HB 4200

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).