wa-law.org > bill > 2025-26 > HB 2247 > Original Bill

HB 2247 - Concerning veterinarian-client-patient relationships.

Source

Section 1

  1. A veterinarian-client-patient relationship is the basis for interaction between veterinarians and their clients and patients. A veterinarian-client-patient relationship exists when all of the following conditions have been met:

    1. The veterinarian has assumed responsibility for making clinical judgments regarding the health of the animal and need for medical treatment, and the client has agreed to follow the instructions of the veterinarian;

    2. The veterinarian has sufficient knowledge of the animal to initiate, at a minimum, a general or preliminary diagnosis of the medical conditions of the animal. To establish this knowledge, the veterinarian must:

      1. Have physically examined the animal within the last year, or sooner if medically appropriate. In cases where a veterinarian cannot physically examine the animal, such knowledge may be established using telehealth when:

(A) The animal cannot access clinical veterinary care due to substantial challenges including, but not limited to, substantial transportation challenges for the client or animal or the unavailability of in-person appointments for a significant amount of time; or

(B) The animal has an urgent condition that could result in suffering, and it is not medically reasonable for the veterinarian or client to delay care;

    ii. In cases involving operations with several animals, such as encountered at farms, laboratories, or in shelters, be personally acquainted with the keeping and care of the animals by virtue of an examination of the animals or by medically appropriate and timely visits to the premises where the animals are kept; and

c. The veterinarian is readily available for follow-up evaluation or has arranged for emergency coverage and continuing care and treatment.

  1. Once a veterinarian-client-patient relationship has been established, ongoing care may be provided via telemedicine; however, it is the responsibility of the examining veterinarian to determine if an additional physical examination is medically appropriate based on available information regardless of when the last physical examination was performed.

  2. Once a veterinarian-client-patient relationship has been established, the relationship extends to all veterinarians employed or practicing at the same premises or same mobile practice entity as the veterinarian who established the most current veterinarian-client-patient relationship. The veterinarian-client-patient relationship may not be extended to other veterinarians based solely on the accessibility of the medical records.

  3. In the absence of an established veterinarian-client-patient relationship, allowable telehealth services are limited to the following:

    1. Teleadvice;

    2. Teletriage in an emergency situation. A licensed veterinarian who in good faith engages in the practice of veterinary medicine by rendering or attempting to render emergency care to a patient when a client cannot be identified, or where a veterinarian-client-patient relationship is not established, is not subject to discipline based solely on the veterinarian's inability to establish a veterinarian-client-patient relationship;

    3. Telemedicine for the purpose of prescribing sedation, other than a controlled substance, prior to an in-person visit, to facilitate transportation to, examination by, or treatment by a veterinarian, or as provided in subsection (5)(e) of this section;

    4. Dispensing drugs prescribed by another veterinarian licensed under this chapter, if:

      1. Failure to dispense the drug could interrupt a therapeutic regimen or cause a patient to suffer; and

      2. The prescribing veterinarian has ascertained information necessary to fill the requested prescription; and

    5. Poison control services.

  4. A veterinarian providing care for animal patients under the telehealth exceptions for subsection (1)(b)(i) of this section:

    1. May deny treatment because in their medical opinion a physical examination is necessary to adequately diagnose, prognose, and prescribe adequate care for the patient;

    2. Must be licensed as a veterinarian in the state of Washington;

    3. Must, to the extent practicable, have or establish an association with practices that are registered in the state of Washington to which the patient can be referred for an in-person examination;

    4. Must notify the client that prescription drugs or medications may be available at a pharmacy and, if requested, the veterinarian must submit a prescription to a pharmacy that the client chooses;

    5. Must provide the client with the veterinarian's identity and clinic address; and

    6. Must encourage the owner of the animal or the qualified individual to schedule an in-person follow-up examination of the animal to occur not later than 90 days after the date of the examination through telehealth if the veterinarian, the owner of the animal, or the qualified individual has concerns about the animal's health that cannot be addressed through telehealth.

  5. Once a veterinarian-client-patient relationship has been established, all forms of telehealth may be used at the discretion of the veterinarian.

  6. The veterinarian-client-patient relationship may be terminated under the following conditions:

    1. The termination does not constitute patient abandonment as described in board rules;

    2. If there is an ongoing medical or surgical condition, the client is offered a patient referral at the time of termination to another veterinarian for diagnosis, care, and treatment; or

    3. Clients may terminate the veterinarian-client-patient relationship at any time.

  7. For animals or animal products for food consumption:

    1. There must be a written agreement with the client that identifies the farm veterinarian of record who is accountable for drug use and treatments administered to the animals on the farm operation;

    2. The veterinarian of record is the responsible party for providing appropriate oversight of drug use on the farm operation. Oversight includes establishment of diagnostic and treatment protocols, training of personnel, review of treatment records, monitoring drug inventories, assuring appropriate labeling of drugs, and monitoring compliance and outcomes. Veterinary oversight of drug use must include all drugs used on the farm regardless of the distribution of the drugs to the farm;

    3. Provision of drugs or drug prescriptions must be for specific time frames appropriate to the scope and type of operation involved and only for the management groups within the operation that the veterinarian of record has direct involvement and oversight;

    4. A veterinarian issuing a veterinary feed directive must comply with applicable federal laws and regulations, including 21 C.F.R. 558.6.

