Title 201 | Chapter 016 | Regulation 702REG


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BOARDS AND COMMISSIONS
Board of Veterinary Examiners
(Amended After Comments)

201 KAR 16:702.Standards for veterinary surgery.

Section 1.

Definitions.

(1)

"Animal" has the same meaning as KRS 321.181(5).

(2)

"Large animal" includes bovids, camelids, cervids, equids, swine, or other animals ordinarily raised or used on a farm.

(3)

"Patient" has the same meaning as KRS 321.181(47).

(4)

"Professional arrangements" means that the veterinary facility where surgery takes place or the veterinarian who performed surgery shall not list another veterinary facility as able to provide services to a client unless they have previously confirmed that the alternate veterinary facility is available to provide services. This does not need to be done on a case-by-case basis but may be professionally arranged in advance for all clients.

(5)

"Small animal" includes any animal not within the definition of large animal, and regardless of weight includes avians, canids, felines, rabbits, pocket pets, and other animals typically kept as companion animals.

Section 2.

All veterinary surgeriesmedical procedures performed in the Commonwealth shall comply with the following basic surgical standards.

(1)

If patientsanimals are housed or retained for treatment in a veterinary facility:

(a)

Appropriate housing shall be provided for each patientanimal before and after surgery; and

(b)

Enclosures shall be secure and provide a flat surface for the patientanimal that is clean, dry, and warm with adequate space for the patientanimal to turn around, while allowing for safety at various stages of sedation and anesthesia and sufficient visibility by the staff.

(2)

All drugs and biologicals shall be labeled in accordance with 201 KAR 16:600, and procured, managed, and disposed ofmaintained, administered, dispensed, and prescribed in compliance with state and federal laws.

(3)

During the postoperative period, care shall be taken to provide patients with a smooth transition from the anesthetized state.

(4)

Plans shall be in place to handle any emergency that might occur throughout the procedure, and immediately postoperatively while the patient is with the veterinarian or in the veterinary facility.

(5)

Immediately prior to release, patientsPatients shall be evaluated and deemed adequately recovered, stable, mobileambulatory, and within normal physiological parameters following anesthesia. A veterinarian shall use their best professional judgment and medical training to make an appropriate determination about recovery for the specific species and patientimmediately prior to release.

(6)

The client shall be provided clearClear instructions for postoperative care by the client shall be provided to the client both verbally and in writing. For those clients which are provided repeated services, a single instance of written instructions may be provided during the term of the VCPR pursuant to KRS 321.185.

(7)

The client shall be provided options in writingArrangements for follow-up or emergency care during the forty-eight (48) 48-hour period after surgery that includes information for a twenty-four (24) hour emergency veterinary facility or with another veterinary facility where professional arrangements have been made to see clientsshall be provided to the client both verbally and in writing.

(8)

A veterinarian may perform emergency aseptic surgical procedures in another room when the room designated for aseptic surgery is occupied or temporarily unavailable.

Section 3.Section 2.

Additional Requirements for Small Animal PatientsAnimals. All veterinary medical procedures performed on small animals in the Commonwealth shall comply with Section 2Section 1 of this administrative regulation and the following basic surgical standards.

(1)

The operating area shall:

(a)

Be dedicated to surgery while in use for surgical purposes; and

(b)

Contain the necessary equipment for anesthesia, appropriate intubation, administration of oxygen, and monitoring; and

(2)

Establish, maintain, and follow the following protocols:

(a)

Infectious disease protocols to be performed in an environment to minimize infectious disease;

(b)

Aseptic surgical technique protocols;

(c)

Sterile instruments protocols ensuring separate sterile instruments to be used for each patient. Cold sterilization is not considered an appropriate method to adequately sterilize surgical instruments for small animals, except for cold sterilization for endoscopic, laproscopic, and arthroscopic procedures. In these allowable instances of cold sterilization, the method is permitted only by use of FDA-Cleared Liquid Chemical Sterilants and High Level Disinfectantsglutaraldehyde-based products;

(d)

Anesthetic protocols that are balanced and include sedation, the provision of peri-pre- and post-operative analgesia, stress reduction, muscle relaxation, and controlled, complete recovery of consciousness prior to discharge;

(e)

Pre- and post-op monitoring protocols to monitor patients; and

(f)

Thermal support protocols.

