ARC 7563C

ARC 7563C

VETERINARY MEDICINE BOARD[811]

Notice of Intended Action

Proposing rulemaking related to auxiliary personnel

and providing an opportunity for public comment

The Board of Veterinary Medicine hereby proposes to rescind Chapter 8, "Auxiliary Personnel," Iowa Administrative Code, and to adopt a new chapter with the same title.

Legal Authority for Rulemaking

This rulemaking is proposed under the authority provided in Iowa Code section 169.5.

State or Federal Law Implemented

This rulemaking implements, in whole or in part, Iowa Code chapters 17A, 169 and 272C.

Purpose and Summary

This proposed rulemaking updates the Board's auxiliary personnel rules by removing outdated or redundant provisions that are covered by statute.

In addition, the proposed rules stipulate which veterinary practices veterinary assistants, technicians and students are allowed to perform under direct, indirect and immediate supervision from a licensed veterinarian, as well as which practices they are not allowed to perform. These updates are incorporated to reflect changes made by 2023 Iowa Acts, House File 670.

Fiscal Impact

This rulemaking has no fiscal impact to the State of Iowa.

Jobs Impact

After analysis and review of this rulemaking, no impact on jobs has been found.

Waivers

Any person who believes that the application of the discretionary provisions of this rulemaking would result in hardship or injustice to that person may petition the Board for a waiver of the discretionary provisions, if any, pursuant to 811—Chapter 14.

Public Comment

Any interested person may submit written or oral comments concerning this proposed rulemaking. Written or oral comments in response to this rulemaking must be received by the Board no later than 4:30 p.m. on March 29, 2024. Comments should be directed to:

Public Hearing

Public hearings at which persons may present their views orally or in writing will be held as follows:

Persons who wish to make oral comments at a public hearing may be asked to state their names for the record and to confine their remarks to the subject of this proposed rulemaking.

Any persons who intend to attend a public hearing and have special requirements, such as those related to hearing or mobility impairments, should contact the Board and advise of specific needs.

Review by Administrative Rules Review Committee

The Administrative Rules Review Committee, a bipartisan legislative committee which oversees rulemaking by executive branch agencies, may, on its own motion or on written request by any individual or group, review this rulemaking at its regular monthly meeting or at a special meeting. The Committee's meetings are open to the public, and interested persons may be heard as provided in Iowa Code section 17A.8(6).

The following rulemaking action is proposed:

Item 1. Rescind 811—Chapter 8 and adopt the following new chapter in lieu thereof:

CHAPTER 8

AUXILIARY PERSONNEL

811—8.1(169) Registered veterinary technician—certificate of registration.

8.1(1) In addition to the requirements set forth in Iowa Code section 169.34(1), prior to issuance of a certificate of registration, the applicant will:

a. Successfully pass the VTSE as approved by the board;

b. Provide a statement indicating all jurisdictions in which the applicant is or has ever been certified, licensed, permitted, or otherwise credentialed to perform authorized medical services to an animal patient as a veterinary technician, and consent to release to the board such information from jurisdictions in which the applicant is or has ever been certified, licensed, permitted, or otherwise credentialed;

c. Provide information or consent to the release of information pertinent to the character and education of the applicant as the board may deem necessary in order to evaluate the applicant's qualifications; and

d. Submit evidence of having completed at least 30 hours of approved continuing education within the last three calendar years from the date of the application, unless the applicant recently passed the VTNE within the last three calendar years. New graduates and applicants within one year after the date of graduation are exempt from continuing education requirements for initial certification. Applicants who apply more than one year but less than two years after the date of graduation need to complete at least ten hours of approved continuing education. Applicants who apply more than two years but less than three years after the date of graduation need to complete at least 20 hours of approved continuing education. A maximum of ten hours of continuing education may be achieved by the completion of approved distance education courses.

8.1(2) A certificate of registration issued during a triennium, upon the applicant's completion of these requirements and payment of the prorated triennial certificate of registration fee, is issued for the balance of the triennium. A certificate of registration expires on December 31 of the third year of the triennium.

811—8.2(169) Fee schedule for registered veterinary technicians.

