By:  Bivins                                           S.B. No. 1296
                                 A BILL TO BE ENTITLED
                                        AN ACT
    1-1  relating to the practice of veterinary medicine, including the
    1-2  State Board of Veterinary Medical Examiners and dangerous drugs;
    1-3  providing penalties.
    1-4        BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
    1-5        SECTION 1.  Section 2, The Veterinary Licensing Act (Article
    1-6  8890, Revised Statutes), is amended by amending Subsection 2 to
    1-7  read as follows:
    1-8              <(2)  Any person shall be deemed in the "Practice of
    1-9  Veterinary Medicine" who represents himself as engaged in the
   1-10  practice of veterinary medicine; or uses any words, letters, or
   1-11  titles in such connection or under such circumstances as to induce
   1-12  the belief that the person using them is engaged in the practice of
   1-13  veterinary medicine, or any person who performs a surgical or
   1-14  dental operation or who diagnoses, treats, immunizes or prescribes
   1-15  any prescription drug, prescription medicine, veterinary appliance,
   1-16  or veterinary application for any physical ailment, injury,
   1-17  deformity, or condition of animals, for compensation.>
   1-18              (2)(a)  "Veterinary Medicine" shall include veterinary
   1-19  surgery, reproduction and obstetrics, dentistry, radiology,
   1-20  ophthalmology, dermatology, cardiology, and all other disciplines
   1-21  and specialties of veterinary medicine.
   1-22                    (b)  "The practice of veterinary medicine" shall
   1-23  mean:
    2-1                          (1)  the diagnosis, treatment, correction,
    2-2  change, manipulation, relief, or prevention of animal disease,
    2-3  deformity, defect, injury, or other physical or mental condition,
    2-4  including the prescription or administration of any drug, biologic,
    2-5  anesthetic, apparatus, or other therapeutic or diagnostic substance
    2-6  or technique, also to include the use of any mechanical, manual, or
    2-7  surgical procedure for artificial insemination, oocyte and embryo
    2-8  collection, pregnancy evaluation, or reproductive soundness
    2-9  evaluation, or to render advice or recommendation with regard to
   2-10  any of the above; or
   2-11                          (2)  to represent an ability and
   2-12  willingness to do an act included in (1) above; or
   2-13                          (3)  to use title, words or letters to
   2-14  induce the belief that one is legally authorized and qualified to
   2-15  do an act in (1) above; or
   2-16                          (4)  to receive compensation for performing
   2-17  an act included in (1) above
   2-18                    (c)  "Compensation" shall include, but not be
   2-19  limited to, all fees, monetary rewards, discounts, and emoluments
   2-20  received directly or indirectly.
   2-21              (3)  "Board" means the State Board of Veterinary
   2-22  Medical Examiners.
   2-23              (4)  "Licensee" means any person holding a license to
   2-24  practice veterinary medicine issued by the Board.
   2-25              (5)  "Applicant" means any person requesting that the
    3-1  Board examine the person's qualifications for the practice of
    3-2  veterinary medicine or requesting the issuance or renewal of a
    3-3  license.
    3-4              (6)  "License" means license to practice veterinary
    3-5  medicine.
    3-6              (7)  "General supervision" shall mean that the actual
    3-7  physical presence of the responsible veterinarian is not necessary,
    3-8  but means of communication is readily available.
    3-9              (8)  "Direct supervision" shall mean the actual
   3-10  physical presence of the responsible veterinarian on the premise.
   3-11        SECTION 2.  Section 2A, The Texas Veterinary Licensing Act
   3-12  (Article 8890, Revised Statutes), is amended to read as follows:
   3-13        Sec. 2A.  (a)  A veterinarian-client-patient relationship
   3-14  exists if:
   3-15              (1)  A veterinarian assumes responsibility for medical
   3-16  judgments regarding the health of an animal and a client who is the
   3-17  owner or other caretaker of the animal agrees to follow the
   3-18  veterinarian's instructions; <or> and
   3-19              <(2)  A veterinarian, through personal examination of
   3-20  an animal or a representative sample of a herd or flock, obtains
   3-21  sufficient information to make at least a general or preliminary
   3-22  diagnosis of the medical condition of the animal, herd, or flock,
   3-23  which is expanded through medically appropriate visits to the
   3-24  premises where the animal, herd, or flock is kept.>
   3-25              (2)  There is sufficient knowledge of the animal(s) by
    4-1  the veterinarian to initiate at least a general or preliminary
    4-2  diagnosis of the medical condition of the animal(s).  This means
    4-3  that the veterinarian has recently seen and/or is personally
    4-4  acquainted with the keeping and care of the animal(s) by virtue of
    4-5  the examination of the animal(s), and/or by medically appropriate
    4-6  and timely visits to the premises where the animal(s)  is (are)
    4-7  kept; and
    4-8              (3)  The practicing veterinarian is readily available
    4-9  or has provided follow-up medical care in case of adverse reactions
   4-10  or failure of the regimen of therapy.
