Informal Guidance on Chapter 487
Veterinary Technician and Veterinary Assistant Duties
The State Board of Veterinary Medical Examiners (SBVME or Board) has received numerous inquiries regarding the implementation of Chapter 487 of the Laws of Maryland 2024 (HB 1097), which was introduced and passed by the Maryland General Assembly during the 2024 legislative session and signed by Governor Wes Moore on May 9th, 2024. In addition to inquiries, we have received a great deal of feedback regarding the bill’s contents and expressions of concern about how this legislation will impact the day to day operations of veterinary practices.
The Maryland legislative session generally occurs between January and early April each year. During this time, bills may be introduced, debated, amended, and voted upon that impact the practice of veterinary medicine. In many instances, these bills do not originate with the SBVME, but have been developed and introduced by delegates or senators addressing concerns raised by their constituents. We urge all veterinarians, veterinary technicians, veterinary assistants, and veterinary practice owners to stay informed about legislative activity and participate in the process so that our elected representatives are fully informed about issues that may impact the profession. Membership and participation with the Maryland Veterinary Medical Association (MDVMA) is a great way to stay involved and informed about issues that may impact your practice. Additionally, you may wish to be involved by providing testimony on bills during the legislative session.
This bill, Chapter 487, was not introduced or sponsored by the SBVME. However, we had the opportunity to provide feedback regarding its contents after its introduction. The bill addresses the role of registered veterinary technicians (RVTs or veterinary technicians) as well as non-credentialed staff (veterinary assistants) at veterinary practices and outlines certain health care tasks that may be performed by these professionals under various levels of supervision. The law takes effect on October 1, 2024.
Before addressing the substance of the bill, the Board would like to acknowledge the significant contributions that RVTs and veterinary assistants provide to veterinarians, veterinary practices, and the patients and clients they serve. It is the Board’s understanding that HB1097 was introduced to provide clarity and consistency regarding the tasks that RVTs may perform under various levels of supervision and to improve the quality and accessibility of care in Maryland. The bill sponsor noted concerns that RVTs have been “underutilized and advanced training . . . disincentivized due to a lack of clarity and consistency with regard to their duties.” Accordingly, Chapter 487 provides a framework of healthcare related tasks that were often in question in terms of what staff could perform them and what level of supervision was required.
Chapter 487 amends and adds to the definitions section of the veterinary practice act to provide for three levels of veterinary supervision of non-veterinarian employees. These include “immediate supervision,” “direct supervision,” and “indirect supervision.” The bill then amends the existing definition of “veterinary technician” and adds a new definition for “veterinary assistant,” defining “veterinary assistant” to mean “. . . a person who: (1) Aids a veterinarian or veterinary technician in patient care; and (2) Is not registered with the Board as a veterinary technician.”
A new § 2-309.1(a) of the Practice Act lists certain healthcare tasks that a veterinary assistant may perform under the direct supervision of a veterinary practitioner or an RVT under the direct supervision of a veterinary practitioner. This expresses statutory authorization and acknowledgement of the role RVTs can play in overseeing veterinary assistants in performing their duties.
While the statute provides a catchall in § 2-309.1, which allows the SBVME to specify other acceptable tasks for veterinary assistants by regulation, we do not interpret the legislation to be an exhaustive list of the tasks veterinary assistants may perform. The Practice Act still provides that any employee of a veterinary practitioner does not run afoul of the Act “. . . when administering medication or rendering auxiliary or supporting assistance under the responsible direct supervision of a licensed and registered veterinarian.” See Agric. § 2-301(g)(7). In regulations, the SBVME has defined “responsible direct supervision” to mean “competent, immediate, and active supervision.” See COMAR 15.14.01.17A(2).
The statute also authorizes a veterinary assistant to set up and monitor anesthesia while under the immediate supervision of a veterinary practitioner or veterinary technician. See Agric. § 2-309.1(b).
Section 2-309.1(c) sets forth tasks a veterinary technician may perform under the direct supervision of a veterinary practitioner.
In addition, § 2-309(d) authorizes veterinary technicians under indirect supervision of a veterinary practitioner to perform all of the tasks listed in the statute veterinary assistants may perform under direct supervision. This means that under appropriate circumstances, at the discretion of the supervising veterinary practitioner, veterinary technicians may do things like taking radiographs, performing nail trims, administering medications, collecting blood, urine, and fecal samples, etc., even if the supervising veterinary practitioner is not in the building. However, as with any other health care task, the supervising veterinary practitioner ultimately is responsible for ensuring that the veterinary technician to whom a task is delegated is trained, qualified, and acting according to established directions, procedures, or protocols in providing the services.
We have received feedback from many veterinary practitioners and hospitals indicating that their veterinary assistants routinely perform tasks like administering non-rabies vaccines. We interpret the statute as allowing a veterinary practitioner to authorize a properly trained and qualified veterinary assistant to administer non-rabies vaccines, as long as a veterinary practitioner is providing responsible supervision and has recently examined the patient, determined that there are no medical conditions that would make vaccine administration contraindicated, and would be readily available to step in to assist in the event of an adverse reaction. The same is true for RVTs. In addition, all staff, whether RVTs or veterinary assistants, should assess and record the patient's vital signs (temperature, pulse, and respiration), and take a patient history which includes any current or new symptoms the patient is exhibiting before administering a vaccine. Staff should be trained to consult with the supervising veterinary practitioner who must be on site if the patient's presentation raises questions about whether the vaccine should be administered or if an adverse reaction occurs.
