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PA Bulletin, Doc. No. 09-2251

NOTICES

Notice of Comments Issued

[39 Pa.B. 6916]
[Saturday, December 5, 2009]

 Section 5(g) of the Regulatory Review Act (71 P. S. § 745.5(g)) provides that the Independent Regulatory Review Commission (Commission) may issue comments within 30 days of the close of the public comment period. The Commission comments are based upon the criteria contained in section 5.2 of the Regulatory Review Act (71 P. S. § 645.5b).

 The Commission has issued comments on the following proposed regulations. The agency must consider these comments in preparing the final-form regulation. The final-form regulation must be submitted within 2 years of the close of the public comment period or it will be deemed withdrawn.

Reg. No. Agency/Title Close of the Public Comment Period IRRC
Comments
Issued
16A-6513 State Board of Physical Therapy
Continuing Education Providers
39 Pa.B. 5435
(September 19, 2009)
9/19/09 11/18/09
16A-5722 State Board of Veterinary Medicine
Responsibility to Clients and Patients
39 Pa.B. 5438
(September 19, 2009)
9/19/09 11/18/09
16A-5723 State Board of Veterinary Medicine
Biennial Renewal Fees
39 Pa.B. 5436
(September 19, 2009)
9/19/09 11/18/09
16A-7015 State Board of Certified Real Estate Appraisers
Appraisers Trainees; Initial and Continuing Education;  Supervised Experience; Practice Standards
39 Pa.B. 5423
(September 19, 2009)
9/19/09 11/18/09

State Board of Physical Therapy
Regulation #16A-6513 (IRRC #2786)

Continuing Education Providers

November 18, 2009

 We submit for your consideration the following comments on the proposed rulemaking published in the September 19, 2009 Pennsylvania Bulletin. Our comments are based on criteria in section 5.2 of the Regulatory Review Act (71 P. S. § 745.5b). Section 5.1(a) of the Regulatory Review Act (71 P. S. § 745.5a(a)) directs the State Board of Physical Therapy (Board) to respond to all comments received from us or any other source

House Professional Licensure Committee comment—Reasonableness; Clarity.

 In a letter dated October 21, 2009, the House Professional Licensure Committee commented on the following issues:

 • Wording changes with regard to the usage of ''courses'' and ''programs'' in Subsections (d)(1), (3), (5) and (6).

 • Validity of course approval if program and course dates are not firm or if the dates change.

 • How will licensees be informed of the approval or disapproval status of a course or program?

 • How will distance learning be addressed with regard to distance learning?

 We will review the Board's responses to these issues in our consideration of whether the final-form regulation is in the public interest.

____

State Board of Veterinary Medicine
Regulation #16A-5722 (IRRC #2787)

Responsibility to Clients and Patients

November 18, 2009

 We submit for your consideration the following comments on the proposed rulemaking published in the September 19, 2009 Pennsylvania Bulletin. Our comments are based on criteria in section 5.2 of the Regulatory Review Act (71 P. S. § 745.5b). Section 5.1(a) of the Regulatory Review Act (71 P. S. § 745.5a(a)) directs the State Board of Veterinary Medicine (Board) to respond to all comments received from us or any other source.

1. General—Clarity.

 The response to Regulatory Analysis Form Question #14 states that the Board has ''attached information regarding the widespread acceptance that the use of analgesia is the acceptable and prevailing standard of care.'' However, no such information was attached to our copy of the proposed regulatory package. This information should be included with the final-form document submittal.

2. Section 31.21.—Rules of Professional Conduct for Veterinarians.—Protection of the public health, safety and welfare; Reasonableness; Need; Implementation procedures; Clarity.

Euthanasia

 Paragraph (a)(1) references ''humane euthanasia,'' while other subsections simply refer to ''euthanasia.'' We recommend using one term throughout the regulation.

Reasonable attempt

 Paragraph (a)(1) uses the phrase ''reasonable attempt'' twice in regard to determining the identity of the animal's owner and contacting the owner. The phrase ''reasonable attempt'' is vague. We recommend that the final-form regulation establish a clear standard for compliance by veterinarians and potential enforcement by the Board.

Proper veterinary medical judgment

 Paragraphs (a)(1) and (2) require the veterinarian to exercise ''proper veterinary medical judgment.'' This requirement is vague. The regulation should specify what standard the Board will use to determine a violation.

