How a veterinary or animal-services employer operates
The employer of this class sells the in-person encounter between a licensed professional or a trained handler and an animal whose owner brought it to a fixed premises. Its revenue arrives when a dog is examined on a table, a cat is anesthetized for a dental cleaning, a spay is performed in a surgical suite, a boarding run is occupied for a week while its owner travels, a groomer works a coat for ninety minutes, a training class of eight owners and eight dogs meets on a floor, or a shelter places an animal at an adoption event. Every one of those events happens at a premises, with a customer who traveled there from a home, with supplies bought in a regulated market, on a schedule fixed weeks ahead, by a workforce that is predominantly female, commutes daily and has school-age children at home. Each of those elements is a thing an order can reach, and between March 2020 and September 2021 each was reached. This section states the functions in operational terms, the revenue lines, the inputs and counterparties, the workforce, the seasonality and geography, and the counterparty map that the layers section then fills with instruments.1 The statute those orders are measured against is read element by element at The Statute.
CL: clinical and surgical services
The clinical line comprises wellness examinations and vaccinations; in-house laboratory work, radiography and ultrasound; dentistry under general anesthesia; spay, neuter and other soft-tissue surgery; orthopedic surgery; oncology, internal medicine, ophthalmology and the other referral specialties; end-of-life care. This is the largest revenue line of a veterinary practice, and it is the line the orders suspended in terms. The work happens in examination rooms with the owner present for history and consent, and in surgical suites with anesthesia machines, ventilators, surgical masks, gloves and gowns, the same equipment and the same protective supplies the human hospitals needed in March 2020. Colorado suspended "all voluntary or elective surgeries or procedures, whether medical, dental, or veterinary"; Minnesota postponed "indefinitely" every such procedure "that utilize[s] PPE or ventilators"; Oregon cancelled every elective and non-urgent PPE-utilizing procedure at "veterinary clinics"; Michigan ordered every veterinary facility to postpone "all in-person non-essential veterinary services"; Indiana cancelled veterinary elective procedures from April 1 to April 26, 2020; Utah's order reached "all licensed health-care professionals," and Summit County recited that "urgent medical, dental, and veterinary procedures are restricted per Utah" order.2 When the suspensions ended, Colorado, Minnesota and Oregon replaced them with recommencement orders that conditioned every elective procedure on PPE adequacy, distancing, screening, written plans and owner consent for a year or more; Michigan, Oregon, Virginia and California wrote "veterinary clinics" or "veterinary settings" into workplace rules; and Pennsylvania, Kansas, California, Delaware, Michigan and Brookings, South Dakota required a face covering of every person who entered a "veterinary clinic" by name, one of the airborne-transmission controls each placed on its health-care settings.3
EM: emergency and urgent care
The emergency line is the twenty-four-hour emergency hospital and the emergency line of the general practice: trauma, toxin ingestion, obstruction, dystocia, acute pain, euthanasia. Under the suspension orders this was the only line permitted, and the orders defined it. Michigan permitted only services "necessary to preserve the life of an animal," "necessary to treat serious pain," "necessary to euthanize an animal" or "necessary to treat or prevent the transmission of any infectious disease that can be transmitted between animals and human beings"; Minnesota supplied veterinary urgency criteria ("threats to public health, threats to the health or safety of the animal's owner (e.g., in the case of service animals), and threats to the health or safety of the animal"); Oregon's test was whether the procedure could be delayed three months without harm; Colorado's was irreversible harm.4 Emergency care was performed curbside, with the owner in the parking lot, under the stay-at-home orders that permitted travel to a veterinarian only for the care the orders left un-postponed.5
BD: boarding and daycare
Boarding and daycare comprise overnight boarding runs and suites, daytime play groups, pet sitting and walking. Demand for boarding is the demand of an owner who is traveling or at a workplace; it is a derivative of the airline schedule, the hotel occupancy rate and the office. The function was designated essential by name in Florida ("pet boarding facilities"), Maryland ("kennels"), Illinois ("animal shelters, rescues, shelters, kennels, and adoption facilities"), Ohio, Montana, Wisconsin and Minnesota; Dallas County permitted "[p]et daycare, but only for employees of Essential Businesses."6 The designation fixed the premises open; the travel and telework orders of every level of government fixed the demand at a fraction of the year before.
