California Expands Access to Veterinary Telemedicine

SACRAMENTO, CA – Veterinarians practicing in California can provide services to new patients via remote technologies under a law taking effect on January 1, 2024. Until Assembly Bill 1399 was passed by the legislature and signed into law by Governor Gavin Newsom, California restricted the use of veterinary telemedicine to situations where a veterinarian had previously physically examined the animal in person.

AB 1399 authorizes licensed veterinarians to examine animals on camera using telehealth technologies. The law lifts the restriction on providing recommendations for treatment or prescriptions without an in-person visit. California’s previous legal restrictions governing the establishment of a Veterinarian-Client-Patient-Relationship (VCPR) were among the most restrictive in the nation.

The bill was co-authored by Assemblymembers Laura Friedman (D-Burbank) and Josh Lowenthal (D-Long Beach) and moved quickly through the legislative process with bipartisan support.

“During the pandemic, we saw how effective telehealth can be for human healthcare; so why not apply this working model to veterinary care where there is a huge shortage?” said Assemblymember Friedman. “Telehealth is a proven, safe means for delivering care. I’m pleased so many of my colleagues agree that we can prevent thousands of animals from needlessly suffering.”

“I am proud to be a joint author on AB 1399, which takes what we learned from the pandemic and expands telehealth access to veterinary medicine. Expanding access to telemedicine is particularly important for humans and animals that live in rural locations, lack access to transportation or have other mobility issues. As we face a statewide shortage of veterinarians, the virtual house call is an excellent option for our pets to improve access to healthcare, when deemed appropriate by an attending veterinarian.”

The San Diego Humane Society and the ASPCA® (The American Society for the Prevention of Cruelty to Animals®) proposed the bill to increase access to services via telehealth in the face of alarming challenges faced by California pet owners when seeking veterinary care.

“The benefits of telehealth are clear – when used responsibly, veterinary telehealth can help reduce animal suffering, address barriers to care, keep pets in their homes, and extend the capacity of animal shelters to serve animals and their communities by increasing access to veterinary care,” said Brittany Benesi, senior director of state legislation for the ASPCA’s Western division. “A.B. 1399 makes veterinary care more accessible to California pet owners and we’re grateful to Governor Newsom for signing this lifesaving bill into law to enable California veterinarians to use technology to protect the pets who need it most.”

“We were thrilled to learn that Governor Newsom signed A.B. 1399 into law and know this will bring countless benefits for animals and pet owners across California,” said Dr. Gary Weitzman, president and CEO, San Diego Humane Society. “This is an incredible step in the right direction for the future of accessible veterinary care, making telehealth a reality for both pets and shelter animals in under resourced and low attention regions of our state. A.B. 1399 is combining modern technology, already used in human telehealth, with the practice of veterinary medicine to eliminate barriers around access to care and it will make a lifesaving difference for so many animals.”

The veterinary industry is experiencing a critical shortage of veterinarians in California and nationwide. Research conducted in 2022 by Mars Veterinary Health found that based on expected needs, by 2030 about 55,000 additional companion animal veterinarians will be needed in the workforce. A shortage of about 24,000 companion animal vets is expected by 2030. A 2020 study by Banfield Pet Hospital® estimated that the shortage means 75 million pets may not have access to veterinary care by 2030.

California is the sixth state — after Arizona, Idaho, New Jersey, Vermont, and Virginia — to permit a VCPR to be established online. Arizona’s law is also new this year. Arizona Governor Katie Hobbs signed into law Senate Bill 1053, which allows veterinarians licensed in Arizona to establish a VCPR through telemedicine, effective October 1, 2023. Most other states still tightly restrict the use of telemedicine by veterinarians. Legislative attempts to allow a virtual VCPR were unsuccessful in the past year in Arkansas, Florida, and Michigan.

According to the Veterinary Virtual Care Association, a nonprofit association dedicated to developing best practices for delivering virtual care for animals, Florida allows virtual establishment but not prescriptions without an in-person physical examination. New York has guidelines requiring in-person establishment of a VCPR, but they are not legally binding. Nine of the remaining states expressly prohibit the virtual establishment of VCPR, and 33 states have laws that require varying forms of an in-person event to establish a VCPR.

There is broad agreement that veterinary medicine has a place for telehealth. How modern technology is implemented, particularly in establishing the VPCR, remains a topic of debate. Proponents of a virtual VCPR claim that establishing that relationship electronically would improve access to care. However, many veterinarians don’t agree because animals need preventive care tailored to specific needs that require an in-person visit for proper assessment.

California’s new law was opposed by the California Veterinary Medical Association (CVMA), the American Veterinary Medical Association (AVMA), and the California Veterinary Medical Board (CVMB). The CVMB maintained its opposition even after negotiating the inclusion of several amendments to the bill’s language.

The AVMA policy, “Telemedicine,” advocates strongly for telemedicine to be used only after an in-person VCPR has been established. The policy states: “With the exception of emergency teletriage, including poison control services, the AVMA opposes remote consulting, including telemedicine, offered directly to the public when the intent is to diagnose and/or treat a patient in the absence of a VCPR.”

AVMA President Rena Carlson and AVMA CEO Janet Donlin explained the Association’s position in a letter to Gov. Newsom asking him to veto California’s bill. “Veterinary telemedicine is most effective and safest—for patients, clients, and veterinarians and their teams—when used to maintain a Veterinarian-Client-Patient Relationship (VCPR) that has already been established via an in-person examination of the animal or animals. The physical examination is the most valuable tool the veterinarian has in their toolbox,” Drs. Carlson and Donlin wrote.

Faced with a losing battle to maintain the face-to-face VCPR requirement in Arizona, the AVMA, and Arizona Veterinary Medical Association decided to strike a deal on amendments in exchange for their neutral stance on the measure.

While the debate over the method of establishing the VCPR continues, efforts to include telehealth technology in the overall provision of veterinary medicine beyond the initial VCPR also continue. In July 2022, the Coalition for Connected Veterinary Care was formed by a group of leading professional and industry organizations Seeking to enhance and expand patient care through the wider use of telehealth in veterinary medicine. The AVMA was a lead partner in the newly formed coalition.

“Veterinary telemedicine is most effective and safest—for patients, clients, and veterinarians/veterinary practices—when used to maintain a VCPR that has already been established via an in-person examination,” noted Dr. Link Welborn, Chief Executive Officer of the Veterinary Study Groups, another founding member of the Coalition. “We’ll be looking to Coalition members to help develop and share resources that will support veterinarians in seamlessly integrating telehealth into their practices while recognizing the importance of the VCPR.”

California is often seen as an incubator and exporter of policies with nationwide influence on other state legislatures and even the United States Congress. California adopting AB 1399 will likely increase the consideration of similar actions by other state governments.