HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: CS/CS/HB 723 Medical Treatment of Animals
SPONSOR(S): Commerce Committee, Regulatory Reform Subcommittee, Buchanan
TIED BILLS: IDEN./SIM. BILLS: SB 448
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Regulatory Reform Subcommittee 17 Y, 0 N, As CS Thompson Anstead
2) Commerce Committee 20 Y, 1 N, As CS Thompson Hamon
SUMMARY ANALYSIS
In Florida, the practice of “veterinary medicine” means the diagnosis of medical conditions of animals, and the
prescribing or administering of medicine and treatment to animals for the prevention, cure, or relief of a wound,
fracture, bodily injury, or disease. Veterinarians are regulated by the Board of Veterinary Medicine (Board) in
the Department of Business and Professional Regulation (DBPR) pursuant to ch. 474, F.S., relating to
veterinary medical practice (practice act). The purpose of the practice act is to ensure that every veterinarian
practicing in this state meets minimum requirements for safe practice to protect public health and safety.
Current law defines a “veterinarian/client/patient relationship” (VCPR) as one in which a veterinarian has
assumed responsibility for making medical judgments about the health of an animal and its need for medical
treatment. Veterinarians are permitted to prescribe drugs in the course of veterinary practice; however, the
veterinarian must be either personally acquainted with the keeping and caring of the animal and have recently
seen the animal, or have made medically appropriate and timely visits to the premises where the animal is kept
before prescribing drugs in the course of practice.
The use of electronic communications to facilitate patient health care (telemedicine) is not addressed in the
practice act and is not specifically prohibited or authorized in Florida. However, medical doctors may practice
telemedicine in Florida and may establish a patient relationship with a patient evaluation via telemedicine
under certain circumstances.
The bill establishes a framework for the practice of veterinary telemedicine as follows:
Authorizes a veterinarian practicing veterinary telemedicine to order, prescribe, or make available
medicinal drugs or drugs defined in ch. 465, F.S., the Florida Pharmacy Act.
Limits a veterinarian’s authority to prescribe controlled substances while practicing telemedicine to
situations where the veterinarian has previously performed an in-person physical examination or made
medically appropriate and timely visits to the premises where the animal is kept.
Prohibits veterinarian’s from prescribing Schedule II controlled substances while practicing
telemedicine, unless prescribed to treat a terminal patient that is transferred to the veterinarian for
hospice services by a veterinarian who has previously performed an in-person physical examination of
the patient, or made medically appropriate and timely visits to the premises where the animal is kept
and the veterinarian practicing telemedicine has reviewed the patient's medical records.
Specifies that only Florida licensed veterinarians may practice veterinary telemedicine, and grants the
Board jurisdiction over the practice of veterinary telemedicine.
Allows an animal control authority under the “indirect supervision” of a veterinarian to administer rabies
vaccinations.
The bill is not expected to have a fiscal impact on state or local government, and may have a positive fiscal
impact on the private sector.
The bill provides an effective date of July 1, 2022.
This docum ent does not reflect the intent or official position of the bill sponsor or House of Representatives .
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FULL ANALYSIS
I. SUBSTANTIVE ANALYSIS
A. EFFECT OF PROPOSED CHANGES:
Current Situation
Practice of Veterinary Medicine
The Board of Veterinary Medicine (Board) in the Department of Business and Professional Regulation
(DBPR) implements the provisions of ch. 474, F.S., relating to veterinary medical practice (practice
act). The purpose of the practice act is to ensure that every veterinarian practicing in this state meets
minimum requirements for safe practice to protect public health and safety.1
A “veterinarian” is a health care practitioner licensed by the Board to engage in the practice of
veterinary medicine in Florida2 and subject to disciplinary action from the Board for various violations of
the practice act.3
The practice of “veterinary medicine” is the diagnosis of medical conditions of animals, and the
prescribing or administering of medicine and treatment to animals for the prevention, cure, or relief of a
wound, fracture, bodily injury, or disease, or holding oneself out as performing any of these func tions.4
Veterinary medicine includes, with respect to animals: 5
Surgery;
Acupuncture;
Obstetrics;
Dentistry;
Physical therapy;
Radiology;
Theriogenology (reproductive medicine);6 and
Other branches or specialties of veterinary medicine.
The practice act does not apply to the following categories of persons:
Veterinary aides, nurses, laboratory technicians, preceptors, 7 or other employees of a licensed
veterinarian, who administer medication or provide help or support under the responsible
supervision8 of a licensed veterinarian;
Certain non-Florida licensed veterinarians who are consulting upon request of a Florida-licensed
veterinarian on the treatment of a specific animal or on the treatment on a specific case of the
animals of a single owner.
