Bills introduced in state legislature would determine extent of nonprofit clinic limitations.
The young legislative session in Alabama has already seen three “spay-neuter” bills introduced, continuing the contentious debate begun during last year’s session surrounding the role of low-cost spay-neuter clinics in the state.
Last year’s legislative session sparked a clash between nonprofit clinics and the Alabama State Board of Veterinary Medical Examiners (ASBVME). The state board’s public opposition to the nonprofit clinics deteriorated into what Alabama Veterinary Medical Association (ALVMA) President William Allen, DVM, called a “PR nightmare” for the state’s veterinary community.
Faced with restoring the public image of the state’s veterinarians, the ALVMA has abandoned its once well-intention neutrality. It’s now opposing the state board in support of a bill that he hopes private veterinarians and nonprofit entities can agree on.
Senate Bill 25, introduced by Republican state Sen. Paul Bussman, a practicing dentist, proposes to make an exception in the state’s veterinary practice act--which currently does not allow nonveterinary ownership of veterinary practices--for nonprofit spay-neuter clinics. It is a direct response to last year’s House Bill 156, which died due to lack of compromise and eventually inaction by the legislature. The state veterinary board and the Alabama Veterinary Practice Owners Association (AVPOA), formed last year in opposition to HB 156, unanimously endorse the new Senate bill.
“Senator Bussman has introduced this bill in an effort to allow the spay-neuter clinics to proceed with their moral mission of providing donor-subsidized spays and neuters to underserved pet owners,” says Robert Pitman, DVM, president of the state veterinary board, in a letter to Alabama veterinarians. “He has also addressed the regulatory responsibilities of the ASBVME as mandated by the Alabama legislature.”
SB 25 enacts measures to ensure extensive board oversight of nonprofit clinics with additional inspections, reports and license requirements, and it limits the clinics to spay-neuter services only. It also prohibits nonprofit clinic veterinarians from possessing any drugs or equipment not related the spay-neuter process.
“The ASBVME unanimously endorses SB 25 as a fair compromise to all parties,” Pitman says in his letter. However, the U.S. Federal Trade Commission (FTC) may not feel the same way, even though the bill provides the veterinary ownership exception the FTC has called for in the past.
Earlier this year Allen asked an attorney to review and comment on SB 25--specifically whether the provisions of the bill might violate federal antitrust law. Gregg Brantley Everett, an attorney with Gilpin Givhan law firm in Montgomery, responded. “Unfortunately, SB 25 ... substantially restricts the ability of spay and neuter clinics to use the new exemption because of all the additional licensing requirements,” Everett told Allen in a January letter. “It should also be noted that the constitutionality of SB 25 is highly questionable.”
Everett’s conclusion? “The State Board of Veterinary Medical Examiners could be investigated and [be charged] by the FTC if Senate Bill 25 passes as written and the board tries to enforce it.”
Allen has written to ALVMA members stating that the association’s executive board cannot support SB 25 without specific amendments. The ALVMA believes that minimum standards of care and public health concerns demand that nonprofit veterinarians be able to treat parasites, administer rabies vaccinations, and provide antibiotics and pain medication for conditions unrelated to sterilization as they deem appropriate. SB 25 would not allow for those treatments.
The ALVMA also disagrees with the need for additional board oversight. “[The ALVMA] executive board questioned the wisdom in treating any colleague or his or her patients in this manner,” Allen writes. “Additionally, discriminatory language against veterinary colleagues who work in the spay-neuter clinics regarding additional inspections and reporting was recommended for removal from the bill.”
The result of the ALVMA’s requested amendments (which were not accepted by the Senate bill’s sponsor) is House Bill 188, sponsored by Alabama Speaker of the House Mike Hubbard, a Republican. “The bill restricts the activity of the spay-neuter clinics but refrains from treating the spay-neuter veterinarians as if they were second-class veterinarians just because of where they practice,” Allen says in his letter. “They are required to be licensed the same as you and I are obligated by that license to provide a certain level of standard of care.”
Contention over the issue seems to have shifted: It’s no longer private practices against nonprofit entities but veterinarians against veterinarians. “They, through their irrational, self-serving practices, have taken up an adversarial position against the ASBVME which is designed to keep the practice of veterinary medicine of the highest quality,” says Buddy Bruce, president of the Alabama Veterinary Practice Owners Association, in a letter to the state’s veterinarians. He alleges that the ALVMA is no longer relevant and urges ALVMA members to demand resignation of executive committee members. He encourages the veterinary community to reject HB 188 and the ALVMA and join him in support of SB 25.
However, both the practice owners association and ALVMA support means testing as a way to limit services to people who can’t afford spay-neuter services, though no bill presently contains language calling for it. The two groups believe that nonprofit clinics enjoy an unfair tax advantage. “It is fundamentally unfair for tax-exempt clinics to compete with tax-paying hospitals, and tax-exempt entities should require means testing to determine eligibility,” the ALVMA position statement reads. And from the practice owners group: “The ALVPOA feels certain that if ‘means testing’ were included with either bill that very few, if any, veterinarians in the state would have an issue with any services provided by the 501(c)3s,” Bruce says.