ADMINISTRATIVE RULES

SOAHR 2008-043

DEPARTMENT OF COMMUNITY HEALTH - DIRECTOR'S OFFICE

VETERINARY MEDICINE - GENERAL RULES

Filed with the Secretary of State on February 23, 2011

These rules become effective immediately upon filing with the Secretary of State unless adopted under sections 33, 44, or 45a(6) of 1969 PA 306. Rules adopted under these sections become effective 7 days after filing with the Secretary of State.

(By authority conferred on the department of community health by sections 16145 and 18801 of 1978 PA 368, MCL 333.16145 and MCL 333.18801 and Executive Reorganization Order Nos. 1996-1, 1996-2, and 2003-1 MCL 330.3101, 445.2001, and 445.2011)

R 338.4903 of the Michigan Administrative Code is rescinded; R 338.4901, R 338.4902, R 338.4906, R 338.4908, R 338.4911, R 338.4914a, R 338.4915 and R 338.4918 are amended; and R 338.4921, R 338.4922, R 338.4923 and R 338.4924 are added to the Code as follows:

PART 1. GENERAL PROVISIONS

R 338.4901 Definitions.

Rule 1. As used in these rules:

(a) "Board" means board of veterinary medicine.

(b) "Client" means an owner, as defined in section 18802(3) of the code, or a responsible party.

(d) "Department" means the department of community health.

(e) "Patient" means an animal, as defined in section 18802(2) of the code.

R 338.4902 Licensure by examination; requirements.

Rule 2. An applicant for a Michigan veterinary license by examination shall submit a completed application on a form provided by the department, together with the requisite fee. In addition to meeting the requirements of the code and the administrative rules promulgated pursuant to the code, an applicant shall meet both of the following requirements:

(a) Either graduated from a board-approved veterinary college or obtained a certificate from the educational commission for foreign veterinary graduates of the American veterinary medical association.

(b) Achieved a score of pass on the North American veterinary licensing examination developed by the national board of veterinary medical examiners.

R 338.4903 Examinations; approval and adoption.

Rule 3. The board approves and adopts the North American veterinary licensing examination developed by the national board of veterinary medical examiners.

R 338.4906 Licensure by endorsement; requirements.

Rule 6. (1) An applicant for a Michigan veterinary license by endorsement shall submit a completed application on a form provided by the department with the requisite fee. An applicant shall meet the requirements of the code and the administrative rules promulgated pursuant to the code.

(2) An applicant shall have either graduated from a board-approved veterinary college or obtained a certificate from the educational commission for foreign veterinary graduates of the American veterinary medical association.

(3) If the applicant was first licensed in another state of the United States and engaged in the practice of veterinary medicine for a minimum of 5 years immediately preceding the date of filing an application for Michigan veterinary licensure, it will be presumed that the applicant meets the requirements of section 16186(1)(a) of the code.

(4) If an applicant does not meet the requirements of subrule (3) of this rule, the applicant shall have been first licensed in another state of the United States after he or she achieved a score of pass on the North American veterinary licensing examination developed by the national board of veterinary medical examiners.

(5) In addition to meeting the requirements of either subrule (3) or (4) of this rule, the applicant's license shall be verified, on a form provided by the department, by the licensing agency of any state of the United States in which the applicant holds a current license or ever held a license as a veterinarian, which includes, but is not limited to, showing proof of any disciplinary action taken or pending disciplinary action imposed upon the applicant.

R 338.4908 Approval of veterinary colleges; adoption of standards.

Rule 8. (1) The board approves and adopts herein by reference the standards for accrediting colleges of veterinary medicine adopted by the American veterinary medical association (avma) council on education entitled "Accreditation Policies and Procedures of the AVMA Council on Education", April 1, 2008.

(2) The standards for accrediting colleges of veterinary medicine adopted by the American veterinary medical association council on education may be obtained, at no cost, from the American Veterinary Medical Association, 1931 North Meacham Road, Suite 100, Schaumburg, IL 60173 or at the association's website at http://www.avma.org. A copy of the handbook is available for inspection and distribution at cost from the Board of Veterinary Medicine, Department of Community Health, 611 West Ottawa, P.O. Box 30670, Lansing, MI 48909.

R 338.4911 Veterinary examination of patient when procedures are delegated; veterinarian observation of delegatee's performance.

Rule 11. A veterinarian shall not delegate the performance of acts, tasks, or functions that fall within the practice of veterinary medicine unless the veterinarian has first examined the patient on which the delegated procedures are to be performed and determined the need for such veterinary services. The delegating veterinarian shall observe and monitor the performance of the delegated procedures to the extent necessary to ensure that the activities of the delegatee are within the scope of the orders, assignments, or prescriptions of the veterinarian.

R 338.4914a Educational limited licenses.

Rule 14a. (1) An applicant for an educational limited license shall submit a completed application on a form provided by the department, together with the requisite fee. In addition to meeting the requirements of the code and the administrative rules promulgated pursuant to the code, an applicant shall meet both of the following requirements:

(a) Achieve a score of pass on the North American veterinary licensing examination developed by the national board of veterinary medical examiners.

(b) Admitted as a student to a postgraduate training program at a college of veterinary medicine approved by the board.

(2) The holder of an educational limited license shall not do either of the following:

(a) Engage in the practice of veterinary medicine outside of his or her postgraduate training program in the college of veterinary medicine approved by the board for the training.

(b) Hold himself or herself out to the public as being engaged in the private practice of veterinary medicine.

R 338.4915 Relicensure.

