Bill Summary – FastDemocracy

SB 189
                      Department of Legislative Services
                              Maryland General Assembly
                                    2020 Session
                           FISCAL AND POLICY NOTE
                              Third Reader - Revised
Senate Bill 189               (Senators Gallion and Bailey)
Education, Health, and Environmental Affairs          Environment and Transportation
    State Board of Veterinary Medical Examiners – Cease and Desist Orders and
                                  Civil Penalties
This bill authorizes the State Board of Veterinary Medical Examiners (SBVME), on review
and approval of the Secretary of Agriculture, or the Secretary’s designee, to issue a cease
and desist order or impose a civil penalty against a person for specified reasons, including
(1) practicing, attempting to practice, or offering to practice veterinary medicine without
being licensed; (2) taking an action for which SBVME determines there is a preponderance
of evidence of grounds for discipline under specified existing provisions; or (3) taking an
action that poses a serious risk to the health, safety, and welfare of an animal patient. The
bill also establishes procedural requirements and other provisions related to the cease and
desist order and civil penalty authority.
                                    Fiscal Summary
State Effect: General fund revenues and special fund expenditures may increase relatively
minimally each fiscal year, beginning in FY 2021.
Local Effect: None.
Small Business Effect: None.
                                         Analysis
Bill Summary: The bill authorizes SBVME, on review and approval of the Secretary of
Agriculture, or the Secretary’s designee, to issue a cease and desist order against a person
who:
      practices, attempts to practice, or offers to practice veterinary medicine in violation
       of specified existing prohibitions, including practicing veterinary medicine without
       being licensed, registered, and otherwise authorized to engage in the practice; or
      takes an action (1) for which SBVME determines there is a preponderance of
       evidence of grounds for discipline under § 2-310 of the Agriculture Article
       (Standards of Conduct and Ethics; Grounds for Refusal, Suspension, or Revocation
       of License) or § 2-313 of the Agriculture Article (Prohibited Acts) or (2) that poses
       a serious risk to the health, safety, and welfare of an animal patient.
In lieu of a cease and desist order, SBVME may impose a civil penalty of up to (1) $5,000
for a first offense and (2) $10,000 for a second or subsequent offense. In setting the amount
of a civil penalty, SBVME must consider (1) the seriousness of the violation; (2) the harm
caused by the violation; (3) the good faith of the violator; (4) any history of previous
violations by the violator; and (5) any other relevant factors. Before a civil penalty is
imposed, the board must provide a person notice of the alleged violation and an opportunity
for a hearing.
A person against whom a cease and desist order is issued or a civil penalty is imposed may
seek review of the order or penalty under the Administrative Procedure Act.
An action for a cease and desist order or a civil penalty is in addition to, and not instead of,
(1) existing authorized disciplinary actions against a veterinarian or veterinary practitioner
or (2) an action for injunctive relief.
SBVME must adopt regulations to carry out the provisions of the bill, including hearing
procedures and sanctions for violations of a cease and desist order. The sanctions
established by regulations may include a civil penalty consistent with the civil penalty
authority established under the bill.
Any penalties collected are paid into the State general fund.
Current Law:
Section 2-313 of the Agriculture Article (Prohibited Acts)
With the exception of specified acts or omissions in giving emergency veterinary aid, care,
or assistance, a person may not:
      practice veterinary medicine unless the person is licensed, registered, and authorized
       to engage in the practice by SBVME;
SB 189/ Page 2
      practice veterinary medicine under a name other than the one on the person’s license
       and registration, or induce any person to so practice in violation of State law
       governing SBVME and the practice of veterinary medicine;
      practice veterinary medicine unless the person’s license and registration are
       displayed in the person’s regularly established office and place of practice;
      own, maintain, conduct, operate, or manage a veterinary office, veterinary dental
       office, veterinary hospital, or a dog, cat, or animal hospital, unless (1) the person is
       a licensed veterinarian or (2) the office or hospital is under the direct supervision
       and control of a licensed and registered veterinarian and a license or registered
       veterinarian is employed in the office or hospital;
      advertise any veterinary office, veterinary dental office, veterinary hospital, or a
       dog, cat, or animal hospital except in accordance with rules and regulations of
       SBVME;
      subject to exceptions, practice veterinary medicine and sell or dispense any
       medication, which is not in the original manufacturer’s container;
      advertise as an SBVME registered veterinary technician unless registered with the
       board; or
      practice as a veterinary technician unless employed by a veterinary practitioner.
Specific penalties are not established for violations of these prohibitions; however, the
board may bring an action for an injunction against a person who violates the statutory
provisions governing SBVME and the practice of veterinary medicine (within which the
prohibitions are included). The prohibitions are also within the Agriculture Article, and a
violation of any provision of the Agriculture Article is a misdemeanor and subject to fines
and/or imprisonment specified under Title 12 of the article.
