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RULE PROPOSALS
VOLUME 42, ISSUE 12
ISSUE DATE: JUNE 21, 2010
LAW AND PUBLIC SAFETY
DIVISION OF CONSUMER AFFAIRS
STATE BOARD OF VETERINARY MEDICAL EXAMINERS

 

Proposed Readoption with Amendments: N.J.A.C. 13:44

Rules of the State Board of Veterinary Medical Examiners

Authorized By: State Board of Veterinary Medical Examiners, Leslie Aronson, Executive Director.
Authority: N.J.S.A. 45:16-3.

Calendar Reference: See Summary below for explanation of exception to calendar requirement.
Proposal Number: PRN 2010-097.

Submit comments by August 20, 2010 to:

Leslie Aronson, Executive Director
State Board of Veterinary Medical Examiners
PO Box 45020
Newark , NJ 07101

The agency proposal follows:

Summary

The State Board of Veterinary Medical Examiners (the Board) proposes to readopt N.J.A.C. 13:44 with amendments. These rules were scheduled to expire on January 7, 2010 pursuant to N.J.S.A. 52:14B-5.1. Pursuant to Executive Order No. 1 (2010), the chapter expiration date is extended from January 7, 2010 until the completion of the review of administrative regulations and rules by the Red Tape Review Group, and until such time as the extended regulation or rule is readopted pursuant to the Administrative Procedure Act, N.J.S.A. 52:14B-1 et seq.

The Board has undertaken a review of the existing provisions of N.J.A.C. 13:44 in order to determine their necessity and reasonableness. The Board believes that the rules proposed for readoption, as amended, are necessary, reasonable, understandable and responsive for the purpose for which they were originally promulgated. The following summarizes each subchapter in N.J.A.C. 13:44 and the amendments proposed to the existing rules.

Subchapter 1 outlines the licensing procedure. N.J.A.C. 13:44-1.1 sets forth the documentation an applicant who wishes to take the New Jersey State Jurisprudence Examination must submit to the Board. The rule permits an applicant to apply for a temporary permit, which allows the holder to be employed as an assistant veterinarian in New Jersey , as long as the applicant is supervised by a licensee. N.J.A.C. 13:44-1.2 lists additional documentation an applicant must provide to the Board prior to taking the New Jersey State Jurisprudence Examination. N.J.A.C. 13:44-1.3 sets forth passing scores for the New Jersey State Jurisprudence Examination and the process for a licensee to review the Examination if he or she fails.

N.J.A.C. 13:44-1.4 allows the Board to license applicants who are licensed in other states that have education requirements similar to those required in New Jersey . Such applicants for licensure must pass the New Jersey Jurisprudence Examination. The Board proposes to amend this rule to correct a cross-reference in paragraph (a)3. N.J.A.C. 13:44-1.5 sets forth the documents that such applicants must submit to the Board.

N.J.A.C. 13:44-1.6 sets forth requirements for license renewal, the reinstatement of suspended licenses and the reactivation of inactive licenses. N.J.A.C. 13:44-1.7 and 1.8 are reserved sections. N.J.A.C. 13:44-1.9 requires licensees to have proof of licensure available wherever they practice.

Subchapter 2 deals with temporary permits, which allow unlicensed qualified veterinary graduates to work as assistants to licensees. N.J.A.C. 13:44-2.1 requires an unlicensed qualified veterinary graduate to obtain a permit before working for a licensee. N.J.A.C. 13:44-2.2 sets out eligibility requirements for a temporary permit and the general restrictions placed on a permit holder. This rule refers to the "New Jersey Licensing Examination." The title of this examination has been changed to the "New Jersey State Jurisprudence Examination" and the Board proposes to amend this rule to use the correct title.

Subchapter 3 provides definitions relevant to the practice of veterinary medicine, such as "animal or veterinary facility," "person," "practice of veterinary medicine, surgery or dentistry" and "qualified veterinary graduate." The Board proposes to amend the definition of "practice of veterinary medicine, surgery or dentistry" to clarify that acupuncture referred to in the definition is acupuncture performed on animals.

