Agriculture, Forestry & Economic Development - Senate

I went to a committee to order. We have a couple bills today if you would please silence your phones. When a sitter and say that I'll probably have money go off. Thurstone fueled in the table. Thank you your bill for. If you would please state your name for the record and you're recognized. A Matt stone Senate district to. Mr chairman members I have a bill in this to run this going to address the problem with a track of timber is sold in the state of Arkansas let me interrupt just bonus surveys it is Senate bill two forty six Senate bill two forty six I'm sorry. You're recognized. Currently in Arkansas if you can get sixty percent of the signatures you can cut attracted timber as long as you make a diligent effort to locate the non owner on located layers that may own of interest in the property. But there's a loophole in the law that it it while you're doing your due diligence if you locate one of the unknown around located layers if they decide that they do not want to cut the timber than like a block of timber sale. so someone that has a little of the one one percent or two percent interest and blocked him timber sale what that does it denies the other landowners who own the timber income from their timberland. A call state of Arkansas severance tax that they're not allowed to collect and also stopped a state of Arkansas for collecting capital gains tax on the landowners who live within the state this would get it to where if you make a due diligence to present all the known or unknown heirs at least have an opportunity to accept or reject the timber contract if you can procure sixty percent of those areas you can go ahead cut the timber you still have to pay the other people their money's not taken from them they located the layers are paid whether they want to sell or not in the in the unlock on located layers their money is deposited in the county where the property is located in it if and when they're located thing come for to pick it up. Questions from the committee. No questions Senator Leding. When the funds for the unknown heirs are deposited in the county where the property is is it just sit there forever is the county of able to access the **** sister for five years and no one claims it is teach back to the county. Anyone here speak for against this bill. Close for your bill yes one other item of note I've also talked to the Arkansas forestry association and also the Arkansas timber producers association they've read the bill and looked at it and they're good with it also. motion to passenger second I have a second all in favor say aye. Congratulations we'll pass thank you. President of all. Senator hill are you here yes are you gonna pass on Senate bill five yes he told me that I just want to I I just wanna put it on record. Okay the Committee were looking house bill eleven eighty two. You would please recognize record and you're recognized to present your bill. Ricky Hill thank you Mike Donald center. Thank you Senator Ricky Hill district eleven. The representative bought District eighty seven you're recognized. Mister chair you should have an amendment should be here any moment. We already have is not here yet this will be bringing it will cover will cover that in a second okay I'm with income is going to start this out basically say what a great turnout we have today for that committee all of this how much more could we ask for going to do to do the things to serve the people of Arkansas you get a lot of people here to speak for against this bill so that's that's what the that's what America's all about the state of Arkansas I will state that I have a twelve fifteen meeting today so hopefully we'll be through with the do you need my phone to cancel. You. The like there there there is amendment coming on this it should be here in a moment and I'll let the. Representive all present that one gets here W. hen Sturch that's okay with you going you're recognized making some introductory comments and I will let her explain the bill okay the this is H. B. eleven eighty two which of the vet tech specialist bill. Which I personally consider this to be a L.. I move that merry medicine to the twenty first century bill by self defense get them a little more in line with the way we do other business and other other industries. Arkansas has a shortage of veterinarians especially are large and will be at we have an abundance of lost up producers who need good quality care for their animals. Unfortunately there are not enough new veterinarians come out of it near a school when invigorating medicine in the state of Arkansas granted we do have two schools online to have it near in the medicine in the future but we're looking at eight ten twelve years away on that. Our veterinarians need assistance now not twelve years now. We are in a state of emergency for veterinarians the services in Arkansas that is why we start of it take program back in twenty nineteen in which the veterinarian board in all veterinarians follow us on that one I have never been here in five years that the veterinarians have not fault everything is come before this committee Nassar was committee for four years. So I want to just keep that in mind the folders on the vet tech program that we started in the finest nail for continuing it. The veterinarian takes can only be obtained after two years of education. In five years of working current currently under someone are you looking at seven to nine years experience for a specialist which we do not have any specialist currently in the state of Arkansas. One thousand figures out to you. We have roughly four hundred twenty veterinarians in the state of Arkansas Nestor going fourteen for one hundred thousand people which is what Arkansas business showed back in April of twenty two oblique was. We have one million seven hundred thousand cattle. Hundred sixty eight thousand horses. A million ninety five thousand. Dogs eight hundred ten thousand kept in four hundred and twenty veterinarians if you figure that out that is roughly. The and the overall figure you're looking at the. Fifty three thousand one hundred seventy nine square miles in the state of Arkansas we have a veterinarian for every one hundred twenty six miles. If you take the populated areas of the state out that number is even greater if you take up northwest Arkansas Pulaski County with a population that numbers greater you go between Little Rock Arkansas. Efficiency there are three veterinarians on interstate forty. You go from Hazen Arkansas commit this there's one. That tell you there is a shortage especially in the delta area the economic area that needs help that's where we're suffer to the citizens in those areas are suffering their animals are paid the ultimate sacrifice because of lack of veterinarians in the Humane this that we must health for the. This being left behind by agreed. But not when the specialist in the technician to go forward into their career. We've got to do something about that folks. They're actually a hundred fifty seven activit takes in the state of Arkansas that is all we pass programs Arkansas state university have the program they're turning students out yearly on that in a twenty cent twenty nineteen. We passed the vet tech Bill the Arkansas to relieve some of the workload on a written hearings and help our farmers and ranchers if we're not going to allow growth in this vet tech industry. One we passage start with we're limiting these people ability to earn a living to do more. Do what they can do. I'm passionate about this I'm not just any Jackley a guy sitting down here got to her had a cattle six performance horses. Four dogs. A cat and a rabbit so I do think I will first in this area. So you ask. What is this about ask yourself the five W's who what when where and why. Who needs yes the animal animal owners in Arkansas especially in economically challenged areas that's the area I want to keep focusing on is not the Northwest Arkansas Pulaski County if these other areas that are underserved. What what do they need the veterinarian services at competitive rates we have a veterinarian traveling a hundred seat twenty six miles to get there you're not getting that service we need these takes to go out to those forms make the calls related messages back to a veterinarian who is in his office thank you regards the case as. So we need them to work together on this. When we need it we need it now we don't need eight years now we don't need it ten years from now we need it now this is a state of emergency in Arkansas we just got over the COVID emergency never in the veterinary emergency let's look at this and let's think about the people the consumers of the state not just an industry who want a lander back pockets. What we needed at the most. We did it in the eastern part the state in the delta the southern part of state the southwest part of the state that's what we needed at all over when we needed it approved animal health and consumer demand this consumer demand. This bill is not for everyone if your veterinarian you do not want to do this you have the right to opt out we're not forcing you to do anything if you don't like it don't do it but don't limit those who want to do it. Let's think about the vendor to do to help who are aggressive who work past five o'clock who work on into the night let's think about those veterinarians they're the ones that need the help the ones who are going the nine to five first they don't need help you're drawing a paycheck I want this to be for the individuals out here hustling trying to make a living trying take care the cattlemen the horsemen in this state of Arkansas those are the guys I'm looking at to try to help I'm not trying to help the poultry farmers they got their own good news that they use I'm looking at our livestock producers who we are failing in this state I think that's a total embarrassment for us to be failing or livestock producers. With that being said Motorrad over to senator vault she won't be quite as passion as I allowed it but I'll I'll let her go to the bill I don't want to be a senator I'm definitely a representative and I believe that our amendment is there. I don't know if the Senate could handle myself and records and centre Health. Have more of an. They have. Get it will. Thank you. Did you get one. Okay. Pardon Sir. Yes. Yeah me too I'm trying to be. I'm trying to be. Coming up. To the. If you own a copy of the amendment only raise your hand will go down have staff I want have staff to make more copies I don't think we have enough copies. Two. I will have the additional copies coming in this is fairly complicated the amendment to read in the bill of I have. You shouldn't call well if you would allow her to explain to is not mean there's complicated sounds like it is. And thank you Sir so after. Much deliberation over the last few days and talking over the last few days I'm now waving a white flag in giving the veterinarian board exactly what they want so if they can speak against it now I'll be very disappointed in any that that comes and speaks against this after I'm conceding to them so this takes away all prescriptive authority. There will not be any prescriptive authority left in the bill that's why it's there so many lines is because of that there was a piece in there that I actually overlooked on my and that was the compensation part that is now retracted and gone that is no longer in there either. Amber it said on your page. Repealing the amendment the yes Sir I am part of the amendment you circle page when we go on it in your amendment it's paid it will be on your page six and it says excluding major abdominal and I'm taking out the word major and this is everything that was brought to me that they were against and wanted to be fixed on the bill so. That is me waving a white flag trying to be open minded even though I limit let me restate for the committee yes I don't remember amendment page two