BILL ANALYSIS �
AB 1890
Page 1
ASSEMBLY THIRD READING
AB 1890 (Chau)
As Amended May 13, 2014
Majority vote
BUSINESS & PROFESSIONS 14-0
-----------------------------------------------------------------
|Ayes:|Bonilla, Jones, | | |
| |Bocanegra, Campos, | | |
| |Dickinson, Eggman, | | |
| |Gordon, Hagman, Holden, | | |
| |Maienschein, Mullin, | | |
| |Skinner, Ting, Wilk | | |
|-----+--------------------------+-----+--------------------------|
| | | | |
-----------------------------------------------------------------
SUMMARY : Establishes title protection for certified athletic
trainers. Specifically, this bill :
1)Prohibits a person from holding himself or herself out to be
an athletic trainer or a certified athletic trainer, or from
using the term "AT," "ATC," or "CAT" to imply or suggest that
the person is an athletic trainer unless he or she meets both
of the following requirements:
a) He or she has done either of the following:
i) Graduated from a college or university after
completing an athletic training education program
accredited by the Commission on Accreditation of Athletic
Training Education, or its predecessors or successors; or
ii) Completed requirements for certification by the
Board of Certification, Inc. (BOC), prior to January 1,
2004; and,
b) He or she is certified by BOC.
2)Deems that it is an unfair business practice for any person to
use the title of "athletic trainer," "certified athletic
trainer," or any other term, such as "certified," "licensed,"
"registered," "AT," "ATC," or "CAT," that implies or suggests
that the person is certified as an athletic trainer, if the
AB 1890
Page 2
person does not meet the specified requirements.
3)Provides that a person who has worked as an athletic trainer
in California for a period of 20 consecutive years prior to
January 1, 2015, and who is not otherwise eligible to use the
title of "athletic trainer," may use the title "athletic
trainer."
FISCAL EFFECT : None. This bill is keyed non-fiscal by the
Legislative Counsel.
COMMENTS :
1)Purpose of this bill. This bill would enact title protection
for athletic trainers certified by BOC, meaning that
individuals who are not certified athletic trainers would be
prohibited from holding themselves out to the public as
athletic trainers. An exemption is provided to uncertified
individuals who have worked as athletic trainers in California
for 20 consecutive years prior to 2015. This bill is
sponsored by the California Athletic Trainers' Association
(CATA).
2)Author's statement. According to the author, "Although many
high school and college sports teams already employ [athletic
trainers], and several California State University campuses
offer bachelor degrees in athletic training, California is one
of only 2 states that do not regulate this vital and growing
profession. Currently, anyone can label him[self] or herself
an athletic trainer without the proper education, training, or
certification. Without state oversight, the public could be
harmed by relying on someone who calls themselves an [athletic
trainer] without the appropriate background. AB 1890 would
protect Californians by ensuring that only those people who
have the proper education, training, and certification may
call themselves an athletic trainer."
3)The practice of athletic training. According to the sponsor,
athletic trainers are physical medicine and rehabilitation
specialists who generally work in institutional settings under
the direction of a physician. In practice, they may be the
first healthcare providers on the scene when injuries occur
(whether at sporting events or on job sites), and must be able
to recognize, evaluate and assess injuries and provide
AB 1890
Page 3
immediate care when needed.
Athletic trainers are considered "health care professionals"
by the American Medical Association, which states that
"athletic training encompasses the prevention, diagnosis and
intervention of emergency, acute, and chronic medical
conditions involving impairment, functional limitations, and
disabilities." Athletic trainers are distinct from "personal
trainers", who are generally thought of as individuals who
prescribe, monitor and modify individual exercise programs in
a fitness or sports setting. Athletic training and physical
therapy are also different professions, although there are
certainly substantial areas of overlap.
The United States (U.S.) Department of Labor describes the
areas of expertise for certified athletic trainers as:
application of protective or injury-preventative devices;
evaluation of injuries; first aid and emergency care;
development and execution of rehabilitation programs for
injured athletes; and program planning for injury and illness
prevention of athletes.
