BILL ANALYSIS                                                                                                                                                                                                    Ó



                                                                     AB 161


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          GOVERNOR'S VETO


          AB  
          161 (Chau)


          As Enrolled  September 9, 2015


          2/3 vote


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          |ASSEMBLY:  |80-0  |(April 20,     |SENATE: |40-0  |(September 3,    |
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          |ASSEMBLY:  |80-0  |(September 4,  |        |      |                 |
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          Original Committee Reference:  B. & P.
          SUMMARY:  Establishes title protection for certified athletic  
          trainers (CATs).  Specifically, this bill:


          1)Prohibits a person from holding himself or herself out to be  
            an athletic trainer (AT) or a CAT, use the title "athletic  
            trainer," "certified athletic trainer," "licensed athletic  
            trainer," "registered athletic trainer," or any other term  
            such as "AT," "ATC," "LAT," or "CAT," to imply or suggest that  
            the person is an AT unless he or she meets the following  
            requirements:
             a)   He or she has done either of the following:








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               i)     Graduated from a college or university after  
                 completing an athletic training education program  
                 accredited by the Commission on Accreditation of Athletic  
                 Training Education (CAATE) or its predecessors or  
                 successors; or
               ii)    Completed eligibility requirements for certification  
                 by the Board of Certification, Inc. (BOC) or its  
                 predecessors or successors; and


             b)   He or she is certified by the BOC, or its predecessors  
               or successors.
          2)States that it is an unfair business practice, as specified,  
            for a person to use the title "athletic trainer,"  "certified  
            athletic trainer," "licensed athletic trainer," "registered  
            athletic trainer," or any other term such as "AT," "ATC,"  
            "LAT," or "CAT," that implies or suggests that the person is  
            an AT if he or she does not meet the specified requirements.
          3)Provides that a person who has worked as an AT in California  
            for a period of 20 consecutive years, prior to January 1,  
            2016, and who is not otherwise eligible to use the title  
            "athletic trainer," may use the title "athletic trainer."


          The Senate amendments add the terms "licensed athletic trainer"  
          and "registered athletic trainer" to list of prohibited titles,  
          and permit an individual to complete an athletic training  
          program accredited by the CAATE or its predecessors or  
          successors and complete eligibility requirements by the BOC's  
          predecessors or successors, as specified.  


          EXISTING LAW:  Provides for the regulation of various  
          professions and vocations including those of an athlete agent.  


          FISCAL EFFECT:  None.  This bill is keyed non-fiscal by the  
          Legislative Counsel.  









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          COMMENTS:  


          Purpose.  This bill is sponsored by the California Athletic  
          Trainers Association.  According to the author, "[ATs]  
          specialize in the prevention, diagnosis and intervention of  
          emergency, acute, and chronic medical conditions involving  
          impairment, functional limitations, and disabilities.  Their  
          clients include a wide range of people engaged in physical  
          activities from professional and amateur athletes to industrial  
          workers and entertainers.  [ATs] are employed by professional  
          sports teams, colleges and universities, high schools,  
          outpatient rehabilitation clinics, hospitals,  
          industry/corporations, performing arts groups, physicians, the  
          military and other institutions.  Nearly 40 [percent] of [ATs]  
          in California work with non-athletes in various industries  
          because they can reduce employee injuries and worker's  
          compensation costs.  


          "Although many high school and college sports teams already  
          employ ATs, and several California State University campuses  
          offer bachelor degrees in athletic training, California is the  
          only state that does not regulate this vital and growing  
          profession.  Currently, anyone can label him or herself an [AT]  
          without the proper education, training, or certification.   
          Without state oversight, the public could be harmed by relying  
          on someone who calls themselves an AT without the appropriate  
          background.  [This bill] would protect Californians by ensuring  
          that only those people who have the proper education, training,  
          and certification may call themselves an [AT]."


          Background.  This bill would establish a title protection for  
          ATs who have been certified by the BOC, meaning that individuals  








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          who are not certified would be prohibited from holding  
          themselves out as an AT.  This bill provides an exemption for  
          those individuals who have been practicing as an AT for 20  
          consecutive years prior to January 1, 2016.  


          Athletic Trainers.  According to the National Athletic Trainers  
          Association (NATA), ATs are health care professionals who  
          collaborate with physicians to provide preventative services,  
          emergency care, clinical diagnosis, therapeutic intervention and  
          rehabilitation of injuries and medical conditions.  ATs work in  
          a variety of settings, including schools, colleges, professional  
          sports, clinics, hospitals, corporations, industry, performing  
          arts venues, municipalities (e.g. fire and police departments)  
          and the military.


          Students who want to become CATs must earn a degree from an  
          accredited athletic training curriculum.  Accredited programs  
          include formal instruction in areas such as injury and illness  
          prevention, first aid and emergency care, assessment of injury  
          and illness, human anatomy and physiology, therapeutic  
          modalities, and nutrition and include both classroom learning  
          and clinical education experience.  More than 70% of certified  
          ATs hold at least a master's degree.  California is one of only  
          two states which do not regulate the athletic training  
          profession.   


           Board of Certification, Inc.  The CAATE is the national agency  
          responsible for accrediting education institutions for athletic  
          training.  Currently, in California, at least 13 universities  
          provide bachelor degree in athletic training programs certified  
          by CAATE.  The BOC provides the certification examination, which  
          is based on the CAATE educational principles, and the BOC is the  
          only entity which provides athletic training certification and  
          would be the sole provider of the certification examination in  
          California.  Certification is voluntary and this bill would not  
          require certification in California nor would non-certified  








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          individuals be subject to regulatory discipline for practicing  
          the profession.  


          Title Act vs. Practice Act.  There is an important distinction  
          between regulations which require licensure and those which  
          protect a professional title.  Statutes regulating professions  
          in California generally fall into two categories:  a "practice  
          act" or a "title act."  A "practice act" regulates the duties,  
          responsibilities and scope of practice that a licensee can  
          perform upon meeting specific educational, experiential or  
          training requirements.  A "title act" simply regulates the use  
          of the title an individual may use in practice.  In order to be  
          permitted to use a title, a state may require proof that an  
          individual has a certain level of experience or education  
          relevant to the particular title being regulated.  Title  
          protection is generally intended to be a means of market  
          differentiation whereas a "practice act" would literally  
          prohibit individuals from engaging in the practice regardless of  
          how it is described.  This bill would allow individuals to  
          continue to practice athletic training in California, but they  
          would not be permitted to call themselves "ATs" or use the title  
          "ATC," "LAT," "AT," or "CAT."


          The Role of Title Protection.  This bill would provide  
          BOC-certified ATs with title protection, while those  
          non-certified individuals who advertise the use of the name AT  
          would risk legal action-except for those individuals who meet  
          the 20-year exemption.  


          GOVERNOR'S VETO MESSAGE:


          This bill prohibits a person from using the title of athletic  
          trainer unless they have received a bachelor's degree and are  
          certified by a national certification body.  I vetoed a nearly  
          identical measure last year and continue to believe that the  








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          conditions set forth in this bill impose unnecessary burdens on  
          athletic trainers without sufficient evidence that changes are  
          needed.




          Analysis Prepared by:     Elissa Silva / B. & P. / (916)  
                          319-3301          FN: 0002451