Subchapter 4 contains rules of practice. N.J.A.C. 13:44-4.1 imposes requirements for labeling medications dispensed by a licensee. The rule permits licensees to prescribe, dispense or distribute prescription items if there is a valid veterinarian-client-patient relationship and if the prescription is properly recorded in the medical record. A licensee is allowed to dispense prescription items without a valid veterinarian-patient-client relationship if the licensee is dispensing based on a prescription issued by another licensee. A licensee cannot prescribe or fill a prescription when the licensee knows or should reasonably know that the prescription is to be used for an illegal or illicit purpose by the recipient. When requested to do so, a licensee is required to provide a written prescription to a client. A prescription must be recorded in the patient's medical records. The Board proposes to amend this rule to correct a typographical error.

N.J.A.C. 13:44-4.2 allows licensees who work for municipal rabies clinics sponsored by the State of New Jersey, or who perform emergency services on behalf of any State, Federal, municipal or county agency, to perform that work without a valid veterinarian-client-patient relationship and without maintaining medical records as required by N.J.A.C. 13:44-4.9.

N.J.A.C. 13:44-4.3 allows unlicensed agents of Cook College of Rutgers and members of the poultry industry to perform certain poultry husbandry procedures. Any husbandry procedure performed on caged or exotic birds must be performed by a licensee.

N.J.A.C. 13:44-4.4 imposes requirements on licensees who provide services to pet shops, pounds, shelters and adoption facilities. The rule sets forth the information a licensee must include on an animal's health certificate, adoption form or "Fit for Purchase" form and what a licensee must do prior to signing such forms. N.J.A.C. 13:44-4.5 states that it is professional misconduct for a licensee to accept any form of compensation for referring a patient.

N.J.A.C. 13:44-4.6 allows veterinary facilities to continue operating for a limited time after a licensee has died. Such facilities must employ a substitute licensee to conduct the practice of veterinary medicine at the facility. N.J.A.C. 13:44-4.7 requires licensees to provide emergency care.

N.J.A.C. 13:44-4.8 regulates advertising. A licensee is allowed to advertise in print or electronic media provided that the information presented is not false, misleading, fraudulent or deceptive. A licensee is required to substantiate the truthfulness of any material representation in an advertisement if required by the Board. A licensee is required to keep a copy of all advertisements, with the date and place of publication, for three years and to provide them to the Board for review upon request. N.J.A.C. 13:44-4.8 states that a licensee may only advertise that he or she is a specialist if he or she holds Board certification. This board certification is issued by a national specialty certifying entity, not the Board. The Board proposes to amend this rule to clarify that it does not certify specialists.

N.J.A.C. 13:44-4.9 requires licensees to maintain patient records and sets forth the information that must be contained in patient records. Licensees must provide copies of records to the animal's owner, a representative of the owner or another veterinarian. The rule also sets forth procedures for the dissemination of patient records when a veterinary facility closes. The Board proposes to amend subsection (a) of this rule to require that the name of a veterinary facility appear on every [page=1134] page of a record. The rule is also proposed for amendment to combine provisions in paragraphs (a)1 and (a)10, which require identification of the treating licensee and the individual making entries into the record, and to recodify these combined provisions as new paragraph (a)2.

N.J.A.C. 13:44-4.10 requires licensees to complete 20 credit hours of continuing education every biennial period as a prerequisite of license renewal. The rule sets forth the methods by which a licensee may obtain continuing education hours and requires licensees to maintain records documenting that they have completed continuing education requirements. The rule requires the Board to perform audits on randomly selected licensees to determine compliance with the continuing education requirements and permits the Board to review a licensee's continuing education records at any time to determine whether a licensee has complied with continuing education requirements. N.J.A.C. 13:44-4.10(a) indicates that continuing education requirements will be a condition of renewal beginning with the 2009 biennial license renewal. Since this license renewal date has passed, the Board proposes to amend this rule, so that it states that continuing education requirements must be completed for every biennial license renewal.

N.J.A.C. 13:44-4.11 sets forth standards for veterinary facilities that identify themselves as emergency facilities. The rule does not apply to facilities that are not emergency facilities and that advertise an after-hours phone number to be called when the facility is closed. N.J.A.C. 13:44-4.12 requires a licensee to notify the Board of a change of mailing address within 30 days of the change.

