116060-1:n:01/06/2010:JRC/th LRS2010-47




SB454
By Senator Smitherman
RFD Business and Labor
Rd 1 23-FEB-10


SYNOPSIS:This bill would amend the Alabama Athletic Trainers Licensure Act to delete the title "Apprentice Athletic Trainer" and replace it with "Athletic Training Student" and to further expand certain definitions.
 This bill would delete the staggered expiration dates for the initial appointments to the board of athletic trainers that are currently obsolete.
 This bill would allow a person involved in an approved athletic training education program to serve as an athletic training student.
 This bill would also expand the therapeutic treatments an athletic trainer may use.
 This bill would also make it unlawful for a person to provide athletic training service or represent themselves to be an athletic trainer without a license.

A BILL
TO BE ENTITLED
AN ACT

To amend Sections 34-40-2, 34-40-3, 34-40-4, 34-40-5, as amended by Act 2009-41, 2009 Regular Session (Acts 2009, p. 140), 34-40-6, 34-40-9, 34-40-10, 34-40-11, 34-40-13, 34-40-14, and 34-40-15, Code of Alabama 1975; relating to the Alabama Athletic Trainers Licensure Act; to delete the title "apprentice athletic trainer" and replace it with "athletic training student"; and to expand further certain definitions; to delete obsolete dates; to allow a person enrolled in an approved athletic training program to serve as an athletic training student; to expand therapeutic treatments an athletic trainer may use; to make it unlawful to provide athletic training services without a license; and to repeal Sections 34-40-7 and 34-40-16, Code of Alabama 1975.

BE IT ENACTED BY THE LEGISLATURE OF ALABAMA:

Section 1. Sections 34-40-2, 34-40-3, 34-40-4, 34-40-5, as amended by Act 2009-41, 2009 Regular Session (Acts 2009, p. 140), 34-40-6, 34-40-9, 34-40-10, 34-40-11, 34-40-13, 34-40-14, and 34-40-15, Code of Alabama 1975, are amended to read as follows:

§34-40-2.

"As used in this chapter, the following words and phrases shall have the following meanings, respectively, unless the context clearly indicates otherwise:

"(2)(1) ATHLETE. A person who participates in an athletic activity being conducted by an educational institution, professional athletic organization, or a board sanctioned amateur athletic organization, in association with an educational institution, industrial organization, or professional, amateur, or recreational sports club or organization, participates in functional activities, exercise, recreation, sport, or game requiring physical strength, range of motion, flexibility, body awareness and control, speed, stamina, or agility.

"(3)(2) ATHLETIC INJURY. An injury received by an athlete as a result of the preparation or participation of the athlete in an athletic activity sustained by an athlete that affects the athlete's participation or performance in sports, games, recreation, exercise, or activity that requires physical strength, agility, flexibility, speed, stamina, or range of motion; or condition identified by a licensed physician as benefiting from athletic training services.

"(4)(3) ATHLETIC TRAINER. A person licensed by the Alabama Board of Athletic Trainers as an athletic trainer and who practices athletic training on an athlete under the direction or referral, or both, of a licensed physician after meeting the requirements of this chapter and rules and regulations promulgated pursuant to this chapter. A board certified, allied health care professional licensed by the Alabama Board of Athletic Trainers who meets the qualifications of the regulations set by the board and practices athletic training under the direction of a licensed physician.

"(5)(4) ATHLETIC TRAINING PRACTICE. The practice by an athletic trainer of prevention, recognition, assessment or evaluation, therapeutic management, disposition, reconditioning, and rehabilitation of athletic injuries performed under the direction of a licensed physician and within the professional preparation and education of a licensed athletic trainer. The practice of athletic training does not include the practice of physical therapy or occupational therapy or joint manipulation as routinely performed by a licensed chiropractor. For the purpose of the preceding sentence, "joint manipulation" means the manipulation, adjustment, or Grade V mobilization of a joint by direct force performed at the limit of the range of motion of the joint, but within the anatomical integrity of the joint. Manipulation commences where mobilization ends and begins when the elastic barrier of resistance is encountered. Practice by an athletic trainer of any of the following:

"a. Under physician direction or referral, or both, the prevention of athletic injuries.

"b. The organization and administration of athletic training programs.

"c. Athletic counseling and guidance and the education of athletes regarding athletics and athletic training.

"d. Under physician direction and referral, the rehabilitation and reconditioning of an athlete.

"e. Under physician supervision, the evaluation, the recognition, and management of athletic injuries.

"(5) ATHLETIC TRAINING SETTINGS:

"a. Traditional setting. An educational institution or professional, amateur, or recreational sports club or organization. In this setting, the athletic trainer works under the direction of a licensed physician in providing injury prevention, rehabilitation, and health and wellness services for which the athletic trainer has received the appropriate education and training.