Notice to the client

 Paragraph (a)(2) requires the veterinarian to provide the client with notice of his or her intention to withdraw and discontinue treatment of an animal. What type of notice will the Board find acceptable to notify clients of the withdrawal? We recommend that the final-form regulation require the notice to be in writing.

Personal client information

 Subsection (c) requires veterinarians and their staff to protect the personal privacy of clients and specifies the protection of ''a client's Social Security number and sensitive financial information and confidential health information about the client.'' Section 31.1 of the existing regulations defines a ''client'' as a ''person . . .'' While this information should definitely be protected if the veterinarian possesses it, we question under what circumstances a veterinarian would obtain or need a person's social security number or confidential health information. We request an explanation of why it would be necessary for a veterinarian to request, possess and document a person's social security number, sensitive financial information or confidential health information.

Acceptable and prevailing standards

 Subsections (d) and (f) require veterinarians to practice in accordance with ''acceptable and prevailing standards.'' A commentator is concerned that this term is subject to interpretation, since what is considered ''acceptable and prevailing'' can vary from region to region, or between general and specialty practices. We agree that it is not clear what standard the regulation sets. We recommend that the Board define this phrase or amend the regulation so that the final-form regulation sets a clear standard for compliance.

Subsection (e)

 We raise three issues with this subsection.

 First, this subsection requires a veterinarian to explain to a client the ''significant potential risks'' of treatment options. Commentators are concerned that the term ''significant'' could be held to a subjective interpretation. We agree that the phrase ''significant potential risks'' is vague. We recommend deleting the word ''significant.''

 Second, this subsection requires a veterinarian to obtain written consent for euthanasia. However, if the client is not present to provide a signature, veterinarians shall obtain oral consent and subsequently obtain the client's signature. The House Professional Licensure Committee (HPLC) questioned the signature requirements. Commentators described the subsequent request for a client's signature, after their animal was euthanized, as unrealistic and an awkward request that could come across as inappropriate or insensitive on the part of the veterinarian. We agree. The Board should explain the need for and reasonableness of obtaining signatures in the circumstances raised by the commentators and the HPLC. If the Board believes signatures are needed, the regulation should provide guidance for the circumstances where the veterinarian acted in accordance with the regulation but, due to circumstances beyond the control of the veterinarian, the client does not provide a subsequent signature.

 Finally, commentators also questioned the responsibility imposed on veterinarians if the client refuses to sign the consent form or fails to return it. Would this constitute grounds to discontinue the treatment of an animal? The regulation should also address these circumstances.

Subsection (g)

 Who determines what is considered a ''reasonable period of time'' to forward records to a new veterinarian? The final-form regulation should set a finite time limit to forward the records.

 In addition, a commentator suggests that if the original veterinarian withdraws and the client wants to consult with another veterinarian about the same case, that the records be transferred to the new veterinarian in accordance with Section 31.22(8) of the existing regulation. Has the Board considered including a cross-reference to this section?

____

State Board of Veterinary Medicine
Regulation #16A-5723 (IRRC #2788)

Biennial Renewal Fees

November 18, 2009

 We submit for your consideration the following comments on the proposed rulemaking published in the September 19, 2009 Pennsylvania Bulletin. Our comments are based on criteria in section 5.2 of the Regulatory Review Act (71 P. S. § 745.5b). Section 5.1(a) of the Regulatory Review Act (71 P. S. § 745.5a(a)) directs the State Board of Veterinary Medicine (Board) to respond to all comments received from us or any other source.

Statutory authority; Legislative intent; Fiscal impact.

 This proposed rulemaking would provide for incremental biennial license renewal fee increases for veterinarians and veterinary technicians for the next six biennial renewal cycles. The current renewal fee for veterinarians is $300 and the current renewal fee for veterinary technicians is $75. The renewal fees at the end of the 2020-2022 biennial period will be $590 for veterinarians and $140 veterinary technicians.

 Subsections 13 (a),(b) and (c) of the Veterinary Medicine Practice Act (Act) (63 P. S. § 485.13 (a), (b) and (c)) establish the Board's authority for setting and raising fees. Those sections state the following:

a) The board shall, by regulation, fix the fees required for examination, licensure, certification, registration, renewal of licenses and registrations, renewal of certificates and temporary permits.
(b) If the revenues raised by fees, fines and civil penalties imposed pursuant to this act are not sufficient to meet expenditures over a two-year period, the board shall increase those fees by regulation so that the projected revenues will meet or exceed projected expenditures. (Emphasis added.)
(c) If the Bureau of Professional and Occupational Affairs determines that the fees established by the board pursuant to subsections (a) and (b) are inadequate to meet the minimum enforcement efforts required by this act, then the bureau, after consultation with the board, shall increase the fees by regulation so that adequate revenues are raised to meet the required enforcement effort.