Faculty veterinarians when they have assigned teaching duties at accredited 9 institutions;
Certain graduated intern/resident veterinarians of accredited institutions;
1 S. 474.201, F.S.
2 S. 474.202(11), F.S.
3 Ss. 474.213 & 474.214, F.S.
4 See s. 474.202(9), F.S. Also included is the determination of the health, fitness, or soundness of an animal, and the performance of
any manual procedure for the diagnosis or treatment of pregnancy or fertility or infertility of animals.
5 See s. 474.202(13), F.S. Section 474.202(1), F.S., which defines “animal” as “any mammal other than a human being or any bird,
amphibian, fish, or reptile, wild or domestic, living or dead.”
6 The Society for Theriogenology, established in 1954, is composed of veterinarians dedicated to standards of excellence in animal
reproduction. See https://www.therio.org/ (last visited Jan. 5, 2022).
7 A preceptor is a skilled practitioner or faculty member who directs, teaches, supervises, and evaluates students in a clinical setting to
allow practical experience with patients. See also https://www.merriam-webster.com/dictionary/preceptor#medicalDictionary (last
visited Jan. 5, 2022).
8 The term “responsible supervision” is defined in s. 474.202(10), F.S., as the “control, direction, and regulation by a licensed doctor
of veterinary medicine of the duties involving veterinary services” delegated to unlicensed personnel.
9 Ss. 474.203(1) and (2), F.S., provide that accreditation of a school or college must be granted by the American Veterinary Medica l
Association (AVMA) Council on Education, or the AVMA Commission for Foreign Veterinary Graduates.
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Certain students in a school or college of veterinary medicine who perform assigned duties by
an instructor or work as preceptors;
Certain doctors of veterinary medicine employed by a state agency or the United States
Government;
Persons or their employees caring for the persons’ own animals, as well as certain part-time or
temporary employees, or independent contractors, who are hired by an owner to help with herd
management and animal husbandry tasks; and
Certain entities or persons 10 that conduct experiments and scientific research on animals as part
of the development of pharmaceuticals, biologicals, serums, or treatment methods of treatment
or techniques to diagnose or treatment of human ailments, or in the study and development of
methods and techniques applicable to the practice of veterinary medicine. 11
Any permanent or mobile establishment where a licensed veterinarian practices must have a premises
permit issued by DBPR.12 Each person to whom a veterinary license or premises permit is issued must
conspicuously display such document in her or his office, place of business, or place of employm ent in
a permanent or mobile veterinary establishment or clinic. 13
By virtue of accepting a license to practice veterinary medicine in Florida, a veterinarian consents to:
Render a handwriting sample to an agent of the department and, further, to have waived any
objections to its use as evidence against her or him.
Waive the confidentiality and authorize the preparation and release of medical reports
pertaining to the mental or physical condition of the licensee when the department has reason
to believe that a violation of this chapter has occurred and when the department issues an
order, based on the need for additional information, to produce such medical reports for the time
period relevant to the complaint.14
For Fiscal Year 2020-2021, there were 12,156 actively licensed veterinarians in Florida. DBPR
received 472 complaints, which resulted in 17 disciplinary actions. 15
Veterinarian/Client/Patient Relationship
The practice act defines a “patient” as any animal for which the veterinarian practices veterinary
medicine.16
The practice act defines a “veterinarian/client/patient relationship” (VCPR) as one in which a
veterinarian has assumed responsibility for making medical judgments about the health of an animal
and its need for medical treatment.17
Veterinarians are permitted to prescribe drugs in the course of veterinary practice, but may be
disciplined by the Board for certain related violations, including ordering, prescribing, or making
available medicinal drugs or drugs 18 or controlled substances 19 for use other than for the specific
treatment of animal patients for which there is a documented VCPR and without:
Having sufficient knowledge of the animal to initiate at least a general or preliminary diagnosis
of the medical condition of the animal, which means that the veterinarian is personally
10 See s. 474.203(6), F.S., which states that the exemption applies to “[s]tate agencies, accredited schools, institutions, foundations ,
business corporations or associations, physicians licensed to practice medicine and surgery in all its branches, graduate doctors of
veterinary medicine, or persons under the direct supervision thereof . . . .”
11 See s. 474.203, F.S.
12 S. 474.215(1), F.S.
13 S. 474.216, F.S.
14 S. 474.2185, F.S.
15 Department of Business and Professional Regulation, Division of Professions Annual Report Fiscal Year 2020 -2021,
http://www.myfloridalicense.com/DBPR/os/documents/DivisionAnnualReport_FY2021.pdf (last visited Jan. 5, 2022).
