House Agriculture, Forestry and Economic Development

February 1, 2023

Rep Fortner: Thank you very much. I appreciate you making the extra effort to be here today. I know it wasn’t easy. And those of you in the audience, we appreciate you too because it took an effort to get here period. This morning, we’ve got a couple bills we’re going to hear. Has everyone had an opportunity that wants to speak either for or against to sign up? If you want to speak that’s your right, but you have to sign up so we can recognize you. Okay, with that said, we’re going to– oh, Vice-Chairman Lynch, do you have anything to say this morning?

Rep Lynch: I feel like a stepchild. Okay, so don’t forget next Wednesday at 9:45 we’ll be taking our group pictures, so next Wednesday at 9:45. So wear your bow ties. And LSU will be here tomorrow. Chairman Fortner will be announcing the time and the place upon adjournment tomorrow. So that’ll let everybody know where you need to be if you want to come, thanks.

Rep Fortner: And just to supplement that a little bit, for that LSU meeting, we’re going to invite the whole body. So everybody can come but they’re coming to talk to us but we’re going to let everyone come and hear about that school and LSU and how that works for our students. All right, Representative Vaught, you’re on the agenda. Are you ready?

Rep Vaught: Yes, sir.

Rep Fortner: Okay, are you going to present House Bill 1033, or are we going to skip over that one today?

Rep Vaught: Skip over that one, please.

Rep Fortner: All right, we’ll skip over 1033. Are you prepared to present House Bill 1182?

Rep Vaught: Yes, sir. And I have an amendment.

Rep Fortner: All right, you’re recognized for your amendment.

Rep Vaught: So I needed to add a Senator to the bill, so this amendment will add Senator Hill to be a co-sponsor on the other end.

Rep Fortner: All right, is there any questions for her on that? It’s pretty straightforward. All right, all in favor. Oh, wait a minute.

Rep Vaught: Motion do pass.

Rep Fortner: Motion to adopt the amendment?

Rep Vaught: Yes.

Rep Fortner: Okay, all in favor? Any opposed? All right. That’s why we got the smart young guy here to keep the old guy– oh, no comments. All right, now are you ready to proceed with your bill?

Rep Vaught: Yes, sir.

Rep Fortner: As amended?

Rep Vaught: As amended, yes, sir. So I figure by now most of y’all have heard a lot about House Bill 1182. It is the veterinarian technician specialist bill. As you’re all aware, Arkansas has a shortage in large animal veterinarians and an abundance of livestock, large livestock in our state. I believe those producers deserve and want quality veterinarian care. Unfortunately, there aren’t enough new veterinarians going into our state to help sustain us. 

And I know that I’ve seen where some people say well, just add slots to Mississippi, add slots to LSU. And that’s a great idea. I’m not against that idea. The problem is that’s eight years out before we have somebody from those slots. And they may not come back to Arkansas after they’re in those states. So we have to account kind of for that too, the number of years that it would take to get someone in and out of school. And with our average age of large animal veterinarians being 55 plus, you can see that we need to do something sooner rather than later.

I’ve been working with both sides on this bill, I’ve had comments from each side that they want this and they want that. So I gave Arkansas VMA everything they’ve asked for with the exception of they wanted to take out all the prescriptive authority. And I will go through the bill in a minute and show you where there’s restrictions around that already in place. I felt it’s important for us to leave that in there just in case the federal government does approve certain restricted drugs. And this way we won’t have to wait for a session to come back and run a bill or we won’t have to be asking for a special session and it’ll be the trigger that allows them to just go ahead and do those things.

In this bill, I have a definition of collaborative practice agreements, and I’ve added a definition of that practice. This bill in no way allows anyone to hang their own shingle, and I’ll show that in the bill in just a few seconds also. And a vet that doesn’t want to use these veterinarian technician specialists, they don’t have to hire them. But this is something that rural veterinarians that deal with nothing but large or mainly large animals, this is something that’s very appealing to those veterinarians.

I should also mention that the veterinarian technician specialist board certification can only be attained after a minimum of five years of clinical experience as a credentialed technician or technologist. So on average, the combination for this person, the combination of school that they will get will be seven to nine years. It’s not like this is going to be a flip around either. But it will help these people who didn’t get accepted to veterinarian school. I think those that want to do something in this field but they don’t want to go to vet school, this might be appealing to those that would like to work in this industry also.

So on average, it’s a combination of seven to nine years of education and clinical experience that is required prior to application. So they can’t even apply for this until they’ve served this time, just so you understand, have this education. They have to log in a minimum of 50 cases and complete four in-depth case reports within the application year. So they’ve got to do all of that in one year.

So I kind of want to give you a little bit of backdrop on to become a nurse practitioner. It takes less years to become a nurse practitioner than it does to be this. So it’s not like we’re giving less education. We’re actually educating them more than what even a nurse practitioner would have to get. And I will say the veterinarian tech specialists, they are not– I mean, I didn’t give them all that they wanted either. So I tried to come into the middle, figure out something that was good for Arkansas and for our livestock producers that would benefit everybody. So it’s not like I gave one group all that they wanted and the other group only partial of what they wanted. I truly tried to find middle ground for everybody. And hopefully, that we could get something passed.

If you’ll look in the bill, if you don’t mind pull up the bill. I know a lot has been said about the supervision part of the bill. And if you’ll go to page 3, line 16, it says “a veterinarian technician specialist shall perform specialized veterinary technology under the direction, supervision, and responsibility of the licensed veterinarian.” So you can see again, they cannot hang their own shingle. They are still underneath the veterinarian and the veterinarian is the one who is responsible for that caseload.

If you go down to line 23, it says “supervision of the veterinarian technician specialist may be direct supervision, indirect supervision, and immediate supervision. A veterinarian who utilizes indirect supervision of a veterinarian technology specialist shall” – you’ll notice the word shall – “retain control of the authority over the care of the animal patient and review all the record-keeping and notes documented by the veterinarian technician specialist on the charts regarding the care of the animal patient.” So as you can see, the vet is still in control of this animal. So this isn’t like they can just go out and do what they want to do without having some boundaries on them. 

A licensed veterinarian, if you’ll go down to 33, yeah, go down to 36. This subsection does not relieve a veterinarian technician specialist of the responsibility or liability of any of his or her own acts. So the part above it, I was talking about the vet’s still in control of the animal. This is a way to make sure if we keep the perimeter surrounded like that, it’s a way to make sure that the vet– that this will not be abused. Because again they can’t go hang their own shingle, they still have to be under a collaborative with the veterinarian. And it says that the veterinarian would be responsible but it also says that it “does not relieve a veterinarian technology specialist of any responsibilities or liabilities for his or her own acts and omissions.”

If you look to the next line, “a licensed veterinarian shall not” – again shall not – “establish a separate office or clinic in a location other than his or her regular office and place the separate office or clinic under the control or supervision of a veterinarian technician specialist.” Again, they cannot hang their own shingle. They have to be within that practice where that veterinarian is at. I know that there’s been a lot of emails about how the vet, how this could be– a vet could just start opening up clinics everywhere. We could have somebody from New York open up a vet clinic here. It states in the bill also that it has to be a vet clinic from Arkansas. So this again is a tight-knit perimeter that says only this way can we do this, okay?

So if you’ll go down– let me see, if you’ll go down to line 18 on page 4, it says “a veterinarian shall not enter into a collaborative practice agreement with more than three veterinarian technician specialists at one time.” So again, they can’t have practices all over Arkansas where they’re abusing this. They can only have three of these people even underneath them at one time. So again that’s very tight-knit, can’t be abused, very tight-knit.

If you will go down to line 36 on page 4. “If a collaborative practice results in a complaint, a violation of this chapter, the Veterinarian Medical Examining Board may review the role of the collaborating veterinarian or the veterinarian technician specialist, and in collaborative practice to determine if the collaborating veterinarian or the veterinary technician specialist is unable to manage his or her responsibilities under the collaborative practice agreement.” So again there is a stop there if something does go wrong and there is a complaint, there is a place to go to and complain. 