"b.1. Nontraditional clinical setting. A hospital, department, outpatient facility, clinic, or physician's office. In this setting, the athletic trainer works under the direction of a licensed physician in providing injury prevention, rehabilitation, and health and wellness services for which the athletic trainer has received the appropriate education and training.

"2. Nontraditional industrial setting. A work setting whereby the athletic trainer utilizes his or her education in promoting wellness and injury prevention for which the athletic trainer has received the appropriate education and training to decrease injuries. Treatment of industrial injuries by an athletic trainer shall only be upon the referral of a physician licensed to practice medicine in the State of Alabama.

"(1)(6) APPRENTICE ATHLETIC TRAINER ATHLETIC TRAINING STUDENT. A person who assists in the duties usually performed by an athletic trainer and who works under the direct supervision of a licensed athletic trainer.

"(6)(7) BOARD. The Alabama Board of Athletic Trainers.

"(7)(8) PHYSICAL THERAPIST. A physical therapist licensed by the Alabama State Board of Physical Therapy.

"(8)(9) PHYSICIAN. A physician licensed by the Medical Licensure Commission of Alabama.

"(9)(10) PHYSICIAN SUPERVISION DIRECTION. A licensed athletic trainer acting under the supervision direction of a physician if:

"a. The activities are undertaken pursuant to a verbal or written order of the physician who has evaluated the injured athlete; and

"b. The activity is undertaken in accordance with a written protocol signed by the physician which describes the athletic injury encountered and directs appropriate medical interventions consistent with the qualification, training, and experience of the licensed athletic trainer. The State Board of Medical Examiners shall establish minimum medical criteria for any protocol used by athletic trainers and shall specify those conditions and circumstances which require referral to the physician for further evaluation.

§34-40-3.

"(a) The Alabama Board of Athletic Trainers shall be composed of nine members who shall serve four-year terms. Members may not serve more than three consecutive four-year terms. Three members shall be Black African-American, one of whom shall be a physician member. The composition of the board shall be as follows:

"(1) Six members appointed by the Alabama Athletic Trainers Association in accordance with subsection (b) below, one of whom shall be an athletic trainer who is a licensed physical therapist.

"(2) Three physicians licensed to practice medicine actively engaged in the treatment of athletes and athletic injuries appointed by the Medical Association of the State of Alabama.

"(3) The President of the Alabama Athletic Trainers Association who shall serve as an ex officio member of the board and whose term of office shall be yearly to coincide with his or her term as President of the Alabama Athletic Trainers Association.

"(b) The six athletic trainers shall be appointed by the Alabama Athletic Trainers Association. The association shall conduct an annual meeting at which all athletic trainers holding a current license as identified under this chapter shall have the right to attend, nominate, and vote. The association shall regulate and prescribe the date, hour, and place of the meeting, the method of nomination, and the manner of voting. At least 30 days prior to the meeting, the association shall mail notices to each current licensee at the address shown on the current registration notifying of the exact date, hour, and place of the meeting, the purpose of the meeting, and of the right to attend and vote. To qualify as a board member pursuant to this subsection, a person shall be a citizen of the United States and have acted as an athletic trainer for three years within this state immediately preceding appointment.

"(c) In making the initial appointments, the Alabama Athletic Trainers Association shall appoint one athletic trainer whose term will expire in 1994, two athletic trainers whose terms will expire in 1995, and one athletic trainer whose term will expire in 1996, and two athletic trainers whose terms will expire in 1997. The Medical Association of the State of Alabama shall appoint one physician whose term will expire in 1994, one physician whose term will expire in 1995, and one physician whose term will expire in 1996. All appointments expire on December 31 of the year specified.

"(d)(c) Each appointee to the board shall qualify by taking an oath of office within 15 days from the date of the appointment. In the event of death, resignation, or removal of any member, except for physician members, the vacancy of the unexpired term shall be filled by the board.

"(e)(d) The board shall elect a chair, a vice-chair, and secretary from its members for a term of one year and may appoint any committees and formulate any rules it considers necessary to carry out its duties pursuant to this chapter. The board shall meet at least twice each year. Additional meetings may be held on the call of the chair or at the written request of any two members of the board. Five members shall constitute a quorum. The secretary shall keep a record of the proceedings of the board. The board may promulgate and adopt rules and regulations consistent with this chapter which are necessary for the performance of its duties. The board may employ an executive secretary and any officers and employees as may be necessary to carry out the duties of the board. The State Board of Medical Examiners and the Alabama Board of Athletic Trainers shall jointly approve any rule, regulation, or policy that interprets, explains, or enumerates the permissible acts, functions, or services rendered by an athletic trainer or apprentice athletic trainer athletic training student as those acts, functions, and services are defined in Section 34-40-2. Any rule, regulation, or policy adopted in violation of this requirement is invalid. The board shall prescribe forms for license applications, license certificate, license renewal, verification of license, continuing education verification, and any forms for information required from licensees to carry out the duties of the board. The board shall adopt an official seal and a license certificate of suitable design.

