BACKGROUND PAPER FOR THE Veterinary Medical Board

7m ago
909.61 KB
46 Pages
Last View : 17d ago
Last Download : 2m ago
Upload by : Duke Fulford

BACKGROUND PAPER FOR THEVeterinary Medical BoardJoint Sunset Review Oversight Hearing, March 3, 2021Assembly Committee on Business and Professions and theSenate Committee on Business, Professions and EconomicDevelopmentIDENTIFIED ISSUES, BACKGROUND, ANDRECOMMENDATIONS REGARDING THEVETERINARY MEDICAL BOARDNOTE: This background paper was originally published in March of 2020 in anticipation ofthe Sunset Review Oversight Hearing of the Veterinary Medical Board. Due to thecircumstances surrounding the COVID-19 global pandemic, Sunset Review for the Board wasdelayed into 2021. This version of the paper has been updated to reflect any changes or newissues that have been identified during this interim period.BRIEF OVERVIEW OF THEVETERINARY MEDICAL BOARDHistory and Function of the Veterinary Medical BoardThe Veterinary Medical Board (Board) traces its origins back to 1893, originally established asthe State Board of Veterinary Examiners. Since then, the Board has regulated the veterinarymedical profession through many of its changes: from opening the first California veterinarycollege in 1894, to helping eradicate the Hog cholera in 1972, to the creation of the animal healthtechnician profession (now titled Registered Veterinary Technician) in 1975.Today, the Board licenses and regulates Veterinarians, Registered Veterinary Technicians (RVTs),Veterinary Assistant Controlled Substances Permit (VACSP) holders, veterinary schools, andveterinary premises. The Board derives its authority through the enforcement of the VeterinaryMedicine Practice Act (Practice Act).The veterinary profession provides health care to many different types of animals, including petssuch as dogs, cats, rabbits, birds, hamsters and snakes, to agricultural livestock such as cattle,poultry, fish, goats, pigs, and horses. Similarly to human medicine, there are recognized specialtieswithin the veterinary profession: surgery, internal medicine, microbiology, pathology and more.Page 1 of 46

Licensed practitioners of veterinary medicine can operate in a range of environments. They canwork in private clinical practice, or engage in public service as wildlife health specialists,agricultural inspectors, or disease control workers.With pet ownership on the rise in the United States, the veterinary profession also offers a criticalconsumer protection role to Californians and their animal companions. The American VeterinaryMedical Association (AVMA) indicates that in 2016, more than half of Americans, or 57 percent,identified as pet owners. As such, veterinary care continues to be an important part of petownership, with 83 percent of dog owners and 54 percent of cat owners making at least one visitto the veterinarian per year—bringing the total spending on veterinary care at an estimated 27.8billion during 2016. Consequently, the pet-owning public expects that veterinary professionals bequalified, competent, and trained to provide these important services.The Board protects the California public from the incompetent, unprofessional, and unlicensedpractice of veterinary medicine. The Board requires adherence to strict licensure requirements forCalifornia Veterinarians, RVTs, and VACSP holders, and ensures that each licensee possesses thelevel of competence required to perform animal health care services. The Board further protectsthe public by investigating complaints – and if violations are found, take disciplinary actionsagainst licensees.The Board’s current mission statement is as follows:“The mission of the Veterinary Medical Board (VMB) is to protect consumers and animals byregulating licensees, promoting professional standards, and diligent enforcement of theVeterinary Medicine Practice Act.”Board Membership and CommitteesThe Board is composed of eight members: four licensed Veterinarians, one RVT, and three publicmembers. The Governor appoints the four Veterinarian members, one RVT member, and onepublic member. The Senate Committee on Rules and the Speaker of the Assembly each appoint apublic member. The Veterinarian and RVT members of the Board must be licensed by the Boardand have engaged in the practice of veterinary medicine for a period of at least five years. EachBoard member may serve a maximum of two consecutive four-year terms.The current composition of the Board is as follows:TermAppointment AppointingExpiration DateTypeAuthorityName and BioMark T. Nunez, DVMBoard PresidentDr. Nunez of Burbank was appointed to theBoard in August, 2013. Dr. Nunez has beenan Associate Veterinarian at the VeterinaryCare Center since 2012. He was practice6-1-2023Page 2 of 46LicenseeGovernor