I will say that I believe– I hope I don’t talk out of turn, Representative Beaty. But Representative Beaty had somebody give him a great idea that I think is a good idea too. Maybe we should put teeth in that, and if somebody does go rogue, then they can be fined and their licenses can be, the certification for the veterinary technician specialist could be stripped. And I’m for that, if that helps us keep it more tight-knit, I told him we would draft it. I’d help him run it because I believe that that’s a good add.

If you go down to page 5 line 10, it says “the board may” – not shall, it says they “may grant a certification of prescriptive authority to a veterinarian technician specialist who” – and then it gives you who can get it. And I understand that the federal government right now has not released this to go into place. Once again, I know there are certain drugs that they cannot administer, I realize that. But again this is the trigger part. And actually, that certificate wouldn’t even be given out until the trigger happened, does that make sense? I hope that makes sense to everybody because it does not say they shall, it says they may. 

And they also, if you look at line B and C in that same subsection. They have to submit proof of having entered into a collaborative practice agreement with a collaborating veterinarian and acknowledge in writing that he or she is familiar with all states and federal laws and rules regarding prescription, and agrees to comply with those state and federal laws and rules.

If you go down to– because there was another email that I received that talked about the relationship between the animal patient and the veterinarian and the vet specialist. If you go down to line 30, it starts talking about the relationship with and how that’s established. “To establish care for a new animal patient by forming a preliminary veterinarian clinic-patient relationship” – so I’m going to use. Somebody comes in, they’ve not been to this vet but their dog was hit and they need somebody to help them with their dog immediately but they’ve never been to the vet. In my area I could say, somebody who has a little horse or a little pony, that they’ve never taken to the vet and the pony gets sick or gets hurt, then they could establish that relationship after being seen. And I want to say that it says 15 days, within 15 days, that animal must be seen again, all right? So that kind of takes care of that.

If you will go to page 6, line 5, it says “performing minor dental and surgical procedures on animal patients excluding” – because I know there was an email sent out about oh, they’re going to be doing major surgery, major abdominal surgeries. It says “excluding major abdominal, thoracic, and orthopedic surgeries, and neurosurgery.” So those things will not be happening by these technician specialists.

If you’ll look down to line 8. “Administering a drug or a controlled substance to prevent suffering of an animal patient, including without limitation, euthanasia under direct communication with the collaborating veterinarian.” So they cannot even do that without being the veterinarian saying yes, do that.

Let me see how– again this subsection, if you’ll go to line 14 that same area, line 14 says that this can be done. These protocols can’t even be established except when the conflict is– can’t go against state and federal there again. That can’t go against what the federal government says or what the state government says. And you can see that I want that to be in there over and over and over so that we have those tight perimeters so that we don’t have rogue people out there giving medicine that they can’t give. I still say my veterinarians are smart enough to know what those laws are and what people can and cannot give. And they’re not willing to lose their licenses over going rogue. And I would say that a specialist, this veterinarian technology specialist, would not be willing to lose the number of years that they’ve spent in school to become this to go rogue.

So if you look down to line 18. “A preliminary veterinarian-client-patient relationship shall be established between the veterinarian technician specialist and the animal patient or client prior to prescribing under this subsection, unless a veterinarian clinic client-patient relationship already exists.” So again it’s a preliminary. They’ve still got to go back 15 days and make sure that they establish that relationship. They’ve also got to give an informed consent note in the animal patient record treatment. They’ve got to inform that client I’m not a veterinarian, I’m a veterinarian tech. So they know who they’re dealing with, all right?

And then the last section we added the vaccinations for rabies because I understand maybe this is the part all vets actually love. So this right here will give them the rights to go back. The licensed veterinarian technician specialist or agent of the Department of Health to be able to give those rabies shots.

This is not about somebody wanting to take over and be a veterinarian. It’s truly about wanting to be that helping hand to that veterinarian so that they can see more– so large animal vets can see more clients. So it’s not about taking over that role. I think several of you have seen or read the task force recommendations, solutions for the technician utilization. And if you haven’t, I sent it to everybody I do believe this morning. And several of you told me that you had already found that. And if you look at that, we’re trying to do what they have recommended that states do to help these large vets. And with that, Mr. Chair, I’ll take questions.

Rep Fortner: Representative Vaught has presented her bill. Committee members, do you have any questions? Representative Cozart.

Rep Cozart: Thank you, Mr. Chairman. Representative Vaught, I have some pretty simple questions I think, maybe a couple of them real quick. I think I can put it all together. My main concern is if they’re going to work directly for a veterinarian, they’re going to be the one over them and they’re really not going to have their own shingle out. So when they go out and work on someone’s large animal, who does the billing for that job? And if they bill their own would the veterinarian get a part of that?

Rep Vaught: The veterinarian will be the one who bills.

Rep Cozart: So they’ll be totally responsible for billing so they will–?

Rep Vaught: They’re responsible for the animal the entire time.

Rep Cozart: Thank you. That’s all I needed. Thank you, ma’am.

Rep Vaught: Yes, sir.

Rep Fortner: Yes, Representative Magie, go ahead.

Rep Magie: Thank you, Mr. Chair. So go back over for me a minute the rules about the drugs. The federal law, the way I understand it right now through the prescriptive authority, these people are not recognized at a federal level to prescribe anything.

Rep Vaught: Correct.

Rep Magie: Okay. So how does putting this in the bill at this time do anything?

Rep Vaught: So if they do a regulation, because the task force report shows this is a direction in which they’re looking to take, okay that needs to be taken. This way it’s already here. It already has safeguards all the way around it. You can’t even get the certificate to actually even prescribe until the federal government moves something forward.

Rep Magie: Okay. Can I ask one more?

Rep Fortner: Certainly, go ahead.

Rep Magie: Thank you, Mr. Chair. So explain this to me too. The veterinarian is going to be ultimately liable for whatever this veterinary technician does? 

Rep Vaught: Yeah. They are both liable. They’re both liable. It’s in the bill.

Rep Magie: Well, what about– I mean, I don’t know anything about veterinary malpractice insurance. Does malpractice insurance companies–

Rep Vaught: They will sell to the technician.

Rep Magie: –will they cover their technicians?

Rep Vaught: Yes, sir.

Rep Magie: And so it’ll cover the veterinarian?

Rep Vaught: Yes, sir.

Rep Magie: Okay. That wasn’t my understanding that they all covered that.

Rep Vaught: I think I’ll have somebody come to the table who will tell you that you can buy that yourself even.

Rep Magie: Okay. Thank you, Mr. Chair.

Rep Fortner: Any other questions, Committee?

Rep Vaught: Thank you, Mr. Chair.

Rep Fortner: All right. Now, there were several people came in before. If there’s anybody out there that wants to speak for or against this that didn’t have a chance to sign in, raise your hand and we’ll bring this list to you because you have to sign in to speak. We encourage you to speak but if you didn’t get here in time to sign in just raise your hand and we’ll bring it to you.

Okay. All right, we have several that want to speak. What I’ll ask you to do is be as concise and try not to be redundant and go over and over on the same issues. We’re semi-bright and we can understand it the first time. So just try to keep your comments succinct and to the point. Okay, I’m going to start off with Lindy O’Neal, and I understand you are against it. If you’d sit down and recognize yourself for the record.

O’Neal: Thank you, Mr. Chair. I’m really nervous if my voice quivers. I’m Lindy O’Neal, thank you. So if I talk too fast please slow me down, and if my voice quivers just bear with me. I’m a small animal veterinarian in Rogers, Arkansas. I’ve been practicing for 13 years and I graduated from LSU. If you see Dean Oliver tomorrow tell him I said hi. I co-own two animal hospitals in Rogers, and I’m here on behalf of the Arkansas Veterinary Medical Association, as well as the American Veterinary Medical Association. I serve in the Arkansas VMA as a delegate to the American VMA House of Delegates. And within the House of Delegates, I serve on the House Advisory Committee.

I appreciate the opportunity today to testify on House Bill 1182, and I’d like to take five minutes of your time to explain why we are against this as currently written. Veterinarians highly value and support veterinary technicians, including veterinary technician specialists. We’re working across the veterinary profession to better integrate them as key members of our veterinary healthcare teams. And the AVMA has an extensive effort underway to address workforce challenges and promote and improve practice efficiency.

