Proposed new §573.34, regarding authorized degrees, certificates or titles, is proposed to apply to all licenses of the Board, veterinarian and equine dental provider alike.

Proposed new §573.35, regarding display of license, is proposed to apply to all licenses of the Board, veterinarian and equine dental provider alike.

Proposed new §573.36, regarding corporate and assumed names, is proposed to apply to all licenses of the Board, veterinarian and equine dental provider alike.

Proposed new §573.37, regarding ban on the use of solicitors, is proposed to apply to all licenses of the Board, veterinarian and equine dental provider alike. It is also proposed to remove an introductory sentence that contained no legally meaningful language.

Proposed new §573.41, regarding use of prescription drugs, is proposed to include administration of drugs in the list of conduct that is unprofessional for a veterinarian unless the veterinarian has first established a veterinarian-client-patient relationship. Under §802 of the federal Controlled Substances Act, the term "dispense" is defined including administering a drug, so the Board intends this change as a clarification to conform the language of the rule with federal law. This proposal does not change the Board's interpretation of §573.41.

Proposed new §573.42, regarding use of scheduled drugs in training and/or racing, is proposed to clarify that it applies only to veterinarians, since the recent licensure of equine dental provider has changed the meaning of "licensee" in Board rules, and equine dental providers are not authorized to use scheduled drugs without obtaining the drugs from the supervising veterinarian on the basis of a diagnosis of a medically sound need for the drugs by the supervising veterinarian.

Proposed new §573.43, regarding controlled substances registration, is proposed to clarify that it applies only to veterinarians, since the recent licensure of equine dental provider has changed the meaning of "licensee" in Board rules, and equine dental providers are not authorized to use controlled substances without obtaining the drugs from the supervising veterinarian licensed by DPS and DEA. The rule is also proposed to clarify that a veterinarian who has a DPS controlled substances registration can dispense and administer controlled substances even if he or she does not have his or her own DEA controlled substance registration so long as the veterinarian is supervised by another veterinarian who does have a DEA controlled substances registration, but may not procure, purchase or issue a prescription for a controlled substance. The Board does not intend to alter the meaning of the rule at all, but simply to clarify what many had found to be confusing language. Under §802 of the federal Controlled Substances Act, the term "dispense" is defined including administering a drug, so the Board intends the addition of the word "administer" as a clarification to conform the language of the rule with federal law. The title of the proposed rule is amended to remove the term "DEA" because the rule covers both DEA and DPS controlled substance certifications.

Proposed new §573.44, regarding compounding drugs, is proposed to comport with current state and federal regulations on the compounding of drugs by veterinarians. The proposed rule has a simplified structure designed by subject-area, to clarify the limitations that apply to all compounded products, the limitations on compounding for food producing animals, and the limitations on promotion and sale of compounded drugs. The rule is proposed to strengthen the requirement that a veterinarian establish and maintain a veterinarian-client-patient relationship with any animal for which the veterinarian compounds drugs. The proposed rule is intended to limit drug compounding by veterinarians only to treat a specific occurrence of a disease or condition that the veterinarian has diagnosed in a specific patient, and to prohibit veterinarians from compounding on any other basis or in quantities greater than those needed for the treatment of the particular disease occurrence in the specific diagnosed patient. The Board's concern is that some veterinarians compound significant quantities of drugs in advance of diagnosis for business profit reasons without first diagnosing the condition or disease the compounded drug is designed to treat in a particular patient with whom the veterinarian has established and maintained a veterinarian-client-patient relationship. The proposed rule includes more detailed provisions requiring that a veterinarian only compound products made from FDA-approved drugs, and not promote or distribute compounds that are essentially the same as other FDA-approved drugs. The subsection of the proposed rule regarding compounding for food-producing animals parallels existing federal and state law on the subject by requiring that the veterinarian set withdrawal times that are based on scientific information and note the method used to determine the withdrawal period in the patient records, and ensure that procedures are in place to maintain the identity of any food-producing animal that receives a compounded drug. The provisions of the proposed rule on labeling requirements for compounded drugs is simplified to eliminate those requirements that were redundant of the labeling information required for all drugs under §573.40, and clarified with respect to the medically active ingredients to require both name and strength of the ingredients.

Proposed new §573.45, regarding extra-label or off-label use of drugs, is proposed to include compounded drugs explicitly among the list of extra-label or off-label uses for drugs. Although compounding is commonly considered an off-label use, some licensees had expressed confusion in whether the limitations on extra-label use applied to compounding as well. The proposed rule has also been amended to include limitations on extra-label drug use in food-producing animals, based on federal regulations and intended to parallel the requirements for compounded drugs set out in proposed new §573.44.

