National Veterinary Accreditation Program (Proceedings)

Welcome to Module 1: Introduction to the National Veterinary Accreditation Program. This module was developed as supplemental training for the USDA-APHIS National Veterinary Accreditation Program (NVAP) by the Center for Food Security and Public Health at the College of Veterinary Medicine, Iowa State University. The content for this module was finalized in February 2011.

This informational presentation is intended to familiarize accredited veterinarians with animal health regulatory concepts and activities. Information presented here does not supersede the regulations. For the most up-to-date regulations and standards, please refer to the Code of Federal Regulations and your local VS Area Office.

This presentation will:

• Introduce the National Veterinary Accreditation Program,

• Review the history and importance of the NVAP and its contributions to protecting and ensuring animal health,

• Provide information on the Category I and II accreditation levels and program certification opportunities, and

• Highlight the duties and responsibilities of an accredited veterinarian under the new NVAP system

Accreditation is Federal Government approval of private veterinarians to perform certain official regulatory functions on its behalf. NVAP is a voluntary program that certifies private veterinary practitioners to work cooperatively with Federal veterinarians and State Animal Health Officials to protect and ensure animal health. Graphic: A USDA approval stamp for endorsed U.S. origin health certificates.

The NVAP is administered by the Veterinary Services (VS) branch of the U.S. Department of Agriculture's (USDA) Animal and Plant Health Inspection Service (APHIS) in collaboration with individual states.

Veterinarians are accredited by the Federal Government in cooperation with individual State Governments. The accreditation program is managed at the national level; however, the authority to perform accreditation duties is issued on a State-by-State basis. Veterinarians must be authorized in each state that they wish to perform regulatory duties.

USDA-APHIS is dependent on the partnership with accredited veterinarians for carrying out many of the programs and services designed to protect public health and well-being by preventing, controlling, and eradicating disease in animals. The mission of the NVAP is–to provide private veterinary practitioners with the information they need to ensure the health of the Nations' livestock and animal population and to protect the public health and well-being.

There are approximately 71,000+ active accredited veterinarians in the national database. Accredited veterinarians are the backbone of the US' regulatory programs for livestock diseases and have extraordinary responsibilities. They perform health certifications to ensure that animals transported between States and exported to other countries do not introduce disease. They also help USDA conduct surveillance and monitoring for diseases of concern. They are vital to the recognition and prompt reporting of foreign animal disease (FAD) incursions.

• 1907: Private practitioners first performed regulatory work for the FederalGovernment when a large number of horses were exported to Canada. Because there were not enough Federal veterinarians, the Canadian government agreed to accept health inspections and certifications performed by private practitioners qualified by the Bureau of AnimalIndustry (now APHIS).

• 1917: The services of practicing veterinarians were used again when theTuberculosis Eradication program was established.

• 1921: The veterinary accreditation program officially began whenUSDA's Bureau of Animal Industry administered the first accreditation examination to certify practitioners as representatives of the Federal Government. The accreditation program was established so privatepractitioners could assist Federal veterinarians in controlling animaldiseases. Today, accredited veterinarians and Federal and State Animal Health Officials work cooperatively in the NVAP.

• 1992: APHIS established accreditation to be managed nationally, although the authority to perform accreditation work is implemented on aState-by-State basis. The national system approach standardized the accreditation procedures and requirements allowing for more uniformadministration of the program. More than 80 percent of all U.S.veterinarians are accredited.

USDA-APHIS-VS has a long history of cooperating with the veterinarycommunity in performing regulatory work in the United States. APHIS has determined that it needs to enhance the NVAP to provide ongoing supplemental training relevant to the responsibilities of being an accredited veterinarian. Accordingly, the NVAP will ensure that accredited veterinarians have detailed and current information throughout their careers to meet the challenges of disease prevention and emergency preparedness.

The changes are designed to:

• Improve quality and accuracy of accreditation program activities,

• Increase international credibility for the U.S. accreditation program,

• Improve the ability to provide timely animal health information to accredited veterinarians,

• Improve the ability to safeguard domestic animal population health,

• Improve quality and marketability of U.S. animals and animal products, and

• Improve accredited veterinarians' knowledge of the zoonotic nature of many domestic and foreign animal diseases.

