Category: Important News

Legislative Update – Jan 2020

HVMA has introduced HB 2528 and SB 2985 in the 2020 legislative session. These bills modify Hawaii’s veterinary practice act to 1) provide immunity in the absence of gross negligence to veterinarians who provide emergency care to an animal, and 2) clarify that the duty of a veterinarian includes reporting to law enforcement any cases of animal injury or death where there is reasonable cause to believe that it relates to dog fighting or animal abuse, while granting veterinarians immunity from any civil liability for such reporting. These additions to our veterinary practice act would put Hawaii in line with much of the rest of the United States. A big mahalo to Representative Hashem and Senator Baker for sponsoring the introduction of these bills to the legislature. Please thank them, particularly if you are from their districts!

1/28 Update: First round of SUPPORT testimony needed on this measure by Thursday 1/30! Submit online testimony here. Contact us if you have questions or comments on this measure, or if you are able to go down to the capitol and testify in person.

Veterinarian Compliance with DEA and SUPPORT Act

Recently, DEA announced the launch of the Suspicious Orders Report System (SORS) Online, a new centralized database [https://deadiversion.usdoj.gov/sors/index.html], where DEA registrants, including veterinarians, must report suspicious orders of controlled substances. Reporting by practitioner registrants and creation of the database by DEA was required when Congress passed the Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act (SUPPORT Act) last year. The DEA indicates that reporting a suspicious order to SORS Online constitutes compliance with the reporting requirement.

  • The reporting requirement applies to all DEA registrants, including veterinarians.  This is why veterinarians who are DEA registrants have been receiving communication from the DEA on the SUPPORT Act.
  • The circumstances under which it will impact veterinarians should be extremely limited, but the Act does apply to them.
  • All DEA registrants, including veterinarians, are required to design and operate a system to identify suspicious orders for the registrant and to report suspicious orders to the DEA.  The DEA advised that the plan should be in writing and could be requested during an inspection. 
    • Suspicious orders are defined as including requests for controlled substances of unusual size, deviating substantially from a normal pattern and orders of unusual frequency.
    • The DEA also said the definition is not inclusive and a veterinarian should report anytime there is something that makes the veterinarian suspicious. 
    • The AVMA is looking to develop a brief model plan that can be utilized.
  • The reporting requirement applies anytime a registrant, including a veterinarian, is requested to distribute/provide a controlled substance to another registrant under circumstances identified by the registrant as suspicious.  The example provided by DEA was where a veterinarian at one clinic asks to obtain a controlled substance from another veterinarian at a different clinic, such as seeking to obtain ketamine from a nearby clinic due to low inventory.  A veterinarian who receives a request to provide a controlled substance to another practitioner must be aware of the requirement to report the ‘order’ if the circumstances raise any suspicion to believe that the controlled substance will go for an illegal or diversionary purpose.
  • The reporting requirement and SORS Online database are solely for reporting transfers of a controlled substance from one DEA registrant to another DEA registrant that seem suspicious. Veterinarians are not to report to the SORS Online reporting system anything related to the administration, prescribing or dispensing of controlled substances that occur in the ordinary course of veterinary practice.  The SORS Online database is also not to be used for reporting suspicious or drug-seeking behavior of clients. 
  • If a veterinarian believes a request from another practitioner is suspicious, the veterinarian should not supply the controlled substance.  The veterinarian should register for the program on the DEA website and report the order to the electronic database (SORS Online).  A veterinarian only needs to register for the database at the time of the need to file a report of a suspicious order.
  • The DEA will be promulgating rules that will be published in the Federal Register. AVMA will review the rules and respond as appropriate.

Download the AVMA guidance and draft “system” for veterinarians here.

AVMA Update – Jan 2020

The AVMA House of Delegates (HOD) conducted association business, considered policies, discussed topics of interest to members, deliberated and presented action items at the winter session held January 10-11 in Chicago. The Winter session for the House of Delegates was held at the same time as the Veterinary Leadership Conference.

