BILL ANALYSIS �
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|SENATE RULES COMMITTEE | AB 1890|
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THIRD READING
Bill No: AB 1890
Author: Chau (D)
Amended: 5/13/14 in Assembly
Vote: 21
SENATE BUSINESS, PROF. & ECON. DEV. COMMITTEE : 7-0, 6/16/14
AYES: Lieu, Wyland, Berryhill, Block, Corbett, Galgiani, Hill
NO VOTE RECORDED: Hernandez, Torres
ASSEMBLY FLOOR : 72-2, 5/19/14 - See last page for vote
SUBJECT : Athletic trainers
SOURCE : California Athletic Trainers Association
DIGEST : This bill establishes certification and training
requirements for athletic trainers and prohibits individuals
from calling themselves athletic trainers unless they meet those
requirements.
ANALYSIS : Existing law establishes the Unfair Practices Act
which defines unfair competition as any unlawful, unfair, or
fraudulent business act or practice and unfair, deceptive,
untrue or misleading advertising.
This bill:
1. Makes it unlawful for any person to hold himself/herself out
as an athletic trainer or a certified athletic trainer, or
use the term "AT", "ATC" or "CAT" to imply the person is an
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athletic trainer unless he/she is certified by the Board of
Certification, Inc. (BOC), and has done either of the
following:
A. Graduated from a college or university, after
completing an accredited athletic training education
program, as specified.
B. Completed eligibility requirements for certification
by BOC, prior to January 1, 2004.
2. Makes it an unfair business practice for a person to use the
title "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 an athletic trainer, if the person does not meet
the requirements set forth in this bill.
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 "athletic trainer", may use the title "athletic
trainer."
Background
Athletic Trainers . In compliance with the sunrise process, the
California Athletic Trainers' Association (CATA) completed and
submitted an extensive "sunrise questionnaire" to the Senate
Business, Professions and Economic Development Committee in
December 2011 in support of its proposal for licensure (at the
time, a bill proposing licensure was moving through the
legislative process). According to information contained in the
sunrise questionnaire, athletic trainers are allied healthcare
professionals recognized by the American Medical Association,
the American Medical Society of Sports Medicine and others.
Athletic trainers work in collaboration with a physician and
their education is predicated upon a formalized relationship
with a physician, working under established guidelines.
According to the sunrise questionnaire, athletic trainers
evaluate injuries and determine a patient's disposition, respond
to emergencies and make "split second decisions" regarding the
management of an injury as well as making decisions regarding
the course of rehabilitation. Athletic trainers also make
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"immediate decisions regarding serious conditions such as
concussion, spinal cord injury, heat illness and sudden cardiac
arrest without the intervention or advice of other health care
professionals" in situations where an incorrect decision could
lead to a catastrophic or fatal outcome.
An individual can become an athletic trainer by graduating with
a minimum of a bachelor's degree from an accredited athletic
training education program and by passing a national
certification examination offered by BOC. According to the
sunrise questionnaire, 70% of athletic trainers practicing today
hold a master's degree or higher. Athletic trainers, like other
health care professionals, take science based courses in
anatomy, physiology, chemistry and physics and must understand
all systems of the body and their normal and pathological
functions, including biochemical functions. Athletic training
education also includes didactic instruction and clinical
training in risk management and injury prevention, orthopedic
clinical assessment and diagnosis, medical conditions and
disabilities, acute care of injuries and illness, therapeutic
modalities and conditioning and rehabilitative exercise,
psychosocial intervention and referral, nutritional aspects of
injuries and illness, health care administration and
professional development. Although there are currently 16
accredited athletic training programs in California, no person
in California is required to obtain a degree or to become
certified to work as an athletic trainer.
Currently, there are approximately 2,500 certified athletic
trainers practicing in California. Athletic trainers specialize
in the prevention, evaluation, immediate care, treatment and
rehabilitation of injuries and activity related conditions in a
wide range of people engaged in physical activities from
professional and amateur athletes to industrial workers and
entertainers. Athletic trainers 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% of athletic
trainers in California work with non-athletes from a variety of
backgrounds because they may reduce employee injuries and
subsequent worker's compensation costs. Information provided in
the sunset questionnaire highlighted cost savings of around $7
million annually by a large manufacturing firm with over 3,000
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employees as a result of the firm hiring five athletic trainers
to work in an injury preventive role.
Information provided in the sunrise questionnaire found more
than 60 cases of harm as the result of improper care provided by
non-certified "athletic trainers." Of 760 respondents who took
part in a CATA survey for the sunrise questionnaire, 400
reported instances of harm as the result of improper care due to
certified and non-certified athletic trainers. BOC reported
over 2,700 violations of professional practice standards in five
years (2005-10) with nearly 300 violations in California,
including three sexual offenses, and in some cases included
those practicing without a valid certification or practice by
those who had lost their licensure in other states. CATA
asserts that there are "currently no other unregulated
professions that are providing services similar to those of
athletic trainers."