A critical part of this effort is to fully utilize veterinary technicians and technician specialists across all levels of supervision, including immediate, direct, and indirect. Having veterinary technicians and technician specialists work to the top of their training allows veterinarians to also work to the top of our degrees and practice more efficiently. In my own hospital, you’ll find technicians doing things that I can’t do, and they’ll laugh at me if I do it incorrectly.

One of the most considerable concerns with this bill is the tremendous expansion of scope of practice for veterinary technician specialists, so much so that it essentially equates to that of a veterinarian. This bill allows a veterinary technician specialist to establish the veterinarian-client-patient relationship on behalf of the veterinarian for new patients. And even the 15 day turnaround puts it on the owner to bring that animal back to the veterinarian to comply with law.

Having independent prescriptive authority, practicing all aspects of veterinary medicine under indirect supervision, and independently charging a client for services provided. We do not believe this to be in the best interest of our patients, clients, or the public.

Veterinary technician specialists are indeed well-trained but they are not licensed veterinarians. Nine years, four years of veterinary technician training, and five years of clinical practice does not equate to eight years of academic practice. Allowing a technician specialist to perform aspects of medical care means they’ll be authorized to do things they simply do not have the knowledge and skills to do.

We oppose the creation of a new category of practitioner, who has not received sufficient training in physiology, pharmacology, pathogenesis, diagnosis, prevention, surgery, control of infectious and non-infectious diseases. Many other areas that would allow them to function safely and effectively as an independent veterinary medical decision maker.

It’s one thing to allow technicians to perform certain aspects of medical care under indirect supervision at the direction of a licensed veterinarian but it’s dangerous to allow insufficiently trained personnel to have such a scope of responsibilities that this bill would provide. To define surgery as minor or major is rather vague. To some doctors, a minor surgery might be a spay because it’s considered routine. However, it is an open abdominal surgery where reproductive organs are removed. That is major surgery.

Under current law, veterinary technicians including veterinary technician specialists can already act extensively under the indirect supervision of a veterinarian. This is permitted after the veterinarian has established the veterinarian-client-patient relationships. Then under indirect supervision and at the direction of a veterinarian, this technician can do many things that further expand their access to care. This may include a veterinarian sending the technician on a farm call while the veterinarian’s at another farm or at the animal hospital itself.

Some things a veterinary technician or a technician specialist can do include collecting diagnostic samples, taking radiographs, administering fluids, applying bandages, splints, performing wound management and care, performing routine surgeries on food animals, such as pregnancy checks, artificial insemination, correction of a uterine prolapse, and performing routine non-surgical food animal management practices, such as castration, dehorning, tail docking, and ear notching.

Today at this moment for a farm or a ranch, a veterinarian can maintain a veterinarian-client-patient relationship simply by periodically visiting the facility to understand the people, the personnel, and the husbandry practices as is medically appropriate for the circumstances. And then utilize a technician or a technician specialist to assess and conduct procedures as ordered by the veterinarian in between the veterinary visits. We believe that if there is a need or a desire to reevaluate the actions the veterinary technician specialist may take under indirect supervision over and above the many things already allowed, the better course of action is to work with the State Board to evaluate such procedures and add this to the already extensive list. The same is true if there is a need to reevaluate what can be done under immediate or direct supervision.

This bill also authorizes a grant of prescriptive authority to a veterinary technician specialist. This is in direct conflict with federal law. The law around veterinary prescription drugs is very different from that of the delivery of human health care. This is in part due to protect the human health food supply chain, and to protect the public health, ensuring the judicious use of antimicrobials in food animals.

Federal law limits the dispensing of veterinary prescription drugs to buy or on order of a licensed veterinarian. The Federal Controlled Substances Act and regulations do not recognize a veterinary technician specialist as an authorized individual to prescribe controlled substances. So they wouldn’t even be able to obtain a DEA registration. This bill tries to fix this by requiring the individuals to attest that they are familiar with the federal law and they will comply. Purporting to authorize something that is prohibited is not a fix and it will just create confusion.

We also could not support a bill or provisions that place unreasonable liability risk upon veterinarians. This makes the veterinarian legally responsible for all acts and omissions of the veterinary technician specialist. We don’t believe that the professional liability insurance would cover the veterinarian for acts of another individual practicing all aspects of veterinary medicine who is not an employee of the veterinarian. This could leave the veterinarian with legal responsibility for the animal’s care but no liability insurance to protect the veterinarian from the care provided by the technician specialist.

If a veterinarian simply follows the bill language and enters into a collaborating agreement with a technician specialist who’s not an employee of House Bill 1182 who authorizes it, then it’s dangerous for the veterinarian, the technician specialist, the patient, and the client. There could be civil and criminal penalties. In addition, under the terms of this bill, the veterinary technician specialist would be the one determining whether they have the knowledge or not to perform these functions while the veterinarian assumes all legal liability for the actions of a veterinarian technician specialist.

In closing, we do highly value and support technicians and technician specialists. We employ them to be an integral part of our team. We strongly support efforts to address workforce challenges that are in the best interest of the animal and public health. This bill as written contains too many concerns for us to support. Thank you.

Rep Fortner: Thank you. Members, do you have any questions for the witness? Representative Hawk?

Rep Hawk: By the way, you did really good for being nervous. You said you were a delegate for the American Association, correct? Why do you think that they came out and recommended this on their website of the task force? This type of bill, why do you think they recommended this on their website?

O’Neal: Recommended what?

Rep Hawk: So on the American Veterinarian Medical Association website it states – this was published on January the 12th, talks about solutions for technician utilization. And it had mentioned a lot of stuff that’s in this bill and it’s on the website. And so I’m just asking being that you’re a delegate why.

O’Neal: May I see what you’re looking at? Is that possible?

Rep Hawk: Yeah, sure. If that’s okay, Mr Chair?

Rep Fortner: Sure.

O’Neal: Will you show me where you’re looking? So this– I can’t speak specifically about this article, I wasn’t privy to it. AVMA has had many conversations around technician utilization. And so we are in favor of that, technician utilization and technician specialists. The way that it is written in Arkansas law as this bill is written is very different from this definition. This expands the scope of practice, even the way a national veterinary technician specialist is able to practice.

Rep Fortner: Okay. Thank you. Any other questions? Representative Beaty?

Rep Beaty: Dr. O’Neal, you did a great job. 

O’Neal: Thank you.

Rep Beaty: Just a couple of questions. On the onset you talked about vet techs versus vet tech specialists. How many bit tech specialists do we have in the State of Arkansas that you’re aware of?

O’Neal: I believe, tech specialists?

Rep Beaty: Yes.

O’Neal: I believe none.

Rep Beaty: None? Okay, because I looked at– and you’re talking about expansion of the scope of practice. Who makes the ultimate decisions at your clinic and at your offices on what employees, the duties and things that employees are allowed to perform. Who ultimately makes those decisions and grants that authority?

O’Neal: The veterinarian

Rep Beaty: The veterinarian? Did you see anything in this bill that would prevent you as the veterinarian from exercising direct control and running your practice the way you see fit with these veterinary technician specialists?

O’Neal: I think that’s a great question. Do I see something? No, because I will be in direct control, and I know what this bill is telling me I’ve studied it. Where I think it becomes rather dangerous is when we put this out there if this were to pass as written without certain amendments made to it. This could be very dangerous because someone else may read this and believe this to be perfectly true. And they may believe that this person may have federal prescribe ability and not actually do the work themselves to find out is it okay or not. And so at that point, their license is at risk and we can start prescribing antibiotics that may not be of judicious use and be a danger to the food supply chain.

Rep Beaty: Just a follow-up?

Rep Fortner: Follow-up.

Rep Beaty: I would just assert that based on what I read in here, this would do nothing to take control away from the owner and the ultimate person that’s responsible, the veterinarian. But would possibly allow some of those veterinarians to expand their practice, take care of more rural Arkansans that need your services while freeing up your time to deal with more serious matters and more pressing matters.

