Colorado’s Proposition 129 battle exposed critical gaps in how we address access to veterinary care. A veterinarian-legislator who led the opposition shares the evidence-based alternatives that are already making a difference.

Rep. Karen McCormick, DVM

Dr. Karen McCormick is a veterinarian and member of the Colorado House of Representatives. She practiced veterinary medicine for 34 years before entering politics and has been a leading voice on veterinary workforce issues in the Colorado Legislature.

I never expected to spend three years of my legislative career fighting about veterinary workforce issues. When I ran for office, I expected to deal with issues related to climate, education, housing and civil rights. But when the Colorado Veterinary Practice Act came up for sunset review during my first term, I was excited to sponsor the bill—and suddenly found myself at the center of the most contentious veterinary debate our state had ever seen. What started as a simple request to add a new position, the veterinary professional associate (VPA), to our practice act became a master class in why evidence-based policymaking matters, especially when animals’ lives are at stake.

Simple questions, complex problems

In spring 2022, a group of advocates brought forward what seemed like a straightforward request: amend the practice act to include the VPA as a new position. As a veterinarian with almost 40 years of experience, including 16 years of practice ownership, I had what I thought were a few basic questions: What problem are we trying to solve? How will this new position solve it? What’s the economic analysis that shows the need? How will VPAs be trained? Who will be responsible for their oversight?

I couldn’t get answers to any of them.

That’s when I knew we needed to dig deeper. I organized 13 working group meetings that summer, bringing together veterinarians, technicians, economists, legal experts, nonprofit leaders, advocacy organizations, and even officials from the FDA’s Center for Veterinary Medicine. What we discovered was eye-opening—and deeply concerning.

The first major revelation came from William Flynn, DVM, at the FDA’s Center for Veterinary Medicine. I’ll admit, I had forgotten—or maybe never fully understood—that federal prescribing authority in veterinary medicine operates under completely different statutes than human medicine. Under federal statute, if a medication is going into an animal, it must be prescribed by a licensed veterinarian in the course of their professional duties. Period. There’s no provision for midlevel practitioners to prescribe like there is in human medicine. Dr. Flynn told us it would take an act of Congress to change that fact.

Think about the implications. How would a VPA function if they legally can’t prescribe medications? They’d have to be tethered to a veterinarian for every prescription decision. The liability implications alone were sobering—that supervising veterinarian’s license would be on the line for every decision made by someone with a fraction of their training. Plus, having to be involved in every VPA prescription would only increase the workload of the busy veterinarian trying to serve clients and give animals the best care. It adds inefficiency to the delivery of care.

The training gap

This brought us to the second major concern: the proposed training simply didn’t match what proponents claimed VPAs would be prepared to handle. We’re talking about 65 hours of training—five semesters, three of which would be online and only one semester at the university—for someone who was supposed to perform “routine surgeries.” For context, veterinary technician programs in our state require approximately 75 hours of hands-on training. A veterinarian requires upwards of 175 credit hours of in-person education.

When I compared this to physician assistants in human medicine—the model VPA advocates kept citing—the disparity was stark. PAs undergo thousands of hours of clinical training, and they don’t perform surgery. Yet somehow a VPA with 65 hours of mostly online training was going to be competent to spay cats and perform other surgical procedures?

We also asked what exactly constitutes a “routine” surgery. In my experience, “routine” may be considered when you check on a patient 10 to 14 days after the procedure and everything’s OK. During the surgery itself, anything can happen. Complications don’t announce themselves in advance.

The more we examined the proposed curriculum, the more inadequate it appeared. We were essentially being asked to create a position that would practice all aspects of veterinary medicine under someone else’s license, with minimal training, and market it to the public as equivalent to a PA. That wasn’t just misleading—it was potentially dangerous.

Economics that don’t add up

Also highly troubling was the absence of economic analysis supporting the VPA concept. Proponents couldn’t show us data proving there was demand for this position, evidence that it would improve access to care, or projections for what graduates might earn.

When we surveyed veterinary practice owners across Colorado, the results were telling: 95% to 97% said they had no intention of hiring a VPA. When the vast majority of potential employers see no need for a position, what does that say about job prospects for students who’ll spend up to $80,000 on this degree?

During our stakeholder meetings, we consulted with four veterinary economists. Three of the four were skeptical of the VPA concept. They pointed out that if you add personnel to an inefficient system, you don’t make the system more efficient—you make it more chaotic. The real issue isn’t the absence of midlevel practitioners; it’s that we’re dramatically underutilizing the veterinary technicians and veterinary technician specialists we already have.

This was a revelation for me. I learned much that summer about veterinary technician specialists (VTSs)—highly trained professionals who’ve pursued additional certification in areas like anesthesia, dentistry or emergency care. These individuals are already functioning at a level between veterinary technicians and veterinarians, yet they’re largely unrecognized and underutilized across the country.

Finding real solutions

After that summer of listening and learning, instead of creating an entirely new profession with questionable training and unclear benefits, we focused on evidence-based solutions that could make an immediate impact. In 2024 I sponsored two bills that directly addressed the workforce challenges our investigation had identified.