Subchapter 5 sets forth the fees that are charged by the Board.

The Board has determined that the comment period for this notice of proposal shall be 60 days; therefore, pursuant to N.J.A.C. 1:30-3.3(a)5, this notice is excepted from the rulemaking calendar requirement.

Social Impact

The rules proposed for readoption will continue to ensure proper health care of animals. The rules establish practice standards and ensure that veterinarians remain accountable to the public and the Board. The proposed readoption of the current rules and amendments also benefit the Board and licensees by providing procedures for the orderly administration by the Board and by establishing clear practice guidelines.

Many of the rules proposed for readoption specifically protect the interests of the licensee, consumers or both. N.J.A.C. 13:44-1.1(c) allows the Board to refuse licensure to any applicant who violates the dictates of N.J.S.A. 45:1-21. This ensures that licensees will be fit to practice veterinary medicine.

N.J.A.C. 13:44-2.1 and 2.2 allow a non-licensed veterinarian to work for a licensee while waiting to take the New Jersey Licensing Examination, so long as the non-licensed veterinarian obtains a permit from the Board. This assists in the training of people who wish to be licensees and gives licensees access to knowledgeable assistants.

N.J.A.C. 13:44-4.1 sets out requirements for licensees who dispense medications. The rule requires that a valid relationship exist between the licensee and the patient before prescribing medication. This provision helps to ensure that medications are proper for the patient and that there will be no harmful drug interactions. The rule allows a licensee to dispense medication prescribed by another licensee. This allows clients to get medication from licensees who may provide the medication at a lower cost or when their usual licensee is not available. The rule also prohibits a licensee from prescribing or dispensing medication indiscriminately or for illicit purposes. This provision attempts to prevent the abuse of drugs dispensed by licensees. N.J.A.C. 13:44-4.1(a) requires that any dispensed medications have a label, which provides necessary information to a client, as to the strength of a drug and directions for use. This provision gives consumers more information about medications. N.J.A.C. 13:44-4.1(e) requires a licensee to provide a written prescription to a client when asked to do so. This allows consumers to find the least expensive source for medication and discourages licensees from charging excessive fees for medication.

N.J.A.C. 13:44-4.2 exempts licensees who work in rabies clinics sponsored by the State of New Jersey, or who provide emergency services on the behalf of municipal, county, State or Federal agencies, from the requirements of a customary veterinarian-client-patient relationship. This permits licensees to provide services in these settings where establishing such a relationship would be impractical. N.J.A.C. 13:44-4.4, which requires a licensee to sign and print his or her name on any document given to a consumer upon purchase of an animal, benefits consumers by ensuring they know who deemed a pet fit for purchase and ensures that licensees will be responsible for their judgments as to the fitness of an animal for sale.

N.J.A.C. 13:44-4.6, which allows a facility to continue to operate after a licensee dies, ensures that clients have a facility to go to while they find a replacement licensee to attend to their animals. N.J.A.C. 13:44-4.7, which requires that licensees provide emergency care, benefits society by making licensees care for animals that have been in an accident or become ill abruptly. N.J.A.C. 13:44-4.8 requires licensees to be honest and forthright in their advertising. N.J.A.C. 13:44-4.9 ensures that records of patient's treatments are well kept and accurate. The rule benefits society by requiring licensees to provide records to a client upon request.

Economic Impact

Some of the rules proposed for readoption will have an economic impact. N.J.A.C. 13:44-5.1 sets forth the fees that the Board assesses to defray the cost of administering the licensure regime. The fee schedule has an economic impact on licensees and applicants for licensure by establishing fees, which will supply the amount of money necessary for the Board to be self-funding and thus in compliance with N.J.S.A. 45:1-3.2. N.J.A.C. 13:44-1.6 has an economic impact in that it sets forth the time frame for the imposition of fees for registration, late renewal and reinstatement.