owner and Veterinarian at Animal MedicalCenter Inc., Van Nuys from 2006 to 2012,and held multiple positions at the VeterinaryCenters of America (VCA), includingMedical Director and Veterinarian at VCAAnimal Hospital, Burbank from 2002 to2005, and VCA Regional Medical Directorfrom 1999 to 2001. Dr. Nunez was anAssociate Veterinarian at the AnimalMedical Center, Inc., Van Nuys from 1994to 1999, and at Dill Veterinary Hospital from1993 to 1994. He earned a Doctor ofVeterinary Medicine degree from theUniversity of California, Davis.Kathy BowlerBoard Vice PresidentMs. Bowler of Fair Oaks was appointed tothe Board in August, 2014. Ms. Bowler hasbeen a political consultant at the K. BowlerGroup since 2009. She was the Californiadirector for Gore 2000 in 2000, andexecutive director of the CaliforniaDemocratic Party from 1995 to 2009. Ms.Bowler was chief executive officer atStatewide Information Systems from 1987 to1993, and consultant for California StateSenator David Roberti from 1985 to 1987.Christina Bradbury, DVMDr. Bradbury of Meadow Vista wasappointed to the Board in 2018. Dr.Bradbury has been an internist and seniorveterinary associate at Vista VeterinarySpecialists since 2011. She was an internistat Loomis Basin Veterinary Clinic from2010 to 2011, a small animal internalmedicine resident at Colorado StateUniversity Veterinary Teaching Hospitalfrom 2007 to 2010, and a small animalrotating intern at Texas A&M College ofVeterinary Medicine and BiomedicalSciences, Veterinary Medical TeachingHospital from 2006 to 2007. Dr. Bradbury isa member of the Sacramento ValleyVeterinary Medical Association and age 3 of 46

American Veterinary Medical Association.She earned a Doctor of Veterinary Medicinedegree from the University of California,Davis School of Veterinary Medicine and aMaster of Science degree in clinical sciencefrom the Colorado State University, Collegeof Veterinary Medicine and BiomedicalSciences.Jaymie Noland, DVMDr. Noland of Los Osos was appointed to theBoard in September, 2015. Dr. Noland hasbeen head of the California Polytechnic StateUniversity, San Luis Obispo Animal ScienceDepartment since 2013, where she has beenan animal science professor since 1998. Shehas been an independent thoroughbredbreeder consultant since 2008. Dr. Nolandwas an associate veterinarian at the Oak ParkVeterinary Clinic from 1996 to 2000, and atthe South County Veterinary Hospital from1991 to 1996, and was co-owner andoperator at Cal-Tex Feed Yard from 1977 to1988.Jennifer Loredo, RVTMs. Loredo of Riverside was appointed tothe Board in September, 2014. Ms. Loredohas been the supervising RegisteredVeterinary Technician (RVT) at theRiverside County Department of AnimalServices since 2005. She was an RVT atAdvanced Critical Care and InternalMedicine from 2004 to 2005 and at theAnimal Hospital of Walnut from 2001 to2004. Ms. Loredo was a patient relationsrepresentative at Magan Medical Clinic from1997 to 2003.Alana YanezMs. Yanez was appointed to the Board inJuly, 2017. She began her career as anAnimal Care Technician for the Santa CruzSPCA and a Veterinary Technician for aprivate practice veterinary hospital. Ms.Yanez then worked as a Field Deputy r6-1-2020PublicSenatePage 4 of 46