yes I will paid courses page six yes I don't want to the books are about that Sir I didn't see it on here that's why I alluded to page six. But with that I would appreciate a good vote on the amendment. Okay we for the members during discussion any questions on Amendment. No so there are gonna question secretary general. No. So you're saying that the bet to expansions will not be able to prescribe medicine correct it all. For many kind of surgery they will be able to do anything that they can already do so okay thank you okay of the staff wrote and additional copies minimal and everyone else will one please raise your hand. Going to. We've got plenty so you would raise your hand will give them out to you. Okay should want to have a motion. Do pass on the amendment only second second all in favor the members say aye amendment passes I will take a ten minute recess so that everyone in here can see the amendment and understand it with you to and the kid right now is The ten nineteen ten twenty ten thirty will come back in order to take take ten take ten minute recess. Okay members will come back in order we've given ten minutes to look over the of amendment Represent all hell if you continue with your bill. Thank you Mr chair so if you look at hopefully you'll be able to go along and I'm going to try to keep up also with my amendments and how it goes but what we're gonna do is still have a collaborative practice agreement that's written a written plan that identifies a veterinarian and very that Marion techno technician specialist who agree agree to a collaborative together in a joint management and of the health of a. Of the animal that veterinarians animal and it's important to remember this animal is always in the care of the veterinarian even if they have a vet tech specialists this taking care of the animal at the end it's still the the vet who is responsible for the animal so say of that hires at they can only have three I'll get to that a second to say that higher three that bet is still over of those take those technicians specialists and directs what they need to do to an animal so I always a quite it back to my daughter's a physical therapist she has PTA is up underneath there the Buck stops with her every time no matter what it stops with her she's the one who make sure that the patients being taken care of correctly and that the what they're doing what care is being given is what she has directed and. If you'll look on at the next page. Somebody said we met when we have a an amendment in a bill or you own. What page number two so I'll be in the bill and you're in the bill I'm in the bill what I was told I'm sorry okay I'm making the next page sorry. The descriptive enough so we do that yeah yeah I'm getting from the bill actually the bill which is some two yes Sir thank you I've never done that before like read straight from the bill but I felt like when we were on our end it was the first time some people had even heard the bill or read the bill themselves so if you look on section two were adding back at the veterinary technician specialist back there and it was kind of an oversight on our on my part and I apologize so that was one thing that was asked what would be that that would be added back to the bill so that's being added back to the bill. This means that they cannot receive any fee other than what the veterinarian pays them so before I actually had a boo boo that would allow them to take money. From the actual client this strips that back and they can no longer get compensation from the client. So if you get if you just drop down a little bit further some people said you know they asked what the vet tech. How they keep up with their hours and stuff like that so it's quite difficult to even get this bit text technician specialist a certificate it's a two year program but then it's five years underneath somebody so it's not lack I'm going to graduate from school and I'm going to immediately start doing A. B. C. D. E. F. G. it's five years that they are actually in practice next to a veterinarian I which is I think important because a lot of people you can be book smart but it's nice if you can learn from somebody and watch them and and have them guide you hands on so I think that's that's a good aspect that we have in the. In this program and but they also have to do eight continuing advance continuing hours so they have hours that they have to keep up also. I'm on Education Committee so I would consider that to be PD that they have to do that keeps up with their certificates and. A veterinarian technician specialist sign maintain an active veterinarian technicians certificate in the state and fulfill all continuing education hours that's required by them to state certified they have to continue all of that. I'm. So we took out all of the prescriptive authority so all of that is now gone out of the bill so that took. Quite a bit of the lines off of page four and five just so you know. It takes specialised shall perform specialized bring veterinary technology under the direct supervision direction supervision and responsibility of the licensed veterinarian of whom they are employed under at if you drop down to the bottom of this page because someone was. I know that several emails alluded to well the bet is the one who can be sued in the bet is the one who can. Get in trouble it was kind of the same way with nurse practitioners I mean the it stopped with the doctor just so you know but we put some language in here that should help even make sure that no one goes road if you look down to line thirty two on page three alasan veterinarian use and supervision or employing a veterinary technician specialist is individually responsible and liable for the performance of the acts and omissions delegated to the veterinarian technician specialist this is important because we will not have a roadway that trinitarians out there that are hiring that tax and allowing them to just do whatever because it's actually their license that's on the line so I think that's important because it's what I would consider a safeguard in in the bill but it does not let the vet tech specialists off the off the hook if you go down to line two this is a this subsection does not relieve a veterinarian technician specialist of any responsibilities or liabilities of any of his or her own acts and omissions. So they're just as responsible as the bat now then it was brought to my attention maybe we should give the veterinary medical examining board. A little bit of teeth so that they could actually go after rogue players out there who might would not follow the law or the intent of the law and I told as representative Beatty I was good with that if you wanted help with that bill I would help him with that bill because I think that is a good idea to have because it would keep everybody honest all right and. So on that same page line for line three alasan veterinarian shall not. Again I license very merry and shall not establish a separate office or clinic in a location other than his or her regular office and places sept. And place the separate office or clinic under the control of the supervision of a veterinarian technician specialist so some emails were like oh we're going to have these pop up everywhere we're going to have it's going to be just flooded and it's not gonna be as you can see it is very safeguarded it says in their regular office so I do have one bed that has a regular office in two counties. And at but they're already established clinics they've been there forever and it's one guy and he goes back and forth between counties because he's the only one in two counties. So we had to have an office and both of them because of that. So he could actually have somebody over in that office that's already established but we're not gonna be popping up everywhere and. Let's see if you drop down to a line eighteen page four and veterinarian shall not enter into a collaborative practice agreement with more than three. That merry technician specialist at one time so again as you can see it's very tight they can only have three we're not allowing them to have ten fifteen twenty and we're not allowing them to pop these places up everywhere and also the vet tech specialists cannot hang their own shingle because they have to be and this collaboration with this but Merriam. If there's a complaint in the field so there is a place to go if a collaborative practice results in complaints and if you go over to the top of page five a. Of violations of this chapter the veterinary medical examining board may review the role of the collaborating veterinarian or the veterinarian technician specialist in the collaborative practice to determine if the collaborating veterinarian or the veterinarian technician specialist is unable to manage his or her responsibilities under collaborative practice agreement without any adverse effects on the quality of care of the animal patient one thing that I thought was so important about this is quality of care we have large animals we have a dairy if as of June thirtieth of course we all know that you know all these drugs that we could use before that where we can go down to the co op and yet will no longer be able to date to be able to get because of the fads right so if I have a cow go down in ratio Arkansas with milk fever and mama that is actually in say mean Arkansas I can tell you my cow is dying. There's no two ways about it she will die. Quality of care for these animals is what is so important to me. I love animals there's a reason I have an ag business degree it's because I love animals and I want to make sure that our farmers have the quality of care that they deserve for their animals so this will help with that also this bill helps with that and again if we want to go back and give the veterinary medical examining board teeth where they can find people who are role players I'm good with that it's not in this bill is not part of this bill but it's something that can be written. And now you'll see all of the language that you hear will be gonna that eleven or ten three twenty two. So let's go down the line thirty I will be talking about the relationship of the animal. Is that establish care for a new animal patient by forming a preliminary veterinarian client patient relationship so it's important we have those collaborating I relationships I know this is one thing I did not give up so fifteen days was a compromise to me I am. The veterinarians wanted to seven days and the vet techs wanted thirty days I split the difference and said you've got fifteen days to establish that because I felt like it was good middle ground there I mean it and I thought it was a good compromise. On both sides. At so they got fifteen days it says the collaborating veterinarian shall complete the veterinarian client patient relationship five personally seen the animal patient within fifteen days. That could be just come back have them bring the animal back up or Hey I'm doing my routes out about let me run by their house and see if I can't see that animal real quick. I we took out on line six we took out major that's something that was asked to happen so we took out the word major on line six so now it says performing minor dental and surgical procedures on animal patients excluding abdominal Thor Thor ACT or orthopedic surgery and neurosurgery again it's administer they can administer a drug or controlled substance to prevent suffering of an animal patient including without limitations euthanasia under direct communication with the collaborating that so they're not doing this rogue they've got to talk to them that it's got to be a collaborating between the two of them that that's what needs to take place. I the next part we took out prescription. I will say though let me go back up to line fourteen because that's another safeguard they can't do any of those things about five if it conflicts with state or federal law. So someone might say oh