The Joint Committee on
Performance Evaluation and Expenditure Review
Report # 466
A Review of the Board of Veterinary Medicine
Executive Summary
Introduction
The PEER Committee conducted a review of the Mississippi Board of Veterinary Medicine. PEER conducted the review pursuant to the authority granted by MISS. CODE ANN. Section 5-3-57 et seq. (1972). This review is a “cycle review,” which is not driven by specific complaints or allegations of misconduct.
In conducting this review, PEER first determined whether regulation of the veterinary medicine profession is necessary in order to protect the public from risks to safety, health, and welfare. Once PEER established that there is a public need for regulation of the veterinary medicine profession, PEER then evaluated how well the board is carrying out its primary regulatory functions: (1) licensure of veterinarians and veterinary technicians; and, (2) enforcement of state laws, rules, and regulations governing the practice of veterinary medicine.
Need for the Board of Veterinary Medicine
The practice of veterinary medicine by unqualified or unscrupulous individuals includes risks to both animal and human health (e.g., food safety and disease transmission) and creates a need for state government to protect the public. The Board of Veterinary Medicine, if it fulfills its regulatory functions properly, should diminish these risks.
Regulatory bodies such as the Board of Veterinary Medicine help to ensure through examination that veterinarians have the knowledge and competence to practice. The public needs an agency that can receive and investigate complaints about veterinarians and, if necessary, discipline individuals who violate the law.
Licensure
The Board of Veterinary Medicine does not consistently require applicants to comply with state law or its own regulations regarding some licensure and recording requirements. Although the board provides assurance of applicants’ competency by requiring passage of a validated national veterinary medical examination, because the board’s examination of knowledge of state veterinary medical laws and regulations has not been properly developed or administered, the board cannot assure the public that applicants have sufficient knowledge of state veterinary medical laws and regulations.
Lack of Compliance with Some Licensure and Recording Requirements
PEER reviewed files of applicants for veterinary licensure for 2002 and 2003 and found that the Board of Veterinary Medicine does not consistently require applicants to comply with state law or its own regulations regarding some licensure and recording requirements.
For example, the board’s regulations require that when veterinarians from other states apply for licensure in Mississippi, they must provide three letters of recommendation and have practiced in their home state during the past five years (in addition to meeting other requirements). The file for one out-of-state veterinarian who had applied for licensure in Mississippi did not contain three letters of recommendation or any documentation that the veterinarian had been actively practicing veterinary medicine in his home state during the past five years.
The board also does not consistently require applicants to comply with MISS. CODE ANN. Section 73-39-15 (1972), which requires that, prior to engaging in practice, a newly licensed veterinarian must record his or her license with the circuit clerk’s office in the county in which he or she resides. Of the thirty-six applicant files for 2002 and 2003, only two contained documentation of compliance with this requirement.
Problems with State Veterinary Medical Exam Development and Administration
The board has not followed formal test construction standards in the development of the state veterinary medical examination and thereby runs the risk that the test is not meeting its intended purpose of identifying those applicants who possess sufficient knowledge of state laws, rules, and regulations affecting veterinary practice. Due to the way that many of the questions are constructed, a layperson who had not even read these laws, rules, or regulations could answer correctly. The fact that all candidates have passed Mississippi’s state veterinary medical board exam raises questions about the value that the state exam provides in assessing candidates’ knowledge of state veterinary medical practice laws.
In administering the state veterinary medical exam, the board has not followed some standard professional testing guidelines for state regulatory boards. The board only partially followed test administration and examination security standards (e.g., the board has only developed one version of the state examination rather than developing multiple, but equivalent, versions of the test in order to try to prevent cheating). Also, the board has not met test administration standards for accommodating applicants with disabilities because it has not provided a written plan acknowledging compliance with the Americans with Disabilities Act.
Enforcement
The Board of Veterinary Medicine cannot provide assurance that it adequately protects the public from the risks associated with the practice of veterinary medicine. The board does not inspect veterinary facilities throughout Mississippi, has not developed a comprehensive process for handling complaints against veterinarians, and has not consistently imposed fines and penalties when disciplining veterinarians.
Lack of Inspections
In order to carry out the broad purpose of the statutes for protection of animal (and human) health, and because cleanliness is a recognized factor in quality health care, the board should inspect veterinary facilities to determine sanitary conditions. However, the Board of Veterinary Medicine does not inspect veterinary facilities in the state to ensure that practitioners comply with laws, rules, and regulations regarding veterinary practice.
The Executive Director said the board wants to inspect veterinary medical facilities, but that an inspection program has not been implemented due to lack of funding. Despite budgetary limitations, the board has an obligation to request from the Legislature the authority to expend additional special funds or the authority to raise fees in an amount necessary to support the board’s regulatory programs.
