Microchip Regulation Update

On July 1, 2020, the City and County of Honolulu implemented mandatory microchip identification for cats and dogs over the age of four months. This replaces the City and County of Honolulu’s dog license tag requirement, but does not replace the requirement that cats allowed outdoors have visible identification. Any dog or cat without a microchip who is impounded by Hawaiian Humane Society or taken into custody by an animal rescue nonprofit must have a microchip implanted before release. The microchipping obligation does not apply to private individuals returning lost pets or to veterinary clinics, but we hope you will urge your clients to comply with the law. Clients with a new pet who is already microchipped should be informed that they have 30 days to update the pet’s microchip with their owner information.

In addition, the Hawaiian Humane Society will no longer be updating their microchip registry. Instead, they are recommending that veterinarians help pet owners register their information with the microchip manufacturer or with a free online database such as FoundAnimals.org. Pet owners who have microchips implanted by your clinic also have a legal obligation to register their contact information with an online registry within 30 days. Please do not send microchip information to the Hawaiian Humane Society at this time.

Another provision of the new law requires that any intact dog impounded as stray three times in a 12-month period must be spayed/neutered before the dog can be returned to its owner unless a licensed veterinarian finds the dog is medically unfit for sterilization.

Questions or comments may be directed to the Hawaiian Humane Society at info@hawaiianhumane.org or 356-2200.

Update from Hawaiian Humane Society

July 1 marked the implementation of the most significant overhaul of Oahu’s animal welfare ordinance in 25 years. It made changes in three major areas:

  • Stray animal handling
  • Pet identification
  • Routinely stray dogs

The pet identification provisions are expected to affect the greatest number of pet owners.

FAQs

What law has changed?
Revised Ordinance of Honolulu Chapter 7: Animals and Fowl

How did the rules change regarding stray animal holding?
Hawaiian Humane now has legal custody of any stray dog or cat with microchip identification after five days in its care, down from nine. Dogs wearing a current county license tag still must be held for a minimum of nine days. The kenneling fee for stray animals has increased to $10 per day from $2.50. There is still no kenneling charge for animals reclaimed within 24 hours. This is not a legal requirement, but Hawaiian Humane is urging pet owners who travel, particularly if they will not have email or cell phone access, to list their pet sitter or veterinarian as a secondary contact on their microchip registration in the event that their animal gets lost while they are away.

What are the new rules for pet identification?
All dogs and cats are now required to have microchip identification. Pet cats allowed outdoors are still required to have visible identification. That is highly recommended for dogs, as well, but not legally required.

What if you have a current dog license?
Owner information can still be updated with the City and County of Honolulu. No new dog licenses are being sold and licenses can no longer be renewed.

What about microchip registration?
Clinics that wish to upload microchip information should do so with the manufacturer’s database, not Hawaiian Humane. Hawaiian Humane is no longer maintaining a separate microchip database for Oahu and pet owners are no longer legally required to register their microchips with Hawaiian Humane. Under the new ordinance, pet owners who have microchips implanted have 30 days to register their contact information with the microchip manufacturer or a free online database. Similarly, they have 30 days to update any changes to their contact information or to transfer ownership of a pet.

What does the new law say about routine strays, or “frequent fliers”?
Any dog brought to Hawaiian Humane as stray three times in a 12-month period must be spayed/neutered before the dog can be returned to its owner, unless medically contraindicated. Sterilization services will be offered at the Community Spay/Neuter Center, but owners may request that Hawaiian Humane transfer a dog falling under this requirement to a private veterinary clinic upon confirmation of a spay/neuter appointment.

What do we do if someone brings us a lost pet?
Hawaiian Humane remains the official pet lost and found for Oahu. If you need help identifying the owner of a microchipped pet, call the admissions team at 356-2285.

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.