Proposed new §573.51, regarding rabies control, is proposed to remove the rules on supervision by a veterinarian of a non-veterinarian using the veterinarian's signature for official health documents or administering rabies vaccines, but the text is otherwise unchanged. Those provisions have been moved to proposed new §573.10, so that rules regarding supervision of employees are consolidated into one section for purposes of enhanced clarity and ease of reference.

Proposed new §573.52, regarding veterinarian patient record keeping, is proposed to add new items for veterinarians to include in patient records: information regarding referrals to other veterinarians and the client's response to the referral, information regarding consultations with other veterinarians regarding a patient, and copies of any official health documents issued for the animal. This new required information covers the aspects of veterinary practice from which many complaints to the Board arise. Requiring veterinarians to record the information in patient records will expedite the Board's investigations by creating a contemporaneous account of what the veterinarian did during the treatment of the animal. The language of the rule is also proposed to make it apply only to veterinarians rather than all licensees because the recent licensure of equine dental provider has changed the meaning of "licensee" in Board rules. The rule also contains a proposal that requires veterinarians to include any information necessary to either substantiate or document the examination of the patient, broadening the "catch-all" provision to ensure that veterinarians include as much pertinent information as possible in their patient records. The proposed rule is further amended to conform the language of the rule to comport with a previous rule change that altered the records retention requirement so that veterinarians are now required keep both rabies certifications and patient health records for five years. The proposed rule is also amended to standardize and simplify its wording.

Proposed new §573.53, regarding equine dental provider patient record keeping, sets out the information that equine dental providers are required to record for each patient, as well as the requirements that equine dental providers maintain records for five years and provide copies to the client at the time of treatment and to the supervising veterinarian within 15 days of request. This rule parallels proposed §573.52 regarding veterinarian patient record keeping, but is simplified to require equine dental providers to record and maintain only information pertinent to their practice. The requirements that equine dental providers give a copy of their records to the client at the time of treatment and make the records available if the supervising veterinarian requests them were both set by the Texas Legislature in HB 414 and codified in Texas Occupations Code §801.262(d).

Proposed new §573.54, regarding patient records release and charges, is proposed to clarify that it applies only to veterinarians, and not to all licensees of the Board, because equine dental providers are required to deliver their patient records to the client at the time of service. The proposed rule is also renumbered from §573.53.

Proposed new §573.55, regarding transfer and disposal of patient records, is renumbered from §573.54, but the text is otherwise unchanged.

Proposed new §573.60, regarding prohibition against treatment of humans, is proposed to clarify that it applies only to veterinarians, and not to all licensees of the Board, because much of the practice of equine dentistry is inapplicable to humans, whose teeth do not continue to grow throughout their lives. Moreover, any equine dental provider who attempted to practice on humans would be in violation of the laws prohibiting the practice of dentistry on humans by anyone who is not licensed by the State Board of Dental Examiners. Moreover, a majority of the violations of this rule by veterinarians involve prescribing drugs to humans, and equine dental providers cannot legally prescribe drugs.

Proposed new §573.61, regarding minimum security for controlled substances, is proposed to clarify that it applies only to veterinarians, and not to all licensees of the Board, because equine dental providers are not authorized to prescribe or dispense controlled substances. The reference in the rules to Texas Department of Public Safety laws has been removed, as many of the requirements in the rule originate from U.S. Drug Enforcement Administration laws and policies rather than from the Texas Department of Public Safety. The rule is also proposed to include a requirement that a veterinarian maintain a written list of persons who have access to the controlled substance storage areas, which is a requirement based on DEA guidelines.

Proposed new §573.63, regarding inspection of facilities and records, is proposed to apply to all licensees of the Board, veterinarians and equine dental providers alike.

Proposed new §573.64, regarding continuing education requirements, sets out the required number of continuing education hours for veterinarians and equine dental providers respectively. The six-hour requirement for equine dental provider licensees is set by the Texas Legislature in HB 414 and codified in Texas Occupations Code §801.307. The rule is also proposed to clarify and standardize the language regarding continuing education requirements, carrying over continuing education hours from year to year, extensions, and makeup hours so that it applies to all licensees of the Board. The proposed rule also clarifies the language regarding exemptions from continuing education requirements, which apply only to veterinarians because the fee exemptions set by the Texas Legislature under Texas Occupations Code §801.304 apply only to veterinarians. Other subsections that were previously included in §573.64 have been split out into new rules that are proposed in this issue.

Proposed new §573.65, regarding proof of acceptable continuing education, is split out from §573.64 for clarity and ease of reference, and covers types of continuing education, the distribution of hours in each of the various types of continuing education that a licensee can earn each year, and the documents required for proof of each type of continuing education. The proposed rule contains requirements for both equine dental providers and veterinarians.