State Senator Kevin de Leon for 5 years. Shethen worked for the Humane Society of theUnited States as the Manager of the Pets forLife – Los Angeles. In April of 2012, Ms.Yanez was appointed by Mayor Villaraigosato become a Commissioner for Los AngelesAnimal Services, where she served until2016.Dianne PradoMs. Prado was appointed to the Board inJune, 2019. Ms. Prado is the founder andExecutive Director of the Housing Equality& Advocacy Resource Team (HEARTL.A.). Ms. Prado began her career as a staffattorney with the Eviction DefenseNetwork. She then joined the Inner City LawCenter in 2012 as a Staff Attorney with theHomelessness Prevention Project. Ms. Pradothen joined the Slum Housing Litigation unitand became a Supervising Attorney. She is agraduate of Western State UniversityCollege of Law and holds her Bachelor ofArts in Criminology, Law, & Society fromthe University of California, Irvine.Maria Preciosa S. Solacito, DVMDr. Solacito of Palmdale was appointed tothe Board in August, 2020. Dr. Solacito hasbeen Senior Veterinarian at the County ofLos Angeles Department of Animal Care andControl since 2013. She was a ShelterVeterinarian at the County of Los AngelesDepartment of Animal Care and Control,Lancaster from 2008 to 2012. Dr. Solacito isa member of the Southern CaliforniaVeterinary Medical Association, SouthernCalifornia Filipino Veterinary MedicalAssociation, Association for AnimalWelfare Advancement, California AnimalWelfare Association and the PhilippineVeterinary Medical Association. She earneda Doctor of Veterinary Medicine orPage 5 of 46

from the University of the Philippines,College of Veterinary Medicine.The Board has two statutorily created committees: the Diversion Evaluation Committee (DEC)and the Multidisciplinary Advisory Committee (MDC).The DEC was created in 1982 to assist the Board in in identifying and rehabilitating Veterinariansand RVTs suffering from abuse of dangerous drugs or alcohol. The DEC works to treat licensees,with the goal of returning them to the practice of veterinary medicine in a manner that will notendanger the public or animal welfare. The DEC consists of five members comprised of threeVeterinarians and two public members. Each DEC member is required to have experience orknowledge in the evaluation or management of persons with substance abuse.The MDC was created in 2009 to assist, advise, and make recommendations for theimplementation of rules and regulations necessary to ensure proper administration andenforcement of the Practice Act and to assist the Board in its examination, licensure, andregistration programs. The MDC consists of nine members comprised of five licensedVeterinarians, three registered veterinary technicians, and one public member. One veterinarianand one RVT must be Board members.The Board and the MDC also often create subcommittees to focus policy discussions and researchon a variety of specialized topics. These two-member committees can issue recommendations tothe MDC and the full Board on how to address current or emerging issues. The Board reports usingthe following committees:-Executive CommitteeComplaint Process Audit Subcommittee2020 Strategic Plan CommitteeTiered Premises Registration SubcommitteeTelemedicine SubcommitteeForeign RVT Pathway SubcommitteeInspections Program SubcommitteeThe Board notes that the following committees completed their objectives and are no longeractive:-Uniform Standards for Substance Abusing Licensees SubcommitteeCorporate Practice SubcommitteeCannabis Discussion Guidelines SubcommitteeFiscal, Fund, and Fee AnalysisAs a regulatory board under the umbrella of the Department of Consumer Affairs (DCA), theBoard is entirely special funded and does not receive funds from the state’s General Fund. TheBoard generates revenue from the licensing of Veterinarians, RVTs, veterinary premises, and theircorresponding biennial and annual renewal fees. The Board also draws revenue from the VACSPPage 6 of 46