COVID-19 RESOURCES

Updated 5/6/2020

Quick Links to COVID-19 Resources:

AVMA COVID-19 webpage
CDC Guidance to Veterinary Practices
Infection Control in Veterinary Practices
Utilizing Telemedicine
Conserving Mask and Gown Resources
Hawaii State Updates on COVID-19
Hawaiian Humane Society Updated Services

US Government Resources:

Coronavirus Response Business Toolkit
Disaster Assistance Loans from the SBA
Disaster Help Desk for Small Businesses

Join the Discussion

https://www.facebook.com/groups/808COVIDvets/

COVID-19 Vet Resource Survey

Please help Hawaii better understand our veterinary resources (PPE, ventilator equipment, staff) by filling out our survey.

If you are looking to immediately donate any PPE or help with sewn cloth mask donations, please see UH School of Medicine’s Masks4HI webpage.

Guidance on Resuming Elective Services

Veterinary Medicine is an essential business that is part of the critical infrastructure of the United States. Many states did not place formal restrictions on the practice of veterinary medicine, while some states and localities instituted restrictions upon performing non-urgent or elective procedures.

During this crisis, veterinarians continue to exercise their professional judgment as to which services and procedures are urgent or potentially urgent (including those that may be necessary to protect certain vulnerable animal populations, prevent adverse effects on public health, or ensure the safety and security of the food supply if not performed) and which might be postponed. The AVMA also developed case management and triage decision trees to help veterinarians determine urgent and potentially urgent cases, using their professional judgment; support social distancing; and assist in conserving personal protective equipment (PPE).

At this time, resuming non-urgent or elective veterinary services is appropriate. There is a backlog of demand for elective or non-urgent veterinary care that is important for the health and welfare of animals. Failure to provide comprehensive  veterinary care places both animal and public health at risk. Veterinarians have adapted to conserve PPE that is in short supply for the delivery of human healthcare, and the original concern that performing non-urgent or elective veterinary procedures would negatively impact the availability of PPE for human healthcare providers has largely been ameliorated. Veterinarians should have also incorporated creative and effective measures that are consistent with social distancing recommendations and limit person-to-person exposure for staff and clients.

As veterinarians resume providing non-urgent/elective services, veterinary practices should continue invoking strategies that conserve PPE and support social distancing as appropriate and practical. Some measures that have been adopted, as appropriate to practice type, include:

  • Triaging appointments by phone or videoconference, and handling via telemedicine as medically appropriate and as permissible under federal and state law and guidance on what is permissible during the COVID-19 disaster declaration.
  • Inquiring as to whether the client or caretaker is ill with, or may have been exposed to, COVID-19. If so, encouraging someone other than the ill client to bring the patient to the hospital, if in-person care is necessary, or providing care via telemedicine if medically appropriate and permissible under federal and state law and guidance on what is permissible during the COVID-19 disaster declaration.
  • Scheduling appointments so that patient flow can be managed, and social distancing of clients maintained.
  • Restricting the number of clients waiting in the lobby for their appointments and enforcing social distancing.
  • Directly admitting clients and patients to examination rooms from their cars, rather than having them wait in the lobby.
  • Curb-side pickup of patients, keeping clients out of clinics except when required. This includes having clients remain in their vehicles in the parking lot while the patient is evaluated, with veterinarian/client communication by phone or videochat.
  • Curbside delivery of medication refills and veterinary diets
  • Encouraging clients who travel to the clinic to don cloth face coverings.
  • Having staff, rather than owners, hold animals during examinations.
  • Extra attention to cleaning of often-touched surfaces, including an increase in frequency.
  • Adoption of PPE conservation strategies, including extended use of disposable PPE (as appropriate) and replacement of disposable PPE with reusable and appropriately maintained/sterilized cloth gowns and masks.
  • Conducting daily health assessments or self-evaluations of employees, requiring staff to stay home if sick, and immediately sending staff home if they become ill while at work.
  • Dividing clinic staff into teams, so that if a team member is known to be exposed to or becomes ill with COVID-19, it largely localizes risk to that team while allowing important veterinary services to continue to be provided.
  • Diligently apply practices to prevent the spread of infectious disease, such as frequent handwashing and wearing gloves whenever appropriate.

CDC Guidance to Veterinarians

CDC has published new Interim Infection Prevention and Control Guidance for Veterinary Clinics during the COVID-19 Response. This guidance is for veterinarians and veterinary staff providing care to companion animals. The intent of this guidance is to facilitate preparedness and to ensure practices are in place in a veterinary clinical setting to help people and animals stay safe and healthy.