8.2(1) The following fees are collected by the board and will not be refunded except by board action in unusual circumstances, such as documented illness of the applicant, death of the applicant, inability of the applicant to comply with the rules of the board, or withdrawal of an examination application provided withdrawal is received in writing 45 days prior to the examination date. However, the fees may be waived for qualifying military service personnel upon request. Examination fees are not transferable from one examination to another.

8.2(2) Based on the board's anticipated financial requirements, the following fees are hereby adopted:

811—8.3(169) Veterinary technician state examination. The VTSE is given at least once annually at a site or sites to be designated by the board at least 60 days before the date of the examination. The board may provide for additional veterinary technician state examinations as deemed appropriate. In the event the board provides for additional examinations, the site or sites of the examination are designated by the board at least 60 days prior to the date of the examination.

8.3(1) In order for an applicant to sit for the VTSE, the application and fee will need to be received by the board at least 30 days before the date of the examination. The fee for the VTSE may be waived for qualifying military service personnel upon request.

8.3(2) An applicant who fails to earn a passing score on the VTSE is entitled to retake the examination not earlier than 90 days since the applicant last took the examination. The applicant will submit a new application and the application fee in accordance with subrule 8.3(1) to retake the VTSE. An applicant is limited to five total attempts at the VTSE; any additional applications to retake the examination beyond the five allowable attempts may be considered by the board and may be granted at the board's discretion.

811—8.4(272C) Registration as veterinary technician by verification. Registration by verification for a veterinary technician is available in accordance with the following:

8.4(1) Eligibility. A person may seek registration by verification if the person is registered or licensed in at least one other jurisdiction and in circumstances set forth by Iowa Code section 272C.12(1).

8.4(2) Board application. The applicant will submit the following:

a. A completed application for registration by verification.

b. Payment of the application fee.

c. A verification form, completed by the licensing/registration authority in the jurisdiction that issued the applicant's license or registration, verifying that the applicant's license or registration in that jurisdiction complies with the requirements of Iowa Code section 272C.12. The completed verification form is sent directly from the licensing/registration authority to the board. This form is available on the board's website.

d. Proof of passing the VTSE.

e. A copy of the relevant disciplinary documents if another jurisdiction has taken disciplinary action against the applicant.

The board can waive these requirements pursuant to Iowa Code section 169.34(1)"e."

8.4(3) Applicants with prior discipline or pending licensing complaints or investigations. If another jurisdiction has taken disciplinary action against an applicant or if the applicant has a complaint, allegation, or investigation relating to unprofessional conduct pending before any regulating entity in another jurisdiction, the board will proceed according to Iowa Code section 272C.12(1)"f."

8.4(4) Limitations. A person who has had a license/registration revoked, or who has voluntarily surrendered a license/registration while under investigation for unprofessional conduct in another jurisdiction, is ineligible for registration by verification.

811—8.5(272C) Applicants with work experience in jurisdictions without licensure requirements.

8.5(1) Work experience. An applicant for initial registration who has relocated to Iowa from another jurisdiction that did not need a professional license or registration to practice in the profession may be considered to have met any educational and training requirements if the person meets the requirements detailed in Iowa Code section 272C.13(1). The applicant will satisfy all other requirements, including passing any necessary examinations, to receive a license.

8.5(2) Board application. The applicant will submit the following:

a. A completed application for registration through work experience.

b. Payment of the application fee.

c. Proof of passing both the VTNE and VTSE.

8.5(3) Mandatory documentation. An applicant who wishes to substitute work experience in lieu of satisfying applicable education or training requirements carries the burden of providing all of the following by submitting relevant documents as part of a completed registration application:

a. Proof of Iowa residency, which may include one or more of the following:

(1)A residential mortgage, lease, or rental agreement;

(2)A utility bill;

(3)A bank statement;

(4)A paycheck or pay stub;

(5)A property tax statement;

(6)A document issued by the federal or state government;

(7)Any other board-approved document that reliably confirms Iowa residency.

b. Proof of three or more years of work experience within the four years preceding the application for registration, which may include one or more of the following:

(1)A letter from the applicant's prior employer documenting the dates of employment;

(2)Paychecks or pay stubs; or

(3)Any other board-approved evidence of sufficient work experience.

c. Proof that the work experience was in a practice with a scope of practice substantially similar to that for the registration sought in Iowa, which includes:

(1)A written statement by the applicant detailing the scope of practice; and

(2)Business or marketing materials detailing the services provided.

d. Proof that a professional license/registration was not mandatory in the other state, which may include:

(1)Copies of applicable laws;

(2)Materials from a website operated by a governmental entity; or

(3)Materials from a national professional association.

