Idaho veterinarians make tentative peace

Humane Society agrees to limit some services

May 28, 2015
By Edie Lau

Series

Part 1 of 3: Nonprofit veterinary care: for whom and how?

Part 2 of 3: Washington law on veterinary nonprofits: model or muddle?

Part 3 of 3: Idaho veterinarians make tentative peace

See related stories »

Photos by Pete Grady

The Idaho Humane Society’s existing facility (top) is near the Boise Airport in an out-of-the-way location that “nobody has ever just happened to come by,” whereas 35,000 vehicles a day pass its future location (bottom), said IHS Executive Director Dr. Jeff Rosenthal.

For 31 years, the Idaho Humane Society (IHS) has operated a full-service veterinary clinic open to the public, and for most of that time, the private-practice community paid little mind because the hospital was modest and located on the industrial outskirts of town.

That changed when the organization embarked on an ambitious expansion plan involving construction of a 6,000-square-foot animal hospital with teaching facilities for veterinary students on a 10-acre campus in central Boise that will encompass sheltering, adoption, public education in humane animal care and a public dog park.

Area private-practitioners perceived the new complex, scheduled to break ground in 2016, as a “university-type hospital,” and “freaked out,” said Dr. Robert Pierce, president of the Idaho Veterinary Medical Association (IVMA). “They feared they’d lose their life’s work.”

The prospect of having to compete against veterinary clinics run by nonprofit animal shelters and animal-welfare organizations — which are exempt from federal income taxes and benefit from donations and volunteer labor — is a simmering concern of private-practice veterinarians.

In Idaho, the conflict boiled over. The IVMA drafted legislation to circumscribe the scope of services provided by nonprofit clinics and limit them to tending animals belonging to low-income households. The negative attention came at the worst possible time for the humane society, in the midst of a $11.5 million fundraising campaign.

Both sides suffered, said Dr. Jeff Rosenthal, executive director of the humane society. “It was a terrible ordeal for the veterinary community,” he said. “A couple of years of hostility.”

Last month, the hostility came to a formal end when Rosenthal and Pierce signed an agreement under which the humane society voluntarily stopped providing wellness checkups and other non-emergency care to the public at large.

Those services now are available from the IHS only to pets whose owners’ incomes are at or below 75 percent of median income in the counties in which they live; and to active IHS employees and volunteers, as well as to animals in government service.

To the general public, the humane society clinic still provides spay and neuter surgeries, microchipping and treatment for urgent and emergency conditions.

Rosenthal said he would not have been able to accept the agreement otherwise. “There was no way — ethically, morally and practically — we would tell someone who’d come to us with a sick or injured or even dying animal that we couldn’t help them,” he said.

Pierce said the IVMA’s key interest was seeing the humane society focus its care on people who need charity.

“Charities need to operate in a charitable way,” he said. “Really, what we’re trying to do is make sure that the money going to a charity is actually used to help poor people. ... They shouldn't just operate a regular business.”

Ensuring this is in the interest of society as a whole, Pierce said, because taxpayers subsidize charitable organizations. Not only are such groups exempt from paying federal income taxes, he said, the donations they receive likewise are tax-exempt.

Rosenthal said the new limits will affect perhaps half of the people who brought their pets to the humane society clinic for routine wellness care in the past, and the organization will take a financial hit— how much, he said, he doesn’t know.

At the same time, Rosenthal allowed, “If it opens up slots to allow people to come to us who have no other options who have injured animals, then that’s a good thing. … Really, we’re in the business of urgent care.”

For those seeking preventive care, the IHS now asks them to sign a statement certifying their eligibility. They need not show proof.

“I know a lot of veterinarians will say that some people will cheat,” Rosenthal said. “But most nonprofit organizations in this country that are providing service, whether low-cost day care, Boys and Girls Clubs and so forth, nobody asks for documentation because it’s just a logistical nightmare. We’d have to hire a bunch of staff. …”

Moreover, Rosenthal said, many of the people most in need are the least likely to have the paperwork. “By requiring this sort of proof, you tend to shut out the people who most need the service,” he said. “The panhandler on the corner with a dog, we’re lucky if we can get an ID off of him.”

