Suicide Prevention and Mental Health

Delve into the latest research on suicide and its causes in this conversation on veterinary mental health with experts from the AVMA and the Association of American Veterinary Medical Colleges (AAVMC). Learn strategies to promote mental health, prevent suicide, and intervene in a mental health crisis. Come away knowing individual and community risk and protective factors, get guidance on mental health crisis warning signs, and learn how to get help for someone in crisis – vital steps in building healthy communities and supporting our colleagues and peers. A culture of caring offers help and hope to its members—and we all can play a role in building that community.
View webinar here

AVMA Update – April 2021

Aloha Colleagues!

Before I share with you the many programs the American Veterinary Medical Association has available for all members, I did want to take this opportunity to send a huge virtual Mahalo to you for your support of my candidacy for the AVMA Board of Directors District X Representative. Although I was not chosen, I am grateful to have been on the ballot – Mahalo!

We, Carolyn Naun (alternate delegate) and I (Delegate and State Advocacy Committee Member), will continue to represent Hawaii proudly at the House of Delegate meetings. If there are any questions or concerns, please feel free to contact us.

Aloha,
Leianne K. Lee Loy


Highlights from the AVMA:

AVMA Virtual Convention July 29 – August 1, 2021: Registration is open!
Check out “Convention at First Glance” to discover the over 300 hours of
continuing education. avmaconvention.org

VLC (Veterinary Leadership Conference) January 7-9, 2022 avma.org/vlc
(NOTE: Please click here for highlights of the AVMA House of Delegates Winter Session including the Veterinary Information Forum that took place during the VLC.) This is a great conference to develop, improve and perfect your leadership skills.

COVID-19 resource center: www.avma.org/Coronavirus
More information about veterinarians’ ability provide vaccines
E-book: COVID-19: Meeting the Challenge

AVMA Axon online platform – digital education https://axon.avma.org
Certificate Programs, Webinars, My Veterinary Life Podcasts Series

AVMA Trust Retirement Plan avmalifeplans.com/ARP
For questions, or to schedule a personal consultation, email AVMATrustRetirementPlan@transamerica.com or call
312-596-5336.

AVMA, VetSuccess Partnership
• Veterinary Industry Tracker
• To learn more about the AVMA’s economics resources, visit
avma.org/VeterinaryEconomics

Diversity, Equity, and Inclusion: avma.org/diversity

Telehealth
AVMA Guidelines for the Use of Telehealth in Veterinary Practice
2021 AAHA/AVMA Telehealth Guidelines for Small-Animal Practice

Veterinarians as COVID-19 Vaccinators

Submitted by the American Veterinary Medical Association

The AVMA has been working hard for the past few months, as veterinarians have been increasingly discussed as needing to be among those able to assist in efforts to vaccinate people against COVID, to have veterinarians specifically included in the declarations under the federal Public Readiness and Emergency Preparedness Act (PREP Act), which authorizes the HHS Secretary to issue emergency public health declarations and provides limited immunity from liability to those covered under the act.

As of March 12, 2021, veterinarians and veterinary students are included in the PREP Act:

· It allows veterinarians who are licensed to practice under the law of any state to administer COVID vaccines in any jurisdiction in association with a COVID vaccination effort by a state, local, tribal, or territorial authority or by an institution in which the COVID vaccine is administered.

·        This also applies to veterinarians who have held an active license or certification under the law of any state within the last five years which is inactive, expired or lapsed, as well as veterinary students with appropriate training in administering vaccines. The intent is to include recently retired veterinarians who may want to help.

·        Today’s amendment preempts any state law that would otherwise prohibit veterinarians or veterinary students who are a “qualified person” under the PREP Act from prescribing, dispensing, or administering COVID vaccines or other covered COVID countermeasures.

·        Veterinarians and veterinary students will be afforded liability protections in accordance with the PREP Act and the terms of the amendment. However, specific conditions must be met in order for the authorization to administer the vaccines and the liability protections to apply. These liability protections apply from March 11, 2021, through October 1, 2024.

·        In order for the authorization and liability protections to apply, veterinarians and veterinary students must be participating in association with a COVID vaccination effort by a state, local, tribal, or territorial authority, or by an institution in which the COVID vaccine is administered. Additional specific requirements also must be met, such as having basic certification in CPR, completing the CDC COVID vaccination modules, an observation period, etc. There is a separate section of the declaration that applies to those in the uniformed services and for federal employees, contractors and volunteers when authorized to administer COVID vaccine.

