The 2024 Guide to CA 1399 [Infographics]

With a focus on Veterinary-Client-Patient Relationships (VCPRs), prescribing practices, and licensing standards, CA AB 1399 paves the way for responsible and effective telehealth practices among veterinarians.

We have created three infographics to help you understand the guidelines around California’s new regulations. Please feel free to take and share. The text in the infographics can be found below each image.

Jump to prescribing
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Establishing a VCPR under CA 1399

According to Assembly Bill No. 1399, a veterinarian may establish a Veterinary-Client-Patient Relationship (VCPR) through electronic means if the following conditions are met:

1. Authorization by the Client: The client must authorize the veterinarian to assume responsibility for medical judgments regarding the health of the animal patient.

2. Sufficient Knowledge of the Animal Patient: The veterinarian must have sufficient knowledge of the animal patient to initiate at least a general or preliminary diagnosis of the animal patient’s medical condition. This can be achieved through:

   – Examining the animal patient in person.

   – Examining the animal patient using synchronous audio-video communication.

   – Making medically appropriate and timely visits to the premises where the animal patient is kept.

3. Assumption of Responsibility and Communication of Plan: The veterinarian must assume responsibility for making medical judgments regarding the health of the animal patient and must communicate with the client a medical, treatment, diagnostic, or therapeutic plan appropriate to the circumstances.

4. Consent for Telehealth Use: Before delivering veterinary medicine via telehealth, the veterinarian must inform the client about the use and potential limitations of telehealth and obtain consent from the client. This includes acknowledgment that the same standards of care apply to both telehealth and in-person veterinary services, the option for the client to choose an in-person visit at any time, and advice on how to receive follow-up care in case of adverse reactions or technological failures.

5. Compliance with Privacy and Security Standards: The veterinarian must ensure that the technology and methods used comply with current privacy protection laws.

6. Review of Medical History: The veterinarian should obtain and review the animal patient’s relevant medical history and, if available, medical records.

7. Professional Judgment for Telehealth Appropriateness: The veterinarian must employ sound professional judgment to determine whether using telehealth is an appropriate method for delivering medical advice or treatment to the animal patient, ensuring quality of care consistent with prevailing veterinary medical practice.

8. Familiarity with Local Medical Resources: The veterinarian should be familiar with available medical resources near the animal patient’s location and be able to provide a list of nearby veterinarians for in-person consultation if needed.

9. Provision of Veterinarian Information: The veterinarian must provide the client with their name, contact information, and license number.

10. Secure Alternative Contact Means: The veterinarian must secure an alternative means of contacting the client if the primary electronic means is interrupted.

These conditions ensure that even though the relationship is established electronically, the standards of care and responsibility towards the animal patient are maintained at a level consistent with traditional in-person veterinary practices.

Prescribing under CA 1366

Assembly Bill No. 1399 outlines specific regulations regarding the prescribing practices of veterinarians, especially in relation to a veterinarian-client-patient relationship (VCPR) established through telehealth. Here are the key points:

1. VCPR as a Prerequisite for Prescribing: A veterinarian must not prescribe, dispense, or administer any drugs, medicines, applications, or treatments unless a VCPR exists or as otherwise permitted by law. This rule applies except in situations involving wild animals or when the owner of the animal patient is unknown.

2. Sufficient Knowledge of the Animal Patient: To prescribe, a veterinarian must have enough knowledge of the animal patient, which can be obtained through one of the following methods:

   – Examining the animal patient in person.

   – Using synchronous audio-video communication to examine the animal patient.

   – Making medically appropriate and timely visits to the premises where the animal patient is kept.

3. Prescription Duration Limits:

   – For veterinarians who established VCPR by in-person examination or visits, they cannot prescribe drugs for a duration longer than one year from the date of that examination or visit.

   – Veterinarians who established VCPR using synchronous audio-video communication cannot prescribe drugs for a period longer than six months from the date of the examination or prescription. The veterinarian shall not issue another prescription to the animal patient for the same drug unless they have conducted another examination of the animal patient, either in person or using telehealth.

4. Restrictions on Antimicrobial Drugs Prescribing: A veterinarian who established VCPR using synchronous audio-video communication cannot prescribe an antimicrobial drug for a period longer than 14 days. Any further antimicrobial drug prescription requires an in-person examination of the animal patient.

5. Controlled Substances and Xylazine: Controlled substances, as defined in Section 4021, or xylazine can only be prescribed if the veterinarian has performed an in-person physical examination of the animal patient or made medically appropriate and timely visits to where the animal patient is kept.

6. Notification About Prescription Availability at Pharmacies: Veterinarians must inform clients that some prescription drugs or medications may be available at pharmacies and, upon request, submit a prescription to a pharmacy chosen by the client.

7. Restriction on Prescribing for Race Horses: Veterinarians cannot prescribe via telehealth any drug or medication for use on a horse engaged in racing or training at a facility under the jurisdiction of the California Horse Racing Board.

8. Definition of ‘Drug’: For the purpose of this section, “drug” encompasses any controlled substance as defined in Section 4021, or any dangerous drug as defined in Section 4022.

These regulations are designed to ensure responsible prescribing practices while recognizing the growing role of telehealth in veterinary medicine. The bill emphasizes the importance of a legitimate VCPR and imposes specific restrictions to ensure the appropriate use of prescription medications.

Qualification Requirements Under CA 1399

Assembly Bill No. 1399 specifies certain qualifications and requirements regarding the licensing of veterinarians, particularly in the context of practicing veterinary medicine, including through telehealth. The key points are:

1. State Licensing Requirement: Only a person who holds a current license to practice veterinary medicine in the state of California is authorized to practice veterinary medicine, including via telehealth, on an animal patient located within the state.

2. Compliance with Licensing Regulations: The veterinarian must comply with all relevant state and federal regulations, including those related to the practice of veterinary medicine and the prescription of medications.

3. Standards of Practice: The veterinarian is required to maintain the standards of care consistent with prevailing veterinary medical practice. This includes the obligation to make sound professional judgments regarding the appropriateness of telehealth in each specific case.

These qualifications and requirements ensure that veterinarians practicing in California, whether in person or via telehealth, are properly licensed and adhere to the professional standards expected in the veterinary field. The emphasis is on maintaining high-quality care, ensuring the responsible use of telehealth, and safeguarding animal welfare.