Section 4.Section 3.

Responsibility for Patient Care.

(1)

During the forty-eight (48) hour period after surgery, a client shall be provided information in accordance with Section 1(7) of this administrative regulationthe veterinarian who performed the surgery is responsible for patient aftercare and 24/7 emergency management following the surgery.

(2)

If there are no personnel on the premises during any time a patientan animal is left at the veterinary facility:

(a)

Prior notice of this fact shall be given to the client in writing and the notification recorded in the medical records; and

(b)

If requested, the client shall be provided an option to transfer the patient care to a twenty-four (24) hour facility.

(3)

The veterinarian who performed the surgery shall be relieved of this responsibility only when the following conditions are met:

(a)

The veterinarian or veterinary facility has made specific arrangements in writing with another veterinarian to provide emergency care for the surgical patient;

(b)

The client has been informed both verbally and in writing of the transfer of responsibility; and

(c)

The client has been provided current contact information for the new responsible care provider.

Section 5.Section 4.

Large Animal Patient Standards and Exceptions.

(1)

Field surgeries shall be performed within an appropriate environment as possible.

(2)

Appropriate cold sterilization is acceptable in field work.

(3)

During the postoperative period, care shall be taken to provide patients with a smooth transition from the anesthetized state. A veterinarian shall use their best professional judgment and medical training to make an appropriate determination about recovery for the specific species and patient.

(4)

All drugs and biologicals shall be labeled in accordance with 201 KAR 16:600, and procured, managed, and disposed of in compliance with state and federal laws.

(5)

Plans shall be in place to handle any emergency that might occur throughout the procedure, and postoperatively while the patient is with the veterinarian.

(6)

The client shall be provided clear instructions for postoperative care in writing. For those clients which are provided repeated services, a single instance of written instructions may be provided during the term of the VCPR pursuant to KRS 321.185.

(7)

The client shall be provided options in writing for follow-up or emergency care during the forty-eight (48) hour period after surgery that includes information for a 24-hour emergency veterinary facility or professional arrangements with another veterinary facility.Client Notification. Clients, owners, or the designated care provider for the patient shall be informed both verbally and in writing of the following information following surgery.

(1)

Post-operative medical care instructions; and

(2)

24/7 emergency contact information for the forty-eight (48) hour period following surgery.

MICHELLE M. SHANE, Executive Director
For JOHN C. PARK, DVM, Board Chair
APPROVED BY AGENCY: November 13, 2023
FILED WITH LRC: November 13, 2023 at 11:30 a.m.
CONTACT PERSON: Michelle Shane, Executive Director, Kentucky Board of Veterinary Examiners, 107 Corporate Drive, Second Floor, Frankfort, Kentucky 40601, phone (502) 782-0273, fax (502) 695-5887, email michelle.shane@ky.gov.