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

Telemedicine Expansion Order

On March 29th, Governor Ige signed an executive order allowing veterinarians to practice telemedicine without a previously established Veterinary-Client-Patient-Relationship (VCPR) or physical examination of the patient to establish a VCPR. This order remains in effect only during the COVID-19 emergency period. Read full executive order here.

We are extremely appreciative that our local government is enabling us to continue to care for patients while we respect the current social distancing and shelter-in-place orders to prevent the spread of COVID-19. AVMA has laid out specific guidance on Telemedicine.

On March 24th, FDA announced that they are taking steps to temporarily suspend enforcement of certain federal VCPR requirements as it relates to allowing veterinary telemedicine during this period of social distancing. This change only affects regulations regarding extralabel drug use in animals and veterinary feed directives. Read press announcement here.

AVMA Resources

Interim recommendations for intake of companion animals from households where humans with COVID-19 are present

Considerations for food animal veterinarians during the COVID-19 pandemic

AVMA Social Media Posts/Images

Available Webinars

  • CARES Act small business loan programs
    Learn how to prepare for the new Paycheck Protection Program launching Friday, and understand how it compares with the U.S. Small Business Administration’s (SBA) Economic Injury Disaster Loans.
  • COVID-19 Insurance Claims and CARES Act Leave Provisions
    Understand the paid leave and unemployment insurance provisions in the stimulus package and how they might apply to you and your business in this webinar with insurance and employment law experts – sponsored by AVMA LIFE and AVMA PLIT.

Essential vs. Non-Essential Services

HVMA and AVMA are working to educate our state and local governments on the essential services that veterinarians provide. We strongly discourage veterinarians from offering non-essential services during this period as this undermines our efforts. Continuing to offer or promote non-essential services during this period of government-mandated social distancing increases the risk of virus transmission to our staff, our clients, and our communities at large. Additionally, continuing to perform non-essential procedures and surgeries uses up limited resources that are in short supply and may be necessary for essential procedures and surgeries in the near future. Please consider the serious consequences of continuing practice as usual in the face of the rapid and undetected spread of COVID-19. Below are several guidelines to help you determine which services are essential.

“As restrictions in elective or non-essential services are put in place, either voluntarily or through government or regulatory body mandates, careful consideration of what is considered essential is needed. Essential procedures include those required to alleviate animal pain and suffering, to prevent imminent threat of death of the animal, and matters pertaining to public health (e.g. vaccination against rabies). Other considerations may be involved, including supply availability, the ability of the clinic to practice appropriate social distancing, and factors related to management of specific cases either in the clinic or at home.

“Recommendations may change based on our growing understanding of this disease, changes in messaging from governments and regulators, and as this pandemic evolves. Veterinarians and owners must understand this is a fluid situation and the goal cannot be maintaining “business as usual” but rather providing the optimal outcomes for animals, owners and veterinary facilities, while doing our part to support social distancing efforts. Any consultations that do not absolutely require physical contact with the animal should be done via telemedicine.”

Read full OVMA guidelines including owner risk assessment and social distancing in practice (pdf).

WSAVA Vaccine Guidelines During COVID-19

The World Small Animal Veterinary Association has released guidelines advising veterinarians on routine prophylactic vaccination (pdf) during the COVID-19 pandemic response.

DIY N95 Replacement Mask

The University of Florida Health’s department of anesthesiology has developed 2 prototypes for respirator masks that can be produced in large quantities using materials already found in hospitals and medical facilities. The makeshift mask uses Halyard H600 two-ply spun polypropylene that cannot be penetrated by water, bacteria, or particles. It blocks 99.9% of particulates, making the masks about 4% more effective at blocking particulate material than the N95 masks. Read more and see tutorials here.

Federal CARES Act

The Coronavirus Aid, Relief and Economic Security Act (CARES Act) was passed and signed on Friday March 27th. The CARES Act seeks to:

  • Support businesses to retain their employees and maintain operations
  • Expand unemployment insurance benefits in light of COVID-19 emergency
  • Provide individual support

AVMA has provided resources here to help veterinarians understand and interpret this legislation.

