The Board adopts new §573.24, regarding the Responsibility of a Veterinarian to Refer a Case, covers the duty of a veterinarian to refer a case to a more qualified veterinarian if the care and treatment of the animal is beyond his or her capabilities. The provisions in the adopted rule were split out from the previous version of §573.23 in the interests of clarity and ease of reference. The term "specialist" is now defined under new §573.80 to increase uniformity and clarity in the Board's rules, and is employed in this new rule. The Board did not receive any comments regarding this rule. The text of the adopted rule has not changed from the published proposed text, and therefore will not be republished.

The Board adopts new §573.25, regarding Issuance of Official Health Documents Through Direct Knowledge Only, which sets out the requirement that veterinarians only issue official health documents based on personal knowledge gleaned by examining the animal. The adopted rule applies only to veterinarians because equine dental providers are not authorized by law to issue official health documents. Adopted §573.25 employs the term "official health documents," which is now defined under new §573.80 to increase uniformity and clarity in the Board's rules. The adopted rule has been renumbered from repealed §573.24 to accommodate other new sections added to Chapter 573. The Board did not receive any comments regarding this rule. The text of the adopted rule has not changed from the published proposed text, and therefore will not be republished.

The Board adopts new §573.26, regarding Avoidance of Guaranteeing Cures, which forbids all licensees from guaranteeing cures. The adopted rule applies to both equine dental providers and veterinarians alike, because no licensee should make bold, misleading assertions to their clients about the possibility of a cure, regardless of practice area. The adopted rule is renumbered from repealed §573.25 to accommodate other new sections added to Chapter 573. The Board did not receive any comments regarding this rule. The text of the adopted rule has not changed from the published proposed text, and therefore will not be republished.

The Board adopts new §573.27, regarding Honesty, Integrity and Fair Dealing, which requires that all licensees conduct their practice with honesty, integrity and fairness. The adopted rule applies to all licensees of the Board, veterinarian and equine dental provider alike, because the Board believes that all licensees, regardless of practice area, should conduct their practices with honesty, integrity and fair dealing to their clients. The adopted rule is renumbered from repealed §573.26 to accommodate other new sections added to Chapter 573.

The proposed text of §573.27 as published explicitly required that licensees obtain informed consent from clients prior to beginning treatment on a patient. The Board received five comments from the public, including TVMA, opposed to the informed consent provision of this rule. Three of the commenters, including TVMA, expressed concern about a veterinarian on a farm call, who finds other animals with problems that need treating aside from the one he was called to treat, and no one with authority to give permission. One member of the public expressed concern that the proposed rule would keep clinics from being able to change the treatment protocol for a hospitalized animal if the animal's condition changed and the clinic staff was unable to contact the owner. Three public commenters, including TVMA, expressed concern regarding how this rule change would cause increased paperwork for vaccine clinics and low-cost spay/neuter clinics. Four public commenters, including TVMA, expressed concern about the phrase "in a manner understood by the client or the client's representative" because they felt that it was too vague and presented a standard that could not be met by licensees serving Spanish-speakers or the mentally impaired or hearing impaired. Two of the commenters, including TVMA, requested that the language be changed to "in a manner that would be understood by a reasonable person." Two public commenters, including TVMA, recommended that the language of the rule should be changed to say that veterinarians must inform their clients only "to the best of their ability." One member of the public was concerned that the proposed rule only applied to veterinarians, but the proposed rule in fact applied to all licensees. One member of the public expressed concern that explicitly requiring informed consent in the rule would create additional litigation and non-economic damages.

In response to these comments, the Board adopts only the first sentence of the published proposed text of §573.27, and does not adopt the requirement that a licensee obtain informed consent. This is a non-substantive change from the published proposed rule, so the Board has republished the adopted text of §573.27. It is important to note that Texas Occupations Code §801.402(12) forbids licensees from performing unauthorized treatment, and the Board has long interpreted that provision as requiring that a licensee obtain informed consent from the client. The adoption of §573.27 without the proposed amendment regarding informed consent does not change the Board's long-standing interpretation of Texas Occupations Code §801.402(12).

The Board adopts new §573.28, regarding the Observance of Confidentiality, which allows veterinarians to waive confidentiality as necessary to collect on a debt owed by a client for veterinary services, in keeping with the Texas Legislature's amendment of the Veterinary Licensing Act, codified in Texas Occupations Code §801.353(d-1). The adopted rule is also renumbered from repealed §573.27 to accommodate other new sections added to Chapter 573.

