A lawmaker asking a bill sponsor if she’s willing to cancel an amendment to save her bill, a lobbyist mispronouncing a customer’s last name, and a mysterious nongovernmental corporation trying to make a selfish change in Attacking sounds like the beginning of a particular Carson City nightmare.
However, that same situation happened for MP Shannon Bilbray-Axelrod (D-Las Vegas), who held a lively hearing on her Telemedical Veterinary Medicine Act AB200 ahead of the Senate Committee on Commerce and Labor hearing on Wednesday.
The intent of the bill is straightforward: allow licensed veterinarians to practice telemedicine only after a personal examination of an animal. Under the proposed law, veterinarians would not have to examine every member of a herd to consult a veterinarian, and a doctor with access to medical records could also consult on a case remotely.
Former President of the Nevada State Board of Veterinary Medical Examiners Jon Pennelle said that while telemedicine is critical to expanding access to veterinary care, face-to-face visits are required.
“For thousands of years animals have instinctively hidden disease and pain in order to survive,” said Pennelle. “And I feel like there are just too many things that can be missed if you don’t examine and touch a patient first.”
Although many vets praised the move, two proposed amendments took the discussion of the bill off the rails.
A friendly conceptual change proposed by the Nevada Board of Veterinary Medical Examiners was for provisions of another, larger Veterinary Act (SB366) that passed away on the committee. The proposed change would bring about a handful of changes to veterinary medicine outside of telemedicine, including:
- Remove a requirement that the board of directors must publish a notice in a newspaper if an applicant for a license or registration cannot be reached by the board of directors
- Allow the board to accept license applications online by removing a notarial requirement
- Allow licensed veterinary technicians to give zoonotic vaccinations such as rabies
Senator Keith Pickard (R-Henderson) raised concerns about the removal of the requirement to publish notices and requested more information on the terms of the amendment.
However, when the executive director couldn’t be reached on Zoom or the phone to answer Pickard’s question, Bilbray-Axelrod said her only goal was to get the bill off.
Pickard asked Bilbray-Axelrod if she wanted to say that she would be “willing to discard the amendment” in order to save her bill if the amendment was “problematic”.
“I tried to be nicer,” replied Bilbray-Axelrod. “But I mean, sure.”
During a public testimony in support, the executive director apologized for her technology problems and said she had written replies to legislative questions.
Despite the confusion over the board’s proposed change, the committee began hearing statements about the legislation – when dealing with legislative nightmares.
Dutch Pet, Inc., a California-based telemedicine company that was recorded in March in Delaware, has testified against the bill. The company was at the forefront of a drive to deregulate veterinary medicine in Florida and tabled a conceptual change prior to the hearing requiring that language requiring physical examination be prior to the choice of telemedicine.
John Oceguera, a lobbyist for the company, represented the company and asked legal advisor Virginia Mimmack to testify about the change. Legislators were further confused by several incorrect expressions of her surname as “Mimic”, adding to the confusion and delay.
Mimmack said the physical exam requirement was inconsistent with laws in other states such as New Jersey, Virginia, Idaho and Michigan and would prevent new entrants to Nevada’s veterinary markets.
“As currently written, the only veterinarians who can take advantage of the many benefits telemedicine offers are those veterinarians who already have an inpatient practice in Nevada,” said Mimmack.
This testimony raised questions for about half an hour from the legislature, who wanted further clarification on Dutch Pet’s motives for opposing the law.
“I’m trying to make the connection about why you would want to testify in Nevada legislation about veterinarians in Nevada if you don’t have vets here,” said Senator Roberta Lange (D-Las Vegas), noting Florida and Arizona both recently had Bills that pushed for the deregulation of veterinary telemedicine rejected.
Senator Dina Neal (D-Las Vegas) described Mimmack’s comments as “confusing” and unrealistic. Senator Melanie Scheible (D-Las Vegas) expressed her thoughts more clearly.
“Let’s just make it clear that your amendment allows Dutch Pet to come to Nevada,” she said. “If the amendment is not accepted, Dutch Pet’s business model is illegal in Nevada. And that’s the real deal, isn’t it?”
“Our testimony today is really not about Dutch Pet. Dutch Pet is not currently operating in Nevada. However, today’s testimony is about a remote prohibition of establishing a VCPR.” replied Mimmack. “It doesn’t allow new entrants, and several other states have found ways to do so.”
Pickard said he tends to be in favor of expanding competition, but worries that without personal exams, veterinarians could make false diagnoses or miss warning signs.
“If you don’t have Dr. Doolittle on the staff, you can’t speak to the patient,” Pickard said.
Committee chairman Senator Pat Spearman (D-Las Vegas) joked that she closed the hearing five years and six months later. The committee took no action on the bill.
Editor’s Note: This story first appeared in Behind the Bar, The Nevada Independent’s newsletter devoted to extensive coverage of the 2021 legislation. Sign up for the newsletter here.