811—8.6(169,272C) Endorsed certificate of registration.

8.6(1) The board may issue an endorsed certificate of registration to an individual who satisfies the requirements set forth in Iowa Code section 169.34(2) and who satisfies the following:

a. Successfully pass the VTSE as approved by the board;

b. Provide a statement indicating all jurisdictions in which the applicant is or has ever been certified, licensed, permitted, or otherwise credentialed to perform authorized medical services to an animal patient as a veterinary technician, and consent to release to the board such information from jurisdictions in which the applicant is or has ever been certified, licensed, permitted, or otherwise credentialed;

c. Provide information or consent to the release of information pertinent to the character and education of the applicant as the board may deem necessary in order to evaluate the applicant's qualifications; and

d. Submit evidence of having completed at least 30 hours of approved continuing education within the last three calendar years from the date of the application. New graduates and applicants within one year after the date of graduation are exempt from continuing education requirements for initial certification. Applicants who apply more than one year but less than two years after the date of graduation need to complete at least ten hours of approved continuing education. Applicants who apply more than two years but less than three years after the date of graduation need to complete at least 40 hours of approved continuing education.

8.6(2) The board can waive these requirements pursuant to Iowa Code section 169.34(2)"e."

811—8.7(169) Supervision of veterinary auxiliary personnel.

8.7(1) Emergencies. Under conditions of an emergency, veterinarian auxiliary personnel may render without supervision such lifesaving aid and treatment as follows: administration of oxygen; maintenance of airways including the nonsurgical insertion of an endotracheal tube; placement of an intravenous (IV) catheter; administration of fluids; external cardiac massage; and control of hemorrhage. Even under conditions of emergency, a veterinary assistant or veterinary technician student may not render additional lifesaving aid and treatment as follows: the administration of emergency pharmaceuticals. Emergency aid and treatment, if rendered to an animal not in the presence of a licensed veterinarian, may only be continued under the supervision of a licensed veterinarian, which in the case of emergency may include telephone or other means of immediate communication with a veterinarian en route to the site, until the veterinarian arrives in a timely manner.

8.7(2) Veterinary assistants. The following delegated tasks may be performed by a veterinary assistant under the indicated level of supervision if the supervising veterinarian has delegated the task.

a. Tasks that require direct supervision:

(1)Take patient's medical history.

(2)Take patient temperature, pulse, and respiratory rate (TPR).

(3)Oscillometric measurement of blood pressure.

(4)Record client/patient complaint(s).

(5)Administer subcutaneous (SQ) and intramuscular (IM) injections.

(6)Administer SQ fluid.

(7)Maintain IV fluids.

(8)Implant an SQ microchip.

(9)Implant growth-promoting implants.

(10)Manage a nasogastric (NG) tube, not including insertion or placement.

(11)Administer and monitor light/moderate sedation.

(12)Apply government-required identification.

(13)Administer internal and external parasite treatments.

(14)Vaccinate livestock.

(15)Vaccinate companion animals (excluding canine rabies, pursuant to Iowa Code section 351.33).

(16)Radiograph and ultrasound positioning.

(17)Ocular tonometry, fluorescein stain, and Schirmer Tear Testing to monitor animal eye health.

(18)Remove sutures, staples, or drains.

(19)Venipuncture for the purposes of IV injections and blood withdrawal for sampling.

(20)IV catheter placement.

(21)Expression of urinary bladder.

(22)Drain and lance abscesses.

(23)Dental prophylaxis (teeth cleaning).

(24)Laser therapy treatments.

