Related Statutes and Rules
VEB administers ch. 89, Stats., as well as the administrative rules in VE 1-10, Wis. Adm. Code, and in the administration of these statute and rules, VEB may issue administrative orders imposing discipline for unprofessional conduct related to the practice of veterinary medicine, including issuing an administrative warning to, or reprimanding, any person holding a veterinary medical license, or denying, revoking, suspending, limiting, the person’s license, as specified by statute. Plain Language Analysis
There is a current definition, in s. VE 1.02 (3m), Wis. Adm. Code, of veterinary complementary, alternative, and integrative therapies (“CAITs”). However, that definition does not specify how these CAITs are to be treated within the practice of veterinary medicine. There have been numerous requests made to the VEB, from veterinarians, certified veterinary technicians, and members of other licensed professions, to clarify the referral relationship that a veterinarian may have with these other professionals for the veterinarian’s clients, and the delegation to certified veterinary technicians for the provision of CAITs upon a veterinarian’s animal patients. The VEB proposes to create a rule, s. VE 7.025, specifying that a veterinarian may make a referral to another Wisconsin-licensed professional, so long as the other professional gives evidence to the veterinarian of his or her license in good standing with the Wisconsin Department of Safety and Professional Services, to perform the type of CAIT for which the referral is made, and his or her education, training, and experience in performing that type of CAIT on an animal. The proposed rule includes a provision that the veterinarian-client-patient relationship (“VCPR”), as defined in s. 89.02(8), Stats., does not extend to the CAIT provided by the other professional, where the veterinarian demonstrates meeting the requirements in making the referral or the client obtains a therapy provider for the client’s animal without a referral. In addition, the VEB proposes to create an additional provision, within s. VE 7.02 delegation of veterinary medical acts, for the veterinarian to delegate to a certified veterinary technician the performance of a CAIT on an animal patient, where the certified veterinary technician is not a licensed professional performing a CAIT. By including this provision in the section on delegation of veterinary medical acts, the VEB makes clear that the technician’s CAIT performance is under the direct supervision of the veterinarian, who will continue to have all of the supervisory responsibilities specified in this section, and within the VCPR. Summary of, and Comparison with Existing or Proposed Federal Statutes and Regulations
There are no federal regulations governing the practice of veterinary complementary, alternative, and integrative therapies.
Comparison with Rules in Adjacent States
Illinois’s veterinary medicine and surgery practice act defines CAITs very similarly to the current definition in s. VE 1.02(9), Wis. Adm. Code. The act specifically allows a member in good standing of another licensed or regulated profession within any state or an Illinois-approved member of an organization or group to provide hands-on active participation in the treatment and care of a patient, within a veterinarian-client-patient relationship and with informed consent from the client, so long as the member works under the supervision of the veterinarian. The veterinarian maintains the veterinarian-client-patient relationship, but is immune from civil and criminal liability for the member’s assistance, except for willful and wanton conduct. The other professional may not state or imply in any way that they are licensed or engaging in the practice of veterinary medicine. Iowa’s and Michigan’s veterinary statutes and rules do not address this issue.
Within Minnesota’s practice of veterinary medicine act, there is a provision that specifically states that the act does not prohibit a licensed chiropractor from registering with its chiropractor board and performing animal chiropractic on animals that have been referred to the chiropractor by a veterinarian.
Summary of Factual Data and Analytical Methodologies
This rule was developed with the assistance of a VEB-appointed rules advisory committee that included five Wisconsin-licensed veterinarians, two Wisconsin-certified veterinary technicians, two Wisconsin-licensed members of other professions who provide complimentary, alternative, or integrative therapies on animals, two public members, and a VEB member as a liaison to the Board. The committee looked at practices in other states, consulted with veterinary medical groups, and brought expertise on the use of these CAITs in assisting animals for their health and well-being.
Effect on Small Business
This rule change is anticipated to have an effect on small business, as many veterinary practices that will be subject to this definition change, are small businesses. However, it is not expected to have any adverse economic impact on these veterinary small businesses.
Instead, the proposed rule is anticipated to have a positive impact for veterinarians, certified veterinary technicians, and other Wisconsin-licensed professionals, as it clarifies the steps a veterinarian shall use to make a referral to another professional for CAITs and the delegation for these CAITs to certified veterinary technicians under the veterinarian’s supervision. The VEB has received many requests for just this type of guidance from veterinarians, other professions practicing these therapies, and certified veterinary technicians in Wisconsin.
There were some comments, in the initial posting for economic impact, from some persons who practice equine massage therapy, but are not licensed as massage therapists in Wisconsin. Some expressed concern that veterinarians would no longer be able to refer clients to an unlicensed massage therapist practicing equine massage therapy. However, the rule clarifies that the referral by a veterinarian is only to a licensed professional, as CAITs are already currently within the statutory definition of the practice of veterinary medicine, and only a referral to another licensed professional or delegating with the established VCPR, comports with the statutory language. However, this rule does make clear that it does not interfere with the relationship between any animal owner and a person the owner chooses to perform a CAIT on the owner’s animal. In addition, the rule also clarifies that this is a referral and the other licensed professional does not work under the supervision of the referring veterinarian making it important that the referral is to a licensed professional that will have its own professional client-patient relationship. Only where a certified veterinary technician is delegated by the veterinarian to perform a CAIT, will the performance of the CAIT be under the direct supervision of the veterinarian and within the VCPR.
This rule is not expected to have a substantial adverse economic effect on “small business” so it is not subject to the delayed “small business” effective date provided in s. 227.22(2) (e), Stats. VEB Contact
Where and When Comments May Be Submitted
Questions and comments related to this this rule may be directed to:
Cheryl Daniels, Board Counsel
Veterinary Examining Board
c/o Department of Agriculture, Trade and Consumer Protection
P.O. Box 8911
Madison, WI 53708-8911
Telephone: (608) 224-5026
Rule comments will be accepted up to two weeks after the last public hearing is held on this rule. Hearing dates will be scheduled after this rule hearing draft is approved by the Veterinary Examining Board.
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Section 1. VE 7.02(3) (d) is created to read:
7.02 (3) (d) Except to certified veterinary technicians who are also licensed professionals governed by the provisions in VE 7.025, the provision of any complementary, alternative, or integrative therapy, as defined in VE 1.02(3m).
Section 2. VE 7.025 is created to read:
7.025 Veterinary referral to a license holder in another profession. (1) A veterinarian may make a referral to a client, for treatment of a patient by a license holder in another profession, using complementary, alternative, or integrative therapies, as defined in s. VE 1.02(3m), if the license holder, to whom the client and patient are referred, provides the following evidence to the veterinarian for performing the type of therapy for which the referral is being made: (a) The license holder’s current licensing in good standing, with the applicable board through the department of safety and professional services, and,
(b) The license holder’s education, training, and experience in performing the therapy on an animal.
(2) The veterinarian-client-patient relationship, as defined in s. 89.02(8), Stats., does not extend to the provision of any complementary, alternative, or integrative therapy performed on a veterinarian’s patient, by a license holder in another profession, where the veterinarian demonstrates meeting the requirements, in sub. (1), for making the referral to the license holder, or the client obtains the services of the therapy provider without a referral by the veterinarian. Section 3. Effective date and initial applicability. This rule takes effect on the first day of the month following publication in the Wisconsin administrative register, as provided under s. 227.22(2)(intro.).
