ARC 8168B
VETERINARY MEDICINE BOARD[811]
Notice of Intended Action
Twenty-five interested persons, a governmental subdivision, an agency or association of 25 or more persons may demand an oral presentation hereon as provided in Iowa Code section 17A.4(1)"b."
Notice is also given to the public that the Administrative Rules Review Committee may, on its own motion or on written request by any individual or group, review this proposed action under section 17A.8(6) at a regular or special meeting where the public or interested persons may be heard.
Pursuant to the authority of Iowa Code section 169.5, the Iowa Board of Veterinary Medicine hereby gives Notice of Intended Action to amend Chapter 1, “Description of Organization and Definitions,” Chapter 8, “Auxiliary Personnel,” and Chapter 10, “Discipline,” Iowa Administrative Code.
The proposed amendments revise and adopt new definitions, set out categories and requirements for veterinary auxiliary personnel, and update the implementation statutes in the Chapter 10 rules regarding discipline standards. The changes provide for additional classifications of non-veterinarian employees who are employed by veterinarians. The amendments include additional education, testing and continuing education requirements for these personnel. In addition, the amendments define for each class of personnel the level of supervision by a licensed veterinarian that is required for assisting the veterinarian in the treatment of animals and for performing laboratory work in a veterinary practice. The amendments also increase the fees in Chapter 8.
Any interested persons may make written comments or suggestions on the proposed amendments on or before 4:30 p.m.	on October 19, 2009. Written comments should be sent to Dr. David Schmitt, Executive Secretary, Iowa Board of Veterinary Medicine, Wallace State Office Building, 502 East Ninth Street, Des Moines, Iowa 50319; or faxed to (515)281-4282. E-mail comments may be sent to David.Schmitt@IowaAgriculture.gov.
A public hearing will be held on October 19, 2009, at 10 a.m. in the Wallace Auditorium at the address listed above, at which time persons may present their views either orally or in writing. At the hearing, persons will be asked to give their names and addresses for the record and to confine their remarks to the subject of the proposed amendments. Any persons who intend to attend the public hearing and have special requirements, such as those related to hearing or mobility impairments, should contact the Board and advise of specific needs.
No waiver provision is included in the proposed amendments. However, the Board’s general waiver provisions, found at 811—Chapter 14, apply.
These amendments are intended to implement Iowa Code chapters 169 and 272C.
The following amendments are proposed.
	Item 1. Adopt the following new definition of “Supervision” in rule 811—1.4(17A,169):
“Supervision” means the following, as applicable:
	1.	“Immediate supervision” means that a licensed veterinarian is on the premises and within eyesight or hearing range.
	2.	“Direct supervision” means that a licensed veterinarian is on the premises and is readily available.
	3.	“Indirect supervision” means that a licensed veterinarian is not necessarily on the premises but is able to perform the duties of a licensed veterinarian by maintaining direct communication.
	Item 2. Amend rule 811—8.1(169,17A) as follows:
811—8.1(169,17A) Definitions. As used in these rules this chapter, the following terms shall mean:
“Accredited school of veterinary technology” means a two-year college level training program providing basic training leading to a certificate of completion of a two-year program recognized and approved accredited by the AVMA committee on accreditation of training for veterinary technicians or recognized and approved by the board.
“Board” means board of veterinary medicine.
“Certified veterinary assistant” means an individual who has successfully passed examinations prescribed by the board.
“Department” shall mean means the Iowa department of agriculture and land stewardship.
“Non-credentialed veterinary assistant” means an individual employed by a veterinarian who is not a registered veterinary technician or certified veterinary assistant or a veterinary assistant.
“Registered veterinary technician” means an individual who is a graduate of an accredited school of veterinary technology or is currently registered in the state of Iowa as a veterinary technician and who has successfully passed examinations prescribed by the board.
“Veterinary assistant” means an assistant employed by a licensed veterinarian for a purpose other than performing diagnosis, issuing prescriptions or performing surgery and includes, among other assistants, registered veterinary technicians.
“Veterinary technician” means any citizen of the United States who shall have graduated in veterinary technology from a two-year AVMA accredited school of veterinary technology; or in lieu thereof has assisted a licensed veterinarian for five years prior to 1980, or worked under the direction of a licensed veterinarian for at least three years, including at least one year of formal training approved by the board, in veterinary technology prior to 1981; and who shall have successfully passed an examination prescribed by the board.
	Item 3. Amend rule 811—8.2(169) as follows:
811—8.2(169) Registration of veterinary technicians Certification and registration.