So I just look at it as an opportunity to expand the services that are most important in rural Arkansas that veterinarians provide. So I would just ask that you look back at that and your own comments that you’re in charge, you make the decisions. These folks are going to be your employee, regardless of what’s in this rule or in this law if it passes out. It’s just allowing for a certification and maybe a little bit more training. And scrutiny placed on that position to give confidence to the public in that trained professional representing your interest in the community. So I respect your comments and appreciate that. And thank you for being here today.

O’Neal: Thank you.

Rep Fortner: Thank you. Any other questions, Committee? Thank you very much for coming.

O’Neal: Thank you for your time.

Rep Fortner: Now, we’ll have speaking for the bill, Tabitha Norris. Identify yourself for the record, please.

Norris: I’m Tabitha Norris. So, I too am very nervous.

Rep Fortner: We’re all nice people, just relax.

Norris: That’s good to know.

Rep Fortner: Is your mic on?

Norris: And I also can talk very fast. Okay. So again, I’m Tabitha Norris. I’ve been a veterinarian for 20 years and a practice owner for eight of those years. So there was an online article in Arkansas Money and Politics that was posted April of 2022, and it states that Arkansas has the fewest veterinarians per capita in the United States, with 14 veterinarians per 100,000 people.

As a veterinarian and owner of three rural small animal practices, I can testify to some of the issues in our industry. Our profession is overwhelmed and emotionally worn. Veterinarians are in short supply and often need abbreviated schedules for various reasons. It’s difficult to get veterinarians to rural areas without the amenities of a large city. Currently practicing doctors are frazzled and near burnout due to the lack of time off and hectic schedules to try to help all of our patients.

To top it all off, without its own veterinary school, Arkansas simply is not producing enough doctors to meet the needs of the clients and patients. Most of the practice owners that I know are actively looking for associates to fill these needs. There’s talk of a veterinary school coming to Arkansas but it will be eight years or more before the fruits of that labor can be appreciated.

We ourselves have been aggressively searching for a doctor for the past five years. We attend meet and greets at veterinary schools, we post ads in all the appropriate places, we host and mentor externs. We’ve even built an apartment at our house to host those externs. We offer above-average salaries and benefits but with all of that, we’ve been unable to find a doctor to add to our team, which seems to be the norm for the moment.

Even as we struggle to find a doctor our business continues to grow. The practices that my husband and I own are spread over approximately 40 miles and they are very rural. We originally had two. We added on a third clinic in 2021. We did not want nor plan on adding to our workload but we found ourselves feeling obligated to a town with no doctor and desperate for care. We were able to accommodate this need for one reason only, and that was with the addition of CVTs, so that’s just certified veterinary technicians to our team.

In May of 2021, we hired a newly graduated technologist from Mississippi State. We added a second in March of 2022. The changes to the Practice Act allowed them to support our doctors in a way that have been life-changing. They each work closely with our doctor by following up with recheck appointments, seeing young animals for a vaccine series, and even doing thorough exams on very sick patients and working through the case with their doctor. They see these patients only when a valid veterinary-client-patient relationship is intact. And this has opened up the doctor’s schedule so that we are not turning sick patients away and we still have time to offer the best quality of medicine to each patient.

They’re also the reason we can help the town of Fordyce with veterinary care, a town so small that it will not support a full-time veterinarian, and the chances of anyone else going there non-existent. While one of our doctors leaves our established clinic to care for new patients a few days a week at Fordyce, a CVT is able to stay and care for already established patients.

Even with the benefit of our CVTs, there are a few hurdles we have yet to overcome. It is heartbreaking to have to turn new patients away that we know our CVT could see because of a lack of VCPR on the occasion that they are without a doctor. I do believe that a valid answer to this problem is the veterinary technician specialty academies. The experience and intense training that is required to achieve this additional board certification would certainly prepare our VTSs to care for patients that are not able to be immediately seen by our doctors, and the doctors could then provide their scheduled follow-up care.

With this legislation our VTS would be able to make decisions regarding our patients’ care, using the collaborative agreement with their doctor. And the VTS would be able to offer end-of-life care including euthanasia and the most basic wound care, such as suturing a laceration without the doctor in the building. These are services that they are more than capable of providing and would continue to free up their doctor for more complicated and intense cases.

In addition, we can attest to the fact that by fully utilizing our CVTs we have been able to better pay our entire staff, including our veterinarians. By providing this higher-skilled position of a VTS we give these bright and motivated individuals a place to learn and grow, as well as to provide a higher level of income for our families– for their families, excuse me.

And I wanted to say, I don’t want to be redundant with what DeAnn said, but I do want to add that one of the things that I think came out in the email from the board is they were worried that there would be confusion that veterinarians might let their VTS accidentally prescribe because that prescriptive authority is actually in the bill. But again, if you see that they have to have that certificate granted by our licensing board to be able to do that. So the licensing board is actually overseeing that part of it. There’s no way for them to prescribe without that.

And then the other thing that I wanted to comment on and you touched on it already. So there is concern that a veterinarian will be responsible for the outcome of the decisions of a VTS. I have over 40 staff members and two of those are veterinarians. I’m responsible for every outcome every day, all day, every day. And so to me, this is no different. It is my responsibility to put protocols and safeguards in place to ensure that we are meeting and exceeding the standard of care for each animal. It’s my responsibility to continually vet my doctors and my entire staff to ensure that we are offering excellent client and patient care.

We do have an insurance product for our CVTs but it is not a professional liability insurance. I spoke with our insurance agent and asked them about this particular product and he said it does not exist for them because there has not been a need for it. And so I asked him if that need was present would that be a product that could be created? And he said yes, they would basically adjust the veterinary professional liability insurance.

So the bottom line is that it is the veterinarian who’s ultimately in control of what they are comfortable letting their VTS do within the confines of the bill as presented. This is an ideal way to help rural practitioners meet the ever-increasing demands on their time, while still providing excellent patient care.

Rep Fortner: Thank you for your testimony. Members, you have any questions? Representative McNair, you’re recognized.

Rep McNair: From someone that’s vocation is auto repair, how beneficial would these techs be to you with the exception of the prescription authority? 

Norris: Yeah. So definitely where I see them being the most helpful are those emergency situations where a veterinarian is not available because our schedule is full, because our kids are sick, because of all of those things. And I’ve been told well, you should send them to the emergency clinic. Our closest emergency clinic is probably an hour and 45 minutes away. And it is triage so often our patients are waiting six or eight hours to be seen if they’re seen at all. And then they’re charged much more than they would have been by us. 

So often those patients go without care until they can get in with a veterinarian. And lots of the– again I can only speak for the rural area but many of our colleagues are booked out weeks before they can see patients. And so that would be for me where it would be most helpful is where they could see those patients and kind of stand in that gap for those 15 days until that recheck. 

Rep McNair: Thank you.

Rep Fortner: Any other questions, Committee? Okay. Thank you. Now against, Marlow Ball.

Ball: Thank you, Mr. Chairman. My name is Marlow Ball, and I’m a small animal veterinarian. I own a practice less than two miles from here. I’m also an aspiring homesteader. Had an interest in large animal medicine before and during veterinary school. I’m here to speak against this for a number of reasons. I want to say that there is a severe shortage of large animal veterinarians. But I do not feel that this bill addresses the causes of those shortages. And I feel that it puts veterinarians at risk, producers at risk, and the entire industry at risk if training is not the core of any kind of legislation changes.

I’m sure I don’t have to tell you, Arkansas is the second in the nation for broiler production. Pork production exceeds $80 million a year. And we rank 12th nationally in beef cow operations. I had an animal science degree that was wonderful at the University of Arkansas. We have a lot of large animal science training opportunities. We also have two veterinary schools that may be in the works in our state, one is private one is public. If we don’t set up training for a veterinary technician specialist in these avenues, then I think that we are really missing an opportunity. I think that we’re putting livestock and public health at risk, entire industries at risk.

As written, this legislation grants permission for technicians to prescribe, perform diagnostics, and surgical procedures. This bill expands the scope where there currently is no training. There is training for certain aspects, but this scope is far exceeding what training is currently in the works. It does not require any additional training in pharmacology, in surgery, in herd safety, or in public health.