"(f)(e) Members of the board shall receive fifty dollars ($50) for every day actually spent in the performance of their duties and in addition thereto shall be reimbursed according to the state travel policy for other expenses in the same amounts and under the same conditions as state employees are reimbursed.

"(g)(f) It shall be the duty of the board to pass upon the qualifications of applicants for licensure as an athletic trainer, and to issue licenses and annual renewals to athletic trainers. The board shall be responsible for fixing fees for such applications, licenses, renewals, verification of licensure, replacement of licenses, name changes on licensees, publication fees, or other administration fees deemed necessary to carry out the provisions of this chapter.

§34-40-4.

"No person shall use the title "athletic trainer", "certified athletic trainer", or "licensed athletic trainer", or use the letters "LAT", "ATC", or "AT", or any other facsimile thereof, whether or not compensation is received or expected, unless the person is licensed as an athletic trainer in this state pursuant to this chapter. No person shall hold himself or herself out as an athletic trainer or perform the services of an athletic trainer, as defined in this chapter, without first obtaining a license under this chapter; provided, however, that nothing in this chapter shall be construed to prevent any person who is enrolled in an approved college or university athletic training education program, under the direct supervision of a licensed athletic trainer, from serving as an athletic training student.

§34-40-5.

"(a) Any person seeking licensure as an athletic trainer shall be a citizen of the United States or, if not a citizen of the United States, a person who is legally present in the United States with appropriate documentation from the federal government, and meet at least one of the following requirements:

"(1) Satisfactory completion of all of the National Athletic Trainers' Association (NATA) Board of Certification, Inc., qualifications and certification as an athletic trainer in good standing by the National Athletic Trainers' Association Board of Certification, Inc.

"(2) Licensure by reciprocity. The board shall grant, without examination, licensure to any qualified athletic trainer holding a license certificate or registration in another state if that state maintains licensure qualifications which are substantially equivalent to those required in this state, and gives similar reciprocity to licensees of this state.

"(b) Any person desiring to be licensed, desiring a renewal of an existing license, desiring verification of licensure, reinstatement of a license, replacement of a license, or name changes for a licensee as an athletic trainer in this state shall make and file with the board, not less than 30 days prior to any regular meeting thereof, a written application on a form as prescribed by the board. The application shall be accompanied by the payment of a fee, as set by the board, to include publication fees or other administrative fees deemed necessary to carry out the provisions of this chapter, in accordance with subsection (g)(f) of Section 34-40-3. Any licensee who fails to renew his or her license within 90 days following expiration of the previous license shall be required to file a new application and pay an application fee with the board.

§34-40-6.

"An athletic trainer, functioning under the supervision direction of a physician, may use, but is not limited to, therapeutic exercise and modalities for the treatment of athletic injuries for which he or she has received appropriate training or education of heat, light, sound, cold, electricity, exercise, rehabilitation for which the athletic trainer has received appropriate education and training, or other mechanical devices or processes deemed necessary by the directing physician to affect the care, conditioning, and rehabilitation of athletic injuries.

§34-40-9.

"(a) Nothing in this chapter shall be construed as preventing or restricting any of the following persons from engaging in the profession or occupation for which they are licensed, certified, or registered in Alabama as follows:

"(1) Physicians and surgeons licensed by the Medical Licensure Commission of Alabama.

"(2) Dentists licensed by the State Board of Dental Examiners.

"(3) Optometrists licensed by the State Board of Optometry.

"(4) Nurses licensed by the Alabama Board of Nursing.

"(5) Chiropractors licensed by the State Board of Chiropractic Examiners.

"(6) Podiatrists licensed by the State Board of Podiatry.

"(7) Physical therapists licensed by the State Board of Physical Therapy.

"(8) Occupational therapists licensed by the State Board of Occupational Therapy.

"(9) Emergency medical technicians licensed by the State Department of Public Health.

"(b) This chapter shall not apply to the following persons:

"(1) Coaches and physical education instructors in the performance of their duties.

"(2) Apprentice athletic trainers Athletic training students who confine themselves to the duties prescribed in this chapter.

"(3) Athletic trainers from other nations, states, or territories performing their duties for their respective teams or organizations and only during the course of their team's or organization's stay in this state.

"(4) A person who performs any of the services set forth in this chapter as long as the person does not violate this chapter.