   4-11        (b)  The professional services of a veterinarian shall not be
   4-12  controlled or exploited by any lay agency, personal or corporate,
   4-13  which intervenes between the client and the veterinarian.  A
   4-14  veterinarian shall not allow a non-licensed person or entity to
   4-15  interfere or intervene with the veterinarian's practice of
   4-16  veterinary medicine; nor shall the veterinarian submit to such
   4-17  interference or intervention by a non-licensed person or entity.  A
   4-18  veterinarian shall avoid all relationships which could result in
   4-19  interference or intervention in the veterinarian's practice by a
   4-20  non-licensed person or entity.  A veterinarian shall be responsible
   4-21  for his own actions and is directly responsible to the client and
   4-22  for the care and treatment of the patient.
   4-23        SECTION 3.  Section 3, The Texas Veterinary Licensing Act
   4-24  (Article 8890, Revised Statutes), is amended by amending Subsection
   4-25  (a) to read as follows:
    5-1        (a)  The provisions of this Act shall not apply to:
    5-2              (1)  Treatment or caring for animals in any manner
    5-3  personally by the owner thereof, or by any employee of the owner
    5-4  thereof or designated caretaker unless ownership, <or> employment,
    5-5  or designation has been established with the intent of
    5-6  circumventing this Act.
    5-7              (2)  A person performing acts which the Board has
    5-8  prescribed as accepted livestock management practices including,
    5-9  but not limited to:
   5-10              <(2)>  (i)  <Performance of the> operation of male
   5-11  castration on animals raised for human consumption, or docking or
   5-12  earmarking of animals raised for human consumption.
   5-13              <(3)>  (ii)  <Performance of the> operation of
   5-14  dehorning cattle<, or>.
   5-15                    (iii)  Aid in the non-surgical birth process in
   5-16  large animals, as defined by Board rule.
   5-17              <(4)>  (iv)  Treatment of animals for disease
   5-18  prevention with non-prescription medication or vaccine. <internal
   5-19  or external parasites, or vaccination for black leg, shipping
   5-20  fever, or sore mouth with a nonprescription medicine.>
   5-21              <(5)  Selling by a retail distributor of a
   5-22  nonprescription medicine, remedy, or insecticide which is
   5-23  adequately labeled.>
   5-24              <(7)>  (v)  Branding animals in any manner.
   5-25                    (vi)  Artificially breeding a food production
    6-1  animal with thawed semen.
    6-2              <(6)>  (3)  Performance of cosmetic or production
    6-3  techniques to reduce injury in poultry intended for human
    6-4  consumption.
    6-5              (4)  Any employee of a licensed veterinarian performing
    6-6  duties involving food production animals other than diagnosis,
    6-7  prescription, or surgery under the direction and general
    6-8  supervision of such veterinarian who shall be responsible for his
    6-9  or her performance.
   6-10              <(8)> (5)  Acts performed by persons who are full-time
   6-11  students of an accredited college of veterinary medicine, or who
   6-12  are foreign veterinary graduates of a Board-approved equivalent
   6-13  competency program for foreign veterinary graduates and who are
   6-14  participating in an extern or preceptor program approved by the
   6-15  Board if the acts are performed under direct supervision of a
   6-16  licensee employing the person.
   6-17              (6)  The nonsurgical transfer of embryos from food
   6-18  producing and equine animals.
