as otherwise provided in this section, a veterinarian shall not engage in the practice of veterinary medicine unless it is within the context of a veterinarian-client-patient relationship. Subject to federal law, all of the following requirements must be met to establish a veterinarian-client-patient relationship:
(a) The veterinarian must assume responsibility for making clinical judgments regarding the health of the animal and the need for medical treatment and the animal's owner must have agreed to follow the veterinarian's instructions.
(b) The veterinarian must have current knowledge of the animal to initiate, at a minimum, a general or preliminary diagnosis of the medical condition of the animal. A veterinarian may obtain current knowledge of an animal for purposes of this subdivision through any of the following means:
(i) Conducting an in-person examination of the animal.
(ii) Making a medically appropriate and timely visit to the premises where the animal is kept or where a group of animals of the owner is kept.
(2) Subject to this subsection and subsection (3) and except as otherwise provided in this section, once a veterinarian-client-patient relationship is established, a veterinarian may conduct a consultation for an animal through telemedicine using real-time interactive audio and visual electronic technology. All of the following apply for purposes of a consultation through telemedicine under this subsection:
(a) The veterinarian shall not conduct a consultation for an animal through telemedicine if any of the following apply:
(i) The animal is not a companion animal, unless the veterinarian has current knowledge of the animal through a medically appropriate and timely visit described in subsection (1)(b).
(ii) The veterinarian is conducting the consultation to issue an interstate certificate of veterinary inspection or a pet health certificate.
(b) If the veterinarian uses any instrumentation or diagnostic equipment in conducting the consultation, the instrumentation and diagnostic equipment must be capable of electronically transmitting any image and medical record.
(c) The veterinarian shall be readily available, or arrange for emergency coverage, if the animal experiences an adverse reaction or the treatment regimen for the animal fails.
(d) The owner of the animal may request an in-person follow-up evaluation with the veterinarian. If the veterinarian cannot perform an in-person follow-up evaluation of the animal, the veterinarian shall provide the owner with a list of other veterinarians who are geographically accessible to the owner.
(e) The veterinarian shall annually conduct at least 1 in-person examination of the animal.
(3) If a veterinarian conducts a consultation for an animal under subsection (2), the veterinarian may prescribe the animal that was the subject of the consultation a drug under all of the following conditions:
(a) The veterinarian shall not prescribe the animal more than a 14-day supply of the drug with no refills. The veterinarian may prescribe the animal 1 additional 14-day supply of the drug if the veterinarian conducts another consultation under subsection (2) for the animal. The veterinarian shall not issue any additional renewals of the prescription for the animal unless the veterinarian conducts an in-person examination of the animal.
(b) The veterinarian may notify the owner of the animal that some prescription drugs may be available at a pharmacy and, on the request of the animal's owner, send a prescription to a pharmacy of the owner's choice.
(c) The veterinarian shall not prescribe a controlled substance for the animal unless the veterinarian also performs an in-person examination of the animal or makes a medically appropriate and timely visit to the premises where the animal is kept.
(d) The veterinarian shall comply with federal law and any laws of this state for the prescribing of the drug, including, but not limited to, section 16285.
(4) A veterinarian or an animal's owner may terminate a veterinarian-client-patient relationship. A veterinarian may terminate a veterinarian-patient-client relationship by notifying the animal's owner that the veterinarian no longer wants to serve the animal and the animal's owner. If a veterinarian terminates the veterinarian-patient-client relationship when an animal that is the subject of the relationship has an ongoing medical or surgical condition, the veterinarian shall refer the animal's owner to another veterinarian for the diagnosis, care, and treatment of the animal and the veterinarian shall continue to provide lifesaving support to the animal, as needed, for a reasonable amount of time or until a new veterinarian-client-patient relationship is established, whichever occurs first.
(5) In an emergency, a veterinarian may engage in the practice of veterinary medicine through telemedicine without a veterinarian-client-patient relationship until the animal can be seen in person by a veterinarian. However, the veterinarian shall make a good-faith effort to arrange an in-person visit as soon as practicable to establish a veterinarian-client-patient relationship.
(6) A veterinarian may engage in the practice of veterinary medicine through telemedicine without a veterinarian-client-patient relationship if any of the following apply:
(a) The veterinarian renders or attempts to render, in good faith, emergency or urgent care to an animal when its owner cannot be identified.
(b) The animal is in the care or custody of an animal control shelter or animal protection shelter regulated under 1969 PA 287, MCL 287.331 to 287.340, and its owner cannot be identified.
(7) As used in this section:
(a) "Companion animal" means that term as defined in section 50b of the Michigan penal code, 1931 PA 328, MCL 750.50b.
(b) "Pet health certificate" means that term as defined in section 1 of 1969 PA 287, MCL 287.331.
(c) "Telemedicine" means that term as defined in section 16283.
(d) "Veterinarian-client-patient relationship" means the relationship meeting the requirements described in subsection (1).