Statewide Stay-At-Home Order 3/25 – 4/30

Effective March 25 through April 30, 2020, everyone in the State of Hawai‘i is required to stay at home or in their place of residence. This supplement to Governor David Ige’s emergency proclamation was announced on March 23, 2020. Read more here.

Under the proclamation, individuals may leave their home or place of residence only for essential activities, to engage in essential businesses and operations, and only if their work cannot be conducted through remote technology from home.

Veterinarians are currently considered essential businesses. Please continue to refrain from offering non-essential services during this period so we can maintain this status. Offering or promoting non-essential services uses up limited resources that are in short supply and may be necessary for essential procedures and surgeries in the near future. Additionally, encouraging clients to come into public spaces during this period of government-mandated social distancing increases the risk of virus transmission to our staff, clients, and communities at large.

Self-Quarantine for Travelers Arriving After 3/26

Effective, Thursday, March 26, 2020, all persons entering the State of Hawai‘i must self-quarantine for 14 days or for the duration of their stay in Hawai‘i, whichever is shorter. Residents returning to Hawaii must also self-quarantine in a designated location in their residence. If you are assisting with pet travel into the state of Hawaii, please notify pet owners of the self-quarantine requirement.

The Rabies Quarantine Station in Halawa Valley is currently closed to visitors. Pets may be released from quarantine as soon as the mandatory quarantine period is completed.
Details on self-quarantine procedures (pdf)

State and Federal Tax Relief

Internal Revenue Service (IRS) and State of Hawaii Department of Taxation have postponed the due dates for payment and filing of 2019 Federal and State income tax returns to July 2020. Additional action is not needed by Income taxpayers to participate in this tax relief program.
IRS Website
State of Hawaii Department of Taxation Website
State of Hawaii Department of Taxation Announcement 2020-01 (pdf)

Am I Doing the Right Thing?

During this time of undetected spread of COVID-19, please protect your staff, your clients, and your community. If you or one of your staff becomes ill or is known to be exposed to COVID-19, in addition to concerns about your and their wellbeing, there is the possibility that you will be asked by public health officials to temporarily close your practice for personnel isolation and facility cleaning.

With this risk in mind, veterinarians should work to reschedule all nonessential appointments so as to limit public exposure. This includes wellness visits for vaccinations, spay/neuter procedures, routine dental procedures, and anything that can be safely delayed for a few weeks to months.

Veterinary staff members who have symptoms of acute respiratory illness should stay at home and should not return to work until they are free of fever (fever is defined as a temperature of 100.4F or higher, using an oral thermometer), signs of a fever, and any other symptoms for at least 24 hours without the use of fever-reducing or other symptom-altering medicine (e.g., cough suppressants).

In addition, veterinary clinics should be aware that the limit on statewide gatherings of 10 people applies to activity in their clinics.

Telemedicine and emergency teletriage within the context of an existing VCPR can be extremely helpful in limiting your staff’s exposure, and enable you to support and monitor the health of your patients and conform to local requirements, while preventing the potential spread of COVID-19. Conducting pre-visit triage can help protect you and your staff as you prioritize and determine which patients need to be seen at the clinic.

Please do the right thing to limit the spread of this disease in our community.

COVID-19 and Pets

  • Infectious disease experts and multiple international and domestic human and animal health organizations agree there is no evidence at this point to indicate that pets become ill with COVID-19 or that they spread it to other animals, including people.
  • If you are not ill with COVID-19, you can interact with your pet as you normally would, including walking, feeding, and playing. You should continue to practice good hygiene during those interactions (e.g., wash hands before and after interacting with your pet; ensure your pet is kept well-groomed; regularly clean your pet’s food and water bowls, bedding material, and toys).
  • Out of an abundance of caution, it is recommended that those ill with COVID-19 limit contact with animals until more information is known about the virus. Have another member of your household take care of walking, feeding, and playing with your pet. If you have a service animal or you must care for your pet, then wear a facemask; don’t share food, kiss, or hug them; and wash your hands before and after any contact with them.