The published proposed text of §573.28 included the replacement of the word "rabies" with "communicable disease" to ensure that veterinarians are free to disclose information regarding communicable disease vaccines to governmental entities for purposes of protection of public health and safety. The Board received two public comments in response to the proposal, including one from TVMA. Both comments objected to the use of "certificate" in conjunction with "communicable disease." In response to these comments, the Board removed the proposed words "communicable disease" and reverted to "rabies" in the adopted version of §573.28. This is a non-substantive change from the published proposed rule, so the Board has republished the adopted text of §573.28.

The Board adopts new §573.29, regarding Complaint Information and Notice to Clients, which requires that all licensees, veterinarian and equine dental provider alike, provide their clients with information about how to complain to the Board regarding alleged violations of Board rules or the Veterinary Licensing Act. The Board did not receive any public comments regarding this rule. The text of the adopted rule has not changed from the published proposed text, and therefore will not be republished.

The Board adopts new §573.30, regarding Advertising, which sets out the limitations on advertising by licensees. The adopted rule applies the same advertising standards to all licenses of the Board, veterinarian and equine dental provider alike, because no licensee can be allowed to mislead the public by issuing false, deceptive or misleading advertising. The adopted rule includes a clarification of the limitation on the language a licensee can use in advertising, to eliminate any advertising that implies the licensee's services or facilities are superior to those of other licensees, and that is not subject to verification by the public. This clarification is in keeping with the Board's long-standing interpretation that an implication is a form of a statement, and is improper unless it has a basis verifiable by the general public.

The Board received three public comments regarding §573.30. Two of the three commenters, including TVMA, expressed concern about paragraph (4), which reads, "a statement or implication that a veterinarian is a certified or recognized specialist unless the veterinarian is board certified as recognized by the American Veterinary Medical Association in such specialty," because they were concerned that it would give free reign to EDPs to claim that they were specialists. There is no recognized specialization for equine dental providers, so in response to this comment, the Board changed paragraph (4) to read: "a statement or implication that a veterinarian licensee is a certified or recognized specialist unless the licensee is a veterinarian who is board certified as recognized by the American Veterinary Medical Association in such specialty." This is a non-substantive change from the published proposed rule, so the Board has republished the adopted text of §573.30.

Another member of the public expressed concern that the language in paragraph (3) of §573.30, concerning representations that are verifiable by the public, is confusing because it is not clear what the public is capable of verifying. The Board respectfully disagrees. The "subject to reasonable verification by the public" language is not new here and is used by other health service licensing agencies; it limits licensees to advertising superlatives like "best" or "number one" only when the licensee has been awarded that position or title by some verifiable poll or entity. For example, a licensee can advertise that he or she was "voted best veterinarian by the Houston Chronicle" if that is true, because the public can look to the Houston Chronicle to verify the truth of the statement. On the other hand, a licensee cannot advertise "best veterinarian in Houston" since it is impossible for the public to ascertain whether or not that is true. The Board did not make any change in response to this comment.

The Board adopts new §573.32, regarding Specialty Listings, which sets out the conditions under which a veterinarian can claim to be a specialist. The Board intends this adopted new rule to prevent any misleading or confusing advertising by specialized veterinarians, and to allow the public to determine more easily which veterinarians are board-certified in a particular area of expertise. The new adopted rule includes a requirement that a veterinarian indicate his or her specialty when the veterinarian indicates that he or she is a specialist. Equine dental providers are not included in the rule because there is currently no recognized specialization process for equine dental providers. The Board did not receive any public comments regarding this rule. The text of the adopted rule has not changed from the published proposed text, and therefore will not be republished.

The Board adopts new §573.33, regarding Display of Degree, Certificate, or Title from Approved Institutions Only, which requires that licensees display certificates only from board-approved institutions. The new rule applies to all licenses of the Board, veterinarian and equine dental provider alike, because no licensee can be allowed to represent themselves as being qualified by a school, institution or organization that is not approved by the Board. The Board did not receive any public comments regarding this rule. The text of the adopted rule has not changed from the published proposed text, and therefore will not be republished.

The Board adopts new §573.34, regarding Authorized Degrees, Certificates, or Titles Only, which forbids licensees from using degrees or titles to which they are not entitled. The new adopted rule applies to all licenses of the Board, veterinarian and equine dental provider alike, so that no licensee can hold themselves out as holding a degree that they do not actually possess. The Board did not receive any public comments regarding this rule. The text of the adopted rule has not changed from the published proposed text, and therefore will not be republished.