The Volunteer Leaders are committed to representing member interests with this years passionate discussion around AVMA’s Resolution: Policy on Declawing of Domestic Cats. The revised policy states that declawing should not be considered a routine procedure and emphasizes the importance of professional judgment and client education in making decisions that best protect the health and welfare of the patient: “The AVMA discourages the declawing (onychectomy) of cats as an elective procedure and supports non-surgical alternatives to the procedure. The AVMA respects the veterinarian’s right to use professional judgment when deciding how to best protect their individual patients’ health and welfare. Therefore, it is incumbent upon the veterinarian to counsel the owner about the natural scratching behavior of cats, the alternatives to surgery, as well as the details of the procedure itself and subsequent potential complications. Onychectomy is a surgical amputation and if performed, multi-modal perioperative pain management must be utilized.”

Other Resolutions discussed and were approved by the HOD:
Resolution 1: AVMA Policy on Use of Technology in Veterinary Medicine, which states, in part: “The AVMA affirms and encourages the responsible and ethical development and use of technology for a variety of applications in veterinary medicine that can benefit and protect public health, animal health and welfare, and environmental health.”
Resolution 2: AVMA Policy on Cribbing in Horses, which states, in part: “The AVMA condemns the use of hog rings or other devices placed around the teeth to prevent cribbing in horses. These devices are detrimental to the welfare and health of the horse due to the potential to cause persistent pain, damage to the gingiva, periodontal disease and abrasive wear to adjacent teeth. The AVMA encourages research to understand and address the underlying causes of cribbing.”
Resolution 4: Revised Policy on Microchips, which states, in part: “The AVMA endorses the implantation of electronic identification in companion animals and equids and supports standardization in materials, procedures, equipment, and registries. Veterinary healthcare teams are thereby encouraged to recommend the implantation of electronic identification of animals to their clients.”

Membership

The AVMA membership is stronger than ever, with the association’s membership at more than 95,300. Three out of every four veterinarians are members of the AVMA. HOD members also heard updates on the AVMA’s member-focused initiatives: digital education platform, AVMA Axon; our Direct Connect practice resource; our wellbeing and recent graduate initiatives; and efforts related to advocacy and public policy.

The Veterinary Information Forum

Three topics were discussed during the HOD’s Veterinary Information Forum:
Student extern/practice volunteer: Veterinary work experience prior to and during clinical time in colleges of veterinary medicine is valuable. These experiences are part of the non-academic evaluation; give an understanding of our profession; provide to the students and volunteers a degree of comfort with animals in the clinical setting; and provide some basic technical skills and insight into the veterinary working world. These experiences come with the concern of risk, particularly in the case of injury and determination of liability. The action item for this topic is the AVMA Board of Directors develop a toolkit, including potential forms and an awareness campaign, for the protection of practitioners, students and other
members of the veterinary health care team.
Telehealth: An update on AVMA activities in 2019 included support for state veterinary medical associations to engage with regulators; communication and collaboration with industry; and further development of member-focused resources, including continuing education and online resources. The AVMA will continue its work to develop guidelines on telehealth and
connected care.
Cannabis and cannabis-derived products: While the House made no specific recommendations related to cannabis, the AVMA remains committed in 2020 to advocacy for regulatory clarity and the development of additional member-focused resources and education.

Other topics discussed during the Veterinary Information Forum were updates on sexual harassment in the workplace and the utilization of veterinary technicians. During the 2019 annual meeting a resolution was passed recognizing that sexual harassment in the workplace is a serious issue and asked the AVMA Board of Directors to develop supporting resources and report back to the House. The AVMA will work in 2020 to update the AVMA web site to include additional resources on the prevention of sexual harassment in the workplace, as well as include sexual harassment education in AVMA continuing education programs. In addition, the AVMA will explore identifying specific workplace harassment training programs to recommend to veterinary practices.

The AVMA Task Force on Veterinary Technician Utilization report was also shared with House members. The focus of the report was on veterinary technician education, licensing and regulation, economics, supply and attrition, and wellness.

