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STATE OF MICHIGAN  
DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS  
BUREAU OF PROFESSIONAL LICENSING  
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PUBLIC HEARING  
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FRIDAY, FEBRUARY 25, 2022  
AT ABOUT 9:00 A.M.  
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G. MENNEN WILLIAMS BUILDING AUDITORIUM  
525 W. OTTAWA STREET  
LANSING, MICHIGAN  
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RE: Veterinary Medicine - General Rules  
(MOAHR #2021-57 LR)  
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HEARING FACILITATOR:  
DENA MARKS  
Bureau of Professional Licensing  
611 W. Ottawa Street  
Lansing, Michigan 48909  
19 ALSO PRESENT: Kerry Przybylo  
LeAnn Payne  
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Stephanie Wysack  
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REPORTED BY: Lori Anne Penn, CSR-1315  
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I N D E X  
2 Opening Statement - Dena Marks  
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4 COMMENTS:  
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Richard Angelo  
Joseph Dobesh  
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John Tramontana  
Akshay A. Verma  
Catherine Garrett  
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11 Closing Statement - Dena Marks  
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Lansing, Michigan  
Friday, February 25, 2022  
At 9:00 a.m.  
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(Public hearing commenced pursuant to due notice.)  
MS. MARKS: Good morning. My name is  
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Dena Marks, and I'm a departmental specialist for the  
Bureau of Professional Licensing in the Department of  
Licensing and Regulatory Affairs. I will be conducting  
the hearing this morning.  
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This is a public hearing on proposed  
Administrative Rules entitled "Veterinary Medicine -  
General Rules". We are conducting this hearing under the  
authority of the Administrative Procedures Act, Public  
Act 306 of 1969, on behalf of the Department of Licensing  
and Regulatory Affairs, Bureau of Professional Licensing.  
We are calling this hearing to order at  
9:00 a.m. on February 25, 2022, at the G. Mennen Williams  
Building Auditorium, 525 West Ottawa Street in Lansing,  
Michigan. Publication of the notice of public hearing  
was in three newspapers of general circulation. The  
public notice for these rules was published in the Flint  
Journal on January 28, 2022; the Grand Rapids Press on  
January 30, 2022; and the Mining Journal on January 27,  
2022; as well as in the Michigan Register, Issue 2-2022,  
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published on February 15, 2022.  
We are here today to receive comments on  
the proposed rules. If you wish to speak, please make  
sure you have signed in and indicated that you wish to  
speak. You may use the cards provided for this purpose.  
If you would like to speak and have not signed in, please  
do so now. For those of you who do not wish to sign in  
with a card, you may speak at the microphone once we have  
exhausted the cards submitted to me.  
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If you have comments, please make sure  
that they relate directly to the proposed rules. If you  
have questions about the rules, please indicate your  
questions as part of your testimony for the Department's  
review. If you have suggested changes to the proposed  
rules, please include the specific reasons why the  
changes would be in the public interest.  
Please note, if you have already  
submitted comments to the Department in writing or by  
email, those comments will be considered in the same  
manner as the comments made during the public hearing  
today.  
For those making comments today, please  
clearly state and spell your name for the record, and if  
you are speaking on behalf of an organization, please  
identify that organization as well.  
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If you have written comments, you may  
submit them directly to me. The Department will also  
accept written comments postmarked or emailed until 5:00  
p.m. today.  
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The Department staff from the Bureau of  
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Professional Licensing attending today's hearing are  
LeAnn Payne, Kerry Przybylo, and me.  
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So I will take the cards in alphabetical  
order by your last name. If you would like to come up to  
the mic so that it can be heard clearly by everyone and  
so the court reporter can get your name, that would be  
appreciated. So Richard Angelo, if you would like to  
make your comments, please.  
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MR. ANGELO: Good -- is it on? Okay.  
Can you hear me okay?  
MS. PRZYBYLO: It is on.  
MR. ANGELO: Good morning. My name is  
Richard Angelo, last name is spelled A-n-g-e-l-o. I am  
here as both an individual and representing Best Friends  
Animal Society, a national animal welfare organization  
working in all 50 states.  
I'm here to provide comments on,  
regarding specifically the telemedicine and telehealth  
provisions in the proposed rules as they were published.  
I was very, very pleased over a year ago when these rules  
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were actually changed to allow for the client  
relationship to be established by telemedicine, and I  
think many, many Michiganders, their pet companion  
animals, have all benefited from those rules.  
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In working in all 50 states with many  
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veterinary boards and veterinary regulations across the  
country, we've seen over the past years veterinary boards  
actually expand telemedicine rather than contract it.  