Managing Veterinary Practice in a Pandemic:

Multiple universities and practices have implemented the following practices to protect the health of their employees, clients, and surrounding communities:

  • Limit patient care to acutely ill animals and/or emergencies. Animals that are sick or injured should receive veterinary attention.
  • Reschedule existing new and recheck appointments that are considered non-essential (unlikely to experience significant harm if treatment is not administered in a timely manner).
  • Reschedule elective procedures.
  • Utilize telemedicine to assess patient condition and needs.
  • If an animal needs to be seen in person, a healthy family member or friend should bring their sick animal to a veterinary hospital or clinic.
  • Have clients drop off their animal and remain in their cars during appointments.
  • When meeting clients, veterinary team members should wear appropriate PPE.
  • In light of limited supply, be strategic in the use of personal protective equipment (PPE), including masks, gowns, and gloves.
  • If a mobile or house call veterinarian must examine an animal in a home where someone is ill with COVID-19 and no other options are available, consult with local public health officials for guidance. Appropriate PPE and access to handwashing and disinfection materials should be considered in all cases.

Keeping Your Veterinary Team Healthy:

  • Veterinary healthcare team members who have symptoms of acute respiratory illness should stay at home and should not return to work until they are free of fever (100.4F or higher, using an oral thermometer) and any other symptoms for at least 24 hours without the use of fever-reducing or other symptom-altering medicine (e.g., cough suppressants).
  • Communicate about COVID-19 with your team. Flexible sick leave policies are important and team members should be made aware of these policies. Team members who appear to have symptoms of acute respiratory illness upon arrival at work or who become sick during the day should be separated from other team members and sent home immediately.
  • If a team member is confirmed to have COVID-19, the veterinary practice owner should inform other team members of their possible exposure to COVID-19, but maintain confidentiality as required by law. Team members who are exposed to another employee with confirmed COVID-19 should contact their physician or local health department to determine how best to proceed. 
  • Surfaces in the veterinary clinic/hospital that are touched frequently, such as workstations, keyboards, doorknobs, countertops, and stethoscopes, should be cleaned often and wiped down by employees with disposable wipes between cleanings.
  • Provide no-touch disposal receptacles.
  • Place hand sanitizers in multiple locations, including in exam rooms, offices, and conference rooms to encourage hand hygiene.
  • Team members should avoid close contact (within approximately 6 feet) with other people who are ill.
  • Avoid touching your eyes, nose, and mouth.
  • Cover your cough or sneeze with a tissue, then throw the tissue in the trash.
  • Wash your hands often with soap and water for at least 20 seconds, especially after coughing, sneezing, going to the bathroom, and before eating.
  • If soap and water are not readily available, use an alcohol-based hand sanitizer with at least 60% alcohol.

Families First Coronavirus Response Act:

On March 18, 2020, the President signed into law the Families First Coronavirus Response Act (H.R. 6201). 

The final bill included some significant policy changes from the original proposals that were intended to address both the impacts on small businesses and individuals. We expect lawmakers to continue to address economic measures for small businesses and individuals through future legislative packages.

Lawmakers and the Administration remain engaged in ongoing negotiations to produce additional measures, and AVMA continues to ensure the concerns of the profession are heard as this dynamic situation unfolds.

The final bill includes:

  1. FMLA COVID-19 benefit – This benefit provides up to 12 weeks of family and medical leave benefits related to the coronavirus to be paid at 2/3 of regular pay rates after the first 10 days, which are unpaid. The leave is only available for child care in the event of school closure or if the employee’s child care provider is unavailable due to the public health emergency.
  2. COVID-19 sick leave – This benefit applies up to 80 hours of additional paid sick leave for employees related to the coronavirus. There are daily and aggregate caps on the sick leave benefit of either $511 per day and $5,110 in the aggregate if the employee is sick or quarantined, and $200 per day and $2,000 in aggregate if the employee is caring for someone else.
  3. Potential exemption – There is language granting authority to the Department of Labor to create regulations that can exempt small businesses with fewer than 50 employees from the leave requirements when the imposition of the requirements would jeopardize the viability of the business as a going concern.
  4. Tax credits – There are tax credits for employers intended to mitigate the impacts of the expanded leave provisions; and
  5. COVID-19 testing – It provides for free testing for the coronavirus during the emergency.