   6-19              (7)  Recognizing that the American Embryo Transfer
   6-20  Association (AETA) certifies embryo transfer (ET) companies and not
   6-21  individual ET practitioners, and that a conditionally qualified ET
   6-22  practitioner must take and pass the AETA certification exam, that
   6-23  person passing the exam,  as long as he/she remains current with
   6-24  AETA certification, is exempt while performing nonsurgical embryo
   6-25  collection and transfer procedures including rectal palpation of
    7-1  food production and equine animals.  This person must, on an annual
    7-2  basis, register with the Board and pay an annual fee equal to the
    7-3  current rate, including both licensing fee and Professional
    7-4  Licensing Tax, for licensed veterinarians in this state.  This
    7-5  exemption to perform nonsurgical embryo collection and transfer
    7-6  procedures  does not in any way exempt that person from the laws
    7-7  governing the use of prescription drugs either directly or
    7-8  indirectly.
    7-9              (8)  As of September 1, 1993 any resident of the state
   7-10  of Texas who:
   7-11                    (i)  Holds a master's degree in reproductive
   7-12  physiology from a Board-approved college and for the last four
   7-13  years has practiced ET  as a principal occupation; or
   7-14                    (ii)  For the last ten years has practiced ET as
   7-15  a principal occupation, may apply for registration with the Board
   7-16  to perform nonsurgical embryo collection and transfer procedures
   7-17  including rectal palpation of food production and equine animals.
   7-18  Persons applying for equine registration must have suitable equine
   7-19  ET experience.  Application for registration must be made prior to
   7-20  September 1, 1994.  Applicant must provide suitable documentation
   7-21  of qualifications.  Registrant must register annually with the
   7-22  Board and pay an annual fee equal to the current veterinary
   7-23  licensing rate in Texas, including both licensing fee and
   7-24  Professional Licensing Tax.  Registration to run concurrently with
   7-25  the Texas veterinary licensing schedule.
    8-1        (e)  This Act does not apply to any veterinarian residing in
    8-2  another state, lawfully qualified under the laws of that state,
    8-3  meeting licensed veterinarians of this state in consultation.
    8-4        SECTION 4.  Section 4, The Veterinary Licensing Act (Article
    8-5  8890, Revised Statutes), is amended by adding a new Subsection (b)
    8-6  to read as follows:
    8-7                    (b)  A person commits an offense if the person
    8-8  violates this Section.  The offense is a Class A Misdemeanor.
    8-9        SECTION 5.  Section 5, The Veterinary Licensing Act (Article
   8-10  8890, Revised Statutes), is amended by amending Subsections (b),
   8-11  (c) and (i) to read as follows:
   8-12        (b)  Appointments shall be made without regard to the race,
   8-13  creed, sex, religion, or national origin of the appointees.  Six
   8-14  members must be non-specialty licensed veterinarians and three
   8-15  members must be members of the general public.  A maximum of one of
   8-16  the six licensed veterinarians may be a member of the faculty of a
   8-17  college of veterinary medicine.
   8-18        (c)  To be eligible for appointment to the Board as a
   8-19  licensed veterinarian member, a person must:
   8-20              (1)  have resided in the state and practiced veterinary
   8-21  medicine for the six years next preceding his appointment;
   8-22              (2)  be of good repute. <and>
   8-23              <(3)  not be a member of the faculty of any veterinary
   8-24  medical  college or of the veterinary medical department of any
   8-25  college or have a financial interest in a veterinary medical
    9-1  college.>
    9-2        (i)  The State Board of Veterinary Medical Examiners is
    9-3  subject to the Texas Sunset Act, as amended (Article 5429k,
    9-4  Vernon's Texas Civil Statutes); and unless continued in existence
    9-5  as provided by that Act, the Board is abolished, and this Act
    9-6  expires effective September 1, <1993> 2005.
    9-7        SECTION 6.  Section 7, The Veterinary Licensing Act (Article
    9-8  8890, Revised Statutes), is amended by adding a new Subsection (b)
    9-9  and re-lettering subsequent Subsections to read as follows:
   9-10        (b)  The Board shall adopt rules to safeguard the public and
   9-11  insure that only a veterinarian performs, or is involved in,
   9-12  alternate therapies including, but not limited to, animal behavior
   9-13  consultants; ultrasound diagnosis and therapy; magnetic field
   9-14  therapy; holistic medicine; homeopathy; equine dentistry;
   9-15  chiropractic treatment; acupuncture; or laser therapy.