Section 2-310 of the Agriculture Article (Standards of Conduct and Ethics; Grounds for
Refusal, Suspension, or Revocation of License)
SBVME may refuse, suspend, or revoke any application or license, and censure or place
on probation any licensee after a hearing, if the veterinarian or veterinary practitioner:
      is unable to practice veterinary medicine competently due to a physical or mental
       disability;
      is convicted of a violation of specified State or federal drug-related laws;
      is convicted of a felony, or of a crime involving moral turpitude;
      is convicted of (1) violating any provision of State law governing SBVME and the
       practice of veterinary medicine; (2) any unlawful or fraudulent practice; or (3) any
       fraudulent, misleading, or deceptive representation or advertising concerning the
       veterinarian’s or veterinary practitioner’s professional qualifications or the quality
SB 189/ Page 3
       of materials or drugs used by them in their professional work or in the treatment of
       animals;
      has a final judgment entered against them in a civil malpractice case involving gross
       personal negligence;
      obtains the license by fraud or misrepresentation, either in the application, or in
       passing the examination;
      is guilty of employing or permitting to practice veterinary medicine any person who
       does not hold a license to practice veterinary medicine in the State;
      fails to comply with SBVME rules or regulations after receiving a license;
      is grossly negligent or deliberately cruel to an animal;
      is determined by four members of the board to be professionally incompetent as a
       veterinary practitioner;
      is disciplined by a licensing authority of another state, including the suspension or
       revocation of a license to practice veterinary medicine, for an act that would be
       grounds for disciplinary action under Maryland law; or
      fails to comply with specified animal cruelty or animal fighting reporting
       requirements.
Penalties in Lieu of or in Addition to Suspension or Revocation
In lieu of or in addition to suspension of a license, and in addition to revocation of a license,
SBVME may impose a penalty of up to $5,000 for a first offense. In addition to suspension
or revocation of a license, the board may impose a penalty of up to $10,000 for a second
or subsequent offense. Any penalties collected are paid into the general fund.
Background: With respect to the existing prohibition against practicing veterinary
medicine without a license, SBVME periodically receives complaints about
non-veterinarians who are practicing veterinary medicine but views its primary recourse to
be to refer incidents to the State’s Attorney or law enforcement for whom the complaints
can be a low priority. The board has the authority to seek injunctive relief in court but has
not used that option. The authority under the bill to issue a cease and desist order or impose
a civil penalty on a person who practices, attempts to practice, or offers to practice
veterinary medicine without a license will give the board another enforcement option that
is expected to be more efficient and effective than its existing options.
SBVME indicates that the ability under the bill to also issue cease and desist orders to
licensed veterinarians gives the board another enforcement option if a veterinarian is
engaging in a practice the board finds harmful but may be better addressed by preventing
continuation of that specific practice (e.g., a type of surgery for which the veterinarian does
not have a sufficient skill level) rather than the full suspension or revocation of the
veterinarian’s license.
SB 189/ Page 4
State Revenues: General fund revenues may increase relatively minimally each
fiscal year, beginning in fiscal 2021, to the extent civil penalties are imposed under the bill.
SBVME indicates that it does not expect that there will be an overwhelming number of
cases of unauthorized practice of veterinary medicine that it will need to pursue, and civil
penalties may not be imposed in every case. It also does not expect the civil penalty
authority under the bill to materially change the amount of civil penalties imposed on
veterinarians and veterinary practitioners in comparison to what is currently imposed under
existing authority.
State Expenditures: Special fund expenditures may increase relatively minimally
each fiscal year, beginning in fiscal 2021, to the extent hearings need to be conducted as a
result of the issuance of a cease and desist order or the imposition of a civil penalty.
SBVME indicates that hearings may cost $3,000 to $5,000 per hearing, but does not expect
hearings to occur frequently.
                                 Additional Information
Prior Introductions: None.
Designated Cross File:         HB 545 (Delegate Griffith, et al.) - Environment and
Transportation.
Information Source(s): Maryland Department of Agriculture; Department of Legislative
Services
Fiscal Note History:       First Reader - January 27, 2020
rh/lgc                     Third Reader - March 14, 2020
                                  Revised - Amendment(s) - March 14, 2020
Analysis by: Scott D. Kennedy                             Direct Inquiries to:
                                                          (410) 946-5510
                                                          (301) 970-5510
SB 189/ Page 5
Statutes affected: 
Text - First - State Board of Veterinary Medical Examiners - Practicing Veterinary Medicine Without a License - Cease and Desist Order and Civil Penalty: 2-313.2 Agriculture
Text - Third - State Board of Veterinary Medical Examiners – Cease and Desist Orders and Civil Penalties: 2-313.2 Agriculture, 2-313 Agriculture