well they're going to start doing this not not if it conflicts with state or federal law it's in the bill. on the next one we took out on line fifteen we took out the scribe so now it's just dispense and administer medicines or therapeutic devices for animals except when it conflicts with state or federal law. If you'll look on Pat online sporty six a paid six they also have to inform give the client a letter that says Hey I'm not of that so they're informed of that the. By consent with a letter that says Hey I'm not of that. Can I still work on your animal so just so you know and then the one thing that everybody really loved was we give back rabies back to. Them where they can actually do the rabies because I understand that something was passed where they could no longer administer the rabies shots vaccines sub and with that I'll take any questions I'll do my best to answer. Committee. Reprobation Mr. The a quick question on some notes that I've received on That text specialist certification process. So I think I've heard today and throughout my research on this conflicting information and I've heard everything from its four years plus five years under that plus service hours and different things but the the least I've I've heard is a two year online certification and could be under this process and that scares me if the if that is true okay so could you help me the young lady that's about to speak to you can ask for those questions okay perfect we answer any of those she's about to take a test for okay what thank you this act. One of. Due to low. Thank you Mr so I'm. With the when you speak you said there's a two year certification is that correct. Okay. It in the center then there is a five additional years under a veterinarian. Nine is that not being closed in the collaborative practice. Postgraduate. Ma'am don't speak from the you'll have your chance to a and when so all right so so then the collaborative practice agreement is for how long. For as long as I want to be in that plot in that agreement with that veterinarian. Say they moved to the area I'm sorry say they move to another area then they would have to find another veterinarian to get and Cooper to have agreement with they can never be out on their own or hang their own shingle or start their own business. In writing to the. Okay as amended yes Sir. Let me also ask you this ninety they carry any kind of malpractice insurance. I remember correction can carry. Malpractice insurance okay if you ask her that question because I'm not one hundred percent sure but I think if I remember correctly when we were discussing she could okay all right thank you ultimately Senator love the blocked off of it now. Thirty eight years the Chief of off. Okay we'll have a we've got to Page sample witnesses so we'll start with that beginning with the maker can if you will come to the table please. We'll take these in order for and against and I will jump out of order if of something a question comes up that we need to find someone to come back they will to answer questions. Ma'am if you would to introduce yourself for the record and you're recognized. Meg Harrington. First off I would like you to thank you all for allowing me to be here today and to talk on my behalf of my profession my name is Meg Harrington I practice large animal veterinary technology for team of amazing veterinarians in south Arkansas I currently reside in Grant County I have been a credentialed veterinary technologist for over fourteen years this month and I've worked primarily in food animal medicine for majority of those years I am a strong advocate for keeping our production animals healthy keeping our food supply safe and keeping America fed. I have a bachelor's degree in veterinary technology that was obtained from Purdue University school of veterinary medicine in which I took clinicals in the same but schools but merry instead. And after passing the veterinary technician national board exam I became a certified veterinary technologists and twenty twenty two I applied to the academy of internal medicine for veterinary technicians to apply to this academy I did meet several strangers requirements I had to be mentored by a veterinarian who is a diplomat of the American college of veterinary internal medicine and large animal medicine and for context being a veteran diplomat as one of the highest honors of the veterinary profession so I worked alongside one of the most esteemed food animal practitioners to complete this process to break it down further BTS is required to have a degree which is two or four years and veterinary technology from an AVMA accredited college or university which includes didactic instruction and pharmacology anesthesia clinical pathology diagnostic imaging medical terminology anatomy and physiology surgical nursing and large and small animal medicine that less can can continue. In addition to the clinicals completed during my education I have to have five years of post graduate clinicals in veterinary practice underneath the DBM and to get accepted into the academy and pass to national board exams before becoming a credential BTS. The proof of the veterinary technician licensure education professional history fifty plus hours of advance clinically relevant continuing education seventy five case studies and for in depth case reports during my application here which is also acknowledged my competencies and letters of recommendation work knowledge by veterinarians and diplomats of corresponding veterinary academies ensure quality applicants are accepted into these academies. The advance knowledge and skill of a veterinary technician specialist allow a BTS to perform many of the duties and skills that are currently being performed by veterinarians we're just being under utilized. These academies are credited accredited by the national association of veterinary technicians in America and the committee on veterinary technician specialties both are what you're recognized by the AVMA every specialty academy has an already spotty established standardized board examination to be able to credential there applicants which ensures consistency across the nation on the competency and the skill of these qualified individuals within their area of specialty these current master level degree programs that are out there for veterinary technicians are taught by TBMs and BTS's they are online they provide no additional clinical instruction under not AB in a recognized and provide no standardized board examination in order to license graduates however the BTS academies provided vigorous clinical and educational process to ensure the profession has the highest qualified individuals in their specialty to be able to provide the best standard of care for our patients the amount of post graduate clinical instruction education in the passing of two national board exams to be a BTS far exceeds the requirements in the bands of human APR and and which we trust to care for a loved one so we are why are we not offering the same care for veterinary patients to vote I have access to care our current challenge is when we're unable to provide our patients with emergency care when there's no be CPR which is a veterinary client patient relationship care must be declined in the situations we have EMTs nurses in a P. R. ends who are able to care for humans but what about the animal patients that are going without access to veterinary care in emergency situations this bill would allow the BTS to establish a preliminary B. C. P. R. for a new animal patient on behalf of the veterinarian in order to go pull a calf if you're small animal triage a dog that was hit by a car if you work in equine medicine centralization on horse so long that every drug that would be prescribed by the veterinarian prescribed by the veterinarian and dispensed by the veterinary technologist specialist is administered. Third by according to the label that is approved veterinary drug on label this promotes heightened food safety and preservation and supports the judicious judicious use of antimicrobials since every product would have to be used on label with already established meat and milk withdrawals this is an important part of the bill because currently as a CVT an animal cannot be touched without an existing B. CPR therefore if a patient needs emergency care they currently have to be denied care for veterinarian is unavailable under this bill Arkansas animals would have access to life saving necessary veterinary care it would reduce the suffering by utilizing BTS to perform the duties and which they have been trained to do. This is all about providing care to pet owners and livestock producers with better access to care improving animal welfare for example I to bring. Schematics for everybody this is what I patients the life doesn't look very good doesn't. This patient was assessed on a form call which is ten minutes away from the practice that I work at nine the veterinarians were able to go so I was able to because I work under indirect supervision currently as the laws right. The owner opted to euthanize this cow because they didn't want to take on the financial support support supported care the patient had to wait hours before it could be euthanized because I under current law cannot euthanized animals this bill would help solve this problem. This. This patient builder culvert this is a cap the other all It is cast basically. This patient builder Culver needed wonder Brian after assessed in the field. I had advise the owner the cowboy how to cut the necrotic tissue off the because the DVM was not available to get to that form yet in college I was taught how to do a surgical jugular cut down with the scalpel blade over a major vessel in order to place a central line but I'm unable to remove the states can. This bill would fix this problem. And I say this patient this is a new client I received this picture of this Calhoun is which still live in this picture very much so. But because they don't have a the CPR and I could not get one of my veterinarians out of them I was unable to provide care for this patient even though I was fifteen minutes away it loaded and died that's an animal welfare problems for. The unknown where a massive workforce shortage in veterinary medicine and the retention of our technical staff is at all time low because credentialed veterinary technicians have been met with multiple challenges mainly a lack of career advancement and under utilization of skills and barely livable wage by allowing this bill to pass it would establish a defined scope of practice for a better technician specialist and allow those with aspirations to develop their training further an opportunity to be utilized and for the more appropriate compensation for our advanced skills and our knowledge to bring to a veterinary practice we're going to continue to lose more qualified individuals in this profession if we do not make room for opportunities of growth. By voting yes today you allow veterinarians to have the support staff we are their support staff we are not there competition they need in Arkansas to retain highly skilled educated credentialed staff members in the veterinary workforce by allowing the opportunity for career advancement what we understand not everybody area and has an interest in hiring of BTS to work in their practice just as most Indies may or may not choose to hire an APR in we would like to provide the veterinarians the opportunity and the choice to hire such inventors individuals if they have a need to utilize one of them for their education and their skills which are as vigorous if not more than a human APR and. Until opposing veterinarians understand that CB teas and BTS BTS's R. their support staff and an asset to their practice. Just as Indy's benefit from our ends in a PR ends veterinarians will continue to CSS competition and never fully benefit from the value that we can bring them after all veterinary technician would not