Kentucky BVE: June 1 Memorandum and Updated Order

I. Introduction.
On April 21, the Kentucky Board of Veterinary Examiners (KBVE) issued a Memorandum and Order counter signed by the Governor’s Office in accordance with Executive Order 2020-243 which imposed restrictions on the practice of veterinary medicine as part of the response effort to the SARS-CoV-2 / COVID- 19 pandemic. The Memorandum and Order issued today, June 1, provides an update to that Order, easing some of those restrictions.

Licensees should understand that this easing is not a complete return to normal business operations. Should there be another spike in disease cases in the Commonwealth, the Board will reimpose restrictions in accordance with Governor Andy Beshear’s mandates in order to protect public health.

II. June 1 Update to Order and Guidance.
To summarize and ensure that all licensees are following the same guidance, the following numerical list provides updates to the Order issued on April 21.

1) Every licensee’s priority during the COVID-19 State of Emergency should be the protection of public health. This Order remains in place.

a) Corporate-owned practices, even if owned by an entity headquartered out of state, must still comply with the Governor’s Executive Orders.

b) Licensees employed by a corporate entity are ultimately accountable for ensuring the Governor’s EO’s and the Board’s recommendations are followed as outlined. Failure to do so may result in Board discipline.

2) Ensure that your practice follows the Governor’s Executive Orders and Directives to maintain social distancing. This Order remains in place with the following updates.

a) Veterinary practices now have the option to allow clients into the building as long as protocols have been developed to accommodate all of the following considerations, and staff have been fully educated and trained to execute those protocols:

i. Required posted signage on building entrances.

1. #HealthyatWork (Spanish, if needed)

2. Do Not Enter if Sick (Spanish, if needed)

ii. Checking temperatures of clients before allowing entrance.

1. Temperature readings above 100.4oF should be denied entrance.

2. Recording temperatures is not required.

iii. Requiring clients to wear masks while in the building.

1. Notify clients of this requirement (should they wish to enter the building) in advance of their appointment.

2. Have disposable masks available for client usage in the event they do not have one.

iv. Limiting client entrance to only one individual per family.

1. For animal euthanasias, there is an exception of two (2) clients per patient.

v. Providing a handwashing or hand sanitizer station near building entrance and exit for client use.

vi. Wherever possible, employing the use of a dedicated entrance and a dedicated exit.

vii. Payments should be handled from the exam room or over the phone, not in the reception area or a common counter.

viii. Disinfection of all surfaces touched by clients and patients, as well as exam rooms between each use following CDC recommended cleaning protocols using EPA- approved disinfectants or CDC-approved alternatives.

ix. Keeping the commons/waiting areas closed – i.e., clients with patients should still be waiting in their vehicles until called into the building, and clients picking up prescriptions or supplies only should still be using curbside service.

x. Allowing more time between appointments for appropriate social distancing space, waiting times in vehicles (especially as temperatures increase outside), as well as time for disinfection of surfaces between clients. This may mean increasing appointment times to 45-60 minutes per client.

xi. Veterinarians seeing exotic pets or ferrets should take extra precautions, including increased screening questions for clients and deeper disinfection between visits.

b) Scheduling must accommodate for space between clients, even in the parking lot.

c) Curbside exchanges are now optional, but still highly encouraged.

d) Rabies clinics occurring in public locations (i.e., not at a clinic or practice with COVID- 19 protocols in place) shall be allowable if a plan is submitted to the Board and approval of the plan is issued in advance. KBVE will release a form on its website for development of a plan, including submission instructions for seeking approval.

e) Governor Beshear is now allowing businesses such as pet grooming and boarding to open if they follow #HealthyatWork Requirements for Pet Care, Grooming and Boarding Businesses.

3) Conserve consumable PPE. This Order remains in place.

a) The Kentucky Office of Homeland Security reports that PPE shortages include N95 respirators and surgical masks, gowns, sterile cotton swabs, and any other supplies identified by the Governor’s office.

b) With regard to services and procedures that do not use any of the listed consumable PPE, there is no limitation on veterinary medicine except as delineated in Item 1 (protection of public health) and Item 2 (social distancing), above.

4) Notes to equine providers. This Order remains in place with the addition of one person to assist with radiographs. If abiding by the Order delineated in Item 1 (protection of public health), Item 2 (social distancing), and Item 3 (conserving consumable PPE) above,

a) Surgery for sale yearlings is permissible but should be done with the time frame toward the particular sale the individual will be entered so as not to increase surgery workloads to the point of increasing the likelihood of staff exposure risks.

b) Radiographing of sales yearlings is a time sensitive process, and is allowed if the following conditions are met to aid in compliance with social distancing requirements:

i. One designee holds all yearlings to be radiographed;

ii. One designee holds the plate for all yearlings to be radiographed;

iii. The veterinarian clinician takes all the radiographs;

iv. One designee to assist with radiographs or the animal; and

v. All individuals wear masks during the process.

vi. Each individual designee should remain constant for the entire process at each location.

vii. Without exception, no more than four (4) individuals should be involved in the process at any time.

5) The Board continues to encourage the use of telehealth where possible, within the bounds of a current, valid VCPR. The Board considers a VCPR to be current if the patient has been seen within the last 12 months. For a definition of a VCPR in Kentucky, see KRS 321.185.