program, which was first implemented by the Board in 2016. Fee amounts are generally set instatutes, not to exceed a specified maximum. The Board may decide to increase the fees up to itsstatutory caps through regulations.Since FY 2015/16, the Board has been facing a significant budget deficit, with expensesconsistently growing. According to the Board, expenditures have risen from 4.5M in FY 2015/16to 5.9M in FY 2019/20 and reached 6.6M in FY 2020/21. At the same time, the Board’s revenuehas not been able to keep pace.There are several factors contributing to the Board’s declining fund condition:-Increase in Attorney General Fees. In 2019, the Office of the Attorney General notifiedlicensing boards of an abrupt increase in billing rates for client services. New rates includea 30% increase in attorney services and 71% increase in paralegal services.-The VACSP program. Launched in 2016 as part of a new legislative mandate, the Boardreports that this program is not meeting revenue expectations. Issuing these permits isresource intensive, and only accounts for 5% of the total revenue. The VACSP program isdiscussed in more detail in a later section of this report.-Elimination of the California RVT examination. After determining that the Californiaveterinary technician exam did not meet the statutory requirement to test animal health caretasks limited to California because there currently are no animal health care tasksperformed by only California RVTs, the Board opted to eliminate administration of theCalifornia RVT examination. Although the Board is saving 50,000 in administrationcosts, the elimination has reduced revenue streams by 180,000 annually.-General increase in operational costs. The Board is experiencing general cost increases tocover in personnel services (wages and benefits), increased pro-rata costs paid to theDepartment of Consumer Affairs, compensation for Subject Matter Experts and Inspectors,and implementation of various legislative mandates.To address this budget shortfall and stabilize its fund conditions, the Board voted in 2017 toincrease its fees; those increases were enacted in 2018. Unfortunately, the Board continued to facea notable structural deficit which threatened to leave the Board financially insolvent.Existing statute mandates that the Board operate with not less than three months reserve and notmore than ten. With the Board not meeting these parameters, and with a projected insolvency, theBoard voted to increase fees again, this time to their statutory maximums. These emergency feeincreases went into effect in January 2020. Among other fees, these increases raised the initial andrenewal fees for Veterinarians from 350 to 500 and raised the initial and renewal fees for RVTsfrom 160 to 350.With the most recent fee increase, the Board projects sustainability of its fund through FY 2022/23.However, the Board has now reached the statutory maximum for all fees, and will need statutoryapproval to raise fee caps. According DCA projections, the Board’s fund will begin to decrease inPage 7 of 46

FY 2023/24, necessitating fee increases shortly thereafter. The Board has indicated that it wouldlike to discuss setting a new statutory minimum fee for premises registrations and veterinarianlicenses in order to cover revenue generated by the recent RVT increase. Recognizing thedisproportionately affected RVT profession, the Board would like to lower RVT fees if the revenuecan be generated by other means.Budget Change ProposalsSince the last Sunset Review, the Board submitted the following Budget Change Proposals (BCPs)and were granted the authority to hire the additional following positions:-FY 2016/17: Conversion of four limited-term positions to permanent full time positions withtwo year limited term funding to implement the VACSP program.-FY 2018/19: Two of the four limited-term positions were made permanent, and the Boardreceived additional authorization to fund increased AG/OAH costs incurred due to the newprogram.-FY 2019/20: Three positions as well as budget authority to cover operating expenses andequipment costs for new workload associated with the requirements of SB 1480 (Hill, Chapter571, Statutes of 2018).-FY 2020/21: Six three-year limited term positions to support the Board’s enforcementoperations.StaffingThe Board has statutory authority to appoint its own Executive Officer (EO), who is tasked withperforming duties as delegated by the Board. The current EO was appointed into the position onJuly 2, 2018, following the promotion of the previous EO to another state agency.To support its mission, the Board has an additional 29.7 authorized employee positions and 18contracted licensees (Veterinarians and RVTs) who serve as Inspectors and Enforcement SubjectMatter Experts. Board staff is allocated within 3 teams: the Administration, Licensing andExaminations team; the Inspection team; and the Enforcement team.Since the last Sunset Review, the Board was also granted several increases in its budget to provideadditional staff resources to implement the VACSP program, as well as meet the statutorilymandated hospital inspection goals. In addition, the Board received three-year limited termfunding of 898,000 in FY 2020/21 and 850,000 in FY 2021/22 and FY 2022/23 to bolster itsEnforcement operations, which included 6 limited term positions to address the backlog ofcomplaints. These positions were requested to be limited term due to the prior uncertainty of theBoard’s fund condition and was the maximum number of positions for which the Board couldbudget. According to the Board, all positions have been filled.Page 8 of 46