be able to be authorized to practice at all unless we were hired by a veterinarian thank you I'll take any questions. Really. Well yes I have a question yes Sir that I understand you to say that your training exceeds estimates this is what an A. P. R. what a P. in our science yes Sir so we have either two or four year degree in veterinary technology and then we have to have five years of post graduate clinicals and then apply to an academy and get our clinical experience we have competencies in which we have to have a veterinarian acknowledge that we have competencies so if you look at that time frame at seven eight nine years to be able to add to obtain a BTS certification between beginning of your education through the postgraduate clinicals to be able to hang a master's degree to be an APR in at six years which can be completed online well I guess that was my question you know nurse practitioner has a master's degree Sir and I was just wondering House Bill training overrode the education it comes with the yes Sir with a master's degree so the master's degree programs that are currently available to for veterinary technicians as it is are completely online and offer no additional clinical instruction and there's no board certifying examination that ties to that master's degree like but would for a nurse practitioner and I honestly I feel like would flood our profession with maybe less qualified individuals when the BTS is actually more rigorous process one more question diplomate you know I've listened intently when you read your resume in this impressive resume but my question is with someone with an associates degree Babel to do what you're doing right now would they be qualified but the only to associates degree yes Sir yes House so so the bachelor's degree much of the bachelor's degree program includes additional management courses and management is not what I do I work on animals every day so okay I think that's a great question thank you any other questions. Thirty Gilmore pointed out there was so many people we have here we will limit the testimony to five minutes and I'll make an exception to the of of first better to that comes up because we do give you free time to testify it's a lot of times and we will start to the limiting the testimony five minutes. Per person. Okay. No. Yes Sir thank you thank you very much. I will ask I will allow this to choose who they want to go first and and and make a presentation. Of. Oakwood ordered. Then again the we are under time constraint but it's and will allow you leeway to go more than five minutes but I've I sure don't want to go forty five minutes so if you. If you were to introduce yourself for the record please my name is doctor can't McClure I'm an associate executive vice president for the American veterinary medical association inquiry from doctor I'll close. Pardon I'm originally that was issued to you if you want to it is. I was a born and bred in Texas and I hope you won't hold that against me right now I live in Virginia thank you for being here and and you're recognized and I will not go forty five minutes I promise and I will ask you assigned to and told me if I stumble just a little bit I've been trying to make sure I don't testify to something that's been removed from the bill so I I did want to react to a few of the things that have been said and then I have some testimony I'd like to provide but it was said earlier that there were four hundred and twenty veterinarians in Arkansas there are currently one thousand one hundred eighteen that are actively licensed by the board in. Well that's actively license by the board is one thousand one hundred eighteen the Was you know centrally that veterinarians oppose technicians and and the program in two thousand nineteen I don't believe that's correct veterinarians were not supportive of the same thing as now which was an expanded scope of practice for technicians beyond the skills that technicians have we've always been very supportive technicians and fully integrating technicians and technicians specialist into the profession. The the other thing was talking about what what I would say is this is not about greed this is about what's right for the public the profession and the patients under our care and the animals that we care for and with the I know the prescribing pieces been brought out but some of that gets mixed back in and it gets complicated in a hurry one of the examples that was talked about was euthanizing an animal welfare if that's not if you don't have a client patient relationship with that animal and all those are often controlled drugs that are used and it's actually a violation of the federal controlled drug law to prescribe a controlled drug for animal patients that we have not physically examined so all of this the problem is not when it's an existing client because today we can use existing court we can work work with technicians and technician specialist. In an indirect rector immediate supervision with our existing clients and that's very critical because you learn about the that the facility you learn about your client you learn about their their animals that they have on their level of sophistication that care for them and the facilities and everything they have for them and so that that's that's not a minor thing to gloss over even though we don't spend a lot of time on it for the second time but there's the only issue that really comes in as allowing these individuals to establish that require patient relationship and start practicing quote all aspects of it re medicine without the veterinarian having been there to and and made those critical initial evaluations that's the piece that we don't support the and and so again let me be very clear that we support veterinary technicians and technicians specialists they're very valuable members of our team the AVMA I one of the committees of the AVMA is actually accrediting body that accredits two hundred and twenty three technicians schools technology schools I including a issue Beebe we have ongoing efforts to expand their programs and ongoing efforts to encourage the incorporation of technicians and technicians specialists and veterinary practice that's something that's very near and dear to us we do oppose this bill I we do not believe that it will that creating a new category of practitioner because that's what this really does I will address any workforce issues and we don't believe it's appropriate for the animals under our care our clients or the public you may see similarities to delivery of human health care and veterinary medicine but they're actually quite different and just simply applying something done in veterinary and human medicine to veterinary medicine doesn't work D. as part of this is because the nature of our professions are very different I including that many animals under veterinary care under the food supply the work force and settings for the delivery of the care are very different and the roles in protecting human health public health and and. Will differ. The This bill would authorize a veterinary technician specialists to put quote perform all aspects of medical care close quote which means that they'll be allowed to provide a level of care they simply do not have the training knowledge and skills to deliver a missed a late or wrong diagnosis can carry significant animal human and economic impacts of the if you've heard about the technician program it's either a two year associate's degree or four year bachelor's degree they take a national exam upon completing this the technician has demonstrated ability to perform technical tasks to assist in the delivery of veterinary care the veterinary technician specialist as you've heard then has advanced training beyond that clinical supervision and they can perform tasks technical task at a higher level of proficiency and perhaps even take on a few additional tasks that a regular technician will not be able to do but that doesn't quite to having the necessary appropriate skills to diagnose formulate treatment plans prescribed perform surgery or the other things this bill would authorize because it authorizes everything an example I would give you is that a you know technicians are educated on taking X. rays and about radiation safety or veterinarians are also educated on how to interpret them then how to use that information to diagnose prescribe are prognose and formulate a treatment plan another would be to think about a horse colic veterinary technicians are taught how to restrain horses collect vital signs collect blood and how to run laboratory tests VTS in large animal internal medicine would have a much higher level of proficiency in these past I could also do some additional diagnostic tests the veterinarian on the other hand is taught to interpret all of that information from their examination other tools and do other procedures such as a trans rectal palpation of the abdomen ultrasound to diagnose the reason the horses colic and then the. Side with their medication is appropriate or if it would need surgery or even to be euthanized we think would make a great deal of sense to further encourage the utilization utilization of technicians and veterinary technician specialist with established patients with that's under direct indirect remediate supervision as is currently allowed under the Arkansas law and regulations. No the One of the things that was stated in here was about you know not allowing someone to hang out a shingle they couldn't stab work out of a new office but there will be people that will to operate trucks out of existing offices and and I I don't think that's addressed in the bill the other place that's in here is that the in this one's important and I'll end with this because I'm trying to truncate the time down I apologize for that but the the the. Collaborating agreement does not have to be with a veterinarian who employs the individual it's an employee or any supervising veterinarian that's entered into an agreement and that creates a tremendous liability risk veterinary malpractice insurance covers the veterinarian and their employees acting in their assistance for their care it would not cover a non employee VTS who was working under them and even if the VTS I'm not aware of any insurance company and there may be some but I'm not aware of any that provide insurance directly for technicians but even if they did the technician would be the named insured not the veterinarian so the bill places all of the legal responsibility on the supervising veterinarian and yet if you're an associate in a practice and the technicians in that practice employed by somebody else in your the supervising veterinarian you've taken on all of the legal responsibility and you will have a gap in coverage if anything goes wrong and and the only reason I know those things as I sat on the board for the American veteran medical association professional liability insurance trust we provide insurance to very significant segment of veterinarians in the country I'm at an act that would create a very real risk of for veterinarians and then if that technicians insolvent or judgment proof if you will then that leaves the client or the animal owner without coverage and those can be significant they could be an instance for example for heard were boarded those damages can run to be very significant in terms of dollars and leaving coverage bear like that we don't believe is appropriate so anyway this I'm sorry for five one here is trying to cut through it all the bottom line is that we absolutely support our technician college in or veterinary technician specialist colleagues and or working doing everything we can as a profession to expand their ranks and incorporate them into veterinary practice but that doesn't mean that we think it's appropriate to put them out into positions that we do not. Leave their qualified to operate. Thank you for your questions from the committee. Thank you