The rationale for enhancing the accreditation program is based on international and domestic developments, including:

• The increasing need for uniformity and consistency in the administration of the NVAP policy;

• The need to maintain international acceptance of the U.S. veterinary accreditation program (most other countries use government veterinarians to perform the duties conducted by U.S. accredited veterinarians);

• Constantly changing trade requirements and ongoing changes to domestic programs require that the accredited veterinarian stay current through education to be able to perform accreditation duties accurately;

• Increasing number of trade agreements recognized by global organizations (e.g., World Trade Organization); and

• Increasing demand for industry-driven quality assurance programs. Additional reasons for changing the NVAP include

• Strengthening the emergency response capability for animal agricultural emergencies; and

• Recognizing that accredited veterinarians are the country's front-line surveillance system: they will be among the first to detect a foreign animal disease (FAD). Increasing the practicing veterinarians' knowledge of emerging and foreign animal diseases will increase preparedness in the event of a foreign animal disease incursion.

The NVAP published regulations which became effective February 1, 2010. There are now requirements for you to complete designated amounts of APHIS-approved supplemental training and to renew your accreditation every three years. You have also selected an accreditation category based on your scope of practice, and Category II veterinarians are eligible to receive additional training to become Qualified Accredited Veterinarians (QAVs) in specific areas of expertise such as aquaculture.

improve animal health.

The NVAP supplemental training requirements must be met in order to maintain authorization to perform accreditation duties. This training is achieved through completion of modules that focus on the latest scientific information on the transmission, recognition (clinical signs and diagnosis), and reporting of exotic and emerging diseases, and NVAP policy. These modules will increase awareness of prevention and preparedness strategies for animal health emergencies in the United States. Training will be offered in a web-based format, on CD-ROM or printed copy upon request, and in meetings like the one presented here. Each web-based module will take no more than one hour to complete. There will be no charge for the web-based training; the CD-ROM or paper copies will have a minimal cost to cover production, shipping and handling.

In order for a veterinarian to be eligible for accreditation:

• The veterinarian must be a graduate with a Doctorate of Veterinary Medicine or an equivalent degree (any degree that qualifies the holder to be licensed by a State to practice veterinary medicine) from a college of veterinary medicine.

• The veterinarian must be licensed or legally able to practice veterinary medicine in the State in which the veterinarian wishes to perform accredited duties.

• The veterinarian has completed initial accreditation training, using content approved by APHIS (if applying for the first time after July 2011).

• The veterinarian must have completed a core orientation program approved by the Veterinarian-in-Charge for the State in which the veterinarian wishes to perform accredited duties. Upon completion of this core orientation, the veterinarian must sign a written statement listing the date and place of orientation, the subjects covered in the orientation, and any written materials provided. The State Animal Health Official often participates in the core orientation.

As previously mentioned in step 3, veterinary students and veterinarians seeking to become accredited for the first time after July 2011, completion of initial accreditation training is required. There are many topics related to diseases, their control and eradication, animal movement and federal animal health laws that accredited veterinarians must be familiar with in order to successfully participate in the NVAP. A series of web-based training lessons covering these topics and more have been incorporated into the Emerging and Exotic Diseases of Animals (EEDA) course. The complete list of required lessons is on the next slide.

For each of the initial accreditation training lessons there is a section test and participants must correctly answer 80% or more of the questions to receive completion credit. Topics for the required lessons include:

• Professional and ethical responsibilities of the accredited veterinarian;

• Federal animal health laws;

• Animal disease diagnosis, control and eradication;

• Foreign animal disease awareness which includes 2 different lessons; and

• Animal health emergency management which includes 2 different lessons and the completion of 7 incursion examples.

Once participants have successfully completed each lesson and section test, an electronic certificate will be available to print or save. This certificate serves as the–admission pass || to the next phase of the accreditation process, core orientation.