	8.2(1) Registration of veterinary technicians. All veterinary technicians shall be registered by and under the direct control of the board and shall be registered with the state veterinarian, bureau of animal industry, Iowa department of agriculture and land stewardship. Each registered veterinary technician must pass both a written and practical test examinations as approved by the board. Applications for registration shall be obtained from and remitted A person seeking to apply for the registration examination shall obtain an application form from the board and submit the application with the applicable fees to the board. Successful candidates A successful candidate shall be issued a certificate registration by the board stating that the named candidate is registered as a veterinary technician.
	8.2(2) Certification of veterinary assistants. All certified veterinary assistants shall be certified by and under the direct control of the board. Each certified veterinary assistant must pass examinations as prescribed by the board. A person seeking to apply for the certification examination shall obtain an application form from the board and submit the application with the applicable fees to the board. A successful candidate shall be issued a certificate by the board stating that the named candidate is certified as a veterinary assistant.
	Item 4. Amend rule 811—8.3(169) as follows:
811—8.3(169) Examination.
	8.3(1) Veterinary technician. An application fee of $25 shall accompany the application to take the examination; and both A completed veterinary technician examination application with the applicable fees must be received by the board at least 60 days before the examination. An additional fee shall be submitted for the national board written examination as provided by the professional examination service, when utilized by the board as part of their examination process, which shall be the fees charged for the examination by the professional examination service plus $10 for the costs of administration. Applicable fees shall include the fee charged by the AAVSB for the VTNE as well as an administrative fee as set by the board. Examinations shall be given annually in June at a site to be designated by the board at least 30 days before the date of the examination. Additional examinations may be authorized by the board.
	8.3(2) Certified veterinary assistant. A completed certified veterinary assistant examination application with the applicable fees must be received by the board at least 60 days before the examination. Applicable fees shall include the fee as set by the board for the certified veterinary assistant examination as well as an administrative fee of $25 for the board. Examinations shall be given annually in June at a site to be designated by the board at least 30 days before the date of the examination.
This rule is intended to implement Iowa Code sections 169.5(8), 169.9 and 169.12.
	Item 5. Adopt the following new rule 811—8.4(169):
811—8.4(169) Registration and certificate renewal.
	8.4(1) A veterinary technician registration shall be issued for a three-year period, except that a new registration issued during a triennium shall be issued for the balance of that triennium and the registration fee shall be prorated. A veterinary assistant certificate shall be issued for a three-year period, except that new certificates issued during a triennium shall be issued for the balance of the triennium and the certificate fee shall be prorated. A registration or certificate shall expire on December 31 of the third year of the triennium.
	8.4(2) At least two months before the end of a triennium, a renewal notice will be sent to each registrant and certificate holder at the last-known address in the board’s file. Failure to receive the notice shall not relieve the registrant or certificate holder of the obligation to pay triennial renewal fees on or before December 31.
	8.4(3) The renewal application shall include a statement which identifies the jurisdictions in which the registrant or certificate holder is or has ever been registered or certified.
	8.4(4) Renewal fees shall be received by the board on or before the end of the triennium on December 31. Whenever renewal fees are not received as specified, the registration or certificate shall lapse, and the privileges granted by the registration or certificate shall cease until all renewal fees and penalty fees are received by the board.
	8.4(5) If the renewal fee has not been received by the board before the registration or certificate has lapsed, an application for late renewal must be filed with the board with a renewal fee, a reactivation fee, and the late renewal penalty fee.
	8.4(6) A person may renew an expired registration or certificate within five years of the date of its expiration by making written application for renewal and paying the current renewal fee plus all delinquent renewal fees. After five years have elapsed since the date of expiration, a registration or certificate may not be renewed, and the holder must make application for a new registration or certificate and pass the appropriate registration or certificate examination.
	Item 6. Amend rule 811—8.5(169) as follows:
811—8.5(169) Supervision. All veterinary assistants, including registered veterinary technicians, and certified veterinary assistants shall be employed by and receive compensation from and be under the direct supervision of a licensed or license exempt (hereafter referred to as licensed) veterinarian, and shall function at the same place of business as the veterinarian. Such supervision shall include, but not be limited to, the availability of the veterinarian on the premises.
	8.5(1) Veterinarian’s responsibility: For the purpose of this rule, the definition of “supervision” contained in rule 811—1.4(169) shall apply.
	a. 	To personally examine the animal within 12 hours before the assistant carries out any procedures.
	b. 	To direct, control and supervise the conduct of the assistant in the assistant’s work.