   9-16        <(b)> (c)  The Board shall require its licensees to maintain
   9-17  a record-keeping system for controlled substances as prescribed by
   9-18  the Texas Controlled Substances Act, (Article 4476-15, Vernon's
   9-19  Texas Civil Statutes).  The records are subject to review by law
   9-20  enforcement agencies and by representatives of the Board.  A
   9-21  failure to keep such records shall be grounds for revoking,
   9-22  canceling, suspending, or probating the license of any practitioner
   9-23  of veterinary medicine.
   9-24        <(c)> (d)  After notice and hearing, the Board may approve an
   9-25  exception to a rule adopted by the Board.  The Board may consider
   10-1  an exception on the request of a person subject to regulation by
   10-2  the Board.
   10-3        SECTION 7.  Section 9, The Veterinary Licensing Act (Article
   10-4  8890, Revised Statutes), is amended by amending Subsection (d) to
   10-5  read as follows:
   10-6        (d)  The investigation files and records, including those of
   10-7  complaints found to be groundless, of the Board are confidential.
   10-8        SECTION 8.  Section 13,  The Veterinary Licensing Act
   10-9  (Article 8890, Revised Statutes), is amending by amending
  10-10  subsection (d) to read as follows:
  10-11        <(d)  The Board may recognize, prepare, or implement
  10-12  continuing education programs for veterinarians.  Participation in
  10-13  the programs is voluntary.>
  10-14        (d)  The person has fulfilled the continuing education
  10-15  requirements established by the Board.
  10-16        SECTION 9.  Section 14, The Veterinary Licensing Act (Article
  10-17  8890, Revised Statutes), is amended by amending Subsection (a) to
  10-18  read as follows:
  10-19        (a)  Except as provided by this section with respect to
  10-20  conviction of a felony under the Texas Controlled Substances Act,
  10-21  as amended (Article 4476-15, Vernon's Texas Civil Statutes), or
  10-22  Chapter 425, Acts of the 56th Legislature, Regular Session, 1959,
  10-23  as amended (Article 4476-14, Vernon's Texas Civil Statutes), the
  10-24  Board may revoke or suspend a license, impose a civil penalty,
  10-25  place a licensee or a person whose license has been suspended on
   11-1  probation, or reprimand a licensee, or may refuse to examine an
   11-2  applicant or to issue a license or a renewal of a license, after
   11-3  notice and hearing as provided in Section 15 of this Act, or as
   11-4  provided by the rules of the Board, if it finds that an applicant
   11-5  or licensee:
   11-6              (1)  has presented to the Board dishonest or fraudulent
   11-7  evidence of qualification or has been guilty of fraud or deception
   11-8  in the process of examination, or for the purpose of securing a
   11-9  license; or
  11-10              (2)  is chronically, or habitually intoxicated, has a
  11-11  chemical dependency or is addicted to drugs;
  11-12              (3)  has engaged in dishonest or illegal practices in
  11-13  or  connected with the practice of veterinary medicine;
  11-14              (4)  has been convicted of a felony under the laws of
  11-15  this or any other state of the United States or of the United
  11-16  States;
  11-17              (5)  has engaged in practices or conduct in connection
  11-18  with the practice of veterinary medicine which are violative of the
  11-19  standards of professional conduct as duly promulgated by the Board
  11-20  in accordance with law;
  11-21              (6)  has permitted or allowed another to use his
  11-22  license, or certificate to practice veterinary medicine in this
  11-23  state;
  11-24              (7)  has fraudulently issued a health certificate,
  11-25  vaccination certificate, test chart, or other blank form used in
   12-1  the practice of veterinary medicine that relates to the presence or
   12-2  absence of animal disease;
   12-3              (8)  has issued a false certificate relating to the
   12-4  sale for human consumption of inedible animal products;
   12-5              (9)  has committed fraud in application or reporting of
   12-6  any test of animal disease;
   12-7              (10)  has paid or received any kickback, rebate, bonus,
   12-8  or other remuneration for treating an animal or for referring a
   12-9  client to another provider of veterinary services or goods;
  12-10              (11)  has performed or prescribed unnecessary or
  12-11  unauthorized treatment;
  12-12              (12)  has ordered prescription drugs or controlled
  12-13  substances for the treatment of an animal without first
  12-14  establishing a valid veterinarian-patient-client relationship;
  12-15              (13)  has refused to admit a representative of the
  12-16  Board to inspect the client and patient records and business
  12-17  premises of the person during regular business hours;
  12-18              (14)  has failed to keep the equipment and business
  12-19  premises in a sanitary condition;
  12-20              (15)  has committed gross malpractice or is guilty of a
  12-21  pattern of acts indicating consistent malpractice, negligence, or
  12-22  incompetence in the practice of veterinary medicine;
  12-23              (16)  is subject to a disciplinary action in another
  12-24  jurisdiction, including the suspension, probation, or revocation of
  12-25  a license to practice veterinary medicine issued by another
   13-1  jurisdiction.