·        While the liability outlined in the PREP Act is broad, it does not apply to willful misconduct, and the federal government does not provide a legal defense in the event that you are sued. Your state may have separate liability protections, along with separate requirements to qualify, and may or may not provide a legal defense. Veterinary malpractice will not likely respond to claims arising from a veterinarian intentionally vaccinating people against COVID.

More information on vaccination volunteer requirements

Sign up for Hawaii’s volunteer Medical Reserve Corps here

PREP Fact Sheet that Includes Veterinarians as Qualified Health Professionals

Federal Requirements for the Veterinarian-Client-Patient Relationship

The following guidance information has been provided by the AVMA

THE BASICS

The federal government regulates veterinary medicine and animal drugs very differently than it does human health care and drugs intended for human use. This is, in part, because veterinarians are key to maintaining a healthy, safe, and wholesome food supply and because they also play an important role in overseeing the judicious use of antimicrobials in animals. One important difference between human and veterinary medicine is that the U.S. Food and Drug Administration (FDA) has authority under the federal Food, Drug and Cosmetic Act (FDCA) over the use of animal drugs and human drugs by veterinarians, and the authority to define how a veterinarian-client-patient relationship (VCPR) is established for certain uses of animal and human drugs. [1]

For these uses, FDA has authority to require the keeping of veterinary medical records and to access them at any reasonable time to verify and copy them. [2] Use of animal and human drugs by veterinarians that violates the federal VCPR parameters set forth in the FDCA and its implementing regulations results in the drug being statutorily deemed unsafe for the use and, if in animal feed, the feed is statutorily deemed adulterated. [3] The USDA, which regulates veterinary biological products, also has promulgated rules defining a VCPR using the same language as the FDA. [4]

APPLICATION OF THE FEDERAL VCPR

The federal VCPR applies to any use of an FDA-approved human drug in animals, including over-the-counter (OTC) human drugs. [5] It applies to any use of an FDA-approved animal drug in any manner that differs from its approved labeling (Extra Label Drug Use [6]), such as a different frequency of administration, different dose, different medical indication for its use, different route of administration, or use in a different species. [7] It also applies to the use of compounded drugs by veterinarians [8] and a veterinarian’s authorization of a veterinary feed directive (VFD). [9] All of these are very common occurrences in the day-to-day practice of veterinary medicine.

Establishing the federal VCPR requires a physical examination of the animal or timely and medically appropriate visits to the premises where animals are kept. The FDA does not allow the VCPR to be established through electronic means. [10] FDA does allow the VCPR to be maintained electronically through telemedicine. [11] Veterinarians must comply with the federal VCPR in each of the circumstances in which it applies, irrespective of whether state law defines it differently.

The federal VCPR also applies in two important, but more limited, circumstances under USDA authorities. Veterinarians who manufacture biological products for use in their patients must do so within the context of the federal VCPR. [12] Veterinarians also must have established a federal VCPR when using prescription platform product biologics, which are a new category of biotechnology vaccines. [13]

CONFLICTING STATE AND FEDERAL VCPR DEFINITIONS AND TELEMEDICINE

• Conflicting state and federal VCPR definitions (e.g., states allowing the VCPR to be established electronically) would cause significant confusion. The FDA and USDA have used the same regulatory definition to avoid such confusion.
• Veterinarians must comply with the federal VCPR requirements where they apply, regardless whether state laws are more lax. Activities where the federal VCPR applies are extremely common in day-to-day veterinary practice.
• State law and regulations relating to the establishment of a VCPR that conflict with federal law would also cause telemedicine encounters to be frustrating for many veterinary clients. A veterinarian who has not already established a VCPR that complies with federal requirements (i.e., by conducting an in-person examination/visit) could not even recommend the use of an FDA-approved human OTC product for an animal without violating federal law.
• There are many valuable uses of telemedicine within the parameters of a federal VCPR.