Several rules proposed for readoption impose costs on licensees. N.J.A.C. 13:44-1.9 requires a licensee to have proof of licensure wherever he or she practices veterinary medicine. Such proof must be obtained from the Board and the cost of obtaining this proof is borne by the licensee. N.J.A.C. 13:44-2.2 allows a non-licensed veterinarian to work as an assistant to a licensee if he or she obtains a temporary permit from the Board. The cost of the temporary permit is borne by the non-licensed veterinarian. N.J.A.C. 13:44-4.9 requires licensees to maintain patient records and to provide copies of such records to clients who ask for them. The costs of maintaining the records is borne by licensees. A minimal cost for copying records may be borne by consumers. N.J.A.C. 13:44-4.9 also requires that retiring licensees, and executors or administrators of the estate of a deceased licensee, publish two notices of intent to transfer or dispose of the licensee's patient records. The cost of publishing these notices is borne by licensees or estates. N.J.A.C. 13:44-4.10 imposes costs on licensees by requiring them to complete continuing education. N.J.A.C. 13:44-4.11 requires licensees who work at emergency facilities to obtain a registration certificate or a duplicate certificate from the Board. The cost of obtaining these certificates is borne by licensees.

Federal Standards Statement

A Federal standards analysis is not required because there are no Federal laws or standards applicable to the rules proposed for readoption with amendments.

Jobs Impact

The Board does not anticipate that the rules proposed for readoption with amendments will result in the loss or gain of any jobs in the State.

Agriculture Industry Impact

N.J.A.C. 13:44-4.3 affects the agriculture industry as it allows non-licensees who are agents of Cook College or who work in the poultry industry to perform poultry husbandry procedures, such as de-beaking, toe clipping, sex determination, caponizing, clipping of wings, culling and blood testing. This benefits the agriculture industry because these tasks may be performed by non-licensees with less expense to the poultry industry and because there may not be an adequate number of licensees available to perform these tasks on the scale necessary to accommodate the poultry industry.

Regulatory Flexibility Analysis

Since licensed veterinarians are individually licensed by the Board, under the Regulatory Flexibility Act (the Act), N.J.S.A. 52:14B-16 et seq., they may be considered "small businesses" for the purposes of the Act.

The costs imposed on small businesses by the rules proposed for readoption with amendments are the same costs that are imposed on all businesses as set forth above in the Economic Impact statement. The Board does not believe that licensees will need to employ any professional services to comply with the requirements of the rules proposed for readoption with amendments.

[page=1135] The rules proposed for readoption with amendments imposes compliance, recordkeeping and reporting requirements as detailed in the Summary above.

As the compliance, reporting and recordkeeping requirements contained in the rules proposed for readoption with amendments are necessary to adequately regulate licensees and protect consumers who use their services, the Board believes that the rules must be uniformly applied to all licensees and no exemptions are provided based on the size of the business.

Smart Growth Impact

The Board does not anticipate that the rules proposed for readoption with amendments will have any impact on the achievement of smart growth and implementation of the State Development and Redevelopment Plan, otherwise known as the State Plan.

Housing Affordability Impact

The rules proposed for readoption with amendments will have an insignificant impact on affordable housing in New Jersey and there is an extreme unlikelihood that the rules would evoke a change in the average costs associated with housing because the rules concern the regulation of licensed veterinarians.

Smart Growth Development Impact

The rules proposed for readoption with amendments will have an insignificant impact on smart growth and there is an extreme unlikelihood that the rules would evoke a change in housing production in Planning Areas 1 or 2 or within designated centers under the State Development and Redevelopment Plan in New Jersey because the rules concern the regulation of licensed veterinarians.

Full text of the rules proposed for readoption may be found in the New Jersey Administrative Code at N.J.A.C. 13:44.

Full text of the proposed amendments follows (additions indicated in boldface thus ; deletions indicated in brackets [thus]):

SUBCHAPTER 1. LICENSURE BY EXAMINATION; LICENSURE BY WAIVER OF EXAMINATION; BIENNIAL LICENSE RENEWAL; REINSTATEMENT

13:44-1.4 Licensure by endorsement

(a) The Board shall issue a license to an applicant who:

1.-2. (No change.)

3. Except as set forth in [(d)] (c) below, has been awarded a degree in veterinary medicine from a veterinary college or university accredited by the American Veterinary Medical Association (AVMA);

4.-6. (No change.)