Lack of a Comprehensive Process for Handling Complaints and Hearings
The Board of Veterinary Medicine has no formal, written procedures for its complaint and hearing process that it can make available to veterinarians or the public. The complaint process that is in place does not address issues such as investigation of complaints; how the board determines whether to dismiss a complaint or whether to hold an informal or formal hearing; or standards of timeliness for handling complaints, conducting hearings, and disciplining veterinarians.
The board has no summary information on all complaints filed with the board and has not implemented a tracking system to provide information on complaints filed or disciplinary actions taken against veterinarians. This makes it difficult for the board’s staff to monitor the status of complaints and determine whether they have been resolved.
The board has no formal process for reviewing, categorizing, and analyzing the types of complaints filed in order to develop ways to diminish recurrence of complaints or determine continuing education course needs. PEER reviewed files for thirty-three complaints received by the board from August 2001 to January 2004 and found no documentation in the board’s files of any type of analysis conducted to determine the number of each type of complaint received or possible causes of problems.
The board does not provide information to the public on how to make complaints concerning veterinary medical practice. Without knowledge of or access to contact information, timeliness in making investigations and complaints related to violations of law could be hampered.
Inconsistent Imposition of Fines and Penalties
The authorization to impose fines strengthens a board’s enforcement power by providing consequences for noncompliance. A regulatory board should impose administrative penalties in amounts that reflect the severity of the violations and serve as a deterrent to violations of state law, board rules, and regulations.
The Board of Veterinary Medicine has adequate penalties available to it under law. State law provides for disciplinary actions ranging from probation to license revocation and suspension and administrative penalties of up to $1,000 for each separate offense. However, between August 2001 and January 2004, the board was inconsistent in imposing fines and penalties to discipline practitioners.
The board has penalized some practitioners severely for relatively minor violations while issuing minor penalties (or no penalty) to practitioners with major violations. Because the board has not uniformly assessed penalties and has not based penalties on the type and severity of the violation, veterinarians may not take the board’s enforcement power seriously and may continue to violate veterinary laws, rules, and regulations. Such noncompliance could increase risks to animals and the public.
Recommendations
As required by MISS. CODE ANN. Section 73-39-15 (1972), the Board of Veterinary Medicine should ensure that all applicants submit their application thirty days prior to the date of examination.
The board should also require veterinarians from other states who wish to practice in Mississippi to comply with all board regulations and state law requirements for licensure prior to receiving a license.
The Board of Veterinary Medicine should validate its written state board examination to ensure that it measures whether the applicant has sufficient knowledge of state laws, rules, and regulations governing the practice of veterinary medicine.
The Board of Veterinary Medicine should discontinue using the term “oral examination” if its interview of candidates is not part of the examination process and is not used to differentiate between qualified and unqualified applicants. If the board ever chooses to use its interview as part of the formal examination process, it must first validate the instrument in order to ensure its fairness and effectiveness in measuring whatever it purports to measure.
The Legislature should consider amending the Veterinary Practice Law of 1946 to require the Board of Veterinary Medicine to inspect veterinary medical facilities. Additional funds generated from license fees and fines could be used to fund an Inspector position.
The Board of Veterinary Medicine’s Executive Director should immediately prepare a plan for inspecting veterinary facilities under the jurisdiction of the board. In conjunction with development of this plan, the Executive Director should also determine the costs of conducting such inspections and make a recommendation to the Legislature that it grant the authority to expend additional special funds or the authority to raise fees in an amount necessary to support the board’s regulatory programs.
The Board of Veterinary Medicine should develop formal, written standard policies and procedures regarding the investigation of complaints, the conduct of formal and informal hearings, and disciplinary actions taken against veterinarians. Using existing resources, the board should develop a comprehensive reporting and tracking system to ensure that board staff and the general public have quick access to complaint and disciplinary information on veterinarians.
The Board of Veterinary Medicine should provide information to the public on the complaint process. The board should consider posting complaint reporting or contact information in veterinary facilities throughout the state.
The Board of Veterinary Medicine should require board staff to formally review, categorize, and analyze complaints to determine continuing education course needs and develop ways to diminish the recurrence of complaints in a specific area. Board staff should provide an annual written report to the board.
The Board of Veterinary Medicine should review its current enforcement practices and consider imposing administrative fines as set forth in MISS. CODE ANN. Section 73-39-19 (1972) to deter and discipline noncompliant veterinarians.
The Board of Veterinary Medicine should publicize disciplinary actions taken against veterinarians and provide such information to residents in the county where the veterinarian’s practice is located. Using existing resources, the board should consider ways of reporting disciplinary actions in a manner easily accessible to the public, such as newspapers, board newsletters, a board website, or American Association of Veterinary State Boards’ national disciplinary database for veterinarians.