 While we do not question the policy behind these incremental fee increases, we ask the Board to explain how the increases conform to the intent of the General Assembly and Section 13 of the Act. What is the Board's statutory authority for automatic fee increases that may or may not be needed to meet expenditures ten years in the future? If the financial condition of the Board improves, will the fees be decreased accordingly?

____

State Board of Certified Real Estate Appraisers
Regulation #16A-7015 (IRRC #2789)

Appraiser Trainees; Initial and Continuing
Education; Supervised Experience;
Practice Standards

November 18, 2009

 We submit for your consideration the following comments on the proposed rulemaking published in the September 19, 2009 Pennsylvania Bulletin. Our comments are based on criteria in section 5.2 of the Regulatory Review Act (71 P. S. § 745.5b). Section 5.1(a) of the Regulatory Review Act (71 P. S. §  745.5a(a)) directs the State Board of Certified Real Estate Appraisers (Board) to respond to all comments received from us or any other source.

1. Section 36.2. Application process.—Implementation procedures.

 The proposed regulation adds the following new sentence to Subsection (e):

An applicant for licensure as an appraiser trainee shall comply with any increased education requirement that takes effect between the applicant's filing of an application that is disapproved and the applicant's filing of a new application.

 The intent of this statement is not clear. How or when will ''any increased education requirement'' take effect? Will the Board notify applicants of these additional requirements? Is this statement referring to future rulemakings that amend the education standards? The final-form regulation should clarify these issues.

2. Sections 36.11 and 36.12. Qualifications for certification as residential real estate appraiser and general real estate appraiser.—Clarity.

 Existing language in each of these two sections establishes two tiers of educational requirements. For those who complete their education before January 1, 2008, the total ''appraisal classroom hours'' required are 120 hours and 180 hours for certified residential and general real estate appraisers, respectively. As of January 1, 2008, the required total hours increase to 200 and 300 for certified residential and general real estate appraisers, respectively. These increases are consistent with the requirements of the Appraisal Foundation's Appraiser Qualifications Board, which Federal law establishes as the national standard. The proposed regulation uses what the Preamble describes as a ''segmented approach'' to set January 1, 2012, as the deadline for applicants who can demonstrate completion of the 120 or 180 total hour requirement before January 1, 2008. In other words, all applicants will need to comply with the increase to 200 or 300 hours when they file their applications after 2011. We have three questions.

 First, the segmented approach gives applicants up to four years from when they complete their educational requirements to when they apply for certification. The Preamble indicates that the qualified experience requirements can be completed in 24 and 30 months. In addition, these applicants could accumulate qualified experience after completing 75 classroom hours. How did the Board determine that four years was a reasonable amount of time? Why is it appropriate to give these applicants an additional 18 months to obtain experience and apply?

 Second, the final-form regulation should clarify what the Board will consider to be appropriate ''evidence'' of the applicant's completion of certain courses in Subsections (b) and (d)(2). Finally, how will the Board determine that a course is ''equivalent'' to the 15-hour National USPAP course in Subsections (b) and (d)(2)? The final-form regulation should clarify this provision.

3. Section 36.12a. Qualifications for licensure as appraiser trainee.—Implementation procedures; Clarity.

Subsection (b)(2)

 What would the Board consider an ''examination pertinent to the course?'' The final-form regulation should clarify this issue.

Subsection (d)

 Subsection (d) explains the limitations on the biennial renewal of an appraiser trainee license. The license can be renewed no more than four times, unless one or more additional renewals are warranted. When would the Board consider additional renewals appropriate? Will there be a limit on the number of additional renewals permitted? What procedures or process would a trainee use to apply to request an additional renewal? What would be considered ''good cause'' for allowing an additional renewal?

4. Section 36.52. Use of certificate number and title.—Need; Clarity.

 This section lists several titles a certified real estate appraiser is permitted to use. The proposed regulation states that a ''substantially similar title'' may be substituted. What would the Board consider a ''substantially similar title?'' Given the list of titles the proposed regulation already provides, under what circumstances would it be necessary to use a ''substantially similar'' title?

ARTHUR COCCODRILLI, 
Chairperson

[Pa.B. Doc. No. 09-2251. Filed for public inspection December 4, 2009, 9:00 a.m.]



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