I’m an aspiring homesteader. I have two dairy goats, chickens. I share your concerns about the lack of access to large animal vets. I find myself looking at YouTube videos on goat C-sections because the access to large animal veterinarians is really a concern. But to grant prescriptive permission, interpreting diagnostics, and performing surgeries without appropriate training will put entire industries at risk.

Why is there a shortage of veterinarians in large animal medicine? One is our acceptance rate. There’s an 11.7% acceptance rate to veterinary schools. And I feel that this puts an insurmountable obstacle for those with an interest in large animal medicine. And with two vet schools in the works, I think that’s an opportunity to focus on large animal medicine in our state.

The second concern is student loan debt. The average veterinary degree for four years is $183,000 according to AVMA for 2019. The average veterinary salary in Arkansas is $93,000. Compare that to Texas, $103,000. Compare that to a large animal veterinarian and salary start at $51,000, I couldn’t find anything above $84,000. This is not about what veterinarians are paid but when you have insurmountable student loan debt it really restricts your ability to move into large animal medicine.

I’m the perfect example of someone who would like to move in the direction of large animal medicine but just haven’t found a way to provide for my family and repay my student debt burden. I wonder how granting prescriptive authority to untrained persons is going to help recruit more veterinarians to our state. How does that help people who want to practice large animal medicine to do it safely and to do it with protecting them as veterinarians? I think it would actually drive large animal veterinarians away from our state because it puts all the responsibility on the veterinarian and on our license. I have to repay my student loans whether I have a license to practice veterinary medicine or not. So the idea that I would risk that prevents me from providing for my family, my business, everything.

I’m not against better utilization of techs. I support further advancements of veterinary technicians. And I’m open to the idea of a middle practitioner. But if we’re not focusing on training, on food safety, on public health, then I feel that we’re really putting entire industries at risk and all the veterinarians who may or may not choose to go into this agreement. We’re putting veterinarians at risk unless there’s a way to get malpractice insurance that would appropriately cover veterinarians. Thank you so much for your time.

Rep Fortner: All right, thank you. Members, do you have any questions? Yes, Representative Garner.

Rep Garner: I’ve got a question, and I really just want clarification. My background is a nurse practitioner. So I see this as a very similar contract with my physician as the advanced tech would with a veterinarian. So I’m confused, I guess when you start talking about prescribing medicines. This is not prescribing medicines, it’s a collaboration with the physician to get the medicines to the patient. I’m just not seeing in the bill where that’s allowed. It’s not saying that it’s allowed.

Ball: The way that I am seeing it as written, is that we do not have additional training for pharmacology. We do not have training for veterinary technician specialists to– there’s not training on how to perform surgery. There’s not training on how to choose antibiotics, how to choose which diagnostic test should be performed. As a goat owner, I’m looking at the fact that antibiotics will not be available over the counter in June, and that concerns me greatly but when you look at what these rules do, it protects public safety.

Rep Fortner: All right. Any others? All right, thank you. Now speaking for the bill is Megan Harrington.

Harrington: Thank you, Mr. Chair. First off, I would like to thank you all for–

Rep Fortner: Recognize yourself for the record.

Harrington: Oh, I’m sorry, Meg Harrington.

Rep Fortner: Thank you.

Harrington: First off, I would like to thank you for allowing me to be here today and talk on behalf of my profession. My name is Meg Harrington, and I practice large animal veterinary technology for a team of amazing veterinarians in south Arkansas. I have been a credentialed veterinary technologist for 14 years this month, and have worked primarily in food animal medicine for a majority of those years.

I am a strong advocate for keeping our production animals healthy, keeping our food supply safe, and keeping America fed. My very specialized bachelor’s degree in veterinary technology obtained from Purdue University School of Veterinary Medicine included technical and clinical training, and curriculum with anesthesia, pharmacology, clinical pathology, diagnostic imaging, large and small animal surgical nursing, and medicine. I took my clinicals in the same vet school that veterinarians did.

In 2022, I applied to the Academy of Internal Medicine for veterinary technicians. To apply I had to meet several stringent requirements. I had to be mentored by a veterinarian who is a diplomat of the American College of Veterinary Internal Medicine in large animal medicine. For context, being a veterinarian diplomat is one of the highest honors of the veterinary profession. So I worked alongside one of the most esteemed food animal practitioners in the veterinary profession. 

I had to provide proof of my licensure and spend more than 75% of my time in my area of specialty over the past five years. I had to show completion of more than 50 hours of continuing education in my specific area of specialty, log 75 case studies, complete four in-depth case reports. And my advanced technical skills had to be acknowledged by my diplomat to ensure I had the appropriate competencies and training required for this high honor.

The applicant acceptance rate into the Academy is 50%. Once accepted into the Academy and your stringent criteria is met, the examination pass rate is 80%. These academies have dated back 25-plus years. It takes eight years for someone to become a doctor of veterinary medicine, and I respect the degree you’ve all gained. The minimum number of years required for a veterinary technician specialist to become credentialed is seven to nine years of combined education and hands-on clinical experience.

In June of this year, I will sit for my exam during the American College of Veterinary Internal Medicine Forum to become a boarded veterinary technician specialist in production animal medicine. By becoming a VTS I will reach the highest honor of the veterinary technology profession. However, currently, there is no way to differentiate the advanced training and specialization of this role in our state’s Practice Act, leaving this opportunity for advancement in my profession a dead end.

Under our current law, I am able to provide care to several livestock producers in underserved areas, while working under indirect supervision of my supervising veterinarians. Meaning, I have a protocol or direct orders on how to assess and treat patients on a farm call as long as a VCPR exists. We maintain herds that run anywhere from five head to 5,000 head of cattle. A VCPR is renewed in most operations every six months if not sooner, for our veterinarians to meet their requirement for the federal government in renewing a veterinary feed directive. This is going to always require a veterinarian. 

There are several more very important regulatory roles that require our veterinarians to be actively involved in these herds. This is designed to keep our food supply safe and prevent the spread of animal disease. As a CVT who currently works, dispenses and administers medication to food animal patients every single day of the week under indirect supervision mind you, I am very familiar with the purposes of FARAD and AMDUCA in promoting antimicrobial stewardships.

The major challenge lies when our practice receives a call from someone who is considered a non-client, meaning a VCPR has not been established, and they have a cow that’s trying to calf that needs veterinary assistance. They cannot get access to a large animal veterinarian or they can’t get a veterinarian out due to scheduling conflicts. I may have been able to rearrange my schedule to see them because they were non-clients, meaning a VCPR had not been established but we had to tell them no. We had to tell them no. And that’s sad that we have to tell them no because we can’t see them because they were not a client when we could have utilized a technician in this case. I’m medically trained to handle these kinds of cases. I do it every single day. Some things just cannot be addressed through the phone or require physical hands on an animal. We allow EMTs and nurses to perform life-saving interventions on humans but what about the animals that are needing emergency care and can’t get it?

In this case, the patient goes without care, leaving the animal owner with a deceased cow and calf, when one or both of the animals may have been saved with an intervention. Every single time I have to tell a producer no, I’m sorry, I cannot help you. In fact, we could have with the use of a technician. I am haunted by the oath I took 14 years ago at graduation. I took an oath to solemnly dedicate myself to aiding animals and society by providing excellent care and services for animals by alleviating animal suffering and promoting public health. I accept my obligations to practice my profession consciously and with sensitivity, adhering to a professional code of ethics and furthering my knowledge and competence through the commitment of lifelong learning.

I would like to take a page from the AVMA’s own book inside a JAVMA news article from January 2020, created by an AVMA board of directors convened task force that states, that they should examine other health professions for comparable practice models like dental hygienists, nurse practitioners, physician assistants, and use that information to help drive utilization of credentialed veterinary technicians. And expand the investigations to include categories of careers for credentialed technicians in areas such as equine medicine, production medicine, education, specialty practice, and consultation. This bill aligns with the AVMA task force’s recommending.