   13-2        SECTION 10.  Section 14B, The Veterinary Licensing Act
   13-3  (Article 8890, Revised Statutes), is amended by amending
   13-4  Subsections (a) and (b) to read as follows:
   13-5        (a)  If a licensee or non-licensee <person> violates this Act
   13-6  in a manner that constitutes grounds for <disciplinary> action by
   13-7  the Board, the Board may assess a civil penalty against that person
   13-8  in addition to taking action under Section 14 or 14A of this Act.
   13-9        (b)  The Board may assess the civil penalty in an amount not
  13-10  to exceed <$2,500> $5,000 per violation.  In determining the amount
  13-11  of the penalty, the Board shall consider the seriousness of the
  13-12  violation.
  13-13        SECTION 11.  Section 17, The Veterinary Licensing Act
  13-14  (Article 8890, Revised Statutes), is amended to read as follows:
  13-15        Section 17.  The Board may through the Attorney General or
  13-16  any District or County Attorney <may> institute any injunction
  13-17  proceeding or any such other proceeding incident to such injunction
  13-18  proceeding as to enforce the provisions of this Act and to enjoin
  13-19  any person from the practice of veterinary medicine, as defined in
  13-20  this Act, without such person having complied with the other
  13-21  provisions of this Act.  The venue for such injunction proceedings
  13-22  shall be in the county of the residence of the person against whom
  13-23  such injunction proceedings are instituted.  If the person does not
  13-24  reside in this state, venue is in Travis County.
  13-25        SECTION 12.  Section 18, The Veterinary Licensing Act
   14-1  (Article 8890, Revised Statutes), is amended by amending Subsection
   14-2  (b) to read as follows:
   14-3        (b)  A person  commits an offense if the person violates this
   14-4  Section or Section 4 of this Act.  An offense under this Subsection
   14-5  is a Class <B> A Misdemeanor.
   14-6        SECTION 13.  Section 18A, The Veterinary Licensing Act
   14-7  (Article 8890, Revised Statutes) is amended by amending Subsections
   14-8  (b) and (c) to read as follows:
   14-9        (b)  The Board shall maintain an information file about each
  14-10  complaint filed with the Board relating to a licensee or
  14-11  non-licensee.
  14-12        (c)  If a written complaint is filed with the Board relating
  14-13  to a licensee or non-licensee, the Board, at least as frequently as
  14-14  quarterly and until final disposition of the complaint, shall
  14-15  notify the parties to the complaint of the status of the complaint
  14-16  unless the notice would jeopardize an undercover investigation.
  14-17        SECTION 14.  The Veterinary Licensing Act (Article 8890,
  14-18  Revised Statutes), is amended by adding a new Section 18D to read
  14-19  as follows:
  14-20        Section 18D.  A veterinarian shall not violate the
  14-21  confidential relationship between self and client and shall not be
  14-22  required to disclose any information concerning the veterinarian's
  14-23  care of an animal except on written authorization or other waiver
  14-24  by the veterinarian's client or on appropriate court order or
  14-25  subpoena.  Any veterinarian releasing information under written
   15-1  authorization or other waiver by the client or under court order or
   15-2  subpoena shall not be liable to the client or any other person.
   15-3  The privilege provided by this section shall be waived to the
   15-4  extent that the veterinarian's client or the owner of the animal
   15-5  places the veterinarian's care and treatment of the animal or the
   15-6  nature and extent of injuries to the animal at issue in any civil
   15-7  or criminal proceeding.