The first expanded the scope of practice for all licensed veterinary technicians and formally recognized veterinary technician specialists by adding title protection for the VTS. These professionals already have the training and experience to take on more responsibilities. By elevating these roles and their compensation, we could address many of the efficiency issues plaguing veterinary practices without compromising animal welfare.

The second bill was focused on veterinary telehealth, expanding access to care in ways that are legal, safe, and consistent with federal regulations. This bill expands and clarifies how veterinarians may provide care and consultations remotely while maintaining the veterinarian-client-patient relationship required by federal law.

Both bills passed with bipartisan support and are being implemented. The veterinary technician scope expansion is currently having its rules and regulations written by the state board of veterinary medicine. These aren’t theoretical solutions—they’re practical changes that are already beginning to improve how veterinary teams function.

Implementing an imperfect solution

Despite our thorough investigation and the alternative solutions proposed, Proposition 129 was brought to the ballot by entities with big money and backing and was approved by the voters in November 2024. I was frustrated by the simple message marketed to the voters that this proposition would solve the access to animal care issue. We know the biggest barrier to care is cost and there is zero evidence that adding the VPA will help that issue. After passage of Prop 129, our job then became ensuring that we put reasonable guidelines and guardrails in place to implement the program as safely as possible, focusing on consumer protection and protection of animal health and welfare.

The ballot initiative language was incredibly vague, leaving gaps the state board couldn’t fill on their own. Boards can color between the lines of law, but they can’t color outside those lines—they can’t create statutory language that doesn’t exist.

Working carefully to ensure we weren’t contradicting the will of the voters, we crafted legislation to fill the most critical gaps. We established supervision requirements, mandated that VPAs identify themselves to clients, protected veterinarians from being forced to supervise VPAs as a condition of employment, and created the possibility of an alternative pathway for veterinary technician specialists to become VPAs.

One provision that was highly important to me was to limit the ratio of VPAs to supervising veterinarians and maintain that only veterinarians can establish the veterinarian-client-patient relationship to stay in line with FDA prescribing law. These weren’t attempts to undermine the ballot initiative. They were essential consumer protections that the original language had failed to include. House Bill 1285 passed and was signed by the governor in May.

The bigger picture

Throughout this process I have been accused of protectionism—of trying to preserve the status quo to benefit veterinarians financially. While the idea of these supposed veterinary riches is ridiculous, let me be clear: I am protecting something incredibly important. I’m protecting animal health and welfare and public health in accordance with the oath I took 40 years ago. So in many ways I embraced that label. Yes, I am a protectionist. When I took that oath, it was a lifelong oath and I am bound to uphold it.

This was never about economics or professional turf. We need more veterinarians—I’ve never disputed that. But the solution isn’t to create a poorly trained substitute. The solution is to address the real bottlenecks in our system and to correct the problems we’ve created for ourselves.

For example, we’ve trained a generation of veterinarians who are afraid to do surgery. Forty years ago we didn’t just do spays but dorsal laminectomies, and we presented a spectrum of treatment possibilities—platinum care was one option, but so was palliative care, or finding a middle-ground solution within a client’s means.

Today’s graduates do not have the confidence to do many surgeries, and they’ve been taught too often to pursue the “gold standard” in care. They refer cases to specialists that were common in general practice just a few decades ago. The result is rising costs and less-accessible care. Many of the challenges our profession faces we’ve brought on ourselves.

The good news is that we’re already on the right track to address some of these issues. Veterinary schools are recognizing the gaps in clinical preparation and addressing them. We are also creating more veterinarians to mitigate the shortage, with 11 to 12 new veterinary schools coming online and existing schools expanding class sizes. Data suggest that supply will meet demand by around 2030. These are large problems that take time to fix, but the fix is already in motion.

Meanwhile, we have immediate opportunities to better utilize our existing workforce. Veterinary technician specialists represent an enormous untapped resource. Programs like the one at Lincoln Memorial University in Tennessee show how we can elevate technicians with bachelor’s degrees through additional training that brings them to the next level—creating a true master’s in veterinary clinical care that could be an alternative way to create more veterinary technician specialists. That program isn’t currently set up for that purpose, but it is one of the ideas that came out of our working group.

Looking forward

As I finish my fifth year in the legislature, I remain committed to evidence-based solutions for our profession’s challenges. The VPA debate taught me that good intentions aren’t enough—we need data, we need careful analysis, and we need to consider unintended consequences.

The state board is currently working to establish rules and scope of practice for VPAs, a process that should be completed by late summer. I hope they’ll be judicious in their approach, recognizing the training limitations and liability issues we’ve identified. The rest of the country is watching what Colorado does, and we have a responsibility to get this right.

The veterinary profession faces real challenges, but we also have real solutions within our grasp. Let’s focus our energy on evidence-based approaches that truly serve animals, clients and the dedicated professionals who’ve chosen to make animal health their life’s work.