will. Thank you doctor for being here and taking the time so I I know that. last minute there is a an amendment that changed a lot of the servants were sort of working through this as well so but some your remarks and and I I know that you private time to to sort of sift through this amendment that was brought but one of things that you spoke to and I I I just wanna ask your opinion on it so everyone on page six line seven where it strikes major but Donald for radic orthopedic surgery if I'm saying is incorrectly I apologize Thanks to some your test member you said they'll be able to perform major procedures would is that your reading of this bill under and its current form with that language now stricken no Sir what I was referring to was the we're talking about the definition of and I've forget the terms at different times with the practice of. Let's see here the specialized veterinary technology it's on page two line four number twenty there. It's a specialized veterinary technology which is what the of any technician specialist would be authorized to practice he's the performance of all aspects of medical care services diagnosis prognosis and the administration of appliances prescribe drugs medications with maybe the administration prescribed again that depends on if it's already existing clients under indirect or direct I think it's going to place them operating independently in that regard I'm so my my point was to say that. They're not trying to do all that the and I and I understand the intent behind the amendment you're referring to to take me I think we would all agree that it would be appropriate for them to be doing any of domino surgery and I think that was the reason behind striking the major was so that there wasn't a confusion over that and that's not something that I quibble with. A follow up it so and I think it was in twenty nineteen someone probably can speak better I can there the that tech bill I think passed here in Arkansas that created the I guess is indirect and direct relationship that's already in current law so. This language obviously its new language because underline that you're referring to on page. The we're with that again was a page to. How does that differ. Currently from what's currently in place my understanding is that the Arkansas border veterinary medicine has promulgated rules that talk about the specific types of activities and tasks that can be done under immediate direct and indirect supervision so for example under indirect supervision with an existing client if the veterinarian considers it appropriate there's a number of husbandry practices are castration and other things like that that can be that are specifically authorized today for technicians to do is. Either of my other my colleagues from here in Arkansas if I've misstated that can correct it for you but that's my understanding and that with this would you would be expand that way beyond doing those technical provisions to the diagnosing and treating formulating the treatment plans those sorts of things okay and one last fall of Mister thank you on on page five and again amendments make things difficult yes it's it's a it's hard to sort of shift through here But one. Page five. starts at line twenty four without language restriction that. That moves the line twenty up skews me line twenty nine up to section three now but it adds language and if I got this correct it adds language that a collaborative agreement shall be required can can you speak to that what is what is that Nestle mean in your practice. Well I obviously am not I don't have any technicians under a collaborative agreement but I think with the evidence that similar to the collaborative like the a PR in would have with the physician and MD I'm assuming that's the intent behind it yes Sir. At I don't. Any more discount on that well again I I think that My understanding and believe is that the training that goes into that type of a practitioner in human medicine includes the diagnosis those types of things the prescribing that they're authorized to do in for veterinary technicians the exposure they get to that is extremely limited its it's and I see it's non but it's the program is not geared to teaching them to diagnose prognose perform minor surgery in the field to be if there's the with most succinct way I know how to say it is they're not trying to be independent medical decision makers. Thank you senator days. Thank you Mr thank you again for coming on. When I think about food supply. Could you help me understand a spus it if there's any specific risks related to. food supply with now that prescriptive authority is out that makes me feel a little better but could you help me understand just two questions as the first concern had any any thoughts related to that it's it's a a a very real concern the in part of the difference is we talked about for veterinary medicine from human medicine is our ability to have impacts on economically significant agricultural activity within a state and you know failure to diagnose an important disease cannot impact not just the animal and not just the producer but it can impact an entire state if it causes a quarantine or something like that so there are diseases that can be misdiagnosed easily things like anaplasmosis and cattle eighty influenza African swine fever can be easily misdiagnosed and as part of the reason that the veterinarian support for the veterinarian to be the one to see these new patients new clients because a lot of times those are going to be smaller mixed animal operations and and they're ones that that may not have the same level of of personnel that can identify things and related things and so having that veterinarian be the one to make that encounter is because of critical importance and protection against our in identifying any type of disease like that so that it doesn't expand in those there there are certainly infectious diseases like that that occur in Arkansas so that's not some abstract concern. Involvements the concern was going back to what you had said I wanna make sure I understand your testimony on on risk following from a liability perspective. It I heard you outlining. An employee versus the airing to expressionist riches a veterinarian I wanna make sure I'm following that correctly so if there is if there is a a liable because of malpractice Clause with a with a vet tech under a veterinarian who is who is at fault and what's it maybe what's the difference between an employee I thought there is a wording there that I wanna make sure I'm clear on of what's covered what's not from a practice the the the practice form that covers the vast majority of veterinarians in the country today Tom would cover them for the acts or omissions of their employee while they're assisting them in the delivery of care right and but if if that individual is not there employee and this because the idea is if if you're in an associate veterinarian in that practice right you're going to have your own liability coverage and the veterinarians are and then there's going to be a coverage for the veterinarian and the employees the but this contemplates entering into a collaborative agreement with someone who was not your employee and so if the claim is made against that veterinarian for the acts or omissions of someone who was not there employee one of the things the carrier does when they look at that is say they took the boxes on do you meet the conditions for coverage and it's it it's not you I don't you I mean it's not the veterinarian and it's the act of the of the very technician specialist then that would not that would be a claim that would not be covered now if the allegation was directed towards the veterinarian like the veterinarian failed to supervise that could potentially be covered because that's the active the named insured the veterinarian but this provides what I would call vicarious liability mean me being responsible for the acts of another not for my own actions and it places that on on me and the way that that insurance works in our industry that would not be a covered act thank. I've got a couple things only comment on the no get your feedback on it I know that the parties collaborative agreement people are thinking we're going to get ten ninety nine employees the R. issues working diligently against that of a higher due to employees are ten ninety nine employees and basically if an employee works for the same person every day they cannot be a ten a ploy this was gonna be a real problematic in in in the issue for working in a collaborative agreement you're saying I'm working for year were submitted but the feel of that that something is going to have to. Have a come to Jesus meeting on whether you're going to ten ninety nine employer W. to employee. The other thing that you brought up Paul go that the I want to ask about was the fact that it it to allow them for all these the. Activities at that they can do including dispensing of drugs if they were to go to of of of someone raising poultry or cattle farmer or even whatever and and and make a misdiagnosis put to the call to them and say look we need to prescribe this they will have the ability to dispense it medication off the truck that would be correct your understanding of this bill yes okay committee even come hit on some of our older one it's stated that they can have a separate office but if they're at in that truck that is or rolling Office but to the so that going back to the food chain Senator duties on on that if if the N. and again whether ten and nine or W. two employees will be real and it's all about liability school come back to them and to that I don't I don't think it will be a separation liability there but this is my home number financial. No we say about all right of other questions relating in question. You will. A clear we preach come to find of her time at the. I'm sorry the final season and I look listen we're we're we're we're not here to hurry well I want everybody to have an understanding so sure we're going to do this well you will be recognized thank you any and again reading comparing the two reading through here I guess that discussions were prompted something I meant to ask earlier so I I appreciate that on Page six line sixteen. And less I'm reading it wrong and you can you can talk maybe perhaps in practice how things work but that that subsection there F. it is the word prescriber stricken and left with dispense some assuming the way that works is the vet prescribes and then. The VTS would dispense those drugs is that is that the way you read that how does that work would you slightly different terminology but I agree well I'm I'm using lanterns the and what I mean that from a legal standpoint it's the veterinarian who is prescribing and dispensing when it's exists in other veterinarian establishes that that our client patient relationship and then it's the veterinarian who is making that is prescriptive determination and causing it to be dispensed the fact that other agent is the one that physically hands it doesn't from a legal standpoint in my view means that they're prescribing and dispensing on and and that can be done today under indirect supervision in Arkansas with a veterinary technician of every technician specialist when you've got that existing relationship that we talked about and then at as as been said you know the the veterinary has to be the one to use their judgment to decide that's right based on the information that they have from what they know about the client their facilities their animals their husbandry and then what they've been told and and that's an ex that is an extremely valuable role that technicians and technician specialist complex I know no one's trying to say otherwise it's that encounter with the client to ought to establish it that's critical for the veterinarian and then its the to make sure that it's the veterinarian making those decisions around diagnosis formulating the treatment