Public Service Loan Forgiveness Program

The AVMA continues to advocate to protect and enhance the Public Service Loan Forgiveness Program, which has been under scrutiny due to the incredibly low acceptance rate to date and concerns about overall costs. The AVMA’s past efforts include:
– Leading 127 animal health organizations in sending a letter to Congress underscoring the program’s importance to the industry and asking lawmakers to protect Public Service Loan Forgiveness.
– Joining a broad coalition of organizations in sending a letter to Education Department officials expressing concern about the loan forgiveness denials.
– The AVMA is continuing to communicate members’ concerns about the program’s administration to Congress and the U.S. Department of Education.

If you were denied forgiveness through PSLF or have experienced issues with the program, please share your story using the AVMA’s online advocacy tools.

Leianne Lee Loy, Hawaii Delegate
Carolyn Naun, Hawaii Alternate Delegate

Cannabis Info from AVMA

AVMA submitted comments to the FDA regarding critical veterinary issues related to cannabis products, and the importance of addressing them. The AVMA submitted the comments following a public hearing held by the agency in late spring to gather stakeholder input while considering regulatory frameworks for hemp derivatives—including CBD—used for therapeutic purposes and as food additives.

“Veterinarians have a strong interest in, and enthusiastically support, exploring the therapeutic potential of cannabis-derived and cannabis-related products,” according to the AVMA comments. “But we want to be sure we can have continued confidence in the efficacy, quality, and safety of products used to treat our patients.”

The AVMA’s concerns stem largely from the widespread marketing of cannabis-derived products, including hemp products, with health claims that haven’t received the required FDA evaluation and approval. “The FDA should establish a clear and efficient process for approval of cannabis-derived and -related therapeutic products, and then conduct consistent enforcement against manufacturers and distributors who are noncompliant,” the AVMA said in their comments. Read full AVMA article here.

In addition to advocating for practitioners, the AVMA provides several resources regarding cannabis:

Extortion Scam Targeting DEA Registrants

DEA is aware that registrants are receiving telephone calls and emails by criminals identifying themselves as DEA employees or other law enforcement personnel. In an attempt to create the illusion that these criminals are DEA employees, they have masked their telephone number on caller id with a phone number for a legitimate DEA office.  For example, these criminals have used the phone numbers for DEA’s Office of Congressional and Public Affairs and DEA’s 800 number which is used to provide direct support to DEA registrants.

Impersonating a federal agent is a violation of federal law. Registrants should be aware that no DEA agent will ever contact members of the public by telephone to demand money or any other form of payment or threaten to suspend a registrant’s DEA registration.

If you are contacted by a person purporting to work for DEA and seeking money or threatening to suspend your DEA registration, submit the information through “Extortion Scam Online Reporting” posted on the DEA Diversion Control Division’s website, www.DEADiversion.usdoj.gov.

HVTA Update

  • Our goal is to get as many eligible techs grandfathered in as RVTs as possible. So far only 3 have done it! This is the YEAR to get them studying. That way they can take the VTNE in 2020 and beat the 2021 cut-off. Study sessions are on the HVTA website and on the Events tab of our FB Page.
  • We have a FAQ page for anyone who might have questions about grandfathering.
  • Last, we have Clinic/Facility Membership that allows clinics and hospitals to show support for HVTA, post jobs, and we put their clinic name/logo into our newsletter.

Submitted by Sam (Craddock) Geiling, RVT, President, Hawaii Veterinary Technician Association

Rat Lungworm Disease Workshop

The University of Hawai`i at Hilo invites the public to the 6th International Scientific Workshop on Angiostrongylus cantonensis and Angiostrongyliasis (rat lungworm disease), held January 5-8, 2020, at the Hilo Hawaiian Hotel. Dr. Richard Malik (PhD, DVM) of the University of Sydney’s Centre for Veterinary Education will be leading discussion sessions for veterinarians on detection, treatment, and prevention of rat lungworm disease in domestic animals, wildlife, and livestock. There is no fee, but all attendees must register by September 1st at https://hilo.hawaii.edu/conferences/rat-lung-worm-2020/. Case study presentations are also welcome; abstracts due September 1st. For additional information, contact rlwlab@hawaii.edu.