Licensing & ExaminationThe veterinary profession is experiencing consistent growth; since the Board’s last Sunset Reviewin 2016, the Veterinarian licensee population has grown from 12,068 to 12,847. Similarly, theRVT licensee population has grown from 6,379 to 7,191. The Board also requires registration ofall veterinary premises – locations where veterinary medicine, dentistry, or surgery is beingpracticed. Since 2016, the number of premise registrations issued have modestly grown from 3,431to 3,500.Veterinary Medical Board: Licensee PopulationVeterinarianRVTPremisesFY 2015/2016FY 2016/2017FY 2017/2018FY 753,48812,8477,1913,500VeterinariansTo qualify for licensure as a Veterinarian, an individual must graduate from an accreditedpostsecondary institution recognized by the Board or by the AVMA. The Board does accept nonAVMA education, but those candidates must provide a completion certificate from either theProgram for the Assessment of Veterinary Education Equivalence (PAVE) through the AAVSBor the Educational Commission for Foreign Veterinary Graduates (ECFVG) through the AVMA.In addition, candidates must pass three examinations: The Veterinarian California State BoardExam (CSBE), the California Veterinary Law Exam (CVLE)1 and the North American VeterinaryLicensing Examination (NAVLE). The CSBE and CVLE are administered by the Board, and theNAVLE is administered by the International Council for Veterinary Assessment (ICVA). TheICVA is a national organization that provides national veterinary assessments services, and designsits tests by collaborating with stakeholders in academia, licensing boards, and practicingveterinarians.After conducting a review of the content of the CSBE and identifying redundancies with theNAVLE, the Board will be seeking statutory changes to remove the CSBE from licensurerequirement.RVTsTo qualify for registration as an RVT, two pathways to licensure are available. The first requiresgraduation from an AVMA accredited RVT program or a California Board-approved RVTprogram. The second pathway, also known as the “alternate route,” requires candidates to completea combination of 20 semester units, or 30 quarter units or 300 hours of specific education and4,416 hours of directed clinical practice experience completed in no less than 24 months under the1For Non-California graduates only.Page 9 of 46

direct supervision of a California licensed veterinarian. Upon completion of either pathway,candidates must then take a national examination.The testing requirements for RVT registration have changed since the Board’s last Sunset Review.Prior to 2019, candidates for a veterinary technician registration were required to pass twoexaminations: the California Veterinary Technician Examination (CVTE) and the VeterinaryTechnician National Examination (VTNE). After careful consideration of both RVT examinations,the Board determined that the CVTE did not test any animal health care tasks unique to California,as statutorily required, and the VTNE adequately tested the clinical knowledge used to determineminimal competency for California RVTs. Accordingly, the Board voted to discontinue theadministration of the CVTE. As of April 2019, only the VTNE is required for registration as anRVT.VACSPsIn 2013, the Legislature mandated the Board create a Veterinary Assistant Controlled SubstancePermit (VACSP). Holders of this permit are able to perform the functions of a Veterinary Assistant,but are also approved by the Board to obtain and administer controlled substances. VACSP permitholders must be at least 18 years of age and must not have been convicted of a state or federalfelony controlled substance violation. The Board conducts a background check to verify VACSPrequirements are met. Once the VACSP has been issued, the permit holder is required to establisha supervisory relationship with a licensed veterinarian.In 2016, the Board began issuing VACSPs, with 4,937 permit holders to date. The Board’s goal isto process an initial application within four weeks. However, the Board is currently unable to meetthis target. The issue of licensing timelines is detailed in a later section of this paper.School ApprovalThe Board has authority to approve schools offering a curriculum for training RVTs. Privateveterinary technology programs must be approved by both the Board and the Bureau of PrivatePostsecondary Education. In addition, all schools accredited by AVMA are deemed by the Boardto have met the minimum requirements for approved schools. All other veterinary colleges musthave academic standards equivalent to schools accredited by the AVMA in order to be recognizedby the Board.School approval is for a period of no more than four years and must be renewed. The Board is inthe process of developing guidelines for individual school approval and pursuing regulations toestablish an application fee for the program.Continuing EducationExisting law requires veterinarians and RVTs to complete continuing education courses in orderto renew their licenses. Veterinarians are required to complete 36 hours of continuing educationevery two years, and RVTs are required to complete 20 hours of continuing education every twoPage 10 of 46

