BILL ANALYSIS �
AB 374
Page 1
Date of Hearing: April 26, 2011
ASSEMBLY COMMITTEE ON BUSINESS, PROFESSIONS AND CONSUMER
PROTECTION
Mary Hayashi, Chair
AB 374 (Hayashi) - As Amended: April 25, 2011
SUBJECT : Athletic Trainers
SUMMARY : Establishes the Athletic Trainer Licensing Committee
(Committee) within the Medical Board of California (Board) to
license and regulate athletic trainers (ATs), commencing January
1, 2013 and sunsetting on January 1, 2018. Specifically, this
bill :
1)Establishes the Committee within the Board, consisting of the
following seven members:
a) Four licensed athletic trainers who have satisfied
requirements, as specified, with two to be appointed by the
Governor and confirmed by the Senate, one to be appointed
by the Senate Committee on Rules, and one to be appointed
by the Speaker of the Assembly;
b) One public member, to be appointed by the governor and
confirmed by the Senate; and,
c) Two members, one to be appointed by the Senate Committee
on Rules and one to be appointed by the Speaker of the
Assembly, chosen from the following:
i) Physicians and surgeons licensed by the Board;
ii) Osteopathic physicians and surgeons licensed by the
Osteopathic Medical Board of California; or,
iii) Doctors of chiropractic licensed by the State Board
of Chiropractic Examiners.
1)Specifies that all appointments be for a term of four years
and expire on June 30 of the appropriate years. The initial
public member shall serve a term of one year and the two
athletic trainers shall serve terms of three years.
2)Specifies that each member shall receive per diem and
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expenses, as specified.
3)Requires the Committee to issue an AT license to an applicant
who has met all of the following requirements:
a) Submitted an application developed by the Committee that
includes evidence that the applicant has completed athletic
trainer certification eligibility requirements from an
athletic training education program at a four year college
or university approved by the committee;
b) Holds current athletic training certification via a
nationally accredited athletic trainer certification agency
approved by the Committee;
c) Possesses an emergency cardiac care certification from a
certification body approved by the Committee that adheres
to the most current international guidelines for
cardiopulmonary resuscitation and emergency cardiac care;
and,
d) Paid the application fee established by the Committee.
1)Makes a license valid for three years and thereafter subject
to renewal requirements.
2)Requires the Committee to renew a license if an applicant
meets all of the following requirements:
a) Pays the renewal fee established by the Committee;
b) Submits proof of satisfactory completion of continuing
education, as determined by the Committee;
c) Submits proof of current emergency cardiac care
certification, as specified; and,
d) Demonstrates that his or her license is otherwise in
good standing, including, if applicable, that the applicant
for renewal possesses a current, unencumbered certification
from a nationally accredited athletic training
certification agency approved by the Committee.
3)Authorizes the Committee to order the denial of an application
for, or the issuance subject to terms and conditions of, or
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the suspension or revocation of, or the imposition of
probationary conditions upon an AT's license after a hearing
for unprofessional conduct that includes, but is not limited
to, a violation of these regulations or those adopted by the
Committee.
4)Requires the Committee to establish license application and
renewal fees in an amount sufficient to cover the reasonable
regulatory costs of carrying out these provisions.
5)Establishes the Athletic Trainers Account in the Contingent
Fund of the Medical Board of California. All fees collected
pursuant to these provisions shall be paid into the account
and shall be available, upon appropriation by the Legislature,
to the Committee for the regulatory purpose of carrying out
the provisions, as specified.
6)Requires that an AT render treatment under the direction of a
physician and surgeon licensed by the Board, an osteopathic
physician and surgeon licensed by the Osteopathic Medical
Board of California, or a doctor of chiropractic licensed by
the State Board of Chiropractic Examiners who shall order and
oversee the athletic trainer and shall be responsible for the
athletic training activities performed by the athletic
trainer. This direction shall be provided by verbal order
when the directing physician and surgeon, osteopathic
physician and surgeon, or chiropractor is present and by
written order or by athletic training treatment plans or
protocols, to be established by the physician and surgeon,
osteopathic physician and surgeon, or chiropractor when the
directing physician and surgeon, osteopathic physician and
surgeon, or chiropractor is not present.
7)Limits the practice of athletic training to the professional
treatment of a patient for risk management and injury
prevention, the clinical evaluation and assessment of a
patient for an injury or illness, or both, the immediate care
and treatment of a patient for an injury or illness, or both,
and the rehabilitation and reconditioning of a patient's
injury or illness, or both.
8)Prohibits anyone from using the title of AT, or any other
similar term, or engage in the practice of athletic training
unless he or she is licensed pursuant to these provisions.
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9)Prohibits a licensee from providing, or offering to provide,
or representing that he or she is qualified to provide, any
treatment that he or she is not qualified to perform by his or
her education, training, or experience, or that he or she is
otherwise prohibited by law from performing, including grade 5
joint mobilizations.
10)Authorizes the Committee to establish other mechanisms for
the adequate supervision of an athletic trainer.
