The creation of a midlevel professional in veterinary medicine has moved a step closer to reality and, in a novel twist, its fate rests on a public vote.

A push to establish a so-called veterinary professional associate (VPA) role in Colorado cleared a major hurdle today after proponents garnered enough signatures from registered voters in the state to put the initiative to a public vote on Nov. 5, according to the Colorado Secretary of State's office.

The VPA's scope of practice is generally envisioned to include tasks once restricted to veterinarians, such as diagnosing conditions and providing prognoses. VPAs are sometimes compared to physician assistants or nurse practitioners in human medicine.

The Colorado initiative does not spell out in detail the scope of the new role, describing it as within the VPA's "advanced education and experience" and as delegated by the "supervising veterinarian."

That advanced education is defined as a master's degree in veterinary clinical care or the equivalent. Currently, only Lincoln Memorial University College of Veterinary Medicine in Tennessee offers such a degree. Colorado State University College of Veterinary and Biomedical Sciences is on track to offer a program next year.

The concept of a midlevel team member has been floating around the profession for decades but has gotten nowhere, in part due to the steadfast opposition of the American Veterinary Medical Association, which represents veterinarians. However, the idea has gained traction in recent years, owing to rising demand for veterinary care.

Proponents say the midlevel professional is a necessary antidote to workforce shortages. They argue that these paraprofessionals will take pressure off overburdened veterinarians, who can delegate more tasks and, as a result, provide more access to care.

Critics say that delegating veterinarians' tasks to less educated and experienced individuals will put animals at risk.

The Dumb Friends League, which runs multiple shelters and a hospital that provides subsidized veterinary care in Colorado, spearheaded the initiative and celebrated the announcement.

"We are thrilled that Coloradans will get to vote on the ballot measure to increase access to veterinary care through the VPA position," chief executive Dr. Apryl Steele told the VIN News Service today. "We have had incredible support from pet owners, animal welfare advocates, veterinarians, veterinary technicians and other community members. Inaccessible veterinary care is one of the greatest causes of animal suffering, and we must do better."

Steele said the proposed master's degree program at Colorado State University "will result in highly qualified professionals who increase access to veterinary care while always working under the supervision of a veterinarian."

A coalition of veterinary organizations opposed to the midlevel position released a statement warning voters about what it calls a "harmful proposal."

"This ballot measure attempting to create a 'Veterinary Professional Associate' (VPA) would be disastrous for pets and other animals and endangers public health, considering that 75 percent of emerging infectious diseases in humans originate with animals," AVMA President Dr. Sandra Faeh was quoted as saying. "The proposed training for this position is completely inadequate and will lead to missed or delayed diagnoses, ineffective treatment and repeat visits, all of which lead to more suffering for the animal and increased cost for the client."

Separately, a proposed initiative in Colorado to relax veterinary telemedicine rules — by weakening a requirement for an in-person examination by a veterinarian before virtual appointments — did not submit signatures for review and so will not be on the ballot.