years. Continuing education must be obtained in subjects related to the practice of veterinarymedicine and/or veterinary technology. The continuing education courses must be consistent withcurrent standards and practices beyond the initial academic studies required for initial licensure orregistration.Beginning January 1, 2018, a veterinarian who renews their license must complete a minimum ofone credit hour of continuing education on the judicious use of medically important antimicrobialdrugs, as defined, every four years as part of the continuing education requirement.Due to budget limitations, the Board does not have a comprehensive audit program to guaranteethat licensees are completing the CE requirements – but the Board reports that is currentlydeveloping a CE audit process to be able to audit a percentage of its licensee population everyyear, and hopes to have the program operational in 2021.EnforcementThe Board’s Enforcement Unit protects consumers by investigating complaints received,prosecuting violations of the Practice Act and unlicensed veterinary activity, and monitoringlicensee probationers.Since its last Sunset Review, the Board received 5,055 complaints. Subsequent investigations haveled to 107 formal accusations filed through the Office of the Attorney General, the revocation orsurrender of 63 licenses, and 118 licenses placed on probation.In addition, the Board has issued 105 citations. Cite and fine is generally used against unlicensedpractitioners of veterinary medicine, as well as licensees and registrants for offenses in whichformal discipline may not be warranted. Such violations include failure to update an address ofrecord or minor medical record-keeping violations.The Board contracts with Maximus Inc. to provide licensees with access to its Diversion Program.The program aims to identify and rehabilitate licensed veterinary professionals who suffer fromsubstance addiction, including drugs and alcohol. In FY 2016/17, there were 6 new participants inthe Board’s diversion program. There have been no additional participants since. There is currentlyone participant enrolled in the Diversion Program.In addition to Enforcement activities related to licensees, the Board also has authority to conductinspections on any premises where veterinary medicine, dentistry or surgery is being practiced.Through the Board’s contracted inspectors, 42 standards are used to inspect fixed premises, 16standards for mobile premises, and 14 standards for vaccine clinics. Inspections are generallyrandom and entirely unannounced, and may be triggered by complaints alleging violations of thePractice Act.Cost Recovery and RestitutionCurrent law authorizes the Board to request fee recovery from any licensee found guilty ofviolation of the licensing act to pay for the reasonable costs of the investigation and enforcementPage 11 of 46

of their case. Cost recovery is a standard term and condition specified in the Board’s disciplinaryguidelines for all proposed decisions and stipulations.There is no specific amount of cost recovery ordered for revocations, surrenders, and probationers,as each discipline case has its own amount of cost recovery ordered depending on the investigationand prosecution costs incurred. According to the Board, over the prior four fiscal years, the Boardhas ordered cost recovery an average of 28 times per year, with each order averaging 6,490. Afiscal overview of the Board’s cost recovery program is available below:Cost RecoveryTotal Enforcement ExpendituresPotential Cases for Recovery *Cases Recovery OrderedAmount of Cost Recovery OrderedAmount Collected(list dollars in thousands)FY 2015/16 FY 2016/17 FY 2017/18 FY 2018/19 2,054 2,558 2,313 2,4433428262534282625 251 110 161 203 222 204 264 110* “Potential Cases for Recovery” are those cases in which disciplinary action has been takenbased on violation of the license practice act.PRIOR SUNSET REVIEW: CHANGES AND IMPROVEMENTSThe Board was last reviewed by the Assembly Committee on Business and Professions and theSenate Committee on Business, Professions and Economic Development (the Committees) in2016. At that time, the Committees identified 12 issues for discussion. Below are prior issuesraised by the Committees in the Background Paper of 2016, the Committees’ recommendations,and the Board’s responses to how the issues or recommendations were addressed by the Board.Prior Issue #1: (BreEZe) The Committees expressed concerns over implementation difficultieswith BreEZe. The Committees also requested additional information on potential costs related theplatform. The Board reports that is has now fully transitioned and integrated into BreEZe, and thatalthough some implementation challenges remain, the Board is working closely with DCA toidentify design improvements that will streamline licensing and enforcement processes. The Boardlists 520,000 in anticipated cost in FY 2017/18 through FY 2018/19 associated with BreEZemaintenance costs.Prior Issue #2: (RVT Issues) The Committees stated that RVTs represent an important part ofanimal care services, and that the Board and the MDC should provide more attention to RVTrelated policy issues. In response, the Board has enumerated the number of RVT-focused actionsand regulatory packages it has or is currently working on. These include eliminating the RVT stateexam, expanding the RVT Alternate Route to licensure, and expanding RVT animal health caretasks. In addition, the Board notes that Board meetings have a standing RVT item on all of itsagendas to ensure RVT issues are discussed.Page 12 of 46