The Veterinary Accreditation Core Orientation Program includes the following topics:

• Federal animal health laws, regulations, and rules;

• Interstate movement requirements for animals;

• Import and export requirements for animals;

• USDA animal disease eradication and control programs;

• Laboratory support in confirming disease diagnoses;

• Ethical and professional responsibilities of an accredited veterinarian;

• Foreign animal disease awareness;

• Animal health emergency management; and

• Animal health procedures, issues, and information resources relevant to the State in which the veterinarian wishes to perform accredited duties is often covered in State-specific orientation. This State-specific orientation, if necessary, is performed in the desired State of practice after licensure.

Veterinarians apply for accreditation by completing VS Form 1-36A,

–Application for Veterinary Accreditation, || and certify that they are able to perform specific tasks. The document can be accessed at: http://www.aphis.usda.gov/animal_health/vet_accreditation/downloads/vs1-36a.pdf. This information is submitted to the APHIS Area Veterinarian-in-Charge (AVIC) in the State where the applicant wishes to perform accredited duties. The forms are then reviewed by the State Animal Health Official and endorsed (unless the State Animal Health Official sent a written statement to APHIS explaining why the application was not endorsed)

To meet the changing scope of veterinary practice, the NVAP has two species-based categories of accreditation. Veterinarians select an accreditation Category (I or II) when completing VS Form 1-36A.

Veterinarians in both categories will complete supplemental training modules during the 3-year renewal period. When currently accredited veterinarians voluntarily sign up for the NVAP, after completing the steps previously described, you will receive a renewal letter from the USDA that contains your National Accreditation Number (NAN) and your renewal date. Initial renewals of a ccreditation for veterinarians already accredited as of February 1, 2010 will be staggered between 2013, 2014, and 2015. Subsequent renewals will take place three years after the first series of renewals. For example, accredited veterinarians whose initial renewal date is August 31, 2014, will be due for renewal three years after their initial renewal, in 2017. The renewal date is the date that supplemental training must be complete. Category I veterinarians need to complete THREE training modules during their 3-year renewal period tomaintain their accreditation status. Category II veterinarians are required to complete SIX training modules during their 3-year renewal period.

Veterinarians selecting Category I are able to issue official documents for all animals except: food and fiber species, horses, birds, farm-raised aquatic animals, all other livestock species, and zoo animals that can transmit exotic animal diseases to livestock. Even though pot-bellied pigs and certain birds may be kept as pets, they may still harbor diseases which pose significant threats to the nation's food producing pigs and birds. Rabbits are not considered livestock by the USDA, so even though they can be raised for meat, they are considered Category I animals by APHIS.

Veterinarians selecting Category II can perform accredited activities on all animal species. Category II status enables participation in other program certification activities such as certification as a Qualified

Accredited Veterinarian for the Trichinae Certification Program, or other program certifications as appropriate. Photo: (Top) An accredited veterinarian examining a herd of Holstein heifers for outward signs of abnormality

The NVAP gives veterinarians the ability to enhance their knowledge and receive current information on important animal health issues.

Key benefits of accreditation include:

• Enhanced professional knowledge base;

• Up-to-date information on animal health, food safety, and regulatory issues;

• Ability to choose level of accreditation program participation and tailor accredited activity to practice type;

• Ability to receive supplemental training;

• Continued acceptance of official work performed by accredited veterinarians in international markets; and

• Increased marketability of services to clients through areas of expertise recognized by USDA

The Code of Federal Regulations (CFR) is the comprehensive –rule book || that contains all of the current federal regulations. Information pertaining to veterinary accreditation are listed in Title 9—Animals and Animal Products, Chapter I—USDA-APHIS, Parts 160, 161, and 162. It is imperative that all accredited veterinarians review and familiarize themselves with the information in this Chapter, especially Part 161.

Please note that the CFR is updated annually.