plant that can be done within credibly valuable input that comes from the technician and technician specialist and we're all for that. Thank you. Your question. Can. Okay yeah it's M. C. C. L. U. R. E.. Thank you again for just one. Next we have a robin Roberts. If you would identify yourself for the record I'm going to set the clock when you start with a five minute testimony robin Roberts I have been a SCV to pull a little bit closer to you. Thank you man. Robin Roberts and Senators I've been a CVT for just shy of seven years six years prior to that seven I was of an area's distant I've been and the medicine for a total of almost thirteen years I am currently in phase two of my BTS certification within the academy of that Neri technicians in clinical practice our current practice acts have no different patients between that of a CVT and ETS despite the educational and clinical experience differences as of right now my V. T. M. my career is a dead end career and I feel like I've been on every both sides and the playing field for better assistance and better technicians to be able to fight for this today for others in me a light obtaining my VTS will show superior multi disciplinary care the benchmarks are set to ensure that a BTS is an exceptional technician with areas of interest including at minimal five years of experience under like mag and ten had said a diplomatic and that during which is the highest ranking DPM and finally a BTS will demonstrate that they are capable of providing a level of intelligence that is clearly superior to that of the general that Neri technician by successfully passing a board exam through the American boards of veterinary practitioners based on their results input from other veterinarians there is already a presence of highly skilled knowledgeable and educated that our technicians that currently practice their advanced skills and understanding on a daily basis in clinical practice these individuals are dedicated to the an invaluable to multi disciplinary contemporary veterinary medicine who also demonstrate extensive knowledge of groups of drugs biologics supplements their mechanisms of actions clinically relevant to side effects and they therapeutic responses so why can we not give them the respect and always meant they deserve separate to that of the CBT recently the term BTS was called out to be I have trained individual by Sam due to the thought of a BTS eighteen anti microbial resistance to the dispensing of inappropriate drugs. To clarify though this bill states that a BTS is under the order of a supervising that Neri and meaning I did not get any drug that my doctor that I am under did not instruct me to get able for ever and remain the veterinarians choice to hire at the T. S. this bill promotes fully deflation of currency BT's and press profession at that every technology making it more appealing career options sincerity more opportunities for growth this would in turn promote an increase in enrollment to our in state and our technology program recently this morning after released their twenty twenty two demographic survey stating that the top two reasons we have such a high turnover and barriers at full utilization is a wine that interns don't trespass they don't trust the wrist and they don't respect us and the second was a veterinarian hiring on the job people and train them to do our job I fully respect ET and I'm so thankful for what they do I know I want to be their enemy I want to provide them and be for them a tool at my fullest lawful capability that I can be after all I in other cities should be entitled to grow in our profession we passes in two thousand nineteen so why are we holding us back we are more than just a glorified restraint within the last six months of attaining my that tech class and I lost my dog due to shock I was a current. Worker either that area and and he denied me because of schedule conflicts he told me I had to go somewhere else I called every that Merion in my county and they told me no I do goes emergency clinic where he passed when addressed we passed away when I drove into the parking lot I vowed that day to fight for that to fight for the clients like me the owners like me to continue to increase my knowledge of in this profession to pursue the highest most recognized and respected credentials as a veterinary technician this kind of scenario happens every day let's give more animals a chance at survival let's give clients a chance to prove their cells were via the emergency care when a veterinarian is just too busy or they're not a current patient let Arkansas change veterinary medicine for the better thank you senators. Thank you you. Any other questions rich Roberts. The nun thank you for your testimony. Mr yes for recommend coming here between miss Harrington and miss Roberts they will be the first to vet tech specialist trying to take the exam for the state of Arkansas. All right Lortel. I'll differs shall I'm I'm I'm not going to. Thank you senator Caldwell can I utilize some props and some medications with you. Before you. Yes this is Chris Ashford I represent a very I'm sorry say again Dr Chris Ashworth I'm from Greenwood Arkansas. Recognized. Everything out here. So I live in green one I am been veterinarian for thirty six years after veterinary school I attended the university of Illinois and completed a large general internship I then of. Continued and completed a three year residency in food animal medicine and surgery completed a master's degree in nutrition stayed on as an assistant professor teaching veterinary students as at the university of Illinois for a total of seven years I'm the second most educated veterinarian in the state of Arkansas second only to the path ology is that the diagnostic lamb. That's a little bit of my background I rent three hundred head of cattle in in terminology menageries just like this man I've got a horse and counted and donkeys and everything else that clients want to get rid of for whatever reason. The I've taught veterinary technicians and I've been blessed with some great technicians while in the large animal clinic at the university of Illinois as well as my time when I was at the premium mills research center and I was the national veterinarian for Trina mills for beef cattle and dairy cattle. I I love veterinary technicians. I'm opposed to this bill though on several aspects. Previously prior to the amendment the subtitle the bill states the bill is to authorize prescriptive authority for veterinary technician specialists in the collaborative practice agreement. The state of Arkansas does not have the right to grant president of prescriptive authority for veterinary drugs this is one hundred percent held by the food and drug administration the center for veterinary medicine on non controlled substances for controlled substances this authority is granted between of the drug enforcement agency in collaboration with the food and drug administration that is having a drug A. D. E. a license and at that point we'll to talk about individual drugs the first one I'll mention is light a cane this is two percent light came this is what used as a deadening agent your dentist would lose something similar to this to deaden your gum to extract a tooth or to give a filling one of the things so I use this well I'm going to a C. section a cal if I'm going to suture up a horse with a laceration so this is a deadening agents of the animal doesn't feel the pain if you look at the bottom it says for animal looking at the bottle for animal use only keep out of reach of children caution federal law restricts this drug to the use by or on the order of a licensed veterinarian. There is no mechanism for veterinary technicians to prescribe drugs anywhere in the United States. And that's for all drugs that are labeled for veterinary use it then comes back to we move into other sections of drugs so let's talk about the next one will pick new floor this is an antibiotic very commonly used in bovine medicine for treating respire toward disease once again the label on this is very plain very explicit all the way down to telling me where I can give this I can give it subcutaneously but if I give it underneath the skin we cannot utilize the meat for that animal for thirty eight days I can give this in the muscle and I cannot utilize the meat for twenty eight days it's very very prescriptive there are other drugs other antibiotics that in which I'm actually told exactly where to give the drug on the animal at the base of the ear. Now then one of the things that's changing currently in all of my lifetime we've been able to go down to the local co op local farm store and purchase some antibiotics penicillin tetracyclines some of the fish antibiotics Linka myosin. As of June the twenty third of this year this is going to change under FDA order this is been going on for four years so at that point all antibiotics in the United States will be under the prescriptive authority of a physician a dentist or veterinarians this is all trying to minimize anti microbial resistance which is the big issue right now in food animal medicine in particular whether being poultry or whether it be in cattle and then finally we have drugs that are not approved specifically for species one of those would be meloxicam many of you may be taking meloxicam for arthritis this is a fantastic drug it's a nonsteroidal similar to ban Ameen this is not approved for use in cattle however I can prescribe this extralegal under M. do K. okay so there is a federal mechanism by which I can use this but I have to take the responsibility also for the meat and milk withdrawal slaughter withdrawal times for that as well. Finally I want to come to the control drugs I didn't bring one today the control drugs are under the prescriptive authority of the drug enforcement agency so basically you end up once you graduate from veterinary school you pass the national board in the state board you are considered a licensed veterinarian a licensed veterinarian does not have the authority to utilize control drugs controlled drugs you then have to have a nother license with a background check and an application fee in which the drug enforcement agencies looking in your background making certain that you are a reasonable citizen that they believe they can trust to utilize things such as morphine one of the things that were blessed in my profession is right now is we don't have a lot of issues with oxy cotton in particular but on the other hand unfortunately we have really big issues with ketamine and silencing and veterinary clinics are being broken into so that humans can get access to those serving using for recreational drugs. Okay at the bottom line is is the state doesn't have the authority to give a veterinary technician the ability to prescribe these drugs this is all under federal law under the food cosmetics and food drug and cosmetics act. With that I would be more Senator dot com the answer questions and doesn't the bill state that those specifically that everything that a BTS can do falls within asset fall within state or federal law correct and so the what it is is for what's interesting is if that's the case. It comes back to federal law that already says that they can't prescribe right so why are you than opposed to that statement can you help me understand I'm not opposition is that I'm just wanting everyone to understand that there's no legal way that they could prescribe to begin with right and I think they clearly said that like they were saying that if federal law changes then state law would change but that was clearly they stated that on the front end but the thing is is that's not changing if you look at what's going on right now in in medication law is you see that tetracycline and penicillin is coming under more regulation which for the last. My fifty nine years we had not been under regulation okay so it's not regulations not getting looser it's getting tighter