GR: grooming and training
Grooming and training are the grooming table (bathing, clipping, nail trims, dematting) and the training floor (puppy classes, obedience classes, agility, behavior consultations). Grooming is a personal service performed on an animal with its owner at hand; training is a group meeting of owners and animals. Grooming was closed as a personal service or as a business outside the essential designations in the spring of 2020 in Maine ("Dog Grooming" in the non-essential column), Minnesota ("Workers supporting pet grooming businesses are not exempt"), Colorado ("Personal Services include ... dog grooming"), Massachusetts, Kentucky, Oklahoma, West Virginia, Hawaii, Illinois (added to the essential definition only on May 1, 2020) and the City of Los Angeles ("excluding pet grooming and training"); it was permitted only in limited forms in Indiana ("no pet grooming shall be provided to customers inside any home"), New York ("only to the extent necessary to ensure animal health"), Dallas County ("if necessary for the health and wellbeing of the animal") and Honolulu (mobile grooming only); and it reopened under conditions on the function itself: Kentucky's requirement that pets be delivered "curbside, in a crate, or in an entry room to avoid interaction," Hawaii's appointment-only rule with customers waiting in cars, Anne Arundel County's appointment-only rule at fifty percent, King County's fifty percent occupancy limit, Colorado's twenty-five percent at Level Orange and Red, and New Mexico's second closure of November 19 to December 2, 2020.7 Training classes fell under the gathering caps of every State.
SH: shelters, rescues and adoption
The shelter function comprises intake, holding, spay and neuter clinics, adoption counseling, adoption events, transport of animals between shelters and from other countries, and a volunteer workforce. The stay-at-home orders of Illinois, Ohio, Montana, Wisconsin, Minnesota, New Mexico and Colorado named shelters, rescues and adoption facilities as essential and thereby fixed the conditions under which they operated; adoption events and volunteer shifts were group meetings under the gathering caps; and from July 14, 2021 the Centers for Disease Control and Prevention suspended the importation of dogs from more than one hundred countries, an order addressed to the rescues that import, the breeders that export and the veterinarians that certify.8
RT: retail and pharmacy
The retail and pharmacy line comprises prescription diets, parasite preventives, prescription and over-the-counter medications, and the controlled substances a DEA-registered veterinarian dispenses. Pet stores and pet supply were essential in every State list read; the pharmacy line operated under the Drug Enforcement Administration's emergency exceptions for telemedicine prescribing, early refills and practice across State lines, and under the Food and Drug Administration's enforcement policy permitting extralabel and veterinary-feed-directive prescribing without the premises visit the federal regulation otherwise requires; and the American Veterinary Medical Association's April 2020 survey found that more than three quarters of practices reported pet owners had begun buying pet food or medication online.9
SC: PPE and pharmaceutical supply
The supply function buys N95 and surgical masks, gloves, gowns, face shields, sanitizer, anesthesia machines, ventilators, oxygen, vaccines, biologics and pharmaceuticals through national veterinary distributors. From March 2020 this function bought in a market the federal government had placed under Defense Production Act priority and allocation, in which fifteen categories of respirators, masks, gloves, gowns and ventilators were designated "scarce materials" whose accumulation above reasonable demand was a federal crime, and from which the Federal Emergency Management Agency forbade export without allocation; and it bought under State orders that required every veterinary facility to inventory its PPE, ventilators, respirators and anesthesia machines (Minnesota), to report its PPE inventory to the State (New Jersey), to surrender surplus PPE (Oregon), to minimize PPE "that could be used for the care of humans" (Michigan), and to make PPE adequacy the condition of every elective procedure (Colorado, Minnesota, Oregon).10 In July 2021 the Food and Drug Administration revoked the emergency authorizations under which imported and decontaminated respirators had entered that market.11
HR: hiring, credentialing and State board licensure