	8.5(2) Veterinary assistant’s responsibility: The following table sets forth the minimum levels of supervision for registered veterinary technician (RVT), certified veterinary assistant (CVA), and non-credentialed veterinary assistant (NCVA) by task and level of supervision:

Patient Care and Therapeutics	RVT	CVA	NCVA	
Administer subcutaneous medications	Indirect	Indirect	Indirect	
Administer intramuscular medications	Indirect	Direct	Immediate	
Administer intradermal medications	Indirect	Immediate	Not allowed	
Administer intraperitoneal medications	Indirect	Immediate	Not allowed	
Administer intramammary medications for mastitis therapy	Indirect	Indirect	Immediate	
Administer intravenous medications	Indirect	Direct	Not allowed	
Administer intravenous medications via open fluid line	Indirect	Indirect	Direct	
Administer enteral medications by balling gun, dose syringe, and hand pilling	Indirect	Indirect	Direct	
Administer enteral medications by gastric intubation or gastric lavage	Direct	Immediate	Immediate	
Perform ocular diagnostic tests including tonometry, fluorescein stain and Schirmer tear test	Indirect	Immediate	Not allowed	
Administer enema	Indirect	Indirect	Indirect	
Collect and evaluate skin scrapings	Indirect	Direct	Immediate	
Administer subcutaneous fluids	Indirect	Indirect	Direct	
Place intravenous catheters (cephalic, saphenous, jugular)	Indirect	Direct	Immediate	
Maintain and care for intravenous and urinary catheters	Indirect	Indirect	Direct	
Determine and maintain fluid infusion rate	Indirect	Indirect	Direct	
Monitor patient hydration status	Indirect	Indirect	Direct	
Apply and remove bandages and splints	Indirect	Direct	Immediate	
Remove casts	Indirect	Direct	Immediate	
Maintain chest, tracheostomy and pharyngostomy tubes	Indirect	Direct	Immediate	
Collect, crossmatch and administer blood transfusions	Indirect	Immediate	Not allowed	
Perform routine dental prophylaxis	Direct	Direct	Not allowed	
Extract teeth not requiring sectioning of the root	Direct	Not allowed	Not allowed	
Clip teeth on animals (excluding livestock defined in Iowa Code chapter 717B)	Indirect	Direct	Immediate	
Administer pre-anesthetics	Indirect	Immediate	Immediate	
Administer anesthetic agents by injection, mask, induction chamber or endotracheal tube	Indirect	Immediate	Not allowed	
Place endotracheal tubes	Indirect	Direct	Immediate	
Implement and evaluate pain management protocols	Indirect	Direct	Immediate	
Prepare surgical site using appropriate aseptic techniques	Indirect	Indirect	Direct	
Provide surgical assistance	Immediate	Immediate	Immediate	
Perform basic suturing of skin	Direct	Not allowed	Not allowed	
Obtain specimens for laboratory analysis
Voided urine
Place urinary catheter
Cystocentesis
Venipuncture
Skin scraping
Fine needle tissue aspirate
Impression smear preparation
Vaginal smears
Semen collection (excluding livestock defined in Iowa Code
chapter 717B)	Indirect
Indirect
Indirect
Indirect
Indirect
Indirect
Indirect
Indirect
Indirect	Indirect
Immediate
Immediate
Indirect
Indirect
Immediate
Indirect
Indirect
Direct	Indirect
Not allowed
Not allowed
Immediate
Immediate
Not allowed
Immediate
Immediate
Immediate	
Assist in collecting, preparing and evaluating transudates, exudates and cytologic specimens (joint, cerebrospinal, airway, body cavity, bone marrow)	Immediate	Immediate	Immediate	
Analyze laboratory specimens
Urinalysis
Hematology
Clinical chemistry
Coagulation tests
Parasitologic procedures
Microbiologic procedures
Cytology, semen
Collect specimens from necropsy	Indirect
Indirect
Indirect
Indirect
Indirect
Indirect
Indirect
Indirect	Indirect
Indirect
Indirect
Direct
Indirect
Indirect
Direct
Indirect	Direct
Direct
Direct
Immediate
Direct
Direct
Immediate
Immediate	
Perform humane euthanasia	Indirect	Direct	Not allowed	
Observe radiation safety measures	Indirect	Indirect	Indirect	
	a. 	The veterinary assistant, including registered veterinarian technicians, shall not perform surgery; shall not make a diagnosis and prognosis of animal diseases; shall not prescribe drugs, medicine and appliances, and shall not administer rabies vaccine.