   15-8        SECTION 15.  Section 22, The Veterinary Licensing Act
   15-9  (Article 8890, Revised Statutes) is repealed and a new Section 22
  15-10  is added to read as follows:
  15-11        Section 22. (a)  A personal service corporation that provides
  15-12  veterinary services as defined within this Act shall have as its
  15-13  shareholders licensed veterinarians only.
  15-14        (b)  A personal service corporation with shareholders
  15-15  composed of non-licensed veterinarians may not employ a
  15-16  veterinarian to provide veterinary services to the public.
  15-17        (c)  In the formation of partnerships for practice of
  15-18  veterinary medicine, no person shall be admitted as a partner who
  15-19  is not a member of the veterinary profession, duly authorized to
  15-20  practice, and amenable to professional discipline.  No person shall
  15-21  be held out as a practitioner of veterinary medicine or a member of
  15-22  a firm who is not so admitted.  In the selection and use of a firm
  15-23  name, no false or misleading name shall be used.
  15-24        (d)  Partnerships between veterinarians and members of other
  15-25  professions or nonprofessional persons shall not be formed or
   16-1  permitted if a part of the partnership employment consists of the
   16-2  practice of veterinary medicine.
   16-3        SECTION 16.  The Veterinary Licensing Act (Article 8890,
   16-4  Revised Statutes), is amended by adding Sections 23 and 24 to read
   16-5  as follows:
   16-6        Section  23.  (a)  The provisions of this section are
   16-7  applicable to any veterinarian who leases space from and practices
   16-8  veterinary medicine on the premises of a mercantile establishment.
   16-9        (b)  The practice must be owned by a Texas licensed
  16-10  veterinarian.  Every phase of the practice and the leased premises
  16-11  must be under the exclusive control of a Texas licensed
  16-12  veterinarian.
  16-13        (c)  All patient and business records shall be the sole
  16-14  property of the veterinarian and free from involvement with the
  16-15  mercantile establishment or any unlicensed person.  Except,
  16-16  however, that those business records essential to the successful
  16-17  initiation or continuation of a percentage of gross receipts lease
  16-18  of space may be inspected by the applicable lessor.
  16-19        (d)  The leased space shall be definite and apart from the
  16-20  space occupied by other occupants of the premises.  It shall be
  16-21  separated from space used by other occupants of the premises by
  16-22  solid, opaque partitions or walls from floor to ceiling.  Railings,
  16-23  curtains and other similar arrangements are not sufficient to
  16-24  comply with the requirement.
  16-25        (e)  The leased space shall have a patient's entrance opening
   17-1  on a public street, hall, lobby, corridor, or other public
   17-2  thoroughfare.  The aisle of a mercantile establishment does not
   17-3  comply with this requirement.  An entrance to the leased space is
   17-4  not a patient's entrance within the meaning of this subsection
   17-5  unless actually used as an entrance by the veterinarian's patients.
   17-6        (f)  No phase of the veterinarian's practice shall be
   17-7  conducted as a department or concession of the mercantile
   17-8  veterinary establishment and there shall be no legends or signs
   17-9  such as "Veterinary Department," or other of similar import,
  17-10  displayed on any part of the premises or in any advertising.
  17-11        (g)  The veterinarian shall not permit his name to be
  17-12  directly or indirectly associated with the mercantile
  17-13  establishment.
  17-14        Section 24.  In the event of a practitioner's death, practice
  17-15  ownership and patient records become the property of the
  17-16  practitioner's heirs to dispose of as they deem necessary, within a
  17-17  reasonable period of time, not to exceed two years.
  17-18        SECTION 17.  Section 483.042, Health and Safety Code, is
  17-19  amended by adding Subsection (c) to read as follows:
  17-20        (c)  The labeling provisions of Subsection (a) do not apply
  17-21  when a dangerous drug is prescribed or dispensed for administration
  17-22  to food production animals in an agricultural operation under a
  17-23  written medical directive or treatment guideline from a
  17-24  practitioner.  The State Board of Veterinary Examiners shall adopt
  17-25  rules for the labeling or identification of such drugs.
   18-1        SECTION 18.  This Act takes effect September 1, 1993.
   18-2        SECTION 19.  The importance of this legislation and the
   18-3  crowded condition of the calendars in both houses create an
   18-4  emergency and an imperative public necessity that the
   18-5  constitutional rule requiring bills to be read on three several day
   18-6  in each house be suspended, and this rule is hereby suspended.