BOC . According to their Web site, BOC was incorporated in 1989
to provide a certification program for entry-level athletic
trainers. BOC establishes and regularly reviews both the
standards for the practice of athletic training and the
continuing education requirements for BOC certified athletic
trainers. BOC asserts that is has the only accredited
certification program for athletic trainers in the U.S.
Additionally, BOC cites accreditation by the National Commission
for Certifying Agencies (NCCA) and requirements that it undergo
review and re-accreditation every five years through the NCCA.
NCCA is the accreditation body of Institute for Credentialing
Excellence, a non-profit organization that provides educational,
networking, and advocacy resources to the credentialing
community, and is charged with evaluating certification
organization for compliance with the NCCA Standards for the
Accreditation of Certification Programs.
Athletic trainers currently have the option for certification
through BOC. For BOC certification, athletic trainers must have
received a minimum of a bachelor's degree from a National
Athletic Training Association (NATA) accredited institution and
pass a comprehensive exam. All states currently regulating
athletic trainers utilize the BOC examination which is based on
the Commission on Accreditation of Athletic Training Education.
To retain certification, credential holders must continue taking
medical-related courses and adhere to the BOC standards of
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practice.
Title Act vs. Practice Act Protection . It is important to note
the distinction between "title act" and certification or
registration regulation versus "practice act" and licensing
regulation. A practice act along with licensure confers the
exclusive right to practice a given profession on practitioners
who meet specified criteria related to education, experience,
and examination, and often is embodied in a statutory licensing
act (i.e., those who are not licensed cannot lawfully practice
the profession). A practice act is the highest and most
restrictive form of professional regulation, and is intended to
avert severe harm to the public health, safety or welfare that
could be caused by unlicensed practitioners.
A title act and a certification or registration program, on the
other hand, reserves the use of a particular professional
(named) designation to practitioners who have demonstrated
specified education, experience or other criteria such as
certification by another organization. A title act typically
does not restrict the practice of a profession or occupation and
allows others to practice within that profession; it merely
differentiates between practitioners who meet the specified
criteria, and are authorized by law to represent themselves
accordingly, (usually by a specified title) and those who do
not. Some title acts also include a state certification or
registration program, or reliance on a national certification or
registration program, so that those who use the specified title,
and hold themselves out to the public, have been certified or
registered by a state created or national entity as having met
the specified requirements. This entity may also regulate to
some extent the activities of the particular profession by
setting standards for the profession to follow, and to also
provide oversight of the practice of the profession by reporting
unfair business practices or violations of the law and either
denying or revoking a certification or registration if
necessary.
This bill does not establish a licensing practice act, but
instead provides for a title act. It restricts the use of the
title "athletic trainer" to only those who have met certain
education or certification requirements. There is no state
program created to provide oversight of this profession, there
is instead reliance on whether the person meets the education
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requirements or if they have been certified by a specific
corporation.
Comments
According to the author's office, this bill ensures that only
people with the proper education, training, and certification,
may call themselves an athletic trainer. According to the
author's office, 48 states and the District of Columbia regulate
athletic trainers, but in California anyone can label
him/herself an athletic trainer without the proper education,
training, or certification; and, in some cases, individuals such
as janitors, coaches, shipping and receiving clerks and others
have been given the title "Athletic Trainer" and the
responsibility for evaluating and managing concussions, spinal
cord injuries, shoulder dislocations, and knee injuries.
FISCAL EFFECT : Appropriation: No Fiscal Com.: No Local:
No
SUPPORT : (Verified 6/17/14)
California Athletic Trainers' Association (source)
American Medical Society for Sports Medicine
University of Southern California
ARGUMENTS IN SUPPORT : The bill's sponsor, California Athletic
Trainers' Association, writes that this bill ensures that
individuals who call themselves athletic trainers have had the
proper education and training and are certified by a nationally
recognized certifying agency.
ASSEMBLY FLOOR : 72-2, 5/19/14
AYES: Achadjian, Alejo, Ammiano, Bigelow, Bloom, Bocanegra,
Bonilla, Bonta, Bradford, Brown, Buchanan, Ian Calderon,
Campos, Chau, Ch�vez, Chesbro, Cooley, Dababneh, Dahle, Daly,
Dickinson, Eggman, Fong, Fox, Frazier, Garcia, Gatto, Gomez,
Gonzalez, Gordon, Gorell, Gray, Grove, Hagman, Hall, Harkey,
Roger Hern�ndez, Holden, Jones, Jones-Sawyer, Levine, Linder,
Logue, Lowenthal, Maienschein, Medina, Melendez, Mullin,
Muratsuchi, Olsen, Pan, Patterson, Perea, John A. P�rez, V.
Manuel P�rez, Quirk, Quirk-Silva, Rendon, Ridley-Thomas,
Rodriguez, Salas, Skinner, Stone, Ting, Wagner, Waldron,
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Weber, Wieckowski, Wilk, Williams, Yamada, Atkins
NOES: Allen, Donnelly
NO VOTE RECORDED: Conway, Beth Gaines, Mansoor, Nazarian,
Nestande, Vacancy
MW:d 6/18/14 Senate Floor Analyses
SUPPORT/OPPOSITION: SEE ABOVE
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