REGULATORY IMPACT ANALYSIS AND TIERING STATEMENT
Contact Person:
Michelle Shane
(1) Provide a brief summary of:
(a) What this administrative regulation does:
This administrative regulation establishes standards regarding basic requirements for veterinary surgery.
(b) The necessity of this administrative regulation:
This administrative regulation is necessary to establish the standard protocols and procedures for credential holders of the board to perform veterinary surgery on animals.
(c) How this administrative regulation conforms to the content of the authorizing statutes:
KRS 321.235, 321.351, 321.360, 321.990 specifically direct the board enforce the provisions of KRS Chapter 321 and impose penalties, where appropriate. KRS 321.235 authorizes the board promulgate administrative regulations to carry out the provisions of the chapter.
(d) How this administrative regulation currently assists or will assist in the effective administration of the statutes:
This administrative regulation shall assist in effective administration by clearly detailing the basic requirements and standards for veterinary surgery.
(2) If this is an amendment to an existing administrative regulation, provide a brief summary of:
(a) How the amendment will change this existing administrative regulation:
This is a new administrative regulation.
(b) The necessity of the amendment to this administrative regulation:
This is a new administrative regulation.
(c) How the amendment conforms to the content of the authorizing statutes:
This is a new administrative regulation.
(d) How the amendment will assist in the effective administration of the statutes:
This is a new administrative regulation.
(3) List the type and number of individuals, businesses, organizations, or state and local governments affected by this administrative regulation:
2,690 veterinarians and 590 licensed veterinary technicians, and future applicants.
(4) Provide an analysis of how the entities identified in question (3) will be impacted by either the implementation of this administrative regulation, if new, or by the change, if it is an amendment, including:
(a) List the actions that each of the regulated entities identified in question (3) will have to take to comply with this administrative regulation or amendment:
All licensees identified in question (3) are required to have and maintain minimum equipment and supplies to safely and humanely conduct animal surgery. This new administrative regulation establishes the requirements for veterinary surgery, ensuring transparency of board expectations and standardizing veterinary surgery in order to assist in patient care and welfare.
(b) In complying with this administrative regulation or amendment, how much will it cost each of the entities identified in question (3):
There shall be no additional costs imposed as a result of this administrative regulation unless a licensee does not have appropriate equipment and supplies on hand for the services offered.
(c) As a result of compliance, what benefits will accrue to the entities identified in question (3):
Administrative ease of clear communications of the approved requirements.
(5) Provide an estimate of how much it will cost the administrative body to implement this administrative regulation:
(a) Initially:
No costs are anticipated.
(b) On a continuing basis:
No costs are anticipated.
(6) What is the source of the funding to be used for the implementation and enforcement of this administrative regulation:
This administrative regulation does not establish fees. Funding for the KBVE comes from licensure and certification fees.
(7) Provide an assessment of whether an increase in fees or funding will be necessary to implement this administrative regulation, if new, or by the change if it is an amendment:
There is no anticipation of an increase in fees or needed funding to implement this administrative regulation, as the regulation establishes standards for veterinary surgery performed by licensees of the board.
(8) State whether or not this administrative regulation establishes any fees or directly or indirectly increases any fees:
No fees are established or increased by this administrative regulation.
(9) TIERING: Is tiering applied?
No. All regulated entities have the same requirements.

FISCAL NOTE
(1) What units, parts, or divisions of state or local government (including cities, counties, fire departments, or school districts) will be impacted by this administrative regulation?
The Kentucky Board of Veterinary Examiners.
(2) Identify each state or federal statute or federal regulation that requires or authorizes the action taken by the administrative regulation.
KRS 321.235, 321.351, 321.360, 321.990.
(3) Estimate the effect of this administrative regulation on the expenditures and revenues of a state or local government agency (including cities, counties, fire departments, or school districts) for the first full year the administrative regulation is to be in effect.
(a) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for the first year?
No revenue will be generated from this filing.
(b) How much revenue will this administrative regulation generate for the state or local government (including cities, counties, fire departments, or school districts) for subsequent years?
No revenue will be generated from this filing.
(c) How much will it cost to administer this program for the first year?
This is not an agency program. This regulation establishes requirements for licensees of the board.
(d) How much will it cost to administer this program for subsequent years?
This is not an agency program. Costs will be very minimal.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Revenues (+/-):
None.
Expenditures (+/-):
None or negligible.
Other Explanation:
n/a
(4) Estimate the effect of this administrative regulation on the expenditures and cost savings of regulated entities for the first full year the administrative regulation is to be in effect.
(a) How much cost savings will this administrative regulation generate for the regulated entities for the first year?
There will be no cost savings; this amendment simply codifies the requirements for veterinary surgery standards, making them easily accessible for regulated entities and the public.
(b) How much cost savings will this administrative regulation generate for the regulated entities for subsequent years?
There will be no cost savings.
(c) How much will it cost the regulated entities for the first year?
There will be no additional costs involved.
(d) How much will it cost the regulated entities for subsequent years?
There will be no additional costs involved.
Note: If specific dollar estimates cannot be determined, provide a brief narrative to explain the fiscal impact of the administrative regulation.
Cost Savings (+/-):
None.
Expenditures (+/-):
None or negligible.
Other Explanation:
n/a
(5) Explain whether this administrative regulation will have a major economic impact, as defined below.
"Major economic impact" means an overall negative or adverse economic impact from an administrative regulation of five hundred thousand dollars ($500,000) or more on state or local government or regulated entities, in aggregate, as determined by the promulgating administrative bodies. [KRS 13A.010(13)] This amendment shall not have a “major economic impact”, as defined in KRS 13A.010(13).

7-Year Expiration: 7/24/2030

Last Updated: 11/20/2023


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