Our committee did due diligence in drafting this bill and included key stakeholders like the Arkansas VMA. On December 22, 2022. An email was sent from Mr. Rodney Baker which included Dr. Paul Jenkins and Maggie Milligan. They stated that they wanted to work with us to identify conflicts within the bill and provided suggestions and improvements to avoid unintended consequences. We conceded to all their requests and edited the bill to their liking. Be it known that we are in a massive workforce shortage in veterinary medicine and the retention of the technical staff at this time is at an all-time low. And it’s mainly because we’ve been met with multiple challenges. It’s a lack of career advancement, underutilization of our skills, and a barely livable wage.

By allowing House Bill 1182 to pass it would establish a defined scope of practice for a veterinary technician specialist and allow those with aspirations to develop their training further, an opportunity to be better utilized, and afford them a more appropriate compensation for the advanced skills and knowledge that they can bring a veterinary practice.

According to, if I was to go back and get my same education that I did 14 years ago today, it’s going to cost me $91,000 for my four-year degree. Over the next five years, the new grads that are going to be coming out of our in-state veterinary technology program at ASU-Beebe, they’re expected to graduate with $42,000 in student loan debt for a two-year degree. Yet the average hourly rate for credentialed technicians in the state is $15 an hour. You can make more at McDonald’s. We are going to continue to lose more qualified individuals in our profession if we do not make opportunities for advancements in veterinary technology.

An American Veterinary Medical Association economic survey in 2008 found that for every credentialed veterinary technician employed, a practice generated $161,493 more in gross revenue. In today’s dollars adjusting for inflation, it’s closer to $220,000, according to Today’s Veterinary Business. Credentialed veterinary technicians, technologists, and technician specialists are the keys to practice growth as long as veterinarians are completely utilizing them for their education and clinical experience. By having them on staff, veterinary practices can be more efficient, see more patients without having to increase operating hours, and thus, hopefully, addressing some of the fatigue and burnout that exists in our profession.

While we realize not every veterinarian may be supportive of these new roles, or may even feel threatened by these new roles, they must realize that we cannot do our jobs without a veterinarian’s supervision and oversight. It is the veterinarian’s personal choice to hire or not hire a credentialed staff member to work underneath them. But do know that there are veterinarians out there that need this, especially in rural Arkansas. If veterinarians can open their minds to how this could help them, our profession as a whole could be in a better place. Thank you.

Rep Fortner: Thank you. Members, do you have any questions? I think you must have explained it pretty thorough. Thank you.

Harrington: Thank you.

Rep Fortner: Now speaking against, Paul– and I hope it’s Jenkins. All right, come and identify yourself, Paul.

Jenkins: Good morning, Chairman and Committee. I appreciate the opportunity to get to ice skate down and be with you this morning. I come from Vilonia. I’m a veterinarian. I’ve been in practice about 20 years. And myself along with Rodney Baker do legislative issues for the Arkansas Veterinary Medical Association.

Rep Fortner: Paul, could I get you to identify yourself for the record?

Jenkins: Yes. Paul Jenkins, veterinarian.

Rep Fortner: Thank you.

Jenkins: Thank you. So I want to speak to a little bit, and this may help with Representative Hawk’s question about the AVMA, and what we’re seeing nationally in regard to this discussion. This is a statement that we received dated 1/11/2023 from the National Association of Veterinary Technicians in America. And it says, “credentialed veterinary technicians have interest in the mid-level practitioner concept but as a goal or long-term project to be accomplished over time, not as an issue that needs to be addressed right now.”

According to a December 2022 survey conducted by the National Association of Veterinary Technicians in America, once again known as NAVTA. The NAVTA survey showed strong sentiment that veterinary technicians are more concerned with title protection for the veterinary technician title, optimizing veterinary technician utilization, and increasing veterinary technician wages and compensation.

In fact, in a list of eight current hot topics, the creation of a mid-level practitioner position for credentialed veterinary technicians ranked seventh. Ahead of only creating such a position for non-technicians for which there was virtually no support. The NAVTA board of directors agrees with the overwhelming data in this survey and supports the profession, putting its efforts behind the issues of title protection, utilization, and higher wages. Said NAVTA, president, Ashli Selke, RVT, CVT, in quote, “NAVTA has made these issues its top priorities and will continue to advocate for its members on these issues.”

The NAVTA board of directors also notes that there are other significant issues within the discussion of the mid-level practitioner concept that warrant more attention and a slow approach. These include definition of a clear and unique skill set, program assessment, and accreditation. Regulatory structures on both the state and federal levels, financial sustainability of the mid-level position.

And in closing, NAVTA expresses its strong desire to continue to be involved in the conversations and developments with regard to the mid-level practitioner position but notes that the association will be using its valued and limited resources in the other areas of concern expressed by its members. And I would say that for the Arkansas VMA’s position, we share what NAVTA has stated here, is that we should let this play out both methodically and appropriately on the national stage. Furthermore, there could be an opportunity for an accredited training program to come about and that it’s going to be consistent across state lines. With that, I’ll take any questions from the Committee.

Rep Fortner: Thank you. Members, do you have any questions? Representative Magie.

Rep Magie: Thanks, Doc, for coming down today.

Jenkins: Yes, sir.

Rep Magie: Tell me something about– you just mentioned that about accredited training programs. Is there any national accreditation for these veterinary technician programs that’s out there or are there schools that, I mean, this one individual testified about being a Mississippian, their experience in school and all, sounds like a good school but do they all meet the same criteria?

Jenkins: They do. So there are across the nation numerous veterinary technician technology courses and they have to become accredited by the AVMA. However, there’s not an accredited program of any kind that trains a mid-level practitioner type. Okay. Does that help?

Rep Magie: That helps. Yes, sir. Can I ask one other?

Rep Fortner: Certainly. Have a follow-up.

Rep Magie: So are there other states that have passed legislation similar to. Do you know of any information of other states?

Jenkins: I can’t name a state. It’s our understanding from our national organization there are others that are looking at this in a similar fashion. But for me to quote which states and to what effect, no, sir, I can’t.

Rep Magie: It’s not like there’s 45 other states that have already passed legislation–

Jenkins: No, sir.

Rep Magie: –to expand this scope of practice?

Jenkins: Right. And this may help with the Representative’s question about nurse practitioner a while ago, is we know the scope of the bill is not to develop a veterinary nurse practitioner, okay but it plays along those lines. And for example, in the master’s level program to become a nurse practitioner, you’re talking about 600 clinical hours and 45 credit hours. If you move up to the doctorate program, it’s about 1,080 and 72 credit hours, both of those requiring a bachelor’s degree already in nursing. And so our concern with the veterinary technician specialist is yes, there’s a lot of hours that are put into this training but they’re not academic, they’re on the job. And that’s a soft entry into becoming one of these when you compare it to the human world, and you lay this amount of responsibility and prescribing authority on their shoulders.

Rep Magie: Okay. That’s all. Thank you, Mr. Chair.

Rep Fortner: Okay, anyone else? Representative Beaty.

Rep Beaty: Just for educational purposes, Paul, so that I’m aware. How many members do you represent at the Arkansas Veterinary Association?

Jenkins: We’re about 600 strong.

Rep Beaty: 600 members?

Jenkins: Yes, sir.

Rep Beaty: Out of those 600 members, how many of those members reached out to you or to Rodney regarding this piece of legislation, both in support or in opposition? Give me a projected number.

Jenkins: A projected number. So most of those that have reached out in opposition have happened in the last couple of weeks. And I would tell you that it’s somewhere around 100. Yes, sir.

Rep Beaty: Follow-up?

Rep Fortner: Certainly.

Rep Beaty: So I’m going to ask you the same question that I asked Dr. O’Neal. In your practice, who supervises your employees or those vet techs that you have on your staff?

Jenkins: Yeah. So it’s a little bit of a dual effort in our practice. We have two full-time veterinarians. They’re going to play a part in that. We also have a practice manager who happens to be married to my partner. So it’s going to be a group effort in that.

Rep Beaty: And then my last kind of follow-up. In your opinion would a certified veterinary tech specialist be an asset and improve the quality of service and availability throughout the State of Arkansas to Arkansans that need veterinary services?