The Board adopts new §573.35, regarding Display of License, which requires that all licensees display their license and most recent renewal certificate at their practice location. The adopted new rule applies to all licenses of the Board, veterinarian and equine dental provider alike, so that the public will be able to tell immediately from the presence or absence of a displayed license whether their veterinarian or equine dental provider is licensed. The Board did not receive any public comments regarding this rule. The text of the adopted rule has not changed from the published proposed text, and therefore will not be republished.

The Board adopts new §573.36, regarding Corporate and Assumed Names, which forbids licensees from using false, deceptive, or misleading corporate or assumed names. The adopted new rule applies to all licenses of the Board, veterinarian and equine dental provider alike, so that no licensee can deceive the public through the use of a misleading corporate name. The Board did not receive any public comments regarding this rule. The text of the adopted rule has not changed from the published proposed text, and therefore will not be republished.

The Board adopts new §573.37, regarding Ban on the Use of Solicitors, which forbids licensees from paying a third party who refers clients to the licensee. The adopted new rule applies to all licenses of the Board, veterinarian and equine dental provider alike, because no licensee should give kickbacks for referrals. The adopted rule lacks an introductory sentence that had previously appeared in §573.37, because the sentence contained no legally operative language. The Board did not receive any public comments regarding this rule. The text of the adopted rule has not changed from the published proposed text, and therefore will not be republished.

The Board adopts new §573.41, regarding Use of Prescription Drugs, which prohibits veterinarians from prescribing, administering, dispensing, delivering or ordering delivered any prescription drug without first having established a veterinarian-client-patient relationship and a determination that the drugs are necessary for the medical care of the animal. The adopted new rule includes administration of drugs in the list of conduct that is unprofessional for a veterinarian to undertake unless the veterinarian has first established a veterinarian-client-patient relationship. Under §802 of the federal Controlled Substances Act, the term "dispense" is defined to include administering a drug, so the Board intends the new adopted rule to conform the language of the rule with federal law. The addition of administration in the adopted rule does not change the Board's interpretation of §573.41. The new adopted rule applies only to veterinarians, because equine dental providers are not authorized to use or possess any scheduled drug, except to administer drugs to their patients at the instruction of the supervising veterinarian who has an active veterinarian-client-patient relationship with the animal in question and has made a diagnosis of a medically sound need for the drug.

The Board received two public comments regarding this rule, one from TVMA. Both comments expressed concern that the addition of "administer" to the rule would interfere with multi-doctor practices where one veterinarian prescribes a drug and another administers. The Board respectfully disagrees. When multiple doctors are working for a single partnership that has central records and shared clients, the Board looks to the whole partnership's veterinarian-client-patient relationship with the animal. Thus, when one doctor in a partnership examines an animal and prescribes a drug, he has established a veterinarian-client-patient relationship for the whole partnership. Therefore, if a second doctor administers the prescribed drug, he is acting within the established veterinarian-client-patient relationship for the whole partnership, and would not be subject to discipline. The Board did not make any changes in response to this comment. The text of the adopted rule has not changed from the published proposed text, and therefore will not be republished.

The Board adopts new §573.42, regarding Use of Scheduled Drugs in Training and/or Racing, which prohibits veterinarians from giving drugs to an animal for training or racing purposes without a medically sound reason. The new adopted rule applies only to veterinarians, because equine dental providers are not authorized to use or possess any scheduled drug, except to administer drugs to their patients at the instruction of the supervising veterinarian who has an active veterinarian-client-patient relationship with the animal in question and has made a diagnosis of a medically sound need for the drug. The Board did not receive any comments regarding this rule. The text of the adopted rule has not changed from the published proposed text, and therefore will not be republished.

The Board adopts new §573.43, regarding Controlled Substances Registration, which sets out the requirements regarding controlled substance registrations for veterinarians. The new adopted rule applies only to veterinarians, because equine dental providers are not able to obtain controlled substance registrations under state and federal law. The adopted new rule clarifies 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 adopted new rule does not include the term "DEA" because the rule covers both DEA and DPS controlled substance certifications. The Board did not receive any comments regarding this rule. The text of the adopted rule has not changed from the published proposed text, and therefore will not be republished.

The Board adopts new §573.44, regarding Compounding Drugs, which sets out the limited circumstances in which a veterinarian can compound a drug. The adopted new rule parallels current state and federal regulations on the compounding of drugs by veterinarians while emphasizing issues that are of particular significance for veterinarians, such as the importance of the veterinary-client-patient relationship and the limitations on drugs compounded for food-producing animals. The adopted rule is structured 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 new adopted rule strengthens the requirement that a veterinarian establish and maintain a veterinarian-client-patient relationship with any animal for which the veterinarian compounds drugs. The Board intends the adopted rule 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 Cont'd...