This contraction in the proposed rules is going to be  
detrimental to many people across the State given the  
veterinary shortages that are going on across the country  
as well as in our state, rural areas as well as in  
pockets in the urban areas throughout our State.  
We're asking that we leave subsection  
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(d)(i) as is in the rules, allowing the client/patient  
relationship to be established by telemedicine rather  
than requiring an in-person visitation of the animal by  
the veterinarian. The veterinarians in our State, as  
well as across the country, are very, very well-versed in  
what needs to be done, how to treat their patients and  
their clients. The judgment as to whether or not that  
relationship could be established by telemedicine should  
be left to the individual veterinarians.  
I went through your fiscal -- I'm  
sorry -- the regulatory impact statement which stated  
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there wouldn't be any impact in rural areas on some of  
the licensees. I would tend to vehemently disagree with  
that in that many areas where people can't get to the  
veterinarian or there's only one veterinarian, say,  
throughout the U.P., people need and would benefit from  
being able to establish the veterinary client/patient  
relationship through telemedicine.  
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So again, I will be submitting more  
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detailed written comments before the end of the day, but  
we're asking that we leave subsection (d)(i) written as  
is. Thank you.  
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MS. MARKS: Joseph Dobesh.  
MR. DOBESH: Good morning. I'm Joseph  
Dobesh, I'm the chief executive officer of the Michigan  
Pet Alliance, a trade association for Michigan's animal  
shelters, rescues, and their advocates.  
MS. MARKS: Would you spell your last  
name, please.  
MR. DOBESH: Yes.  
MS. MARKS: Thank you.  
MR. DOBESH: Dobesh, D-o-b-e-s-h.  
We stand today in opposition to the  
proposed rule change, specifically the provisions related  
to telemedicine. These provisions instituted during  
COVID have provided a vital access to care for Michigan's  
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pets, particularly those living in rural areas and those  
whose owners may have mobility issues or transportation  
issues. Michigan's animals will undoubtedly suffer with  
this change which runs contrary to the efforts of  
progress in the provision of veterinary services. We  
would ask that this proposed revision be reconsidered,  
that the harms mitigated would be better addressed  
through efforts of the individual veterinarian; we trust  
them every day, we license them, and they go through  
comprehensive training. We know that change and progress  
can never be avoided; to make a -- to make such a  
substantial change through regulation puts Michigan's  
pets at risk, and we would respectfully ask the board to  
leave the provisions as they currently exist as we  
believe they best serve the interest of Michigan's  
companion animals. Thank you.  
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MS. MARKS: John Tramontana.  
MR. TRAMONTANA: Good morning. My name  
John Tramontana, I am the chief executive officer of the  
Michigan Veterinary Medical Association. Thank you for  
the opportunity to allow us to comment today.  
First, we would like to say the MVMA  
strongly supports telehealth and telemedicine. Two years  
ago before the COVID-19 pandemic began, none of this  
technology was legally allowed for veterinarians to use  
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and to access care to allow people in -- with  
transportation issues, in rural areas, it has provided  
more care to veterinarians. But like any type of new  
initiative or new technology, it needs to be done  
ethically and responsibly, therefore, we strongly support  
the changes to these rules and believe this board made up  
of predominantly Michigan veterinarians who understand  
the profession, who understand how these rules are put  
into practice, and understand how they are utilized have  
done so to make sure that these rules are not only clear,  
but are put forth in an ethical and responsible way.  
Without an in-person visit initially,  
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there is a much higher risk of misdiagnotion [ph) -- of  
misdiagnosis, of being able to provide the wrong  
medication. It also has the potential to influence and  
taint Michigan's food supply. Also, it allows people  
outside of the State of Michigan potentially, the old  
rules that is, to treat Michigan patients without  
sufficient knowledge of that patient. We believe  
Michigan veterinarians licensed in Michigan, practicing  
in Michigan, should be able to make that call. We  
believe that these rules do that.  
MVMA strongly supports these changes, as  
does the American Veterinary Medicine Association, as do  
many other organizations who deal with veterinary  
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medicine, including other veterinary colleges and  
universities throughout the country. These changes bring  
Michigan in line with nearly 40 other states, as well as  
federal guidelines and recommendations put forth by the  
Federal Drug Administration, so we -- Food and Drug  
Administration, so we ask that these continue to move  
forward.  
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We would like to commend the board for  
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recognizing the gray area in the previous rules, some of  
the complications that arose, and taking the brave steps  
to move forward with these new rules that protect  
Michigan Animals, protect the public health, and protect  
the veterinary practice in Michigan. Thank you.  
MS. MARKS: Dr. Akshay Verma.  