For equine dental providers, proposed new §573.65 allows credit only for continuing education that relates to clinical practice. Veterinarians can receive credit for continuing education hours related to either clinical practice or practice management under the proposed rule, although veterinarians can only claim five hours per year related to practice management. The proposed rule allows equine dental providers to attain continuing education credit by attending any meeting sponsored by the International Association of Equine Dentistry, to parallel the credit veterinarians receive for attending meetings sponsored by the American Veterinary Medical Association.

Under proposed new §573.65, only veterinary licensees are allowed credit for continuing education classes taken by correspondence, which includes most online classes, and veterinarians are limited to only five hours per year of continuing education by correspondence. The Board believes that there are intangible benefits in taking courses from a live person and meeting peers face-to-face that online courses cannot offer, in that in-person meetings for continuing education hold an attendee's attention more completely and offer enhanced networking and community-building opportunities that benefit the profession. Therefore, under the proposed rule, the Board has set the continuing education requirements for licensees to encourage licensees to attend live classes or other forms of continuing education courses that require extensive interaction. The proposed rule therefore requires that veterinarians receive at least seven hours per year of live continuing education instruction, and that equine dental providers receive at least four hours per year. All licensees are allowed to get continuing education credit for verifiable, monitored online classes that meet new rigorous requirements under the proposed rule, including extensive real-time interaction between students and instructor, and extensive documentation of the students' participation through verbal interaction, software documentation, and real-time surveys. Veterinarians are limited to ten hours per year of verifiable, monitored online courses meeting these requirements, and equine dental providers are limited to two hours per year. The intention of the Board in proposing these limitations on online courses is to ensure that licensees take only the best of the vast array of courses offered online, and that licensees continue to attend live classes for continuing education.

Under proposed new §573.65, all licensees can get continuing education credit for self-study such as reading journal articles relevant to their profession, but these hours are limited to one hour for equine dental providers and three hours for veterinarians. With regard to keeping records of continuing education, the proposed rule is amended to clarify that a licensee must keep records of continuing education for the last four calendar years. The language previously used in §573.64, which required that licensees keep records for the last three renewal cycles, caused confusion among many licensees. The proposed language is not intended as a significant change in how long licensees must keep records.

Proposed new §573.65 also includes more specific requirements regarding the documentation that a licensee must obtain and keep from a multi-day continuing education course. Under the proposed rule, a licensee must indicate which specific sessions of the multi-day program the licensee attended by marking them on a printed agenda for the program. This proposal is consistent with current Board policy, and is intended to keep licensees from claiming credit for a whole multi-day program despite only attending part of it. During the Board's last sunset review, the Texas Sunset Commission recommended this change in the way licensees document their attendance at multi-day courses.

Proposed new §573.66, regarding disciplinary action for non-compliance with continuing education requirements, is split out from previous §573.64 in the interests of clarity and simplification, and states that licensees will be subject to disciplinary action by the Board if they fail to obtain adequate continuing education and maintain appropriate records of the continuing education. Splitting out the proposed new rule from §573.64 will make it easier for the Board to reference the particular rule violated when creating disciplinary orders for licensees that fail to obtain continuing education or maintain continuing education records.

Proposed new §573.67, regarding continuing education as disciplinary action, is split out from previous §573.64 in the interests of clarity and simplification, and states that the Board may require a licensee to obtain additional continuing education as a method of disciplining a violation of the Veterinary Licensing Act or the Board's Rules. Splitting out the proposed new rule from §573.64 will make it easier for the Board to reference the particular rule violated when creating disciplinary orders when the Board orders continuing education as discipline for a licensee.

Proposed new §573.68, regarding monitoring licensee compliance, is renumbered from §573.66. The rule is proposed to apply to all of the Board's licensees, veterinarians and equine dental providers alike. Because inspections of veterinarians and equine dental providers will necessarily involve inspection of different documents and items depending on the profession of the licensee, and because the previous version of the rule stated that the items enumerated in the rule were not an exclusive list of items and documents the Board could inspect, the Board has decided to amend the rule to remove these non-exclusive lists of items for inspection in the interests of simplicity and clarity. The proposal will not change the current practice of the Board.

Proposed new §573.69, regarding conditions relative to license suspension, is proposed to apply to all licensees of the Board, both equine dental providers and veterinarians alike. The proposed new rule is renumbered from §573.68.

Proposed new §573.70, regarding reporting of criminal activity, is proposed to apply to all licensees of the Board, both equine dental providers and veterinarians alike. The proposed rule is renumbered from §573.69. The proposed rule is amended to remove the requirement that licensees report arrests to the Board, replacing it with a requirement that licensees report indictments to the Board. The Board has noted scientific studies that have shown minorities are more likely to be arrested than non-minorities, and has therefore made the proposal in the interests of preventing any inadvertent discriminatory impact of the rule.