11)Exempts all of the following:
a) ATs licensed in another state who are in California
temporarily to engage in the practice of athletic training
for, among other things, an athletic or sporting event;
b) ATs licensed, certified, or registered in another state
who are invited by a sponsoring organization, such as the
United States Olympic Training Center, to temporarily
provide athletic training services under their scope of
practice;
c) Students enrolled in an athletic training program, while
participating in educational activities under the
supervision and guidance of an athletic trainer licensed,
as specified; and,
d) Members of the United States Armed Forces, licensed,
certified, or registered in another state, as part of their
federal employment in California for a limited time.
12)Authorizes the Committee to adopt, repeal, and amend
regulations as necessary to enable it to carry into effect
these provisions. The Committee may consult the professional
standards issued by the National Athletic Trainers'
Association, the Board of Certification, Inc., or any other
nationally recognized professional association.
13)Makes the protection of the public the highest priority,
paramount to any other interests sought to be promoted, for
the Committee in exercising its licensing, regulatory, and
disciplinary functions.
14)Makes legislative findings and declarations.
AB 374
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EXISTING LAW provides for the regulation of various healing arts
professions and vocations.
FISCAL EFFECT : Unknown
COMMENTS :
Purpose of this bill. According to the author's office,
"Athletic Trainers (ATs) are highly trained allied health
professionals, specializing in the prevention, assessment,
treatment, and rehabilitation of muscle and bone injuries and
illnesses.
"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 one
of only 3 states that do not regulate this vital and growing
profession. ATs should not be confused with fitness trainers or
personal trainers, who are not healthcare workers. Without
state oversight, the public could be harmed by relying on
someone who calls themselves an AT without the appropriate
background."
Background. Athletic trainers help prevent and treat injuries
for people of all ages. Their patients and clients include
everyone from professional athletes to industrial workers.
Recognized by the American Medical Association as allied health
professionals, ATs, are one of the first healthcare providers on
the scene when injuries occur, must be able to recognize,
evaluate, and assess injuries and provide immediate care when
needed. ATs may work under the direction of a licensed
physician and in cooperation with other healthcare providers.
Athletic trainers are distinctly different from "trainers". A
personal trainer is an individual who prescribes, monitors, and
changes an individual's specific exercise program in a fitness
or sports setting.
In 2009, 47 States required ATs to be licensed or registered,
which includes certification from the Board of Certification,
Inc. (BOC). For BOC certification, ATs need a bachelor's or
master's degree from an accredited athletic training program and
pass a comprehensive examination. To retain certification,
credential holders must continue taking medical-related courses
and adhere to the BOC standards of practice. In Alaska,
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California, West Virginia, and the District of Columbia where
licensure is not required, certification is voluntary.
Employment of ATs is projected to grow 37 percent from 2008 to
2018 because of their role in preventing injuries and reducing
healthcare costs. In some states, there are efforts underway to
have an AT in every high school to work with student-athletes,
which may lead to growth in the number of ATs employed in high
schools. In addition, as more young athletes specialize in
certain sports, there is increasing demand for ATs to deal with
repetitive stress injuries.
Arguments in support . The California Athletic Trainers
Association writes in support, "California is currently one of
only three states that does not regulate the athletic training
profession. Anyone can label him or herself an athletic trainer
without the proper education or certification - giving athletes,
parents, and coaches a false sense of safety and putting our
children in harm's way. Worse yet, our state is a dumping
ground for out-of-state individuals who are not able to obtain
licensure �or] who have lost their license. Currently, nothing
is stopping them from coming to California and practicing a
trade for which they are not qualified.
Denise De La Torre, a parent of a young athlete, writes, "My son
was put back into play injured by our school trainer and
recently was hospitalized due to that injury?To date his
hospital bills have reached a staggering $40,000?This
hospitalization was preventable had my son been given the time
to heal and had proper after care advise been given to us by our
school's athletic trainer."
Arguments in opposition. The California Physical Therapy
Association writes in opposition, "There is no evidence that the
current lack of regulation poses any threat to the public's
health, safety, and welfare. Protections to consumers, more
specifically, school-age children are adequately provided under
current law. It has not been demonstrated that students in
California suffer a greater frequency of substandard care from
current athletic training service providers. Currently, the
term "athletic trainer" is not a term used exclusively by those
who hold a certification by any certification or regulatory
body. For many years the Legislature has identified that
healthcare providers with various education and training can and
do serve as athletic trainers. AB 374 would prohibit those who
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are trained and have demonstrated continued competency from
providing athletic training services.
REGISTERED SUPPORT / OPPOSITION :
Support
California Athletic Trainers Association (sponsor)
California Community College Athletic Trainers' Association
California Medical Association
Fishermen's Union of America
Hundreds of individuals
Opposition
California Federation of Teachers
California Physical Therapy Association
Occupational Therapy Association of California
8 individuals
Analysis Prepared by : Marina Wiant / B.,P. & C.P. / (916)
319-3301