Athletic trainers are usually employed by organizations such
as professional sports teams, colleges and universities, high
schools, outpatient rehabilitation clinics, hospitals,
corporations, performing arts groups, physicians groups, the
military and health clubs. Roughly 44% of certified athletic
trainers nationwide work with athletes in educational or
professional sports settings, with nearly 19% working in
health care facilities, and more than 10% working in industry,
public safety, and the military. The sponsor reports that
large employers use athletic trainers in part because of their
utility in reducing employee injuries and workers'
compensation costs.
4)Current state of regulation for athletic trainers. The
educational system for athletic training has been standardized
and accredited by a national agency, the Commission on
Accreditation of Athletic Training Education (CAATE).
According to the author, all 48 states currently regulating
athletic training utilize the BOC certification examination,
which is based on CAATE educational principles. BOC is the
only entity that currently provides athletic training
certification, which means that it would be the sole provider
AB 1890
Page 4
of the certification exam required by this bill.
Certification is not currently required to practice athletic
training in California, and noncertified individuals are not
subject to regulatory discipline.
Despite its widespread adoption, BOC has a limited ability to
investigate complaints against certified athletic trainers
because they have no subpoena power and limited staff with no
authority in California. Its sole disciplinary power is the
suspension or revocation of the national certification which
is not recognized in California and thus poses no barrier to
an individual's continued practice here.
According to the sponsor, there are 48 states that regulate
athletic trainers, 39 of which provide licensure (five require
registration and four require certification).
There are 16 accredited athletic training programs in
California. In 2010, 182 Californians became certified
athletic trainers.
Currently, there are approximately 2,500 certified athletic
trainers practicing in California. The sponsor of this bill,
CATA, represents roughly 2,300 athletic trainers in
California.
1)The role of title protection. This bill would provide
BOC-certified athletic trainers with what is termed "title
protection." Title protection means that certified athletic
trainers would have an exclusive right to use the title
"athletic trainer," while noncertified athletic trainers who
advertise the same title risk legal action. The only
exception would be individuals who have been practicing
continuously in California for 20 years or more before 2015,
who would be allowed to use the title as well.
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. In this case, other individuals could
still practice athletic training in California, but they would
not be permitted to call themselves athletic trainers.
Legislation providing title protection or registration for
AB 1890
Page 5
athletic trainers has been passed and vetoed three separate
times in recent years: AB 1647 (Hayashi) of 2010, SB 284
(Lowenthal) of 2007, and SB 1397 (Lowenthal) of 2006.
Governor Schwarzenegger's veto message of AB 1647 stated,
"This bill is similar to legislation I have vetoed twice
before in the past because there is no evidence that
regulating the use of the term 'certified athletic trainer'
poses any threat to the public health and safety."
2)Evidence of substandard practice. According to the author,
"[a] survey of 760 certified athletic trainers? found more
than 60 cases of harm as the result of improper care provided
by non-certified 'athletic trainers.'
"According to the U.S. Department of Labor Division of
Practitioner Data Banks, a voluntary reporting repository for
sanctions made by state boards, there were 469 reports of
sanctions to athletic trainers - both certified and
uncertified - from 2000 to 2010. These sanctions were based
upon misconduct including incompetent practice/harm,
practicing beyond the scope of practice, and sexual
misconduct. The BOC reported over 2,700 violations
[nationwide] of professional practice standards in five years
(2005-10) with nearly 300 violations in California, including
three sexual offenses. In a 2011 case, a collegiate athlete
died because of negligence of a collegiate athletic trainer,
although no lawsuit has been filed to date. Two additional
athletic trainers were fired after being arrested on sexual
abuse charges."
The sponsor reports that it is aware of at least 150
individuals practicing as athletic trainers without BOC
certification in California high schools, and seven
individuals working in California community colleges who are
similarly uncertificated.
Finally, the sponsor contends that "the lack of oversight of
athletic trainers is a consumer protection problem. The
athletes with whom these unqualified individuals work, and the
employers who hire them, have no way of knowing that these
individuals are not qualified to be athletic trainers. The
public has no way to determine if someone practicing athletic
training is qualified. The public has no way to file a
complaint, or ask for a practitioner to be investigated and/or
AB 1890
Page 6
sanctioned for incompetence, unethical practice, etc. This
creates a huge regulatory gap in the healthcare system."
Analysis Prepared by : Hank Dempsey / B., P. & C.P. / (916)
319-3301
FN: 0003458