§34-40-10.

"The board may refuse to issue a license certificate to any person and, after notice and hearing pursuant to its regulations and rules, may suspend or revoke the license certificate of any person or fine a licensee who has done any of the following:

"(1) Practiced athletic training other than under the direction or referral, or both, of a physician licensed to practice medicine or surgery.

"(2) Uses drugs or intoxicating liquors to an extent which affects professional competency.

"(3) Obtained or attempted to obtain a license by fraud or deception.

"(4) Been grossly negligent in the practice of athletic training.

"(5) Been adjudged mentally incompetent by a court of competent jurisdiction.

"(6) Been guilty of conduct detrimental to the best interest of the public.

"(7) Has been imprisoned for violating any state or federal controlled substance law.

"(8) Treated or undertaken to treat human ailments otherwise than by athletic training and according to standards established by the board.

"(9) Advertised unethically according to standards as set by the board.

"(10) Failed or refused to obey any lawful order or regulation of the board.

"(11) Unlawful invasion of the field of practice of any other profession.

§34-40-11.

"(a) Any person whose application for a license is denied is entitled to a hearing before the board if the person submits a written request to the board. Proceedings for revocation or suspension of a license shall be commenced by filing charges with the board in writing and under oath. The charges may be made by any person or persons. The secretary shall fix a time and place for a hearing and shall cause a written copy of the charges or reason for denial of a license, together with a notice of the time and place fixed for hearing to be served on the applicant requesting the hearing or the licensee against whom the charges have been filed at least 20 days prior to the date set for the hearing. Service of charges and notice of hearing may be given by certified mail to the last known address of the licensee or applicant. At the hearing, the applicant or licensee has the right to appear either personally or by counsel, or both, to produce witnesses, to have subpoenas issued by the board, and to cross-examine the opposing or adverse witnesses. The board is not bound by the strict rules of procedure or by the laws of evidence in the conduct of the proceedings, but the determination shall be founded upon sufficient legal evidence to sustain it. The board shall determine the charges on their merits and enter an order in a permanent record setting forth the findings of fact and law, and the action taken. On application, the board may reissue a license to a person whose license has been cancelled or revoked, but the application may not be made prior to the expiration of a period of six months after the order of cancellation or revocation has become final; and the application shall be made in the manner and form as the board may require.

"(b) A person whose application for a license has been refused or whose license has been cancelled, revoked, or suspended by the board may take an appeal, within 30 days after the order is entered in the judicial circuit of his or her residence or in the Montgomery County Circuit Court, to any court of competent jurisdiction.

"(c) Appeal from the judgment of the court lies as in other civil cases.

§34-40-13.

"Any person who holds a license pursuant to this chapter as an athletic trainer may use the words "athletic trainer" or "licensed athletic trainer," and may use the letters "LAT" in connection with his or her name to denote his or her licensure as an athletic trainer. It shall be unlawful for any person to practice or offer to practice athletic training services or to represent himself or herself as an athletic trainer unless the person is licensed as an athletic trainer under the provisions of this chapter.

§34-40-14.

"There is hereby created in the State Treasury a fund to be known as the Athletic Trainers Fund. All receipts of the Alabama Athletic Trainers Board of Athletic Trainers shall be deposited into this fund. The expenses incurred by the Alabama Athletic Trainers Board of Athletic Trainers in carrying out the provisions of this chapter shall be paid out of the Athletic Trainers Fund by warrant of the Comptroller upon the Treasurer upon itemized vouchers, approved by the chair of the board or his or her designee. The Alabama Board of Athletic Trainers may make grants, and to otherwise arrange with qualified individuals, institutions, or agencies to develop and promote athletic training programs and continuing education programs for athletic trainers. No funds shall be withdrawn or expended except as budgeted and allotted according to Sections 41-4-80 to 41-4-96 and Sections 41-19-1 to 41-19-12, inclusive, and only in amounts as stipulated in the general appropriations act or other appropriations acts.

§34-40-15.

"Nothing in this chapter shall authorize an athletic trainer or apprentice athletic trainer athletic training student to engage in the practice of medicine; to diagnose, treat, or cure any human disease, illness, ailment, infirmity, pain, or other condition which is not an athletic injury; to perform surgery of any type or description; or to prescribe any drug or medical device.

"Nothing in this chapter shall mandate third party reimbursement for the services of an athletic trainer."

Section 2. Sections 34-40-7 and 34-40-16, Code of Alabama 1975, are repealed.

Section 3. This act shall become effective immediately following its passage and approval by the Governor, or its otherwise becoming law.


Athletic Trainers
Licenses and Licensing
Athletic Trainers, Board of
Code Amended
Code Repealed