16 S. 474.202(8), F.S.
17 S. 474.202(12), F.S.
18 S. 465.003(8), F.S.
19 S. 893.02(4), F.S.
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acquainted with the keeping and caring of the animal and has recently seen the animal or has
made medically appropriate and timely visits to the premises where the animal is kept;
Being available to provide for follow-up care and treatment in case of adverse reactions or
failure of the regimen of therapy; and
Maintaining records which document patient visits, diagnosis, treatment, and other relevant
information required under the practice act.20
Veterinary Telemedicine
The use of electronic communications to facilitate patient health care (telemedicine) is not addressed in
the practice act and is not specifically prohibited or authorized for practitioners of veterinary medicine in
Florida.21
Veterinary Telemedicine During the Pandemic
On March 24, 2020, the U.S. Food and Drug Administration (FDA) announced that it would temporarily
suspend enforcement of certain prescription limitations in order to allow veterinarians to better utilize
telemedicine to address animal health needs during the COVID-19 pandemic. Specifically, the FDA has
provided guidance related to suspending the enforcement of the animal examination and premises visit
VCPR requirements relevant to FDA regulations governing Extralabel Drug Use in Animals22 and
Veterinary Feed Directive Drugs.23 This allows veterinarians to prescribe or authorize the use of
drugs without direct examination or making visits to patients, which will limit human-to-human
interaction and potential spread of COVID-19 in the community.24
According to the FDA, veterinarians are licensed by their state veterinary licensing board and must
meet the requirements of the licensing board to practice in that state. FDA regulates the devices and
drugs that veterinarians use, and the conditions under which veterinarians may prescribe drugs for
extra-label uses. When an approved drug is used in a manner other than what is stated on the label, it
is an extra-label use. This is commonly called an “off-label” use because the drug is used in a way that
is “off the label.”25
On March 27, 2020, DBPR issued emergency order EO 2020-04, which suspends any restriction of ch.
474, F.S., or ch. 61G-18, F.A.C., which would prohibit an active Florida-licensed veterinarian from
practicing telemedicine on a patient. The order specifies that attending veterinarians must be
comfortable assessing the patient remotely and feel able to exercise good clinical judgment to assist
the patient.26 The emergency order ended with the expiration of Florida’s COVID-19 state of emergency
(EO 20-52) on Saturday June 26, 2021.27
Veterinary Telemedicine in Other States
The use of telemedicine by veterinarians varies by state. Some states allow telemedicine to be used at
the veterinarian’s discretion, others allow it after the establishment of a VCPR, some do not allow it at
20 S. 474.214(1)(y)., F.S.
21 R. 64B8-9.0141, F.A.C. Currently, medical doctors may practice telemedicine in Florida in a patient relationship with a patient
evaluation, under certain circumstances.
22 21 C.F.R. part 530.
23 21 C.F.R. § 558.6.
24 U.S. Food and Drug Administration, Coronavirus (COVID-19) Update: FDA Helps Facilitate Veterinary Telemedicine Duri ng
Pandemic, https://www.fda.gov/news -events/press-announcements/coronavirus -covid-19-update-fda-helps-facilitate-veterinary-
telemedicine-during-pandemic (last visited Jan. 25, 2022).
25 .S. Food and Drug Administration, What FDA Does and Does Not Regulate, https://www.fda.gov/animal-veterinary/animal-health-
literacy/what-fda-does-and-does-not-regulate#top (last visited Jan. 5, 2022).
26 Department of Business and Professional Regulation, Emergency Order EO 2020-04, Mar. 27, 2020,
http://www.myfloridalicense.com/dbpr/os/documents/EO_2020 -04.pdf (last visited Jan. 5, 2022).
27 On March 9, 2020, Governor DeSantis issued Executive Order 20-52 which declared a state of emergency for the entire state due to
COVID-19. The Executive Order was extended several times. Executive Order 21-94 extended the state of emergency for sixty days
from April 27, 2021. The sixtieth day was Saturday June 26, 2021, and the order was not renewed by the Governor.
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all, and others limit telemedicine for purposes of prescribing medication or controlled substances.
Virginia allows veterinarians to practice telemedicine. In addition, it allows a veterinarian who performs
or has performed an appropriate examination of a patient to prescribe certain controlled substances to
a patient via the practice of telemedicine. The Virginia Board of Veterinary Medicine adopted guidance
effective September 17, 2020, for telehealth in the practice of veterinary medicine, which indicates that:
“Using telehealth technologies in veterinary practice is considered a method of service
delivery. The current, applicable regulations apply to all methods of service delivery,
including telehealth. The licensee is responsible for using professional judgment to
determine if the type of service can be delivered via telehealth at the same standard of care
as in-person service.”28
The Idaho Board of Veterinary Medicine provides the following guidance on telehealth:
“The veterinarian must employ sound profession judgment to determine whether using
Telehealth is appropriate in particular circumstances each and every time animal care is
provided and only provide medical advice or treatment via Telehealth to th