and then when you look at silencing coming on xylene the sight was seen and is going to end up being a controlled drug veterinarians may not like it but it's going to happen. So if it's getting tighter and regulation not looser than what is that and veterinarian associations opposition to the bill clearly stating that they only have authority within if as long as it's within federal thing is they can't they have no authority because they can't prescribe it right. So I guess I guess I'm saying I'm not trying to be argumentative I'm just trying to understand because there's been so much information around this but if the bill clearly says that they only have authority that is given to them via federal law and federal laws getting tighter not looser federal law says we can't do that right so then help me understand what the opposition is by the veterinarian association if they're not ever going to have that authority anyways and it clearly states that they only be given that authority via federal law in this bill you see what I'm saying like. There if they're not gonna get the authority and federal law continues to tighten then what then is the concerned with that veterinary association when it clearly states that within the language of the cells I didn't want the state of Arkansas thinking that they have the authority to change that because they don't yes okay and I think the other side has been clear that we that they understand that and so I just wanted to make I just wanted to make sure I was like not missing something that if they had if they if they understood that Senator Davis why did they put in the for initial bill that they wanted to be able to have the ability to prescribe. I thought it said that had to fall within the guidelines of federal law state federal law it states that many times throughout the bill and they couldn't do that because federal law doesn't allow the miss bottle could completely says they can't do that yes so I think so then I guess my. So then I guess we are all clear that the VTS side in the veterinarian side in the Committee side that it it's not allowed under federal law or and it says that in the bill and everyone has been up front about that I was never under the assumption that they could do something different because it's been in the bill and the VTS site has clearly stated that they only would have that authority if federal law gave and that already so I don't think anyone's been unclear on on that and I just wanted to make sure. If I was unclear that I you know make sure I was not missing something that you help me understand that none of the sides were unclear we all understood that only they would be given that authority a federal law a federal law changed sure okay thank you senator Gilmore aye question before we move forward on it Senator Davis own point out that marijuana against the federal law today and flowers in Arkansas for their there is a. Copyright in into that but anyway the I think I've got that right. Means you're more it's quite different. And and I would agree it it is it is allowed heavily regulated when I think there's a little trip to go see that the other day but Just just one follow up on that because that that was something that I've been sort of city wrestling with so just follow up on Senator Davis line of questioning Do you first see it any point that federal law changes to allow any sort prescriptive authority Senator Gilmore I do not and the reason for that is is unfortunately in our society there is a growing drug abuse issue. Now then. I've use silencing for thirty six years it's been out there a long time yeah who would have ever thought that she wins would want to start abusing silencing. I thought the record yes so. So there there is a veterinarian Dr Meredith Jones who now teaches at Oklahoma state who was accidentally injected with silencing by a student at Texas a and M. when she was teaching there was placed in the hospital under observation for three days because of some things that does with with with a heart and then you look at ketamine Kita means being used as an anesthetic and children's coming back for use in adults causes hallucinations but it's one of the reasons that people break into veterinary clinics is is wanting to get through to me these are all controlled drugs they have to be behind to locks into keys separate keys separate locks okay I do not see FDA relaxing drug. A prescriptive authority any time soon on any of these veterinary drugs including penicillin and tetracycline okay so I'm sure going may I follow up. So with that being said that we don't for see any sort of change on that front and I'll just add to a question I asked a second ago now with the amendment that was made on Page six line sixteen you have the bill in front of you. Would you would you like that the man would you like the bill and I usually have it I have it marked as it as it is about dispensing yeah it a strikes prescribing and just puts dispensing right so it and so here's an example of that may I finish the question I'm sorry so with that obviously there has to be a script written correct by someone like yourself and then you mentioned the the fact that it's heavily regulated it's obviously behind lock and key I think you said not one but two keys control drugs right right so. Obviously if they're going to just be dispensing they're not gonna be doing that without the knowledge of a vet correct okay. Your group you for that yes right thank you I think an example of that thank you or as I look at your horse and I give your horse band means an anti inflammatory it just for the record I I didn't I didn't go to to medical school so not not that so I get your band of men and give your for spending on day one for a foot lameness and in the that animal gets better for two or three days and then on day four of this animal needs some more medication I'm out of the office you're away from the farm you call you say doc you know Chester needs another dose so in that case I called the clinic in the veterinary technician can pull up a does the ban mean for you or for someone for your farm to stop by the clinic can pick that that medication up. Okay. Mr I want to ask questions of my wife farmers run dollars to Dennis will favour of the medical doctor so we we understand road diversion of it is or anything of two questions one is there anything in in a current law that would prevent any of this but isn't being on a truck that's not occupied by a veterinarian. and as long as that it is long as that would be an employee of the veterinarian as well as there is a valid valid veterinary client patient relationship intact me I've I've done work for that that family before the technician to be on the trucking could yes could utilize those drugs. The second is is drug diversion you lose a little bit to people break in the to the Clinics now with the. But to a lot of people would never guess that of the even patients who take care and patient shrug but it's real issue yes Senator Wallace you have questions. I'm gonna make sure I understand in thank you for being here to the doctor. I understand he is with the amendment that they're giving away. Their ability to prescribe this. Is all these messes here they're not going to prescribe those correct. Okay in the point you're making thank goodness it legally they couldn't have to a begin with if I had wanted to. Under federal law. Thank you. Only any other questions from committee I will go back Page two. Section twenty which is in line five if you get to. We're in some of the other places we eliminated some of the description of what they could could not do with this this paragraph still in there and it states that the the the specialized in new technology means described what it means they can perform all the aspects of medical care. I mean is that. Page two what have. The Page two. Section twenty the whole section beginning on line five. we we deleted father in along the bill what we we we have deleted that and it's still states that vendors technology means the performance of all aspects of medical care for stagnant Prague gnosis ministration plus scribe drugs. The medication treatment of mental patient under the direct supervision direct or immediate supervision which we always say that the collaborating veterinarian we we lease so that language later on what we have deleted their we would that main in your eyes that of. We will have you go in this the and I'm not trying to well I'm hi this is I just want to point out the tense the tense of the word we're says prescribed Edie. I'm yeah hello anybody anybody but yeah our father owner talk about not doing it dominant surgery and other things will be leaders there but. Is is is and I'm not saying this is intentional law what is still the process is camouflaged in this paragraph understood understood and I'm I'm not the best English I just wanna make sure there but I'm I'm I'm not saying intentionally but unintentionally we have an unintentional consequence right there that we agree to delete it later in the bill what we've built listed in the bill would add as a vendor would if you had a technology out there would you agree or disagree that. They would have the ability to. So Sir Colbert I make an assumption about someone else's one towards me but I would assume that part of that paragraph probably should have been deleted as well but that's well as you will bring other witnesses okay any other Senator Davis please yes I mean when I read it says the administration of appliances and prescribe drugs drugs that are prescribed by the veterinarian right that's I think that's the point he was trying to make not that they're prescribing noted on here here's what I at the end line one issue is the performance of all aspects of medical care. Is what I'm getting at and it diagnosed later in the bill we eliminated some of that but this right here. Include all of what we have eliminated we we give it will be in a bill later on but but right here the performance of all aspects of medical care. Service dog or prognosis and. The bill the. What good does that mean I can do major problems or group the off that language is what I'm asking at chairman Lloyd well it says and I would say no because that's not allowed in the bill anywhere and then the second thing I point out is the end of the paragraph says and under the immediate supervision. And direct indirect and immediate supervision of a collaborating veterinarian so that's got to be with in that context of their collaborative that collaborative agreement that of that has to choose to enter into so it's an agreement that they would come to but that doesn't there's nowhere else in the bill that gives them that authority I think it's just explaining and what can be done within the collaborative agreement that we've taken the surgeries and and the major surgery and all that kind of stuff out. Okay rejection to provide you Sir. Okay to speak for the bill is Cody Joe. To. There's somebody's water I think I may be so soon Senator loves water. Okay next rolling code is it to put. Okay please introduce yourself for the record and you're recognized. Our system. Good morning my name is created to but I am not qualified like all these other people about thirty year pre vet veterinary student at university of Arkansas at Monticello and the President of the pre vet club at on campus a member of the radio team never raised in own animals all my life growing up with. Animals. One of the battles I knew the importance of tools to enhance the communication and productivity between former an animal these goals can include a follow our mayors to know when the Maersk falling growth stimulants and has to produce better cattle vaccines and medications to protect the health of the animal or. A better facilities for the safety of human and animal. so similar is like using a printer instead of having to write it on paper is just a convenience but it's also. Procope increases