Read more about the bill here.

3/24/2020 – The Department of Labor just released Frequently Asked Questions documents on the Families First Coronavirus Response Act:

1) DOL FAQ
2) DOL Fact Sheet for Employers
3) DOL Fact Sheet for Employees

  • Significantly, the FAQ DOL indicates the effective date for the Families First Coronavirus Response Act is April 1, 2020, and applies to leave taken between April 1, 2020, and December 31, 2020. 
  • For the exemption for business with fewer than 50 employees when providing the leave under the act would jeopardize the viability of the business, DOL advises that for now employers should document why they believe this to be the case.  DOL then indicates that more detail will be forthcoming in regulations.

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

AVMA Report Summer 2019

Aloha HVMA Colleagues and Happy Summer!

We are preparing for the American Veterinary Medical Association (AVMA) Summer Session for the House of Delegates which will begin prior to the AVMA Convention – “A Monumental Experience.”

Here are the highlights for our session beginning on Thursday August 1, 2019 in Washington DC:

2019 D.C. Hill Visits: Because we are in DC, we are planning on visiting our legislators to discuss the issues that are important to the AVMA and the veterinary profession. With over 200 individual meetings, this will be the largest veterinary event on Capitol Hill ever conducted by the AVMA!

We are scheduled to meet with Hawaii’s Members of Congress or their staff – Senators Mazie Hirono and Brian Schatz; Representatives Ed Case and Tulsi Gabbard. We will be focusing on three issues for the visits: Veterinary Medicine Loan Repayment Enhancement Act (VMLRPEA); Fairness to Pet Owners Act (FTPOA) and Association Health Plans Act (AHP).

Resolutions to be discussed and voted by the House of Delegates:
a) Model Veterinary Practice Act: The AVMA adopt the revised policy Model Veterinary Practice Act
b) Revised Policy on Judicious Therapeutic Use of Antimicrobials
c) Revised joint AABP-AVMA Policy on Judicious Therapeutic Use of Antimicrobials in Cattle
d) Sexual Harassment Awareness
e) Revised Policy on Pet Heath Insurance
f) Revised Policy on Veterinary Dentistry

Proposed Bylaws Amendment:
a) Council on Research – Responsibility
b) Board of Directors – Qualifications
c) Board of Directors – Composition

AVMA Elections:
There are multiple positions that will be voted on by the House of Delegates:
a) President-Elect
b) House Advisory Committee
c) 6 Council Positions

Congratulations to Carolyn Naun who will be a speaker at this year’s AVMA Convention!

If you need to contact us with comments about the topics we mentioned, here is our email: AVMA_Delegate_HI@avma.org

Aloha!
Leianne K. Lee Loy
Hawaii Delegate

Carolyn Naun
Hawaii Alternate Delegate

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.

Hawaii Rabies Quarantine Changes

Rule amendments to Chapter 4-29, HAR recently received final approval from the Governor and will become effective on August 31, 2018. A summary of the more significant changes follows. The complete Chapter 4-29, HAR with amendments is located on the Hawaii Department of Agriculture’s website at: http://hdoa.hawaii.gov/ under the Administrative Rules tab. The Animal Quarantine information page (access by clicking on the Animal Quarantine tab) has been updated and new checklists added to assist with preparing a dog or cat for the 5 Day or Less program and Direct Airport Release.

Exact Changes Made:

A. Section 4-29-2 Definitions
The definition “Service Animal” is added and the definitions of “Service Dog” and “User” are amended to reflect the definition of service animals under current Federal ADA language.

The definition “Eligibility Date” or “Eligible Date” is added for clarification of terminology and means the date determined by the State that an animal may qualify for five day or less quarantine by meeting all the specified requirements.

“Qualification date” is added for clarification and means the date determined by the state that an animal may be released from quarantine by meeting all the specified requirements under Chapter 4-29, HAR.
The definition “Safeguard” is added and means to confine and handle animals so that the animals shall not come into physical contact with any other animal, or cause a potential human exposure, at any time. The location and method of confinement and handling shall be approved by the state.