  1. 21 USC 360b; 21 CFR Part 530
  2. 21 CFR 530.5
  3. 21 USC 360b(a)(1), (2), (4) & (5); 21 USC 342(a)
  4. 9 CFR 107.1(a)(1)
  5. 21 USC 360b(a)(5); 21 CFR 530.2; 21 CFR 530.3(a)
  6. https://www.fda.gov/animal-veterinary/resources-you/ins-and-outs-extra-label-drug-use-animals-resource-veterinarians
  7. 21 USC 360b(a)(4); 21 CFR 530.2; 21 CFR 530.3(a)
  8. https://www.fda.gov/animal-veterinary/resources-you/ins-and-outs-extra-label-drug-use-animals-resource-veterinarians#compounding; FDA Draft Guidance for Industry #256
  9. 21 CFR 558.6(b)
  10. FDA letter to the American Veterinary Medical Association, April 6, 2017 – “Therefore, for the purposes of the federal definition, a VCPR cannot be established solely through telemedicine (e.g., photos, videos, or other electronic means that do not involve examination of the animal(s) or timely visits to the premises).”; During the pandemic FDA announced they will temporarily suspend enforcement of the federal VCPR physical exam and premises visit requirements. https://www.fda.gov/regulatory-information/search-fda-guidance-documents/cvm-gfi-269-enforcement-policy-regarding-federal-vcpr-requirements-facilitate-veterinary. In this announcement FDA reiterated that under normal circumstances – “Given that the Federal VCPR definition requires animal examination and/or medically appropriate and timely visits to the premises where the animal(s) are kept, the Federal VCPR definition cannot be met solely through telemedicine.”
  11. Id. “The regulations do not specifically address the use of telemedicine to maintain an established VCPR. However, based upon the language of the VCPR definition provided above, nothing would prohibit the use of telemedicine (e.g., use of photos, videos, or other electronic means that may be considered virtual) to allow the veterinarian to keep informed and able to make medical judgments regarding the health of the animal(s) and the need for medical treatment between periodic examinations of the animal(s) and/or timely visits to the premises where the animal(s) are being kept.”
  12. 9 CFR 107.1(a)
  13. USDA Veterinary Services Memorandum 800.214

Leianne Lee Loy Running for AVMA Board of Directors Representing Hawaii’s District

Message from Leianne K. Lee Loy, current AVMA Hawaii Delegate and candidate for AVMA Board of Directors Representing District X:

Aloha Colleagues!

I ask for your support and vote to be the next member of the AVMA Board
of Directors. You will be receiving an email from the AVMA with a ballot,
my biography and “Seeking Statement”. You will have from March 1-31st to
vote.

I share with you a platform for which I bring my diverse perspective:
a) Diversity, Equity and Inclusion – educating and advocating for our Veterinary Community.
b) Quality of life for the Veterinary Community – raising a family and caring for our elderly family members while working.
c) Retaining and Maintaining AVMA membership throughout your veterinary Career.
d) Support of “support staff” – veterinary nurses/technicians building a career that brings satisfaction.
e) Critique of the AVMA during COVID 19 – how well did we support the Veterinary Community? There are 500,000 Americans who lost their lives to
COVID19; how were animals/veterinarians affected by those lives lost? As the AVMA reviews their response to this pandemic, strategic plans can be made to prepare for future health emergencies.

An email message will be sent to all eligible voters, providing instructions
and a link to a secure voting website. The email is sent from the address
AVMAelection@avma.org. Please vote!

More information available here:
www.fb.com/VoteLeianneForAVMABoard
www.instagram.com/leianneleeloyforavmaboard

AVMA Update January 2021

AVMA held their first-ever virtual Veterinary Leadership Conference in January. If you are interested in honing your leadership skills, CE is still available on demand through March. 

AVMA House of Delegates also gathered virtually and held the Veterinary Information Form to discuss veterinary medicine during the COVID-19 pandemic and timing of canine spay/neuter. Action was taken on a number of AVMA resolutions and policies, which can be viewed here.

Hawaii’s AVMA House of Delegate representatives are Leianne Lee Loy, DVM (Delegate) and Carolyn Naun, DVM (Alternate Delegate). If you have any concerns regarding veterinary medicine and the AVMA, please contact them at avma_delegate@hawaiivetmed.org.

AVMA News

Veterinary Leadership Conference 2021

Registration for the AVMA Veterinary Leadership Conference (VLC) 2021 is now open. VLC 2021 will be held virtually January 7-9, 2021. HVMA is currently accepting nominations for the designated “Veterinary Leader” from Hawaii, due by November 28, 2020.

Past attendees include Drs. David Gans, Jenee Odani, Aleisha Swartz, and Katie Hancock Reed. Contact us for more information. Read more about the VLC here.

Volunteer Opportunities

We invite you to explore the Committee and Council positions available this year and in 2021.  Please visit the Volunteer Opportunities section of the AVMA website to learn more. As a volunteer, travel, lodging and meals are covered by the AVMA.

AVMA COVID-19 Resources

AVMA Webinars

AVMA House of Delegates Updates

Submitted by HVMA HOD Representatives Leianne Lee Loy and Carolyn Naun

The first Virtual Annual House Of Delegate (HOD) Session was held on July 30 and 31, 2020. Regular Annual Meeting Agenda included: Veterinary Information Forum with open mic discussion, candidate introductions, officer speeches, Informational meeting (AVMF, PAC, PLIT, CVTEA, COE), Reference Committee, and the district caucuses.  