productivity. One specific tool that comes to mind personally from riding horses is first birds are very controversial to many some argue that their animal cruelty or are not beneficial to the rider in some cases this is true what about one a when they're properly utilized. Sports bars are told they do not magically fix the wars they don't make the course faster better athletes they don't replace the seal of the writer they enhance the skills and knowledge and become an extension of the right. Spurs are used to reach the horse in ways that other or otherwise unreachable they're there to better utilize the ability that the horse has. In the same way veterinary technician specialist or a tool our tools veterinarians they're not there to replace their there to be an extension of the veterinarian this bill will not be harmful to veterinarians from my understanding or there could or careers up. From what I read in the bill and I know it's been revised but whenever I read it was section one eighteen I think it was number forty but it states a collaborative practice agreement means a written plan that identifies a veterinarian and a veterinary technician specialist who agrees to collaborate together this is it does not state a practice agreement or veterinary technician or place the veterinarian and that's talk about later. it is extending the rates and availability of veterinarians by using veterinary specialist who are more than qualified with the knowledge and ability to collaborate with veterinarians for the benefit of patient health care. So just going back like I'm like I said I'm not qualified I'm speaking from a pre vet prospective I've grown up with forces we've had many instances I remember whenever I was ten years old I had hold a horse one long shot it because that that was gonna be two or three hours. And he broke his leg so I mean it was unethical to let him wait and set prevent come out. and I think this bill would allow it warrant leeway to provide the ethical. Yes the horse desired another example is recently. We live about two hours the close is veterinarian to us large animal that is two hours away and I horse that our friend had a horse that jumped the fence and like cut herself all up. And it was closer that for them to drive three hours to Louisiana or the vet that was due as close at it it would be eight hours before he got off work and could come to their house and say the eight hours difference versus the three hours of driving to Louisiana. I think just overall that's what I was trying to express through this is. These it takes can be a tool. To get an answer for the health and safety of the animals and that's pretty much it I can try to answer questions but like I said I'm not calling. The Committee you have questions. Related well you to Waterford the rest of your revenue Mike there you look you think we have thank you for coming create your testimony. Okay I'll of again for to the vets to allow their next because. Hello my name drug Connor I'm a veterinarian of thirty four years. I've been a mixed animal practice that the whole time I'm from Mountain Home Arkansas. Greetings from the front line. I've heard a lot of people speculate about what's going on in Arkansas on what we do. I'll try to set it straight I employee nine veterinarians five for full time or part time employees eleven veterinary technicians and assistance of value technicians I'm going to interview three to four veterinary. Technical assistance they graduate from Mississippi State University this this spring. This would have been a timely bill about ten years ago it was hard to get of that ten years ago. When you get an applicant they wouldn't see emergencies they wouldn't work weekends or holidays. I didn't want to do any large animal we're basically competing in a corporate world if you will for the the big money was the corporate clinics in the cities. All those that Scott balled up in north Arkansas in little rock Mountain Home. Jonesborough working kind of those because your jobs for more money. The veterinarian and she saw a problem with that and they changed a little bit. Five years ago like I said I can hardly get an applicant even to to try to hire anyone. And I'll tell you this that this last year in the last twelve months I have hired twelve excuse me for mixed animal veterinarians for. I passed on at least three more. The vet schools have changed their criteria for for some of these students entering that school. They're accepting kids from rural backgrounds next animal homes. They're now cranking out a different product than they were five years ago. Another little thing that's of interest because you know I heard about the big crisis that we're in the middle of we're in a crisis well I mean I've seen worse times thirty four years we have a crisis ten years ago we had bad times five years ago we're almost to a solution right now. Now. The interesting thing about that is to that these veterinary schools by the way are setting up extra clinical practices I missed many CP practice from Mississippi State University is that school. We have over sixty kids sixty not kids sixty almost graduates coming through our program from university Missouri Kansas state Oklahoma state LSU Mississippi state. These are third and fourth year graduates and what they're trying to do is get as many skills as they can and mixed animal practice because they want to go back to a rule setting and they want to go to work. That's sixty and that's within two years some hearing about all these plans to fix a problem this big big problem that we have that or going to if you implemented this today you're talking about nearly seven years before the cavalry comes right over the hill and I'm trying to tell you three years ago my testimony would been very different. Is looking a lot different now. Another thing I tell you this what's the next four years looking like. LSU mama motor went from ninety per class to one twenty per class now they're going to let two hundred and twenty kids per class in. Lang colleges setting up the veterinary school in Little Rock a issue Jonesborough every veterinary college is increasing their enrollment and by the way they're increasing their admittance by these farm kids I'm very very active in our vet tech pro excuse me in our FFA vet science team for H. all of these farm kids all these real kids we have a huge supply these kids come along. They're getting ready to go to work things are going to change and they're going to change a lot quicker than you're going to change. By the way my veterinary technicians I've heard three ID your vet tech school I don't have any hate affair with any veterinary technician I'd love to hire more CVT we've got kids taking courses to become our tease we utilize them I say kids check I've got a registered that technician that used to run the university of Missouri's that school technician program. skilled I got a lot of value they help us out. I'm never been adversarial anything like this now I have a problem with the bill. I think that bills a mile wide or gray and it's got more holes in it than a volleyball net. Thanks that the prescription thing being dropped was a very good thing that really was was a big problem but words like indirect and direct supervision of a vet. I think about this I can be on the beach in Florida and I can indirectly supervise my tax. Sure can I have to have a an existing veterinary clinic I got a couple. Between me and eight other veterinarians what we could have three apiece and each one could own their own clinic and the reason I'm saying this is not because I mean I'm up there doing my own thing trying to take care of my clients right. But there's another side of eternity Medicine you guys haven't even thought about heard about possibly next corporate veterinary. In the corporate world is heavy into veterinary clinics they own over a hundred I think now the state of Arkansas maybe more. Now you open the box to a bunch of business people thirty seconds are you open the door to a bunch of business people to hire these veterinary technologists BTS's. But you don't pay them. They're gonna get taken advantage of. So I'm telling you there's a crop of mixed animal practice veterinarians coming right now I've heard a bunch of I got more coming for you. We're fixing your problem with fix it quick. And now there's getting ready in the next five years to be a glut of those veterinarians so before you sound the alarm and get all worried about you know what all is common. My Senator Scott Flippo said let the market fix itself that's what's about to happen. Markets dictating the product. You're going to pass a law is very specific to a few to the detriment of committee to solve a crisis that pretty much to solving itself. So. Think about that thanks to questions from the committee. We're in love you are sure to love you. You know I'd love for anybody to ask me questions. Nothing. I've heard a bunch of people speak permitted you sound disappointed hi this point I've heard a lot of stuff discussed well when I went to the state that meeting just to see colleagues and see what they think and why would they be for something or why would be they be against something it wasn't fifty fifty it's easily ninety to ten some of its misunderstandings right Sir Love Me a question certain during my code or. So I guess I'm trying to figure this out because he said that you're producing more veterinarians where these veterinarians located. Well then located in Little Rock I think located in northwest Arkansas then located in the Delta where army well it would be good to have a heat map sensor should win yeah so and then you know let the market shake itself out right we lost a local veterinarian to Camden Arkansas. I'm told nobody wants to live in Camden no one wants to right being candid shoot now she moved down there because it's a better job I want to live in came in this for a from exactly by the way the record I'm happy by the way Bradley County boy right here and I'm telling you Crossett Dr scarlet white she's a classmate of mine she's gonna get help if you need to I promise it is coming Spring Hill let's see I saw somebody no I think that was representative Vaught you know from down there in Southeast Arkansas South whiskies me Spring Hill we have a kid that's in fourth year at Oklahoma state university wants to make several practice and he's coming back to Arkansas well most of these kids are coming to Arkansas. Love you get your questions answered is it I mean I can I can give you the specific names and places and where they're going or I say where they say they would like to go. And everybody's hiring but the nice thing the good news is there's a crop of people coming soon and way more later I'm a little more worried for the profession in five years again when LSU's kicking out two hundred twenty nine College graduates the first class in Arkansas state Jonesboro kicked out of class time to this or if you okay the Committee I will let you all assignments will call we can do one of two things we can you just won't we call for immediate consideration someone will do that I'm not suggesting that the others to if you wanna hear more testimony we can reach this I've got a twelve fifteen meeting I can be back at it the upon Germany we want one that could be back upon adjournment of the the Senate so I'm not pollution I have no agenda but other than a I have to keep a twelve fifteen. And now it shows you should wash your call for the. Mr non debatable motion all in favor of that say aye. All opposed say no. Okay the minute me consideration so we're going to vote on house bill of eleven eighty two is amended all in favor the bill say aye All opposed nay no. The Bill pass is. Created by come for those who don't understand immediate consideration I will explain that committee consideration is non debatable and it did call for the of the debate on the bill to stop immediately and so it pass that's what we do.