Conference Registration Open

Registration is open for our 66th Annual HVMA Conference, which will be held from November 7-10, 2019 at the Hilton Waikiki Beach Hotel. We are again offering over 80 hours of RACE-approved CE (up to 27 credits for vets and 16 credits for vet techs) and bringing in world-renowned speakers covering a variety of topics including cardiology, oncology, sports medicine, equine medicine, soft tissue surgery, infectious disease, exotics, essential oils, wellness, the opioid crisis, and emergency & critical care.

Our wet lab offerings include orthopedic labs by Brian Beale and Don Hulse, a small diameter endoscopy lab by Carrie Palm and Sean Hulsebosch, dental radiograph positioning and interpretation labs by Kevin Stepaniuk, and a laser lab by Yukiko Kuwahara.

During the conference, we will hold our annual HVMA Hui on Saturday November 9 at 12:00pm during lunch. You do not need to be a conference attendee to come to the meeting. During the meeting, we will provide an update on what the HVMA has been doing this past year as well as overview any important legislative and island news. If you are interested in sharing anything during this time, please email us.

Also on Saturday November 9 from 6-8pm we will be hosting our annual social cocktail party. Tickets to this event are $60 or complimentary with full conference registration.

Register online for early bird pricing by September 15th. Remember to log in to your HVMA online account to register at the reduced member rates. If you have forgotten to renew your membership for 2019, it’s not too late! We hope you and your staff can join us!

Pesticides Rules Change

§4-66-54 of the Hawaii Administrative Rules is being updated by the Hawaii Department of Agriculture Pesticides branch to mandate that “every retailer that sells or distributes pesticide products to the public shall prominently post within ten feet of any pesticide product display or sales area, a warning sign that includes:

  1. Information regarding the proper handling, storage, and disposal of all pesticides sold;
  2. Emergency telephone numbers to call in case of poisoning from the pesticides; and
  3. A statement that use of any pesticide product in a manner inconsistent with its label is prohibited by law.

The warning sign shall be no less than seventeen inches by twenty two inches and contain lettering of sufficient size, no less than sixteen point bold type, which will enable the sign to be read from a distance of six feet under all lighting conditions normally encountered during business hours.”

The rules have not yet been signed as law by the governor but are expected to be signed some time in the May-June timeframe. These rules will affect
retailers that sell pesticides in any form (flea collars, topical medicine, etc.).

Sample signage wording below:

  1. For the proper handling, storage, and disposal of a pesticide product as required by Federal and State law, please refer to its label.
  2. In case of pesticide poisoning, please call the National Poison Control Center at 1-800-222-1222.
  3. It is a violation of Federal and State law to use any pesticide product in a manner inconsistent with its label.

[Pesticide product signage as required by Hawaii Administrative Rules(HAR) 4-66-54(d).]

For more information, please see the Department of Agriculture website.

Honolulu Street Dog Coalition

The Street Dog Coalition is a Colorado-based nonprofit founded by veterinarian Jon Geller whose mission is to provide free veterinary care and related services to pets of people affected by homelessness. Dr. Geller began providing care through street clinics in Ft. Collins in 2015 and has since expanded to mentor and provide supplies to licensed, volunteer veterinarians willing to lead clinics in their communities. The Street Dog Coalition partnered with the AVMA in July for a clinic at the Denver convention in July, read more about it here.

The Honolulu Street Dog Coalition clinics are led by Aleisha Swartz, DVM, and have started providing veterinary care such as vaccinations, parasite control and treatment of minor medical concerns at the new Punawai Rest Stop in Iwilei. The facility was built by the City and County of Honolulu and is a pet-friendly hygiene center where people can do laundry, take showers, receive mail and access social services.

The number of pets belonging to people affected by homelessness is unknown but is estimated to be approximately 10%. For the first time the 2019 Hawaii Homeless Point in Time Count survey asked people if they had pets; this information should be available in the spring.

If you are interested in more information on how to support this effort, volunteering at the Honolulu Clinics, or starting a clinic on a neighbor island, contact Aleisha at honolulu@thestreetdogcoalition.org. Support staff are welcome to volunteer. For more information about The Street Dog Coalition visit their website.