The following are some duties and responsibilities for all accredited veterinarians:

• Must perform duties only in a State in which they are authorized to perform accredited work;

• Must perform duties in accordance with Federal and State regulations;

• Must accurately and fully complete official documents, clearly identifying animals, dates, and results;

• Are responsible for the security and proper use of all official documents; tags, bands, or other identification devices; and approved digital signature capabilities and should take reasonable care to prevent their misuse;

• Cannot issue documents unless they have personally inspected the animals related to the documents within 10 days prior to issuance;

• Should immediately contact the VS Area Office if they are at any timein doubt regarding how to correctly perform a procedure or what their actions should be in a given situation;

• Must keep current on regulations governing the movement of animals and procedures applicable to disease control and eradication programs, including emergency programs;

• Must take measures to prevent the spread of communicable diseases;

• Must identify or be physically present to supervise the identification of reactor animals (brucellosis, tuberculosis);

• Must report all diagnosed or suspected cases of foreign animal diseases and communicable animal diseases for which APHIS has a control or eradication program;

• Cannot use or dispense any pharmaceutical, chemical, vaccine or serum, or other biological product which contradicts Federal or State statutes;

• May issue an origin health certificate for export under certain circumstances and with AVIC approval; and

• Under certain unique circumstances, can issue a document on animals inspected by another accredited veterinarian.

• For a complete listing of duties and responsibilities of all accredited veterinarians, refer to 9 CFR § 161.4 Standards for accredited veterinarian duties.

The accreditation regulations can be found in 9 CFR, Chapter 1, subchapter J. Category I veterinarians must be able to perform 9 specific tasks. Category II veterinarians must be able to perform those 9 plus another 16 tasks. Next we will discuss those tasks.

The tasks that all Category I veterinarians must be able to perform include:

• Perform physical examination of individual Category I animals to determine whether they are free from any clinical signs suggestive of communicable disease;

• Recognize the common breeds of Category I animals and accurately record breed information on official documents.

• Apply common animal identification for Category I animals.

• Properly complete certificates for domestic and international movement of Category I animals.

• Perform necropsies on Category I animals.

• Recognize and report clinical signs and lesions of exotic animal diseases that occur in Category I animals.

• Vaccinate Category I animals and accurately complete the vaccination certificates.

• Properly collect and ship specimen samples to the appropriate laboratory for testing with complete and accurate paperwork.

• Develop appropriate biosecurity protocols, as well as cleaning and disinfection protocols, to control communicable disease spread inCategory I animals.

Category II veterinarians must also be able to:

• Perform physical examination of individual animals and visually inspect herds or flocks to determine whether the animals are free from any clinical signs suggestive of communicable disease.

• Recognize the common breeds of Category I and Category II animals, including the types of poultry as defined by the National Poultry Improvement Plan and the common breeds of livestock, and be able to accurately record breed information on official documents.

• Recognize all USDA animal identification systems.

• Estimate the age of livestock using a dental formula.

• Apply USDA-recognized identification (e.g., eartag, microchip, tattoo) for the USDA animal identification system.

• Certify the health status of an avian flock regarding diseases of domestic or international regulatory concern, and evaluate records pertaining to poultry flock testing and participation in Federal and State poultry health programs and classifications.

• Properly complete certificates for domestic and international movement of animals.

• Apply and remove official seals.

• Perform necropsies on animals.

• Recognize and report clinical signs and lesions of exotic animal diseases.

• Develop a herd or flock health plan* consistent with requirements of this chapter. *A written herd or flock health management plan, which may include an agreement signed by the owner of a herd or flock, the accredited veterinarian, and a State or APHIS representative, in which each participant agrees to undertake actions specified in the agreement to maintain the health of the animals and detect signs of communicabledisease.

• Vaccinate for USDA program diseases and accurately complete the vaccination certificate.

• Properly collect and ship sample specimens to an appropriate laboratory for testing with complete and accurate paperwork.

• Properly perform testing for tuberculosis (e.g., caudal fold test).

• Develop appropriate biosecurity protocols, as well as cleaning and disinfection protocols, to control communicable disease spread.

• Explain basic principles for control of diseases for which APHIS or APHIS-State cooperative programs presently exist.