Jenkins: So I’ll answer that two ways. One is certified veterinary technicians as Ms. Harrington already stated, not specialists, can provide a lot of these services under current law. So this law stretches that scope of practice is where our concern is. But yes, furthermore, they could be an asset. Even in my practice, if they got specialized in one of these specific academies that I may need, yes, they could. Where our concern lies therein is that with these 12 academies, this person who may get their specialist in say physical therapy. How is that going to keep them from having a broad scope across the board the way this bill is written?

Rep Beaty: Well, I would just follow up with back to my main point is. What’s going to prevent that are the veterinarians that supervise these employees and control their practice. And the main thing is I understand what you were saying about nationally, sit back and wait and see what other states are going to do. But at some point, we’ve got to stop doing that in Arkansas and we need to lead. And this is one of those areas that I think we need to lead on. And let’s improve what the availability of veterinary services in the State of Arkansas and especially in south Arkansas. So, I appreciate your work.

Jenkins: Yeah. And absolutely, we recognize the deficiency in certain areas of the state. And we hope to expand those mechanisms where we can get more graduate veterinarians out. Also, there’s a federal program that will help to place some of those veterinarians. And our concern is that this could deter a young practitioner or graduate from coming to an area like that furthermore. But yes, sir, we respect that.

Rep Fortner: Okay, thank you. We have one more asked to speak.

Jenkins: Thank you, Committee.

Rep Fortner: You’re welcome. Rodney Baker. Identify yourself for the record, please.

Baker: Yes, sir. I’m Rodney Baker. And I represent the Arkansas Veterinary Medical Association as their lobbyist, contract lobbyist. And I want to put a little background on some of this if I can and point out a couple things in the bill I think need to be clarified. Representative Vaught and I have talked on three or four occasions, and we did make some suggestions. Some of those have been adopted. Some of those are some of the things that were quoted here today in support of the bill, as a matter of fact.

A couple of things that I suggested to her as we were going through this that are in the bill. Also when before the bill was finalized and introduced, I pointed out to her that in further research those don’t look like they work. And I’ll give you one of those, on the establishing the veterinary client-patient-relationship and curing that with allowing the tech to start it and curing that with the vet within 15 days. That will not work with federal FDA definitions. It says clearly that the veterinarian has to establish that relationship with a personal visit or visit to the farm. 

So that was an attempt to try to find some common ground. The language prior to that was not about the veterinary technical relationship. It was, I believe the words were to establish a professional relationship which has been used in medicine not here. So I made that suggestion. I also suggested, informed Ms. Vaught that that probably was not going to work. Also similarly on prescriptive authority because the federal prescription guidelines are so tough, are so rigid I should say.

Let me also point out that on page 2 of the bill, line 14, where it says that “a technician shall not receive a fee or other compensation.” I would point out that previously in that line technician specialist was removed. The current law has that chapter for technician, technologist, and technician specialist. That technician specialist language is removed in this bill and the language for technician specialist is moved over to another chapter in the law with this amendment. And if you will go to page 4, line 7, it says a veterinary technician specialist may receive compensation for performing a practice of specialized veterinary medicine– or technology, excuse me.

I’d also bring you back to page 3 on line 19 that says—well, start with 16. “A veterinary technician specialist shall perform specialized veterinary technology under the direction, supervision, responsibility of the A, licensed veterinarian with whom she is or he is employed or collaborating veterinarian under a collaborative practice agreement.” Collaborative practice agreement is an agreement to work. You have language here that allows for compensation. The prohibition against that is taken out in the previous chapter, so it does allow for it. And it also states in here how it can be, or how this person is to operate with either as an employee or under an agreement.

One of the concerns that we have under a contract, let’s say, is this person becomes a contractor, 1099 contractor. If they’re receiving compensation by virtue of their own fees particularly. Malpractice insurance now for a practitioner, for a veterinarian, covers the veterinarian and the people that work for him. It does not cover a contract employee. So the veterinarian will not have that liability. Can that be changed in a policy someday in the future? I would assume so. My experience tells me that insurance companies, if there’s enough demand and premiums are big enough, they can figure out a way to write premium. But that’s not where we are today. And if the technician specialist can get their own malpractice, it stands that it’s not going to cover the veterinarian because it’s going to cover that person’s business and not someone else’s business.

Those are concerns we have that leave the veterinarian exposed. It leaves a lot of people exposed, frankly. Because if there’s a civil dispute over care of a patient and compensation is awarded. Maybe if there’s no malpractice, there may or may not be compensation there to be awarded. Those are things that need to be considered in this.

We’re also concerned about under the prescriptive authority. And Ms. Vaught has said very clearly that that doesn’t occur until the federal law change. A, we see no movement to change federal law. In fact, FDA has taken off the relaxation they put on during COVID for telemedicine for veterinarians, that’s coming off next– well, in February, so this month, I guess. And also, they’re tightening down on that. They’re also tightening down on antibiotics, which is a sore subject with a lot of us but you’re going to have to have a prescription to use these antibiotics in the future. That is to address where antibiotic resistance is occurring to try to stop that.

I would point out those of you from east Arkansas you’ve seen resistance occur to pesticides in your plants over there, and what that can do to you. In many cases, there’s not a good alternative. So it makes sense honestly, to try to keep that resistance away, whether or not it’s comfortable or not. I guess we were talking about this earlier and someone used– Linda used the example it’s kind of like seat belts. It was an inconvenience when it happened, it was a pain. I’ve said all those things personally but my daughter as an eight-year-old talked me into using a seat belt. And I do it habitually now and it’s for my protection, my good. That’s kind of where we are in this.

But I would point out that under the prescriptive authority this bill says the agency may issue a license. And it does say can’t do this if a federal, state law if it conflicts with that. I understand that. That’s pretty vague, and it’s pretty back door. If you are serious about not allowing that or allowing some pressure to be applied in the future to go ahead and try to grant some of those licenses, it should be clear, spelled out in the bill that none of this will occur unless the federal law has changed, unless and when the federal law has changed. Otherwise, you’ve got a law that somebody picks it up that has not sat through these conversations with us, a year or two year, five years from now. Again we don’t see any pressure to change the law at the federal level and reads the Arkansas bill, it looks like they’ve got this authority. Very vague statement about unless it conflicts. That means somebody’s got to go research everything. We shouldn’t as good public policy be writing situations that are written vaguely, that may cause people to do something unintentionally.

And I’ll back up to one more thing if I may about the FDA rules. We know that there’s not an FDA examiner that comes in your office every week. They’re not on every corner but they do show up when complaints are filed. In this bill, the technician specialist acknowledges, is required to acknowledge down the road, whenever it happens, that there’s a license prescriptive authority issue. They’re required to acknowledge that they understand all the laws. So any violation of that law there’s already going to be a written situation in the record where they, if they violate it, they knowingly violated and that’s a more serious offense.

Some of these offenses, because we’re regulating animal health and the food chain. Some of those offenses have the potential to arise to not just civil but actually criminal penalties. Now is that the exception? Probably. Could it occur? Yes, it can. And vagueness can lead to somebody making a mistake they wouldn’t otherwise make. So these are some points we want to clarify. These are why we’re against some of these.

We did work with Ms. Vaught. She adopted a lot of the language. Some of it frankly, it was language that was left out of the first section that specialists were removed from. And left out of the new section, and we asked for it to be put back, such as a restriction on managing the separate facility. So we did do those things. Also, we tried to find ways to make some of this work within the scope of what we see and that’s the existing client-patient relationship but that does not work with the federal rules and regs. And we would ask you to not put our people in a position to where they may do something unintentionally that causes them financial harm. Mr. Chairman, I’ll be glad to take a question if I have an answer.

Rep Fortner: Thank you. Representative Beaty.

Rep Beaty: Mr. Baker?

Baker: Yes, sir.

Rep Beaty: Could you explain your– I guess exactly are you just the lobbyist for the veterinarian association?

Baker: I’m not a veterinarian. I have a degree in animal husbandry. And I spent a lot of years representing agriculture, some 38 years representing agriculture. Most of it over here but I’m not a veterinarian. And when I started out talking to Ms. Vaught on this, there were things that I didn’t know that I was in the process of researching. And we had an interest of getting things done in a timely manner. I made some suggestions. I didn’t have full knowledge or as much knowledge as I’d like to have had.