The function comprises recruiting veterinarians and technicians; State veterinary board licensure and renewal; DEA registration; USDA accreditation; technician credentialing; continuing education at conferences. The governors, licensing departments and boards remade this regime by emergency order for eighteen months. The in-person examination rule that defines the veterinarian's relationship with the animal's owner and the patient (the "VCPR," the relationship federal and State regulations require before a veterinarian prescribes) was waived in California (June 4, 2020 to October 31, 2021), Colorado, Florida, Hawaii (April 25, 2020 to August 6, 2021), Maine (April 6, 2020 to August 30, 2021) and Pennsylvania (March 18, 2020 to March 31, 2022); Kentucky's Board of Veterinary Examiners issued its COVID-19 Order of April 16, 2020, which the General Assembly ratified by 2021 HJR 77 and extended to January 15, 2022 by 2021 Special Session HJR 1; Maine issued emergency and reactivated licenses; California waived face-to-face training for licensure applicants; Tennessee suspended the Department of Health's inspections of veterinary facility licensure applicants; and from March 11, 2021 the Secretary of Health and Human Services drew "veterinarian[s] licensed or certified to practice under the law of any state" and "veterinary student[s] with appropriate training" into the persons authorized to prescribe, dispense or administer COVID-19 vaccines, a redeployment California ordered by name on March 30, 2021.12
OP: administration, front desk and telework
The administrative function comprises reception, check-in, scheduling, records, billing and owner communication. The telework mandates of the closure States moved the administrative staff home; Michigan compelled telemedicine "to the fullest extent possible"; Michigan's health department limited gatherings in the waiting rooms of "veterinary clinics"; and curbside operation converted the front desk into a telephone and a parking lot.13
WF: workforce availability
The industry's workforce is predominantly female, includes a large share of parents of school-age children, commutes daily and, in the largest metropolitan areas, by transit. The school closures of the spring of 2020 in every State, the emergency-only child-care orders, the Families First leave mandate through December 31, 2020, the quarantine and isolation directives, the federal conveyance face-covering order on every transit commute from February 1, 2021 and the school masking and quarantine orders of the 2021-22 year each fixed who could come to work on a given day; under the stay-at-home orders staff carried travel authorization letters to reach the clinic.14
CB: the customer base
The customer base comprises pet owners, breeders, rescues and shelters, and agricultural producers (livestock, equine, poultry, dairy). The pet owner was confined by the stay-at-home orders to enumerated purposes, and in Michigan to "veterinary services that, in accordance with a duly implemented ... veterinary services postponement plan, have not been postponed"; the breeder and the rescue were reached by the dog-importation suspension; the agricultural customer was reached by the meat and poultry plant orders and the plant outbreak closures that governed where its animals could go; and every customer operated under the eviction moratoria, the unemployment of April 2020 and the Delta-wave orders of the summer of 2021.15
The revenue lines
The revenue lines are professional services (examinations, vaccinations, diagnostics, dentistry, surgery), the largest line and the one the elective-procedure orders suspended; emergency and critical care; pharmacy and retail (the line that shifted online); boarding and daycare (the line tied to travel and workplace attendance); grooming and training (the line closed as a personal service); shelter adoption fees, municipal animal-control contracts and donations. Every line depends on a physical encounter at the premises or on a counterparty whose own operations were ordered.16
The inputs and counterparties are pet owners under the stay-at-home, face-covering and Delta-wave orders; breeders, rescues and shelters under the gathering caps and the importation suspension; agricultural producers under the plant orders and the H-2A consular closures; reference laboratories and diagnostic imaging providers; veterinary distributors and pharmaceutical and biologics manufacturers under the allocation and scarce-materials orders; landlords under the moratoria; human hospitals, whose shortages were the recited premise of the veterinary suspensions and to which veterinary teaching hospitals lent ventilators and anesthesia machines; the schools and child-care centers of the workforce; the transit systems of the commute; the State veterinary boards, the FDA, the DEA and the USDA; and the courts and motor-vehicle offices through which the industry's contracts and licenses run. Each is a class of counterparty whose orders limited this industry's commerce, and each appears in the layers section with exhibit identifiers.17