(25)Take ear cytology samples.

(26)Conduct livestock necropsy for sample collection purposes.

(27)Administer medication(s) prescribed by a veterinarian other than medications administered while boarding the animal.

b. Tasks that require immediate supervision:

(1)Monitor heavy sedation.

(2)Monitor general anesthesia.

(3)Surgical assistance (including but not limited to passing instruments, tissue retraction, assist in hemostasis—utilizing sponges and clamps).

(4)Shockwave therapy for pain treatment.

(5)Take blood pressure.

(6)Nonsurgical castration.

(7)Nonsurgical dehorning.

(8)Place endotracheal tube (ET) tube.

(9)Administer anesthetic-related drugs (general anesthetic, not locals or reversal agents), maintenance and recovery.

(10)Administer enema.

(11)Animal dynamic rehabilitation therapies.

(12)Rectal palpation for pregnancy testing of bovine.

c. Veterinary assistants are not permitted to perform the following tasks:

(1)Reading ear and skin cytology.

(2)Equine floating teeth services.

(3)Gingival resection.

(4)Prohibitions contained in Iowa Code sections 351.33 and 169.32(2).

8.7(3) Veterinary technician student. A veterinary technician student may perform tasks as allowed in subrule 8.7(4) for registered veterinary technicians except that the tasks must be performed under the indicated level of supervision if the supervising veterinarian has delegated the task.

a. Tasks that require direct supervision include all tasks requiring indirect supervision if they were performed by a registered veterinary technician.

b. Tasks that require immediate supervision include all tasks requiring immediate or direct supervision if they were performed by a registered veterinary technician.

c. Tasks that are not allowed include all tasks that are not allowed to be performed by a registered veterinary technician.

8.7(4) Registered veterinary technician. The following delegated tasks may be performed by a registered veterinary technician under the indicated level of supervision if the supervising veterinarian has delegated the task.

a. Tasks that require indirect supervision:

(1)Administration, preparation, and application of treatments, including but not limited to drugs, medications, controlled substances, biological and immunological agents in livestock and previously established biologic and immunologic protocols in companion animals, unless prohibited by government regulation.

(2)Intravenous catheterizations and maintenance of intra-arterial catheterizations.

(3)Collection and preparation of cellular or microbiological samples impressions or other nonsurgical methods, except when in conflict with government regulations.

(4)Collection of urine by bladder expression, catheterization (unobstructed) and insertion of an indwelling urinary catheter.

(5)Monitoring, including but not limited to electrocardiogram (ECG), blood pressure, carbon dioxide (CO2) and blood oxygen saturation.

(6)Radiography and ultrasonography imaging for purposes other than diagnosis.

(7)Clinical laboratory test procedures.

(8)Implantation of a subcutaneous microchip.

(9)Laser therapy.

(10)Staple removal.

(11)Application of splints and slings for the temporary immobilization of fractures.

(12)Euthanasia of livestock as defined in Iowa Code section 717.1(4), excluding equine species.

b. Tasks that require direct supervision:

(1)General anesthesia and sedation, maintenance and recovery.

(2)Administer general anesthesia.

(3)Nonemergency endotracheal intubation.

(4)Regional anesthesia, including paravertebral blocks and local blocks.

(5)Dental procedures, limited to:

1.The removal of calculus, soft deposits, plaque, and stains.

2.The smoothing, filing, and polishing of teeth.

(6)Collection and preparation of cellular or microbiological samples by skin scrapings, except when in conflict with government regulations.

(7)Blood or blood component collection, preparation, and administration for transfusion or blood banking purposes.

(8)Placement of tubes, including but not limited to gastric, nasogastric, and nasoesophageal.

(9)Ear flushing with pressure or suction.

(10)Application of casts, splints, and slings for the immobilization of fractures.

(11)Fluid aspiration from a body cavity or organ (i.e., cystocentesis, thoracocentesis, abdominocentesis).

(12)Stapling and gluing of an existing surgical skin incision.

(13)Placement of intraosseous and nasal catheters.

(14)Performing enemas.

(15)Performing fluorescein stain ocular tonometry or the Schirmer tear test.