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MR. VERMA: Hello. I'm a veterinarian,  
I'm also a certified rehabilitation practitioner and a  
behavior resident with the American College of Veterinary  
Behaviorists.  
MS. MARKS: Doctor, would you please  
spell your name for the reporter, please.  
MR. VERMA: Yeah. My first name A, as in  
apple, -k-s-h-a-y, my last name is V, as in Victor,  
-e-r-m, as in Mary, -a. And I'm here representing my  
personal practice, Personalized Veterinary Behavior and  
Rehabilitation, as well as a board member of the Humane  
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Society of Huron Valley. I also am an adjunct professor  
at the College of Veterinary Medicine at Michigan State,  
but I'm not -- I don't claim to represent Michigan  
State's interests.  
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And I just wanted to bring up a couple  
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observations that I've made. I've also attended  
committee meetings at the State House where I've seen the  
MVMA discuss that there's something -- that there are  
going to be veterinarians out of state practicing  
medicine as a result of these rule changes, and it  
doesn't really make sense because you still need a  
license in Michigan in order to practice. This is a  
heavy regulated profession, it's not just a trade, you  
know, we have very (inaudible) --  
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COURT REPORTER: I'm sorry. Very?  
MR. VERMA: -- stringent requirements to  
become veterinarians. And I don't understand why the use  
of telemedicine wouldn't be up to the individual  
practitioner. In fact, I think that these changes could  
put practitioners at risk, such as practitioners who  
practice veterinary behavioral medicine where we deal  
with aggressive patients where it may not be considered  
legally an emergency, but it could very well put our  
staff at risk and us at risk in order to interact with  
these patients physically before we've been able to  
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prescribe the appropriate medications. And even if we  
see these patients in person, many times we don't  
actually perform a physical exam because we can't touch  
the patients until we've prescribed something. So  
telemedicine has been going on for a long time because as  
long as we've established a VCPR in person, we can  
communicate, even prior to COVID we've been able to  
communicate with our clients as long as we've seen him  
within a year. It's also something that we're teaching  
at Michigan State to our behavior students, you know, our  
services are split between in-person and telehealth, but  
many of our clients are established as virtual clients  
initially. And we do review medical records just like it  
is stipulated in the current rule. So as you can see,  
I'm opposed to the rule changes.  
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And I also don't understand why now that  
the State legislature seems to not have an appetite for  
this change, the MVMA has come to LARA to try to change  
the rules, you know, without involving the legislature,  
and it just doesn't make sense to me because I don't  
understand who is harmed, if there's been any  
demonstration of harm over the past two years while this  
has been in place.  
And I also don't understand if the  
thought is that veterinarians are going to lose money or  
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something like that, it doesn't really make sense because  
there's extreme waits at every single veterinary hospital  
right now, and access to care is a huge issue, and we  
can't legislate a turnback in time.  
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You know, in pediatric -- it was brought  
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up at the State meeting that in pediatrics you can also  
legally perform telemedicine. Are we saying that there's  
a greater danger to the animals than there are to our  
kids?  
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And I also -- or the example of  
(inaudible) --  
COURT REPORTER: Excuse me. Example of?  
MR. VERMA: Chloramphenicol, it's an  
antibiotic. But basically an example of antibiotics that  
shouldn't be used prescribed to food animals and to  
contaminate our food supply, why would a veterinarian  
just because they're behind a computer suddenly lose  
their mind and prescribe heavy-duty antibiotics? You  
know, there's no such thing as a virtual veterinarian and  
a veterinarian; just like in my practice and in our  
department at Michigan State, we practice in-person  
medicine and telehealth, it is not like we just switch to  
being virtual veterinarians and suddenly lose our  
knowledge and our training.  
And then lastly, as a board member of the  
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Humane Society of Huron Valley, the current, unlike the  
appropriate avenues through the legislature which were  
providing some exceptions for shelters, this rule -- rule  
changes provide no exceptions for shelters, which MVMA's  
own shelter veterinarian who came to speak had mentioned  
that she was concerned about there being an exception for  
the premises, which I don't understand why a building  
has -- what a building has to do with the VCPR, but that  
is essentially the argument through the legislative  
options, but in the rule changes before us, there is no  
acknowledgment that shelters may require telehealth (1)  
for shelter veterinarians to communicate with their staff  
if an animal's been brought in and the veterinarian  
hasn't had a chance yet to examine the animal, and it  
could be, you know, after hours; but then also with  
specialty medicine and other consultants that may wish to  
help the shelter with their, you know, extreme caseloads,  
and that's something I do through my practice is I  
consult with (inaudible) --  
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COURT REPORTER: Consult with?  