	b.  8.5(3) Emergencies. Under conditions of an emergency, a veterinary assistant including a registered veterinary technician may render without supervision such lifesaving aid and treatment as follows: administration of oxygen; maintenance of airways including the nonsurgical insertion of an endotracheal tube; and control of hemorrhage. Under conditions of emergency, a registered veterinary technician and a certified veterinary assistant but not an unregistered a non-credentialed veterinary assistant may render such additional lifesaving aid and treatment as follows: placement of an IV catheter and the administration of fluids; external cardiac massage; and the administration of corticosteroids. Emergency aid and treatment, if rendered to an animal not in the presence of a licensed veterinarian, shall only be continued under the direction of a licensed veterinarian, which in the case of emergency may include telephone or radio contact by a veterinarian en route to the site, until the veterinarian arrives in a timely manner. “Emergency” for the purpose of this rule means that the animal has been placed in a life-threatening condition where immediate treatment is necessary to sustain life.
	8.5(4) Nothing in this chapter shall be construed to permit a registered veterinary technician or a certified veterinary assistant to make any diagnosis or prognosis; to prescribe any treatments, drugs, medications, or appliance; to perform surgery; or to administer rabies vaccination to a dog.
	Item 7. Rescind rule 811—8.6(169) and adopt the following new rule in lieu thereof:
811—8.6(169) Disciplinary actions and procedures. A disciplinary action against a registered veterinary technician or a certified veterinary assistant, including grounds for disciplinary action, is governed by 811—Chapter 10.
	Item 8. Rescind and reserve rules 811—8.7(169) to 811—8.9(169,272C).
	Item 9. Amend rule 811—8.10(169,272C) as follows:
811—8.10(169,272C) Continuing education.
	8.10(1) At least 30 hours of continuing education in courses approved by the board of veterinary medicine shall be completed triennially within the last three licensing years by each registered veterinary technician. At least 15 hours of continuing education in courses approved by the board shall be completed within the last three years by each certified veterinary assistant. The registrant or certificate holder has the responsibility for financing the cost of continuing education. These Continuing education credit hours may be obtained by attending approved scientific seminars and meetings on the basis of one credit hour for each hour of attendance. Attendance at any board-approved national, state or regional meeting will be acceptable. Credit for qualified graduate college courses may be approved on the basis of multiplying each college credit hour by 10, to a maximum of 15 hours one-half of the required hours during any one triennial licensing period. A maximum of 10 hours during any one triennial licensing period may be achieved by the completion of approved home study distance education courses.
	8.10(2) Each registrant registered veterinary technician shall obtain the 30 credit hours between the registrant’s certificate anniversary date of registration and the last day of the following three-year period. Each certified veterinary assistant shall obtain the 15 required credit hours between the anniversary date of certification and the last day of the three-year licensing period. However, a registrant registered veterinary technician who graduated from an accredited college of veterinary technology within three years of the issuance of an Iowa certificate registration is required to obtain only 20 credit hours for the first triennial registration period. Continuing For registered veterinary technicians, continuing education credits in excess of 30 hours for any three-year period may be carried over to the next triennial period, but the total number of credits credit hours carried over shall not exceed 10 hours. For certified veterinary assistants, continuing education credits in excess of 15 hours for any three-year period may be carried over to the next triennial period, but the total number of credit hours carried over shall not exceed 5 hours.
	8.10(3) Triennial licensing continuing education hours requirements.
	a. 	New graduates. Applicants, within one year after the date of graduation, are exempt from continuing education requirements for initial licensing.
	b. 	Registered veterinary technicians. Applicants who are registered veterinary technicians who apply more than one year but less than two years after the date of graduation must have completed at least 10 hours of approved continuing education. Applicants who apply more than two years but less than three years after the date of graduation must have completed at least 20 hours of approved continuing education.
	c. 	Certified veterinary assistants. During the first year of the credentialing triennium, the credentialed certified veterinary assistant is required to complete 10 hours of continuing education for the first credentialed renewal. If a recently credentialed certified veterinary assistant is credentialed during the second year of the credentialing triennium, the credentialed certified veterinary assistant is required to complete 5 hours of continuing education for the first credentialed renewal. If a recently credentialed certified veterinary assistant is credentialed during the third year of the credentialing triennium, the credential holder is exempt from meeting continuing education requirements for the first credentialed renewal.
	8.10(4) Completion of the continuing education will be reported to the secretary of the board of veterinary medicine on forms provided by the board by December 31 of the triennial anniversary year. The reporting form must be signed by the registrant and accompanied by an administration fee of $15.