The workforce
The workforce comprises veterinarians, veterinary technicians and assistants, kennel attendants, groomers, trainers, receptionists and practice managers, shelter staff and volunteers. The clinical staff are licensed by a State board; the technicians and assistants are the hands that hold, restrain, monitor and clean; the front-desk staff are the interface the curbside orders removed. The industry employed 402,662 people in veterinary services and 137,133 in pet care in 2019; pet-care employment fell to 122,827 in 2020, a decline of 10.4 percent in the year of the orders.18
Seasonality and geography
The calendar
Wellness visits and parasite prevention peak in spring and summer; boarding and daycare peak at school holidays and in the summer travel season; shelter intake peaks in the spring, when the litters arrive. The suspensions of March through May 2020 fell on the spring wellness and surgical season; the travel collapse of 2020 removed the summer boarding season; the winter re-tightening fell on the holiday boarding season; and the Delta-wave orders of the summer of 2021 fell on the second summer season in a row.19
The map
The industry is everywhere: 31,975 veterinary establishments and 20,035 pet-care establishments in 2019, in every county, with the largest concentrations in the metropolitan areas whose local health officers issued the orders catalogued in the layers section, and with the elective-procedure suspensions falling on six States (Colorado, Minnesota, Oregon, Michigan, Indiana and Utah) and the grooming closures on at least fourteen.20
The counterparty map
For each counterparty class the orders that reached it are stated by category, with the subsection of the layers section in which the instruments appear.
| Counterparty class | Orders that reached it | Where the instruments appear |
|---|
| Pet owners (the customer base) | Stay-at-home orders confining travel to enumerated purposes; travel authorized only for un-postponed veterinary services (Michigan); face-covering orders; curfews; eviction moratoria; Delta-wave indoor face-covering orders | The fifty States and the District; the largest metropolitan areas; the ecosystem |
| Human hospitals and health systems (the premise of the PPE orders) | Elective-procedure suspensions reciting hospital PPE shortages; PPE inventory, surrender and minimization orders on veterinary facilities; the FEMA allocation rule; the scarce-materials designation | The federal layer; the fifty States and the District; the counterparties |
| Veterinary distributors and manufacturers (PPE, pharmaceuticals, biologics) | Defense Production Act orders; FEMA export detention; scarce-materials designation; FDA respirator authorization revocations of June 30 and July 6, 2021 | The federal layer; the ecosystem |
| Breeders, rescues and importers | CDC dog-importation suspension from July 14, 2021; gathering caps on adoption events; consular and entry restrictions | The federal layer; the sector regulators |
| Agricultural customers (livestock, poultry, equine) | Executive Order 13917 and the meat and poultry plant orders; plant outbreak closures; H-2A consular suspensions | The ecosystem |
| Licensing boards and licensing departments | VCPR and telemedicine waivers; emergency and reactivated licenses; inspection suspensions; vaccinator designations | The sector regulators |
| Schools and child care (the workforce's children) | Statewide closures of spring 2020; remote and hybrid orders of 2020-21; school and child-care face-covering and quarantine orders of 2021 | The counterparties; the ecosystem |
| Transit and travel (the commute and the boarding customer's journey) | Transit service reductions; the CDC conveyance order and TSA directives; entry proclamations; land-border notices; State traveler quarantines; Hawaii Safe Travels | The federal layer; the largest metropolitan areas; the ecosystem |
| Landlords and lenders | Eviction and foreclosure moratoria; court closures | The counterparties |
| Courts and public offices | Court closures; motor-vehicle and board office closures; remote-notarization orders | The counterparties |