Rule 15. (1) An applicant for relicensure whose license has been lapsed for less than 3 years under section 16201(3) of the code may be relicensed after submitting a completed application on a form provided by the department with the requisite fee. The applicant's license shall be verified, on a form provided by the department, by the licensing agency of any state of the United States in which the applicant holds a current license or ever held a license as a veterinarian. Verification includes, but is not limited to, showing proof of any disciplinary action taken or pending disciplinary action imposed upon the applicant.

(2) An applicant for relicensure whose license has been lapsed for 3 years or more under section 16201(3) of the code may be relicensed after submitting a completed application on a form provided by the department with the requisite fee and satisfying either of the following requirements:

(a) If the applicant had been licensed in another state of the United States and had legally engaged in the practice of veterinary medicine within the 3-year period immediately preceding the date of the application for relicensure, then the applicant's license shall be verified, on a form provided by the department, by the licensing agency of any state of the United States in which the applicant holds a current license or ever held a license as a veterinarian. Verification includes, but is not limited to, showing proof of any disciplinary action taken or pending disciplinary action imposed upon the applicant.

(b) If the applicant had not engaged in the practice of veterinary medicine within the 3-year period immediately preceding the date of the application for relicensure, then the applicant shall do both of the following:

(i) Have his or her licensure verified, on a form provided by the department, by the licensing agency of any state of the United States in which the applicant holds a current license or ever held a license as veterinarian, which includes, but is not limited to, showing proof of any disciplinary action taken or pending disciplinary action imposed upon the applicant.

(ii) Take or retake the North American veterinary license examination developed by the national board of veterinary medical examiners (nbvme) and achieve a score of pass as recommended by the nbvme.

R 338.4918 Assessment of fines.

Rule 18. When a fine has been designated as an available sanction for violation of sections 16221 to 16226 of the code, in the course of assessing a fine, the board may take into consideration the following factors without limitation:

(a) The extent to which the licensee obtained financial benefit from any conduct comprising part of the violation found by the board.

(b) The willfulness of the conduct found to be part of the violation determined by the board.

(d) The cost incurred in investigating and proceeding against the licensee.

R 338.4921 Medical records; requirements.

Rule 21. (1) A veterinarian who practices veterinary medicine in Michigan shall maintain a medical record for each patient that accurately reflects the veterinarian's evaluation and treatment of the patient. Entries in the patient record shall be made in a timely fashion. The patient record shall contain documentation of a valid veterinarian-patient-client relationship.

(2) A record shall be maintained on either a herd or flock, or an individual patient. Records shall be legible and shall be retrievable. A record shall be maintained in either a written, electronic, audio, or photographic format.

(3) A record for an individual patient, group, herd, or flock shall document all of the following:

(a) Identification that may include, but not be limited to, a tattoo, tag number, lot number, pen number, age, name, markings, sex, and species of the patient, as available.

(b) Date of the last veterinary service.

(d) Location of patients, if not at the location of the veterinary practice.

(e) Reason for the contact including, but not limited to, the case history, problem and/or signs of a problem, and whether the contact was a routine health visit or an emergency call.

(f) Vaccination history, when appropriate and if known.

(g) Results of the physical examination and a list of abnormal findings.

(h) Laboratory reports and other reports, when appropriate.

(i) Diagnostic procedures utilized and the reports that pertain to these procedures.

(j) Procedures performed including, but not limited to, surgery and rectal palpations.

(k) Daily progress notes, if hospitalized.

(l) Documentation of informed consent, if appropriate.

(m) Documentation of diagnostic options and treatment plans.

(n) Records of any client communication deemed relevant.

(o) Documentation of prescribed medication.

(4) Records shall be maintained for a minimum of 3 years from the date of the last veterinary service.

R 338.4922 Veterinarian-client-patient relationship; requirements.

Rule 22. All of the following requirements shall be met for a veterinarian-client-patient relationship to exist:

(a) A veterinarian shall assume responsibility for making clinical judgments regarding the health of the patient and the need for medical treatment, and a client shall have agreed to follow the veterinarian's instructions.

(b) A veterinarian shall have sufficient knowledge of the patient to initiate at least a general or preliminary diagnosis of the medical condition of the patient. "Sufficient knowledge," as used in this subrule, means that the veterinarian has recently seen and is personally acquainted with the keeping and care of the patient by virtue of an examination of the patient, or by medically appropriate and timely professional visits to where the patient is kept.

(c) A veterinarian shall be readily available, or shall arrange for emergency coverage, for follow-up evaluation in the event of adverse reactions or the failure of the treatment regimen.

R 338.4923 Dispensing or prescribing a prescription product; veterinarian-client-patient relationship required.

Rule 23. (1) If a veterinarian recommends a specific medication for a patient, the veterinarian shall honor a client's request for a prescription in lieu of dispensing a prescription product.

(2) Without a veterinarian-client-patient relationship, a veterinarian's merchandising or use of veterinary prescription drugs, including the extra-label use of any pharmaceutical, may be considered unprofessional conduct in violation of section 16221 of the code.

R 338.4924 Terminating a veterinarian-client-patient relationship.

Rule 24. (1) A veterinarian may terminate a veterinarian-client-patient relationship by notifying the client that the veterinarian no longer wishes to serve that patient and client.

(2) If the veterinarian-client-patient relationship has been terminated but an ongoing medical or surgical condition exists, the patient shall be referred to another veterinarian for diagnosis, care, and treatment. The former attending veterinarian shall continue to provide life-saving support, as needed, during the transition period.