Compliance with this rule and subrule 8.6(7) is waived until January 1, 1993. Registrants whose certificate triennial anniversary dates fall in the year 1993 shall complete and report 10 credit hours. Registrants whose certificate triennial anniversary dates fall in the year 1994 shall complete and report 20 credit hours. All registrants whose certificate triennial anniversary dates fall in the year 1995 and subsequent years shall complete and report the full 30 credit hours.
	Item 10. Adopt the following new rules 811—8.11(169) to 811—8.13(169):
811—8.11(169) Temporary veterinary technician permit.  The board may issue a temporary veterinary technician permit to an applicant who is certified in another jurisdiction and who has met all of the requirements for a veterinary technician registration except for passing the state veterinary technician examination. A temporary veterinary technician permit is not available to a person who has previously taken and failed the state veterinary technician examination.
	8.11(1) An application for a temporary veterinary technician permit shall be made on a form provided by the board. The applicant shall provide a statement indicating all jurisdictions in which the applicant is or has ever been licensed, registered or certified to practice as a veterinary technician. The applicant shall provide information and consent to the release of information to the board from jurisdictions in which the applicant is or has ever been licensed, registered or certified.
	8.11(2) The board may require from an applicant or obtain from other sources such other information pertinent to character and education of the applicant as the board may deem necessary in order to evaluate the applicant’s qualifications.
	8.11(3) The applicant shall provide evidence of approved continuing education totaling at least 30 hours obtained within the last three licensing years.
	8.11(4) The temporary permit fee and the application fee shall accompany the application.
	8.11(5) Holders of a temporary veterinary technician permit shall establish and maintain an association with an Iowa-licensed veterinarian. The licensed veterinarian shall be in a position to regularly observe the activities of the permit holder.
	8.11(6) The temporary veterinary technician permit shall expire upon the board’s receipt and issuance of a veterinary technician registration or upon notification of failure of the examination by the applicant. The temporary veterinary technician permit is valid for one year from the date of issue but is no longer valid if the test candidate failed the examination or became registered upon passing the examination.
811—8.12(169) Reactivation of registration. A registered veterinary technician or certified veterinary assistant whose registration has lapsed or who has been placed on inactive status shall, prior to engaging in activities for which a registration is required in the state of Iowa, make application for reactivation by doing all of the following:
	1.	Submit written application for reactivation to the board upon a form provided by the board;
	2.	Furnish evidence of completion of compliance with the continuing education requirements specified in rule 811—8.10(169,272C); and
	3.	Successfully complete the examination procedures specified in rule 811—8.2(169,17A) within one year of reactivation.
811—8.13(169) Fee schedule for registered veterinary technicians and certified veterinary assistants.
	8.13(1) The fees listed in subrule 8.13(2) shall be collected by the board and shall not be refunded except by board action in unusual instances such as documented illness of the applicant, death of the applicant, inability of the applicant to comply with the rules of the board, or withdrawal of the application for examination provided that the request for withdrawal is received in writing 45 days prior to the examination date. Examination fees shall be nontransferrable from one examination to another.
	8.13(2) Registered veterinary technician and certified veterinary assistant. The fee for the VTNE, which is utilized by the board as a part of the examination process, shall be the fee charged that year by the AAVSB plus an administrative fee of $25 set by the board for administration of the examination. Based on the board’s anticipated financial requirements, the following fees are hereby adopted:

Registration or certificate—application fee..............................................$15	
VTNE examination fee………………………...................... set by AAVSB	
VTNE administrative fee……………………………………………......$25	
Triennial registration or certificate………………………………….…..$15	
Late renewal penalty……………………………………….....................$50	
Temporary veterinary technician permit—application fee ………….….$15	
Temporary permit fee…………………………………………………...$15	
Reactivation fee for inactive or lapsed registration..................................$15	
Duplicate registration or certificate………………..................................$15	
Official verification of registration or certificate………………………..$15	
Charge for insufficient funds or returned checks……………….……….$25	
State veterinary technician examination fee……………….....................$50	
State veterinary assistant examination fee………………………….…...Set by IBVM	
State veterinary technician administrative fee…………………..............Set by IBVM	
State veterinary assistant administrative fee……………………..……...$25	
Reinstatement administrative fee………………………………..............$25	
Reactivation administrative fee…………………………….….………...$25	
	Item 11. Amend rules 811—10.1(17A,169,272C) to 811—10.11(17A,169,272C) and 811—10.13(17A,169,272C), parenthetical implementation statutes, by adding “272D.”