Prior Issue #3: (RVT Law Exam Costs) The Committees asked the Board to consider solutionsto lower costs to licensure for RVT candidates, including converting the California RVT exam intoa mail out examination. As discussed earlier in this report, after careful analysis of the CaliforniaRVT examination, the existing statute, the occupational analysis, an analysis from AAVSB, andinput from stakeholders, the Board approved eliminating the administration of the RVT exam atits April 2019 Board meeting.Prior Issue #4: (University Licensure) The Legislature amended statutes to create a UniversityLicense, issued to veterinarians who are both employed by and who engage in the practice ofveterinary medicine in a California university. The Board reports having fully implementedBusiness and Professions Code (BPC) Section 4848.1 and began issuing university licenses in FY2017/18.Prior Issue #5: (Delinquent Registration Status) The Committees recommended that premiseregistrations be cancelled by the Board after five years in a delinquent status, as consistent withother license types maintained by the Board. The change was enacted through the Board’s Sunsetlegislation.Prior Issue #6: (Compounding of Drugs) The Committees recommended that the Board workwith the Board of Pharmacy to grant limited authority for veterinarians to compound drugs. TheBoard’s Sunset legislation enacted the change, and the Board began the rulemaking process on theissue. However, during its re

VETERINARY MEDICAL BOARD History and Function of the Veterinary Medical Board The Veterinary Medical Board (Board) traces its origins back to 1893, originally established as the State Board of Veterinary Examiners. Since then, the Board has regulated the veterinary medical professio

Related Documents:

May 02, 2018 · D. Program Evaluation ͟The organization has provided a description of the framework for how each program will be evaluated. The framework should include all the elements below: ͟The evaluation methods are cost-effective for the organization ͟Quantitative and qualitative data is being collected (at Basics tier, data collection must have begun)

On an exceptional basis, Member States may request UNESCO to provide thé candidates with access to thé platform so they can complète thé form by themselves. Thèse requests must be addressed to esd rize unesco. or by 15 A ril 2021 UNESCO will provide thé nomineewith accessto thé platform via their émail address.

̶The leading indicator of employee engagement is based on the quality of the relationship between employee and supervisor Empower your managers! ̶Help them understand the impact on the organization ̶Share important changes, plan options, tasks, and deadlines ̶Provide key messages and talking points ̶Prepare them to answer employee questions

Bruksanvisning för bilstereo . Bruksanvisning for bilstereo . Instrukcja obsługi samochodowego odtwarzacza stereo . Operating Instructions for Car Stereo . 610-104 . SV . Bruksanvisning i original

Chính Văn.- Còn đức Thế tôn thì tuệ giác cực kỳ trong sạch 8: hiện hành bất nhị 9, đạt đến vô tướng 10, đứng vào chỗ đứng của các đức Thế tôn 11, thể hiện tính bình đẳng của các Ngài, đến chỗ không còn chướng ngại 12, giáo pháp không thể khuynh đảo, tâm thức không bị cản trở, cái được

veterinary practice means a business that provides veterinary services. veterinary practitioner means a person who is registered under this Act as a veterinary practitioner. veterinary science includes any branch of the science or art of veterinary medicine or of veterinary surge

10 tips och tricks för att lyckas med ert sap-projekt 20 SAPSANYTT 2/2015 De flesta projektledare känner säkert till Cobb’s paradox. Martin Cobb verkade som CIO för sekretariatet för Treasury Board of Canada 1995 då han ställde frågan

service i Norge och Finland drivs inom ramen för ett enskilt företag (NRK. 1 och Yleisradio), fin ns det i Sverige tre: Ett för tv (Sveriges Television , SVT ), ett för radio (Sveriges Radio , SR ) och ett för utbildnings program (Sveriges Utbildningsradio, UR, vilket till följd av sin begränsade storlek inte återfinns bland de 25 största