The IHS does ask low-income pet owners applying for reduced-fee services to prove their income status by showing pay stubs, Social Security statements or other documents.

Why, then, has the organization opted not to request income proof under its new policy restricting wellness services to low-income households? Or, conversely, why request it of those applying for discounted medical care?

Rosenthal said that asking for documentation from large numbers of people is impractical and potentially risky, owing to the need to keep the financial information confidential. “For a vaccine program, it seems like an overkill, frankly,” he said.

For access to discounted care, though, asking for documentation makes sense, he believes. “There’s an art to this, I suppose,” he mused. “… The donors expect us to be wise stewards of the resources.”

Still, if an applicant for reduced-fee care doesn’t produce the requested paperwork, the clinic will not refuse care. “You have to be flexible so that animals don’t leave here suffering,” Rosenthal said.

How conflict evolved

Rosenthal said it was important for the IHS to come to terms with the IVMA to the controversy, in light of its expansion plans. “This was a real headwind in our capital campaign,” he said.

The campaign has raised nearly 75 percent of its $11.5 million goal. The humane society already has acquired for $1.8 million the 10-acre site for its new campus. Although only about three miles from the existing location, the expansion will put the facility on a retail corridor at the geographic center of a region dubbed the Treasure Valley.

The existing hospital is cramped for the IHS veterinary team of eight doctors; at 2,000 square feet, Rosenthal said, it’s more appropriately sized for a practice of one full-time and one part-time veterinarian.

“We’re doing close to 10,000 spays and neuters a year, and lots of other stuff,” Rosenthal recounted. “We have a student program now with two resident students at all times from Washington State University. We’re a required rotation, kind of an adjunct teaching facility, so we needed room.”

He speculated, “Maybe it wouldn’t have raised as much concern if we’d decided to build on where we are right here behind the airport. Nobody would have known.”

But making do with the existing site wasn't a great option because expectations for humane societies have changed over the years, he said. The existing building was designed to house large numbers of animals for short periods of times. In the past, shelters were places where “the animals were not expected to come out on the other side,” Rosenthal said. “Now we’re under intense public pressure to save everything. The public is more and more demanding (that) from us.”

So the animals stay much longer as the staff works on saving not only the cream of the crop as in the past, but saving those with severe medical or behavioral issues, Rosenthal said. ”Veterinary hospitals are the tools we have to do that.”

Rosenthal said he understands why private practitioners might be unnerved by the prospect of a new, larger hospital closer to the heart of the city. He believes the wariness with which private-practice owners increasingly view nonprofit clinics is fueled at least in part by increased competition within the private sector.

“We’ve had a full-service hospital on the site since 1984,” Rosenthal said. “At that time, there were five other vet hospitals in the city of Boise in the Yellow Pages. Since that time, there’s been a huge number of vets that have come to this town. Even though we’ve been here longer than almost everybody else, as the pie gets cut into smaller slices, (and) as the economy tanked, people became increasingly sensitized. Every year, it seems more vets come to Boise and tap a shingle on the door.

“We got blamed, I think, for maybe some over-saturation.”

Rosenthal blamed himself for not developing relationships with the private-practice community after he joined the IHS in 2000. “I just kind of assumed everything was copacetic,” he said.

In accepting the agreement with the IVMA, the IHS headed off attempts to legislate the issue. Rosenthal is glad. “I don’t think that’s the answer to everyone doing a better job on getting along with each other,” he said.

One provision in the agreement has the IVMA and IHS meeting quarterly for the first two years and at least once a year from then on. The document states: “The purpose of these meetings is to review the means testing protocol, types and number of services being offered by the IHS, and to solicit suggested improvements to foster open communications and mutual support between the IVMA membership and the IHS …”

In perhaps a recognition that the new peace may be fragile, the agreement calls for meetings to be attended by two or more state legislators to serve as facilitators and mediators if disagreements arise.

In an opinion piece published in the Idaho Statesman newspaper explaining the original dispute and subsequent agreement, Pierce observed that IHS doctors are also members of the IVMA, “and thus, this was really a family quarrel.”

He concluded with optimism, “The family fight has ended and a needed precedent has been established; both sides are happy to move on.”