  8. Medical records must be maintained pursuant to board rules.

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    1. A veterinarian may use or prescribe drugs only within the context of a veterinarian-client-patient relationship except as outlined in subsection (4) of this section. Veterinary prescription drugs are restricted by federal law, under 21 U.S.C. Sec. 353(f), and may only be used by or on the order of a licensed veterinarian.

    2. Extra label use may be allowed only when ordered by a veterinarian and within the context of a veterinarian-client-patient relationship.

    3. A veterinarian providing care through telehealth may not prescribe a drug to the animal patient for a period longer than three months from the date of issuing a prescription unless a veterinarian has examined the animal patient in person. The veterinarian may not issue another prescription to the animal patient for the same drug unless they have conducted another examination of the animal patient, either in person or using telehealth.

    4. A veterinarian providing care through telehealth may not prescribe an antimicrobial drug to the animal patient for a period longer than 21 days of treatment. The veterinarian may not issue any further antimicrobial drug prescription, including a refill, to treat the condition of the animal patient unless the veterinarian has conducted an in-person examination of the animal patient.

  10. A veterinarian providing care for patients using telehealth shall inform the client about the use and potential limitations of telehealth and obtain consent from the client to use telehealth, including acknowledgment of all of the following:

    1. The same standards of care apply to veterinary medicine services via telehealth and in-person veterinary medical services;

    2. The client has the option to choose an in-person visit from a veterinarian at any time; and

    3. The client has been advised how to receive follow-up care or assistance in the event of failure to respond or declining clinical condition; or of an adverse reaction to the treatment; or in the event of an inability to communicate resulting from technological or equipment failure or failure to be able to reconnect for a follow-up conversation.

  11. A veterinarian who practices veterinary medicine through telehealth must do all of the following:

    1. Certify with the board of at least 14 days a year of practice in a clinic setting with hands-on animal experience unless telehealth medicine is less than 90 percent of the veterinarian's annual practice in Washington, unless the veterinarian has over 20 years of practicing veterinary experience. The board may exempt individual veterinarians otherwise precluded from in-person practice from the requirements of this subsection;

    2. Ensure that the technology, method, and equipment used to provide veterinary medicine services through telehealth complies with all current applicable privacy protection laws;

    3. Have historical knowledge of the animal patient by obtaining, if available, and reviewing the animal patient's relevant medical history, and, if available, medical records including any diagnostic data. If medical records exist from a previous in-person visit and are in possession of the client, the client may transmit those records, including any diagnostic data contained therein, to the veterinarian electronically;

    4. Employ sound professional judgment to determine whether using telehealth is an appropriate alternative method from in-person evaluation for delivering medical advice or treatment to the animal patient and providing quality of care consistent with prevailing veterinary medical practice;

    5. As required by subsection (5)(c) of this section, be familiar with available medical resources, including emergency resources near the animal patient's location, be able to provide the client with a list of nearby veterinarians who may be able to see the animal patient in person upon the request of the client, and keep, maintain, and make available a summary of the animal patient record, as specified in board rules;

    6. Provide the client with the veterinarian's name, contact information, and license number that has undertaken the telehealth appointment;

    7. Secure an alternative means of contacting the client if the electronic means is interrupted; and

    8. Not claim to be a specialist unless the veterinarian is certified in such specialty by a board recognized by the American veterinary medical association.

  12. A veterinarian may use telehealth without establishing a veterinarian-client-patient relationship in order to provide teleadvice to another licensed veterinarian or in an emergency situation as long as the client is clearly instructed as soon as possible to have their animal patient evaluated in person by a licensed veterinarian.

Section 2

The definitions in this section apply throughout this chapter unless the context clearly requires otherwise.

  1. "Animal patient" means any animal under the care and treatment of a veterinarian.

  2. "Board" means the Washington state veterinary board of governors.

  3. "Client" means the animal patient's owner, owner's agent, or other person presenting the animal patient for care.

  4. "Department" means the department of health.

  5. "Secretary" means the secretary of the department of health.

  6. "Teleadvice" means the provision of any health information, opinion, guidance, or recommendation concerning prudent future actions that are not specific to a particular animal patient's health, illness, or injury.

  7. "Telehealth" means the overarching term that encompasses all uses of technology geared to remotely deliver health information or education. Telehealth encompasses a broad variety of technologies and tactics to deliver virtual medical, health, and education services. Telehealth is not a specific service, but a collection of tools which allow veterinarians to enhance care and education delivery. Telehealth encompasses teleadvice, telemedicine, and teletriage.

  8. "Veterinary medication clerk" means a person who has satisfactorily completed a board-approved training program developed in consultation with the pharmacy quality assurance commission and designed to prepare persons to perform certain nondiscretionary functions defined by the board and used in the dispensing of legend and nonlegend drugs (except controlled substances as defined in or under chapter 69.50 RCW) associated with the practice of veterinary medicine.

  9. "Veterinary technician" means a person who is licensed by the board upon meeting the requirements of RCW 18.92.128.

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