(16)Imaging, including but not limited to diagnostic radiography, diagnostic ultrasonography, computed tomography, magnetic resonance imaging, and fluoroscopy and the administration of radio-opaque agents or materials.

(17)Collection of blood, except when in conflict with government regulations.

(18)Administration of new/initial biological and immunological treatment protocols on companion animals.

c. Tasks that require immediate supervision:

(1)Suturing an existing surgical skin incision.

(2)Placing an epidural.

(3)Assisting with surgical procedures.

(4)Administering general anesthesia.

(5)Placing abdominal, thoracic, or percutaneous endoscopic gastrostomy (PEG) tubes.

(6)Single root extractions that do not require sectioning of the tooth or sectioning of the bone.

(7)Euthanizing any animal, including the equine species, that is not livestock as defined in Iowa Code section 717.1(4).

(8)Rectal palpation for pregnancy testing of bovine.

8.7(5) Veterinary student.

a. Unless otherwise prohibited by law, a veterinary student may perform surgery or diagnosis under direct or immediate supervision and may perform any other task delegated by the supervising veterinarian under indirect supervision.

b. A veterinary student may not prescribe any drug, medicine or biologic; administer rabies vaccine to dogs as described in Iowa Code section 351.35; sign a certificate of veterinary inspection as described in Iowa Code section 163.12; perform any task requiring USDA accreditation; or perform any task otherwise prohibited by law.

8.7(6) Foreign graduate.

a. Unless otherwise prohibited by law, a graduate of a foreign college of veterinary medicine or a person who has received an Educational Commission for Foreign Veterinary Graduates (ECFVG) or PAVE certificate, either of whom is not a licensed veterinarian, may perform surgery or diagnosis under direct or immediate supervision and may perform any other task delegated by the supervising veterinarian under indirect supervision.

b. A graduate of a foreign college of veterinary medicine or a person who has received an ECFVG or PAVE certificate, either of whom is not a licensed veterinarian, may not prescribe any drug, medicine or biologic; administer rabies vaccine to dogs as described in Iowa Code section 351.35; sign a certificate of veterinary inspection as described in Iowa Code section 163.12; perform any task requiring USDA accreditation; or perform any task otherwise prohibited by law.

811—8.8(169,272C) Continuing education.

8.8(1) In order to renew a certificate of registration, each credentialed veterinary technician completes, triennially, at least 30 hours of continuing education in courses approved by the board. The credentialed veterinary technician has the responsibility for financing continuing education. These credit hours may be obtained by attending approved scientific seminars and meetings on the basis of one credit hour for each hour of attendance. Attendance at any board-approved national, state or regional meeting will be acceptable. Credit for qualified graduate college courses may be approved on the basis of multiplying each college credit hour by 10, to a maximum of 15 hours during any one triennial. A maximum of ten hours during any one triennial may be achieved by the completion of approved distance education courses.

8.8(2) Each credentialed veterinary technician obtains the 30 credit hours between January 1 of the first year of the triennium and December 31 of third year of the triennium. Continuing education credits in excess of 30 hours for the triennium may be carried over to the next triennial period, but the total number of credits carried over cannot exceed 10 hours.

If a recent graduate is credentialed during the first year of the triennium, the person will complete 20 hours of continuing education for the first certificate of registration renewal. If a recent graduate is credentialed during the second year of the triennium, the person will complete ten hours of continuing education for the first certificate of registration renewal. If a recent graduate is credentialed during the third year of the triennium, the person is exempt from meeting continuing education requirements for the first certificate of registration renewal. For the purpose of this rule, "recent graduate" means a person who has graduated from an accredited or approved veterinary technology program no more than three years prior to application for certification of registration.

8.8(3) Completion of the continuing education will be reported to the secretary of the board of veterinary medicine on forms provided by the board by December 31 of the third year of the triennium.

8.8(4) Upon request, the board may waive continuing education requirements for qualifying military service personnel or spouse as defined in 811—Chapter 15.

These rules are intended to implement Iowa Code sections 17A.3, 169.4, 169.5, 169.9, 169.12, 169.20 and 272C.4.