“Veterinary Hospital” is added for clarification and means an office or building designated for the sole purpose of providing veterinary examinations, diagnostics, and medical and surgical treatments of animals operated by a veterinarian licensed to practice in Hawaii.

B. Section 4-29-8.1 Other requirements
Changes are made to: Reduce the minimum time required from the most recently administered rabies vaccine before arrival in Hawaii from 90 days to 30 days;

Modify the minimum time required from a successful OIE-RVA test by reducing the period from the test before arrival in Hawaii from 120 to 30 days; and

Another amendment is added that owners are required to register their pet’s microchip number with the local county humane society or local animal welfare organization. Other changes are made throughout the section for clarification.

C. Section 4-29-8.3 Movement of dogs and cats requiring urgent diagnostic, medical or surgical procedures not available in Hawaii
A new subsection (b) is made to establish requirements for the importation of cloned animals derived from donor tissue originating in Hawaii into the state without quarantine. This provision allows application of advances in science and technology to qualify as a low risk category for import. Requirements for the cloning facility, veterinary management, brood stock, clone animal preparation, transportation and procedures are included.

J. Section 4-29-11 State animal quarantine station
Changes add that admission to the station may be denied to anyone that is not listed as an owner, co-owner, registered handler or authorized visitor on the record of an animal quarantined in the quarantine station. This change will increase biosecurity and minimize the potential of introducing diseases into the station.

An amendment is added to clarify that station veterinarians are authorized to refer an animal to a veterinary facility for diagnostics and treatment not available at the Station with or without prior owner authorization or approval. This is for situations when owners are not available and/or referral is in the best interest of the animal.

K. Section 4-29-17 Fees at the animal quarantine station.
Changes are made to fees for Five-day or less quarantine, Direct airport release, Neighbor Island Inspection Permit (NIIP) and Re-entry fee with direct airport release and ground transportation on Oahu are made. The total new fees for Five­day or less quarantine being $244 (currently $224); Direct airport release total fee of $185 (currently $165); NIIP fee of $165 (currently $145), and Reentry fee with direct airport release of $98 (currently $78).

L. Throughout Chapter 4-29, HAR, the term “service dog” is changed to “service animal” to reflect current Federal ADA language.

Read full press release here

 

RVT in Hawaii FAQs

WHAT DOES THIS LAW DO?
This is a title protection law only. Meaning that, as of July 1, 2018, only people who have registered with the state of Hawaii can use the title veterinary technician, vet tech, CVT, LVT, or RVT.

This includes on name tags, websites, business cards, etc. All staff members can perform the same tasks, but in order to use the title “veterinary technician”, he or she must be an RVT in the state of Hawaii.
Visit https://hvta.org/rvt-in-hi-faq/ for more details.

I AM A VETERINARIAN. WHAT DOES THIS LAW MEAN FOR ME?
For eligible employees to grandfather in, you’ll check off skills and hours on the Hawaii Experience Verification form and have it notarized. Eligible employees will need 5 years practical experience in Hawaii to sit for the Vet Tech National Exam.

Your employees can still do all the skills and tasks that they’ve been performing, but until they register in Hawaii, they cannot use the title “vet tech” or “veterinary technician”.

WANT TO HELP YOUR STAFF BECOME RVTs?
Awesome! The VTNE is a challenging exam, and you can help prepare them. Quiz them, ask them to do drug & fluid calculations, include them in your complicated cases, help pay their fees, and encourage them to attend HVTA’s study sessions.
Visit https://hvta.org/study-sessions-vtne-prep/ for more info.

THREE PATHS TO RVT
1. If already credentialed in another state: transfer VTNE scores, send license verification to DCCA.
2. If graduate of an AVMA accredited vet tech program: pass the VTNE with HI as your state.
3. Alternate Path (aka “grandfathering”): available now through July 2021 for on-the-job-trained technicians with 5+ years of experience in Hawaii, need notarized form from veterinarian, pass the VTNE with HI as your state.

For more information, see the Department of Commerce and Consumer Affairs (DCCA) Vet Tech page.

Sam Geiling, RVT
President, HVTA
Windward Community College
Kaneohe, HI