PA 17-195—sHB 7171

Public Health Committee

AN ACT CONCERNING ATHLETIC TRAINERS

SUMMARY: This act expands and updates the scope of practice for athletic trainers by adding to the definition of “athletic training” in the athletic trainer licensing statutes.

It changes the term for athletic trainers' clients, from “athletes” to “physically active individuals,” and generally includes in the definition members of sports teams or other individuals who regularly participate in sports or recreational activities and are deemed healthy by a health care provider.

Additionally, the act:

1. expands requirements for standing orders between athletic trainers and licensed health care providers to provide care and treatment to physically active individuals;

2. adds to the license renewal requirements for athletic trainers who work somewhere other than at a professional, amateur, school, or other sports organization;

3. modifies the licensure exemption requirements for athletic training students;

4. requires athletic trainers to maintain specified amounts of professional liability insurance, unless their employer maintains such insurance; and

5. requires certain athletic trainers to make their client records available, at their employer's request, for quarterly review.

The act also makes various minor, technical, and conforming changes.

EFFECTIVE DATE: October 1, 2017

SCOPE OF PRACTICE

Under prior law, athletic training was the application or provision of specified services with the consent, and under the direction, of a licensed health care provider (i.e., a physician, chiropractor, podiatrist, or naturopath). The act adds advanced practice registered nurses to the list of licensed health care providers who may direct athletic trainers. It specifies that “consent and direction” means working under a (1) written prescription specifying the plan of care or treatment of musculoskeletal injury or illness or (2) standing order issued by such a provider.

The act also adds the following to the list of permissible services that athletic trainers may provide:

1. any physical agent prescribed by a health care provider (the law already allows manual therapy techniques, aquatic therapy, heat, cold, light, electric stimulation, sound, and exercise);

2. recognition of potential illness within the trainer's scope of practice, education, and training; and

3. wellness care services (e.g., biomechanics, conditioning, nutrition, and strength training) for physically active individuals who are free of underlying pathologies beyond the athletic trainer's scope of practice.

The act removes from the list of permissible services providing (1) exercise equipment and (2) temporary splinting and bracing.

Under prior law, athletic training included the principles, methods, and procedures of evaluating, preventing, treating, and rehabilitating athletic injuries. The act (1) specifies that this includes clinical evaluation and (2) adds to the definition the management, emergency care, and disposition of such injuries.

The act also specifies that athletic trainers may offer education and counseling to the community at large, not just athletic communities, on the prevention and care of athletic injuries.

Physically Active Individuals

The act renames athletic trainers' clients as “physically active individuals” instead of “athletes.” Under prior law, “athletes” generally included members of sports teams or other individuals who participated in sports or recreational activities at least three times per week.

The act instead defines “physically active individuals” as those who are deemed healthy by a health care provider and are:

1. members of sports organizations;

2. regular participants in a sports activity; or

3. participants in an exercise, recreational, or employment activity that requires strength, agility, flexibility, range of motion, speed, or stamina comparable to that required of a regular participant in a sports activity.

Standing Orders

The law permits athletic trainers to provide treatment and care under the standing order of certain licensed health care providers. The act requires that such orders:

1. be followed by the athletic trainer under a health care provider's consent and direction,

2. be annually reviewed and renewed by the health care provider and athletic trainer to ensure the client's quality of care, and

3. require the availability of continuing communication between the health care provider and athletic trainer.

It also requires the order to include the following:

1. a plan for emergencies,

2. appropriate treatments for specific injuries or illnesses,

3. instructions for treating and managing concussions,

4. a list of conditions requiring the immediate referral of the client to a health care provider, and

5. a list of conditions beyond the athletic trainer's scope of practice.

The act also specifies that standing orders apply to the care and treatment of physically active individuals who (1) are members of a sports organization or (2) require emergency treatment, first aid, or care.

LICENSURE

License Renewal

The law requires an athletic trainer renewing his or her license to maintain athletic trainer certification from the Board of Certification, Inc. and pay a $205 fee. The act requires an athletic trainer who practices somewhere other than at a professional, amateur, school, or other sports organization to also provide evidence that he or she completed:

1. the Occupational Safety and Health Administration's 10-hour outreach training program for the construction or general industries and

2. (a) at least 45 hours of direct supervision under a licensed athletic trainer or health care provider or (b) a three-credit college-level course at a nationally accredited program of higher learning on preventing, treating, and caring for workplace injuries.

Licensure Exemptions

Prior law allowed a student intern or trainee to practice without an athletic trainer license if he or she was pursuing a course of study in athletic training. Under the act, such an exemption applies only for students enrolled in an athletic training program accredited by the Commission on Accreditation of Athletic Training Education or its successor. As under prior law, any such student must be supervised by a licensed athletic trainer. The student must also be designated as an athletic training “student” or a similar title, instead of as an “intern” as under prior law.

Professional Liability Insurance

The act requires an athletic trainer renewing a license who provides direct patient care to maintain professional liability insurance or other indemnity against liability for professional malpractice of at least $500,000 for one person, per occurrence, with an aggregate liability of at least $1.5 million. The requirement applies for registration periods starting October 1, 2017 and does not apply if the licensee's employer carries such insurance or indemnity.

Client Records

For registration periods starting October 1, 2017, the act requires licensees who practice athletic training in a workplace to make their client records available, at their employer's request, for quarterly review.