HOUSE OF REPRESENTATIVES STAFF ANALYSIS
BILL #: HB 849 Veterinary Practices
SPONSOR(S): Killebrew and others
TIED BILLS: IDEN./SIM. BILLS: SB 1040, SB 1162
REFERENCE ACTION ANALYST STAFF DIRECTOR or
BUDGET/POLICY CHIEF
1) Regulatory Reform & Economic Development 12 Y, 0 N Thompson Anstead
Subcommittee
2) Commerce Committee 18 Y, 0 N 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 (telehealth) is not addressed in the
practice act and is not specifically prohibited or authorized in Florida. However, medical doctors may practice
telehealth in Florida and may establish a patient relationship with a patient evaluation via telehealth under
certain circumstances.
The bill creates an act cited as the Providing Equity in Telehealth Services (PETS) Act, which establishes a
framework for the practice of veterinary telehealth as follows:
Authorizes a veterinarian practicing veterinary telehealth to order, prescribe, or make available
medicinal drugs or drugs as defined in s. 465.003, F.S., the Florida Pharmacy Act.
Limits a veterinarian’s authority to use telehealth to prescribe a controlled substance listed in Schedule
II of s. 893.03, F.S.
Allows veterinarians who are personally acquainted with the caring or keeping of an animal or group of
animals for food-producing animal operations, who have recently seen the animals or made medically
appropriate and timely visits to practice veterinary telehealth for these animals.
Specifies that only Florida licensed veterinarians may practice veterinary telehealth, and grants the
Board jurisdiction over the practice of veterinary telehealth.
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, 2024.
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 practices 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 they are 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 functions. 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;
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. S. 474.202(1), F.S., defines “animal” as “any mammal other than a human being or any bird, amphibian,
fish, or reptile, wild or domestic, living or dead.”
6 Theriogenology is a branch of veterinary medicine concerned with veterinary obstetrics and with the diseases and physiology of
animal reproductive systems. See https://www.merriam-webster.com/ medical/theriogenology (last visited Jan. 5, 2024).
7 A preceptor is a skilled practitioner or faculty member who directs, teaches, supervises, and evaluates students in a clinica l setting to
allow practical experience with patients. See also https://www.merriam-webster.com/dictionary/preceptor#medicalDictionary (last
visited Jan. 56, 2024).
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 Medical
Association (AVMA) Council on Education, or the AVMA Commission for Foreign Veterinary Graduates.
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Certain graduated intern/resident veterinarians of accredited institutions;
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 employment 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 2021-2022, there were 12,360 actively licensed veterinarians in Florida. DBPR
received 568 complaints, which resulted in 26 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:
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 doc tors 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 2021 -2022,
http://www.myfloridalicense.com/DBPR/os/documents/Division%20Annual%20Report%20FY%2021 -22.pdf (last visited Jan. 5,
2024).
16 S. 474.202(8), F.S.
17 S. 474.202(12), F.S.
18 S. 465.003(8), F.S.
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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
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 (veterinary telemedicine) is not
addressed in the practice act and is not specifically prohibited or authorized for practitioners of
veterinary medicine in Florida.21
According to research conducted by the American Veterinary Medical Association (AVMA), almost one-
third of all pets in the U.S. do not regularly see a veterinarian.22 The reasons for this include cost of
veterinary care, logistical obstacles, and a shortage of licensed veterinarians. 23
Veterinary telemedicine has been found to “help pet owners avoid additional expenses related to
unnecessary time off work or transportation and may provide cost-effective options. Telemedicine can
also address problems with bringing pets to clinics that may be faced by many pet owners, such as
seniors, disabled individuals, those without transportation, and owners of fearful, large, or potentially
aggressive pets.”24
“Interest in veterinary telemedicine has grown significantly in recent years, driven in part by a critical
shortage of veterinary professionals in the workforce and boosted by COVID-19 pandemic emergency
orders that temporarily suspended legal barriers to veterinary telemedicine.”25
Expanding access to veterinary telemedicine may alleviate some of these problems, including, “industry
problems with workforce shortages of veterinary professionals, increased caseloads, and limited work-
life balance.”26
In the human health setting, a 50 state survey conducted by the AVMA found that “all states allow a
physician to establish a relationship with a new patient over telemedicine.” 27 However, the same
approach does not appear to exist with veterinary medicine.
Opponents of veterinary telemedicine argue that animals cannot articulate symptoms like humans,
making physical examinations necessary to diagnose animal ailments. However, it has been found that
“while animals cannot verbally communicate, they provide behavioral signals, which can potentially be
more informative than seeing an animal in an unfamiliar place where the animal is not behaving as it
19 S. 893.02(4), F.S.
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 Malinda Larkin, New, Old Challenges Beg for Radical Change in Veterinary Profession, JAVMA News (Dec. 3, 2020),
https://www.avma.org/javma-news/2020-12-15/new-old-challenges-beg-radical-change-veterinary-profession (last visited Jan. 9,
2024).
23 The Veterinary Care Accessibility Project, Veterinary Care Accessibility Score, https://www.accesstovetcare.org/ (last visited Jan.
9, 2024).
24 Camille DeClementi, Jennifer Hobgood, and Diana Ferguson, IN THE CARDS: BETTING ON VETERINARY TELEMEDICINE
LEGAL REFORM, Florida Bar Journal, (Dec. 2022), https://www.floridabar.org/the-florida-bar-journal/in-the-cards-betting-on-
veterinary-telemedicine-legal-reform/ (last visited Jan. 9, 2024).
25 Id.
26 Id.
27 American Medical Association, 50-State Survey: Establishment of a Patient-Physician Relationship Via Telemedicine,
https://www.ama-assn.org/system/files/2018-10/ama-chart-telemedicine-patient-physician-relationship.pdf (last visited Jan. 9, 2024).
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customarily would. In a clinic setting, dogs and cats may become extremely fearful and withdrawn, and,
in a situation that they perceive as threatening, animals may mask their pain as a survival
mechanism.”28
Historically, physicians resisted expansion of telemedicine in human medicine for similar reasons. By
the 1990s, resistance in the medical community had largely subsided. 29
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
provided guidance related to suspending the enforcement of the animal examination and premises visit
VCPR requirements relevant to FDA regulations governing Extra-label Drug Use in Animals30 and
Veterinary Feed Directive Drugs.31 This allowed veterinarians to prescribe or authorize the use of
drugs without direct examination or making visits to patients, in an effort to limit human-to-human
interaction and potential spread of COVID-19 in the community.32
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.”33
On March 27, 2020, DBPR issued emergency order EO 2020-04, which suspended 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 patie