Highlights of the meeting:
Discussion, cases and stories of HOD COVID-19
Diversity and Inclusion in Veterinary Medicine
Two Resolutions Approved: Revised Policy on Antiparasitic Resistance and Transportation of Research Animals for the Purpose of Research, Testing, and Education

Election results:
AVMA President Elect 2020-2021: Jose Arce
AVMA Vice President 2020-2022: Sandra Faeh

Continuing Education Opportunity with AVMA

This summer, the AVMA’s first Virtual Convention will take place August 20-22. Take a step back from the day-to-day and rekindle your energy and passion for veterinary medicine—without leaving your home!
Tracks include:

  • Cannabis Symposium
  • Companion animal medicine
  • Food animal / equine
  • Practice management
  • Professional development
  • Public and corporate practice
  • Veterinary technology

Find out more and register here

Diversity and inclusion

As you know, diversity and inclusion has become a salient issue over the past several months. AVMA leadership has listened, and the HOD passed recommendations to the Board of Directors outlining some actionable steps. The Multicultural Veterinary Medical Organization released a thought provoking video that we recommend you watch if you have not seen it already: https://www.youtube.com/watch?v=j7Pl4YX_QNc

Given recent events in Washington involving a Member of Congress who is a veterinarian, we wanted to clear up one misunderstanding we have heard regarding the use of member dues. AVMA does take an active role in advocating for the profession and championing the legislative causes that affect us. This effort is nonpartisan in nature.  However, in accordance with federal law, your AVMA dues cannot be used toward political campaign contributions.

The AVMA’s Political Action Committee is a separate entity supported by individual contributions from members. AVMA PAC does support veterinarian Members of Congress, as they understand the challenges faced by our profession and the issues you care about, without regard to party affiliation. You can reach AVMA PAC to provide feedback or to make a contribution at avmapac.org

Here is a link to the statement from AVMA regarding the reported interaction between Rep. Ted Yoho and Rep. Alexandria Ocasio-Cortez: https://www.facebook.com/avmavets/posts/10163691028363990

Rep. Ted Yoho is retiring from Congress at the end of this year.

Paycheck Protection Program Update from AVMA

The AVMA Advocacy team worked very hard to influence and improve the Paycheck Protection Program. The Small Business Administration recently released data on the loans and the uptake by the veterinary profession has been significant. About 56% of veterinary practices took PPP loans totaling an estimated $2.1 Billion, with over 80% of the loans being less than $150,000.  Over 200,000 jobs in veterinary practices have been protected. A blog posting with data and an infographic can be found at https://www.avma.org/blog/covid-19-loans-are-supporting-veterinary-teams-and-patients.

Congress is working on additional legislation that will impact the PPP, which could include retroactive changes.  It is expected to pass before Congress leaves for their August recess.  AVMA is actively seeking measures to ensure favorable tax treatment of PPP loan proceeds, and for a streamlined forgiveness process for loans below $150,000, which would include the vast majority of veterinary PPP loans. We have a Congressional Advocacy Network Action Alert out on the tax treatment of PPP funds that can be found at https://avmacan.avma.org/avma/app/onestep-write-a-letter?0&engagementId=508320.

SARS-CoV-2 Animal Testing

Routine testing of animals for COVID-19 is NOT recommended by the American Veterinary Medical Association (AVMA), American Association of Veterinary Laboratory Diagnosticians (AAVLD), National Association of State Public Health Veterinarians (NASPHV), or the National Assembly of State Animal Health Officials. Nor is it recommended by key federal agencies, including the CDC and USDA.

Current expert understanding is that SARS-CoV-2 is primarily transmitted person-to-person. There is currently no evidence that animals can transmit this virus to people. In rare instances, people have spread the virus to certain animals.

Veterinarians are strongly encouraged to rule out more common causes for clinical signs in animals before considering testing for SARS-CoV-2. The CDC, USDA, and other federal partners have created guidance, including a table of epidemiological risk factors and clinical features for SARS-CoV-2 in animals to help guide decisions regarding animal testing.

The decision to test an animal should be made collaboratively between the attending veterinarian and local, state, and/or federal public health and animal health officials after careful consideration of this guidance as provided.

AVMA-AAVLD-NASPHV-NASAHO Joint Statement on Animal Testing

Hawaii State Dept of Ag Guidelines on Animal Testing


Labs with SARS-CoV-2 PCR Animal Tests