MR. VERMA: Sorry. Humane Society of  
Huron Valley on their behavior cases to try to better  
facilitate re-homing of difficult patients.  
So I just don't understand the harm here.  
Telemedicine has been around for two years and -- well,  
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actually longer than two years, but it's been two years  
since you could establish a VCPR virtually, and I don't  
see these cases of harm being brought forth before the  
licensing board or anywhere else or in the civil courts,  
so it's really a, you know, solution in search of a  
problem, and I don't understand what the appetite is.  
Thank you. That's all I have to say.  
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MS. MARKS: Thank you for the comments.  
If there are no other persons who wish to speak at this  
time, we will take a short recess.  
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(Recess from 9:20 a.m. until 9:25 a.m.)  
MS. MARKS: We are back on the record.  
Catherine Garrett.  
MS. GARRETT: Catherine Garrett,  
C-a-t-h-e-r-i-n-e, Garrett, G-a-r-r-e-t-t. I'm Catherine  
Garrett, director of (inaudible) --  
COURT REPORTER: Excuse me. If you're  
going to read, read slowly.  
MS. GARRETT: Oh, okay. Sorry about  
that.  
So I'm Catherine Garrett, director of  
development and marketing for All About Animals Rescue,  
and I'm here today to speak on behalf of Amber Sitko, our  
president and founder, who couldn't be here. And so she  
wanted me to convey the following.  
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I am writing to express staunch  
opposition to the proposed revised rules to the  
Veterinary Medicine - General Rules in regards to  
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telehealth services, specifically Rule 1a(1)(i) which  
would require the veterinarian to have recently examined  
the animal patient in person -- excuse me, I ran to get  
here -- and I am asking you to honor the original  
language and intent.  
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I am the president and founder of All  
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About Animals Rescue. We have four locations employing  
16 veterinarians that provide veterinary care. Our  
primary focus areas are on low-income pet owners,  
particularly in Detroit and Flint. These communities are  
veterinary deserts with few to no accessible veterinary  
services. While telehealth medicine is a small part of  
our services, we consider it essential in helping the  
underserved pet owners.  
Pet owners can not always travel to a  
veterinarian for many reasons that hit underserved  
communities the hardest. Some owners have no  
transportation, and pets are not allowed on public  
transportation. Uber, Lyft, even if they find a driver  
willing to transport them with an animal, is  
prohibitively expensive, and there is no guarantee they  
can find a driver willing to accept their animals for the  
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trip back home. Any suggestion that they should walk to  
the clinic places an undue burden on both the pet and the  
owner. One must take into consideration the distance,  
physical ability of the pet and the owner, the weather,  
and even their personal safety in attempting to walk to a  
clinic. There are no reasonable options for many pet  
owners and their pets.  
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Michigan veterinarians are highly  
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trained, licensed, and should be trusted to make the  
assessment to determine if telemedicine is appropriate  
for a patient. We are against unnecessary mandates,  
especially when they will cause harm to our patients. If  
the pet owner is unable to provide care for their pet,  
the pet suffers physically, and may even be surrendered  
to a shelter and euthanized. We need to expand care for  
pets, not unnecessarily restrict it.  
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Please consider that this proposed change  
is a direct threat to animals of the underserved in  
receiving healthcare. Whatever the anticipated benefit,  
is it worth the collateral damage this will cause to a  
marginalized population already struggling to secure  
veterinary care for their pets, as well as, and most  
importantly, the unnecessary negative health effects  
caused to the animals themselves because their newfound  
access to medical care is taken away by this change.  
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Respectfully, Amber Sitko, President and  
Founder, All About Animals Rescue.  
MS. MARKS: We're going to go off the  
record and take another short break.  
(Recess from 9:30 a.m. until 9:37 a.m.)  
MS. MARKS: We're back on the record. If  
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there are no further comments at this time, I hereby  
declare the hearing closed. The record will remain open  
until 5:00 p.m. today for any other comments you may wish  
to share about the proposed rules. Thank you for  
attending.  
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(At 9:38 a.m., the public hearing concluded.)  
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C E R T I F I C A T E  
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I, Lori Anne Penn (CSR-1315), do hereby  
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certify that I reported in stenotype the proceedings had  
in the above-entitled matter, that being Bureau of  
Professional Licensing Public Hearing in MOAHR  
#2021-57 LR, at the G. Mennen Williams Building  
Auditorium, 525 West Ottawa Street, Lansing, Michigan, on  
Friday, February 25, 2022, and do further certify that  
the foregoing transcript, consisting of pages 1-19,  
constitutes a true and correct transcript of my stenotype  
notes.  
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_____  
Lor
Penn Reporting, LLC  
lori.penn@yahoo.com  
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