(b)-(c) (No change.)

SUBCHAPTER 2. TEMPORARY PERMITS

13:44-2.2 Eligibility for temporary permit

(a) (No change.)

(b) A person practicing under a temporary permit who fails the New Jersey [Licensing] State Jurisprudence Examination shall file an application for a new temporary permit within two weeks of the date the examination results are issued.

(c) An individual who fails the New Jersey [Licensing] State Jurisprudence Examination four times shall not continue to work under a temporary permit. Such individual may, however, retake the licensing examination until he or she passes the examination.

(d) (No change.)

SUBCHAPTER 3. DEFINITIONS

13:44-3.1 Definitions

As used in this chapter, the following terms have the following meanings unless the context clearly indicates otherwise.

. . .

"Practice of veterinary medicine, surgery and dentistry" means to directly or indirectly diagnose, prognose, treat, correct, change, relieve or prevent animal disease, deformity, defect, injury, wound or other physical or mental condition; including the prescription or administration of any drug, medicine, biologic, apparatus, application, anesthetic or other therapeutic or diagnostic substance or technique on any animal including, but not limited to, animal acupuncture, surgical or dental operations, animal chiropractic, theriogenology, alternative or complementary veterinary medicine, surgery, including cosmetic surgery, any manual, mechanical, biological or chemical procedure for testing for the presence of any disease or pregnancy or for correcting sterility or infertility, including embryo transfer, or to render service or recommendations with regard to any of the above and all other branches of veterinary medicine, surgery and dentistry.

. . .

SUBCHAPTER 4. GENERAL RULES OF PRACTICE

13:44-4.1 Veterinary prescription items

(a)-(d) (No change.)

(e) A licensed veterinarian, in the course of professional practice and an [exiting] existing veterinarian-client-patient relationship, shall, upon request, provide a written prescription to a client who does not wish to purchase a prescription item directly from the licensed veterinarian.

(f) (No change.)

13:44-4.8 Advertising

(a)-(b) (No change.)

(c) A licensee who engages in the use of advertising [which] that contains the following, shall be deemed to be engaged in professional misconduct:

1.-2. (No change.)

3. Any statement or claim or implication arising therefrom that licensee is a specialist where [Board] national specialty board certification in the claimed area exists and the licensee does not possess such certification. Where [Board] national specialty board certification in an area of claimed expertise does not exist, the use of the term "specialist" or its substantial equivalent shall not be utilized provided, however, that nothing herein shall prohibit truthful and non-deceptive statements concerning a licensee's experience or training in a particular area of veterinary practice.

4.-5. (No change.)

(d)-(k) (No change.)

13:44-4.9 Patient records

(a) A licensee shall maintain a separate patient record for each animal, herd or flock. All patient records shall accurately reflect the treatment or services rendered. Such records shall include at least the following information:

1. The name of the facility , [and identification of the treating licensee. If the patient is treated by anyone other than the licensee, the licensee shall ensure that the identity of the individual providing the service is indicated in the patient record and that the provider initials and dates each entry he or she makes on the patient record] which shall appear on every page of the record ;

2. The name, initials or other identifying information to indicate the identity of the licensee or agent making the entry in the patient record and the date on which the entry is made;

Recodify existing 2.-8. as 3.-9. (No change in text.)

[9.] 10. Such other notes or information so as to provide a clear statement of the patient's condition and the veterinary evaluation and response; and

[10. The name, initials or other identifying information to indicate the identity of the licensee or agent making the entry in the patient record and the date on which the entry is made; and]

11. (No change.)

(b)-(i) (No change.)

13:44-4.10 Continuing education

(a) [Beginning with the 2009 biennial license renewal, and for every] Upon biennial license renewal [thereafter], a licensee shall attest that he or she has completed courses of continuing education of the types and number of credits specified in (b) or (c) below. Falsification of any information submitted on the renewal application may require an appearance before the Board and may result in penalties and/or suspension or revocation of the licensee pursuant to N.J.S.A. 45:1-21 through 45:1-25.

(b)-(j) (No change.)

   
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