Rep Beaty: I think we’ve all learned a little bit just with reading and the emails and communications. I wanted to address one thing that you mentioned about the written contract and that that would make someone a 1099 employee. That’s not the case. I think that’s the election that the veterinarian and the VTS would decide on what type of employment, employee they would be classified as. So they would not be a 1099 employee unless both parties agree that that’s the way they would want to go just because you have the contract.

Baker: Well, thank you. I’ll stand corrected on that. But based on your definition it could happen.

Rep Beaty: Yeah, it would be a choice. As anything in this bill would be the choice of the veterinarian and under the guidance and decision-making authority that that doctor has in how they handle their practice. My other question would just be, you mentioned the change in antibiotics and the rules at the fed level that we hear from our constituents on. How are we going to get those medications now? So I assert that those federal changes are going to place an increased demand on the veterinarians of this state in an industry that’s already fallen short of being able to take care of the needs that are there. So would this veterinary technician specialist assist in those areas with providing service to Arkansans and their animals?

Baker: As I understand this rule change, the guidance that was issued by FDA asked the manufacturers to take a product that’s now over the counter and put it in a prescriptive situation, whatever their terminology is. Prescriptions by FDA have to be written by a veterinarian with this pre-existing relationship. And they require that that be a visit either to the farm or attention to the animal by the veterinarian. So I don’t see that there’s a direct link there that you’re looking for. I’ll stand to be corrected but that’s how it appears when I read the definitions.

Rep Beaty: Well, I would just assert that if this were in place, that those folks at the point in time that because they’re going to have to address that issue at some point, that this would allow a little bit less stress or time restraints on our veterinarians.

Baker: A point, I’m not trying to be argumentative, but the testimony here today is that these prescriptive authorities will not be issued until the federal changes their rules. So they would not have A, the prescriptive authority under that situation. And B, the feds would have to change their rules.

Rep Beaty: Yeah. I agree with you there. I don’t think that’s in the bill that they would be able to write the prescriptions.

Rep Fortner: Okay, sounds like everybody agrees on that. All right, does anybody else have a question? Yes, Representative Garner.

Rep Garner: Thank you, Mr. Baker, for being here. And I respect you so much for what you do for your clients. So thank you for being here. I do, I guess, I just need some reiteration because I started as a nurse practitioner 40 years ago when we didn’t have to have a master’s. And we were grandfathered into the program and much of our training was done on-site. So thank goodness, Dr. Westbrook and Dr. Sun took a chance and trained me to do a lot of the things that I could do until a master’s was available. So a lot of what I did, I did as trained by them but it was always, always in collaboration, always. They had a choice to pull me in if they wanted to. They didn’t have to do that.

So I guess my question is – and I think where some of us are talking about, we’re not talking about prescriptive abilities but if I went to see a patient that I was collaborating on and they needed something that I was trained on, some of those assessments. I didn’t make any diagnostic, I just said this is something that’s not right. And I called him and said there’s something going on with this patient. This is what’s going on. That collaboration then allowed me to call in the prescription in his name for. So it’s not a prescriptive thing, it’s an availability issue.

Baker: I believe you could do that now under the existing. We already have vet technicians. We also have vet technologists. And we have a provision in the law for tech specialists but they’re not given independent – I think that’s the word that’s been missing when you talk about the prescriptive authority. We’re talking about an independent prescriptive authority if it’s ever issued. It doesn’t say independent in the bill. But, in the absence of it being independent, there’s no need to have that description in law because they’re already doing these things where they’re calling in and helping out with the prescriptions now. And I’ve got two vets over here shaking their head yes.

This is to go a step farther. Go back to the example somebody gave about a dog coming in, the vet’s not there. And they’re hurt and they need some kind of help right now. If you can get a hold of the vet on the line, of course, they don’t have the pre-existing condition. So two things there, one, to treat that animal they have to have some kind of pre-existing relationship, they pursue that in this, okay? The other is prescriptive authority if that vet’s not there and can’t write a prescription. Under this, what they’re wanting to do if I’m right, allow them to write that prescription. That’s independent prescriptive authority.

Rep Garner: Well, not without a protocol from that physician. I mean–

Baker: The protocol between the two people, the veterinarian, and the person. That protocol may be that if I’m not there you’ve got prescription right.

Rep Garner: Right. That’s what happened–

Baker: The prescriptive authority is what’s being added is not there now. And that is what FDA doesn’t buy. I actually tried to do research on this. I spent some time with a drug enforcement, DEA agent on this. And there’s also language in here about using controlled substances. I’m not an expert on that but there’s different levels of controlled substances and some of the toughest on that is stuff you’d use for euthanasia, which is specifically mentioned in here also. I believe I’m right that a veterinarian has to administer currently those drugs for euthanasia. This would change and I’ll take somebody’s expertise here besides mine.

Rep Fortner: Would you come to the end of the table and identify yourself?

Baker: Sorry, Mr. Chairman. I didn’t mean to turn this into a group discussion. I thought–

Rep Fortner: Oh, it won’t be. And make your comment very brief, please.

Jenkins: Yeah. Once again, Dr. Paul Jenkins, veterinarian. The question was that can euthanasia solution be used by someone other than the veterinarian? And I would tell you that my answer to that is no. That has to be used on the order of a veterinarian.

Rep Fortner: Okay. Thank you. And I think that in fairness, I think there is a comment from. identify yourself for the record, please.

Norris: Tabitha Norris. So when we were writing that, that was a major concern of mine because we didn’t want to do anything outside of what the DEA would allow. And I spoke directly to the DEA multiple times. And basically, the DEA registration, the owner of that registration is responsible for all of their drugs. But they have the ability to send it with their technicians. You could even send it out on a call with them unless it’s limited by state laws. So you’re responsible for the drugs and where they go and that they’re accounted for. But you could let your technician put an animal to sleep in the room or it’s just that right now the way the state laws are written, they can’t do it outside of direct supervision.

Rep Fortner: All right. Thank you. And thank you, Mr. Baker.

Baker: Thank you.

Rep Fortner: Representative Vaught, are you ready to close?

Rep Vaught: I’ll try to be fast because I know we’ve been talking about this for a little while. Nurse practitioners was brought up several times, so I just want to remind you. I think people would have said the sky was going to fall whenever nurse practitioners started being able to do more and more work on people. But I don’t think the sky did fall. And I think we’re just as safe now as we was when they first started doing the nurse practitioner laws.

Again, there’s lots of safety nets in the bill. And I think Mr. Baker brought up about the 15 days, and he thought that the actually the technician can do it but the bill says on line 35, “the collaborating veterinarian shall complete.” It does not say the tech can do it, it says the veterinarian must do it. So that was misinformation. Let’s see. Again they can’t get the certificate to prescribe drugs unless the federal government acts on it. So those will not even be handed out for them to be able to do this, unless that happens.

Remember, somebody does not have to hire these people either. This is only if they want to hire them. They will have an avenue in which they can hire them. But it’s not like we’re mandating that everybody hire one of these technician specialists. I will say that the Cattlemen’s, and Farm Bureau are in support of this bill. And Mr. Cody would have been here to speak but he was out of town. He regrets that he couldn’t be here to speak for the bill.

My husband and I, we own a large animal farm. My veterinarian would definitely take advantage of this. He services several areas and this would be something that would help him. And my husband and I would have no problem with this vet tech specialist coming and working on our animals.

Somebody asked if other states do this right now. Texas and Oklahoma are looking at doing it. Wouldn’t it be great to do something before Texas does it? And with that, Mr. Chair, I will close. And I would ask for a good vote. And motion do pass.

Rep Fortner: Do pass as amended?   

Rep Vaught: Yes, sir. As amended.

Rep Fortner: Okay. Thank you. All right, members, we have a motion of do pass. All those in favor? All those opposed? The ayes have it. Your bill has passed. I want to thank you all for coming. This example of civil discourse makes me proud, and I thank you all for coming.