Hotell För hotell anges de tre klasserna A/B, C och D. Det betyder att den "normala" standarden C är acceptabel men att motiven för en högre standard är starka. Ljudklass C motsvarar de tidigare normkraven för hotell, ljudklass A/B motsvarar kraven för moderna hotell med hög standard och ljudklass D kan användas vid

LÄS NOGGRANT FÖLJANDE VILLKOR FÖR APPLE DEVELOPER PROGRAM LICENCE . Apple Developer Program License Agreement Syfte Du vill använda Apple-mjukvara (enligt definitionen nedan) för att utveckla en eller flera Applikationer (enligt definitionen nedan) för Apple-märkta produkter. . Applikationer som utvecklas för iOS-produkter, Apple .

Le genou de Lucy. Odile Jacob. 1999. Coppens Y. Pré-textes. L’homme préhistorique en morceaux. Eds Odile Jacob. 2011. Costentin J., Delaveau P. Café, thé, chocolat, les bons effets sur le cerveau et pour le corps. Editions Odile Jacob. 2010. Crawford M., Marsh D. The driving force : food in human evolution and the future.

Le genou de Lucy. Odile Jacob. 1999. Coppens Y. Pré-textes. L’homme préhistorique en morceaux. Eds Odile Jacob. 2011. Costentin J., Delaveau P. Café, thé, chocolat, les bons effets sur le cerveau et pour le corps. Editions Odile Jacob. 2010. 3 Crawford M., Marsh D. The driving force : food in human evolution and the future.

MARCH 1973/FIFTY CENTS o 1 u ar CC,, tonics INCLUDING Electronics World UNDERSTANDING NEW FM TUNER SPECS CRYSTALS FOR CB BUILD: 1;: .Á Low Cóst Digital Clock ','Thé Light.Probé *Stage Lighting for thé Amateur s. Po ROCK\ MUSIC AND NOISE POLLUTION HOW WE HEAR THE WAY WE DO TEST REPORTS: - Dynacó FM -51 . ti Whárfedale W60E Speaker System' .

Glossary of Social Security Terms (Vietnamese) Term. Thuật ngữ. Giải thích. Application for a Social Security Card. Đơn xin cấp Thẻ Social Security. Mẫu đơn quý vị cần điền để xin số Social Security hoặc thẻ thay thế. Baptismal Certificate. Giấy chứng nhận rửa tội

More than words-extreme You send me flying -amy winehouse Weather with you -crowded house Moving on and getting over- john mayer Something got me started . Uptown funk-bruno mars Here comes thé sun-the beatles The long And winding road .

Phần II: Văn học phục hưng- Văn học Tây Âu thế kỷ 14- 15-16 Chương I: Khái quát Thời đại phục hưng và phong trào văn hoá phục hưng Trong hai thế kỉ XV và XVI, châu Âu dấy lên cuộc vận động tư tưởng và văn hoá mới rấ

Food outlets which focused on food quality, Service quality, environment and price factors, are thè valuable factors for food outlets to increase thè satisfaction level of customers and it will create a positive impact through word ofmouth. Keyword : Customer satisfaction, food quality, Service quality, physical environment off ood outlets .

(6-a) "Veterinary assistant" means a person who: (A) is employed by a licensed veterinarian; (B) performs tasks related to animal care; and (C) is not a certified veterinary assistant or a licensed veterinary technician. (7) "Veterinary medicine" includes veterinary surgery, reproduction and

THE VETERINARY INFORMATION VERIFYING AGENCY – VIVA: The Texas Board of Veterinary Medical Examiners is a member of the American Association of Veterinary State Boards (AAVSB). AAVSB has created a division called the Veterinary Information Verification Agency (VIVA). VIVA is a central repository for records related to veterinary technician .

27 Science Zoology Dr. O. P. Sharma Amrita Mallick Full Time 18/2009 11.06.2009 Evaluation of Genotxic Effects & Changes in Protein Profile in Muscle Tissue of Freshwater Fish Channa Punctatus Exposed to Herbicides Page 3 of 10. Sl. No. Faculty Department Name of the supervisor Name of the Ph.D. Scholar with Aadhar Number/Photo ID Mode of Ph.D. (Full Time/Part-Time) Registration Number Date of .