While the statutory list of permissible tasks veterinary assistants may perform under direct or immediate supervision is not exhaustive, the Board cautions that the scope of a veterinary technician’s practice when a veterinarian is not on-site should be limited to ensure patient safety.
We also received feedback and questions about having veterinary assistants involved in performing CPR. The statute authorizes veterinary technicians to perform basic life support in CPR under direct supervision, and, under emergency circumstances, provides that veterinary technicians may initiate life support care, including basic and advanced CPR, before a veterinary practitioner has examined an animal. See Agric. § 2-309(d). The Board does not believe that the General Assembly intended to prohibit veterinary assistants from assisting with CPR while being supervised by a veterinary practitioner in the room.
Overall, we are aware of and understand the uncertainty surrounding this legislation and the concern that it will require significant changes in staffing and delegation of tasks in veterinary practices that do not have many (or any) veterinary technicians employed there. When it comes to tasks not listed for veterinary assistants, we urge supervising veterinary practitioners to use good judgment in delegating tasks to be performed by trained staff under direct or immediate supervision. In the upcoming months, the SBVME will be working to draft and adopt regulations to implement the statute.
To date, the Board has not had to take formal action against a veterinary practitioner regarding tasks delegated to staff members. We attribute this to the effective management and assessment of veterinary staff by the supervising veterinarians in hospitals and practices in Maryland. In all cases, whether tasks are performed by veterinary technicians or veterinary assistants, the supervising veterinarian is ultimately responsible for the care provided to the patients and ensuring that their staff are trained to perform delegated tasks. Staff qualification and training may involve formal educational background, past experience, or on the job training.
The Board acknowledges that this legislation has an effective date that does not allow sufficient time for experienced veterinary assistants to complete the educational component required for licensure. Once this legislation takes effect, the Board will continue to rely on the expertise and professional judgment of veterinarians to effectively manage and supervise their staff. If the Board receives a complaint involving a health care task performed by a veterinary technician or veterinary assistant, the supervising veterinary practitioner should be able to provide details of the experience and skill possessed by the staff member to justify the tasks and duties that they have been assigned.
As always, only veterinary practitioners may make a diagnosis or prognosis, prescribe any treatment, drugs, medications, or appliances, or perform surgery. See Agric. § 2-309.1(e). In addition, any person performing tasks as a veterinary technician or veterinary assistant must be employed by a veterinary practitioner or a facility overseen by a veterinary practitioner.
As we move into the future, and the professional scope of RVTs continues to grow in Maryland, nationally, and globally, we hope that veterinary practitioners will encourage their veterinary assistants to expand their professional development and take the next step in their professional careers by pursuing veterinary technician programs, or degrees and experience to become RVTs. The Board’s regulations provide for two pathways for becoming an RVT. One begins with graduation from a veterinary technology program accredited by the AVMA. The second pathway requires an associate’s degree or above and certain coursework, plus 10,000 hours of work experience.
We have also received questions about the use of titles and title protection. Current law, which has not been changed under Chapter 487, provides that a person may not “[a]dvertise as a Board registered veterinary technician unless registered with the Board as required by this subtitle.” See Agric. § 2-313(a)(2)(vii). When the new law, including the added definition of “veterinary assistant” takes effect, practices should begin using the appropriate statutory terms when referring to their staff to provide clarity on employee credentials when interacting with the public and the allied professions. Practice advertising, including websites, should accurately identify the staff title so as not to mislead the public. Staff who are credentialed as veterinary technicians in jurisdictions other than Maryland (including L.V.T.s and C.V.T.s) but who are not registered as veterinary technicians in Maryland should use the title “veterinary assistant” but may also indicate the credentials they hold in the other jurisdictions as long as the jurisdiction is indicated (e.g. LVT - Delaware only).
Changes to or more consistent use of staff titles to reflect the new definitions should not be interpreted to diminish or disparage the valuable contributions made by veterinary assistants in ensuring the health and well-being of animals. The Board recognizes that many veterinary assistants have years or even decades of experience that make them highly qualified to perform appropriate health care tasks under veterinary supervision.
The attached chart provides examples of appropriate credentialing and levels of supervision that would be considered acceptable by the Board. At this time, this chart is not an exhaustive list of tasks and appropriate levels of supervision. Veterinarians must use appropriate discretion to ensure that quality care is provided and should be prepared to justify their decisions when tasks are assigned that may deviate from the levels of supervision provided in the attachment. Emergency hospitals that intend to utilize veterinary technicians for euthanasia should consider having their veterinary technicians take a humane euthanasia by injection course. COMAR 15.14.04.09 provides a list of Board-approved euthanasia courses that may be considered. These courses may also be used for an RVT’s tri-annual continuing education requirements.
Example Tasks for Hospital Staff - Guidance Document - PDF.