Governor DeWine signed H.B. 96, the two-year state operating budget, into law on June 30. Over the last few months, we have reported on provisions in the biennial budget related to agriculture. In this week’s installment, we will examine the changes the bill makes to what is permissible in the practice of veterinary medicine in the state of Ohio.
In the beginning of June, we reported on S.B. 60, which would allow veterinarians to practice telehealth in Ohio. You can find our previous post here. Instead of being passed as a stand-alone bill, the provisions about veterinary telehealth were included in the state operating budget, H.B. 96. Looking broadly at the provisions included in H.B. 96, there are four main changes to veterinary law. The language in the budget bill:
- Allows the use of veterinary telehealth services;
- Allows a veterinary-client-patient relationship (VCPR) to be established via a telehealth visit in some cases;
- Creates special requirements for the use of telehealth services for livestock animals; and
- Allows veterinarians to prescribe medication via telehealth visit with certain exceptions.
Telehealth services for veterinary care permitted
During the Covid-19 pandemic and in the years following, most of us have become familiar with visiting our doctors via telehealth appointments using a computer or smartphone. H.B. 96 allows this appointment method to also be used in veterinary care in the state of Ohio.
Under the budget bill, a licensed veterinarian may conduct the practice of veterinary medicine via telehealth services if all the following apply:
- The veterinarian obtains the informed consent from the client, including an acknowledgement that the standards of care required by Ohio law equally apply to in-person and telehealth visits. The veterinarian shall maintain documentation of the consent for at least three years after receiving the informed consent.
- The veterinarian provides the client with the veterinarian’s name and contact information and secures an alternate means of contacting the client if the telehealth visit is interrupted. Following the telehealth visit, the veterinarian shall make available to the client an electronic or written record of the visit. The electronic or written record shall include the veterinarian’s license number.
- Before conducting an evaluation of a patient via a telehealth visit, the veterinarian advises the client of all the following:
- The veterinarian may ultimately recommend an in-person visit with the veterinarian or another licensed veterinarian;
- The veterinarian is prohibited under federal law from prescribing certain drugs or medications based only on a telehealth visit;
- The appointment for a telehealth visit may be terminated at any time.
- A licensed veterinarian may prescribe drugs or medications after establishing a veterinary-client patient relationship via telehealth services within certain parameters and with certain exceptions (see the “Prescribing medication via telehealth visit” heading below).
Once the veterinarian shares all of this information with their client, and if the rules for prescribing drugs are followed, a telehealth veterinary visit is legally permitted in the state of Ohio under the language of H.B. 96.
Changes to veterinary-client-patient relationships
Much like a doctor-patient relationship takes place between a doctor and a person who is their patient, a veterinary-client-patient relationship takes place between a veterinarian, their client (the animal’s owner), and the patient (the animal). According to Ohio law, a VCPR relationship exists when the following conditions have been met:
- A veterinarian assumes responsibility for making clinical judgments regarding the health of a patient and the need for medical treatment, medical services, or both for the patient, and the client has agreed to follow the veterinarian’s instructions regarding the patient.
- The veterinarian has sufficient knowledge of the patient to initiate at least a general or preliminary diagnosis of the medical condition of the patient. In order to demonstrate that the veterinarian has sufficient knowledge, the veterinarian must have seen the patient recently, and must be personally acquainted with the keeping and care of the patient by doing any of the following:
- Making medically appropriate and timely visits to the premises where the patient is kept;
- Examining the patient in person; or
- Under the new provisions of H.B. 96, by examining the patient in real time via telehealth.
- The veterinarian is readily available for a follow-up evaluation, or has arranged for emergency coverage, in the event the patient suffers adverse reactions to the treatment regimen, or the treatment regimen fails.
H.B. 96 keeps previous Ohio law concerning the establishment of a VCPR intact, but it also broadens the law by allowing for “sufficient knowledge” of a patient to be gained by a telehealth examination. However, as we will discuss below, this is not the case when it comes to livestock animals.
Telehealth for livestock
Up until now, we have discussed requirements for veterinary telehealth broadly. When a telehealth visit includes a client who raises livestock for human food consumption, the new language is a bit more strict. In the case of livestock, a VCPR must be established in person prior to the use of telehealth services. While a VCPR for non-livestock animals may be established via a telehealth appointment, VCPRs involving livestock must first include that in-person meeting. This means that a veterinarian may not treat or diagnose an injury or illness in a livestock animal using telehealth if the veterinarian has not previously established an in-person VCPR with the patient and client. Once an in-person VCPR is established with respect to the livestock, the veterinarian may subsequently treat the livestock via telehealth appointment.
That being said, the language in H.B. 96 allows veterinarian may give tele-advice to a client raising livestock prior to establishing a VCPR in person. Tele-advice means a veterinarian giving “health information, opinion, or guidance that is not intended to diagnose, treat, issue certificates of veterinary inspection, or issue prognoses of the physical or behavioral illness or injury of an animal.” According to the American Veterinary Medical Association, tele-advice can consist of broad recommendations via phone, text, or internet. Examples include recommendations that animals receive annual wellness checks, or that animals should receive preventive medicine to prevent worms or other pests. Under the new language, a veterinarian may give these kinds of general tele-advice regarding livestock, but they may not specifically treat or diagnose a livestock animal using telehealth without first establishing a VCPR in-person.
Prescribing medication via telehealth visit
Is a veterinarian permitted to prescribe medication for an animal via a telehealth visit under the new language? The answer is yes, but certain rules apply. After a VCPR relationship is established, a veterinarian may issue a prescription lasting up to fourteen days for the patient via tele-health visit. The veterinarian may additionally issue one refill of the medication for up to fourteen days if another tele-health visit with the patient and client occurs. However, for additional refills, the veterinarian must see the patient in person. Remember that for livestock animals, the VCPR must be established in person before a veterinarian may prescribe drugs. Further, a veterinarian may not prescribe a controlled substance (see the list of controlled substances in section 3719.01 of the Ohio Revised Code) to a patient unless a physical examination takes place in person.
With the passage of this language in H.B. 96, Ohio becomes the eighth state to allow the practice of veterinary medicine via telehealth. Other states include Arizona, California, Florida, Idaho, New Jersey, Vermont, and Virginia. Proponents of the language cite that it will make veterinary care more accessible in the state, and that it will lessen the stress caused to animals by transporting them to and from a vet’s office H.B. 96 becomes effective on September 30, 2025. To read the budget bill in its entirety, click here.