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H.B. 74 Enrolled





Chief Sponsor: Paul Ray

Senate Sponsor: Michael G. Waddoups

             7      LONG TITLE
             8      General Description:
             9          This bill enacts the Athletic Trainer Licensing Act.
             10      Highlighted Provisions:
             11          This bill:
             12          .    enacts the Athletic Trainer Licensing Act;
             13          .    establishes the Athletic Trainers Licensing Board and its duties and responsibilities;
             14          .    provides for the licensing of athletic trainers;
             15          .    establishes qualifications for an athletic trainer license;
             16          .    establishes the scope of practice of an athletic trainer;
             17          .    provides exemptions from licensure; and
             18          .    defines unprofessional conduct.
             19      Monies Appropriated in this Bill:
             20          None
             21      Other Special Clauses:
             22          None
             23      Utah Code Sections Affected:
             24      AMENDS:
             25          58-1-307, as last amended by Chapters 71 and 153, Laws of Utah 2005
             26      ENACTS:
             27          58-40a-101, Utah Code Annotated 1953
             28          58-40a-102, Utah Code Annotated 1953
             29          58-40a-103, Utah Code Annotated 1953

             30          58-40a-201, Utah Code Annotated 1953
             31          58-40a-301, Utah Code Annotated 1953
             32          58-40a-302, Utah Code Annotated 1953
             33          58-40a-303, Utah Code Annotated 1953
             34          58-40a-304, Utah Code Annotated 1953
             35          58-40a-305, Utah Code Annotated 1953
             36          58-40a-401, Utah Code Annotated 1953
             37          58-40a-501, Utah Code Annotated 1953
             39      Be it enacted by the Legislature of the state of Utah:
             40          Section 1. Section 58-1-307 is amended to read:
             41           58-1-307. Exemptions from licensure.
             42          (1) Except as otherwise provided by statute or rule, the following [persons] individuals
             43      may engage in the practice of their occupation or profession, subject to the stated
             44      circumstances and limitations, without being licensed under this title:
             45          (a) [a person] an individual serving in the armed forces of the United States, the United
             46      States Public Health Service, the United States Department of Veterans Affairs, or other federal
             47      agencies while engaged in activities regulated under this chapter as a part of employment with
             48      that federal agency if the [person] individual holds a valid license to practice a regulated
             49      occupation or profession issued by any other state or jurisdiction recognized by the division;
             50          (b) a student engaged in activities constituting the practice of a regulated occupation or
             51      profession while in training in a recognized school approved by the division to the extent the
             52      activities are supervised by qualified faculty, staff, or designee and the activities are a defined
             53      part of the training program;
             54          (c) an individual engaged in an internship, residency, preceptorship, postceptorship,
             55      fellowship, apprenticeship, or on-the-job training program approved by the division while
             56      under the supervision of qualified [persons] individuals;
             57          (d) an individual residing in another state and licensed to practice a regulated

             58      occupation or profession in that state, who is called in for a consultation by an individual
             59      licensed in this state, and the services provided are limited to that consultation;
             60          (e) an individual who is invited by a recognized school, association, society, or other
             61      body approved by the division to conduct a lecture, clinic, or demonstration of the practice of a
             62      regulated occupation or profession if the individual does not establish a place of business or
             63      regularly engage in the practice of the regulated occupation or profession in this state;
             64          (f) an individual licensed under the laws of this state, other than under this title, to
             65      practice or engage in an occupation or profession, while engaged in the lawful, professional,
             66      and competent practice of that occupation or profession;
             67          (g) an individual licensed in a health care profession in another state who performs that
             68      profession while attending to the immediate needs of a patient for a reasonable period during
             69      which the patient is being transported from outside of this state, into this state, or through this
             70      state;
             71          (h) an individual licensed in another state or country who is in this state temporarily to
             72      attend to the needs of an athletic team or group, except that the practitioner may only attend to
             73      the needs of the athletic team or group, including all individuals who travel with the team or
             74      group in any capacity except as a spectator;
             75          (i) an individual licensed and in good standing in another state, who is in this state:
             76          (i) temporarily, under the invitation and control of a sponsoring entity;
             77          (ii) for a reason associated with a special purpose event, based upon needs that may
             78      exceed the ability of this state to address through its licensees, as determined by the division;
             79      and
             80          (iii) for a limited period of time not to exceed the duration of that event, together with
             81      any necessary preparatory and conclusionary periods; and
             82          [(j) an individual who:]
             83          [(i) is certified as an athletic trainer by the National Athletic Trainers Association
             84      Board of Certification or another entity approved by the division;]
             85          [(ii) is employed or officially associated with an educational institution, a professional

             86      sports organization, or a bona fide amateur sports organization; and]
             87          [(iii) only provides athletic training services:]
             88          [(A) to athletes of the educational institution or sports organization to which the
             89      individual is employed or officially associated;]
             90          [(B) at an official athletic training, practice, or competition site; and]
             91          [(C) that are within the scope of the individual's certification; and]
             92          [(k)] (j) a law enforcement officer, as defined under Section 53-13-103 , who:
             93          (i) is operating a voice stress analyzer in the course of the officer's full-time
             94      employment with a federal, state, or local law enforcement agency;
             95          (ii) has completed the manufacturer's training course and is certified by the
             96      manufacturer to operate that voice stress analyzer; and
             97          (iii) is operating the voice stress analyzer in accordance with Section 58-64-601 ,
             98      regarding deception detection instruments.
             99          (2) (a) A practitioner temporarily in this state who is exempted from licensure under
             100      Subsection (1) shall comply with each requirement of the licensing jurisdiction from which the
             101      practitioner derives authority to practice.
             102          (b) Violation of [any] a limitation imposed by this section constitutes grounds for
             103      removal of exempt status, denial of license, or other disciplinary proceedings.
             104          (3) An individual who is licensed under a specific chapter of this title to practice or
             105      engage in an occupation or profession may engage in the lawful, professional, and competent
             106      practice of that occupation or profession without additional licensure under other chapters of
             107      this title, except as otherwise provided by this title.
             108          (4) Upon the declaration of a national, state, or local emergency, a public health
             109      emergency as defined in Section 26-23b-102 , or a declaration by the President of the United
             110      States or other federal official requesting public health-related activities, the division in
             111      collaboration with the board may:
             112          (a) suspend the requirements for permanent or temporary licensure of [persons]
             113      individuals who are licensed in another state. [Persons] Individuals exempt under this

             114      Subsection (4)(a) [shall be] are exempt from licensure for the duration of the emergency while
             115      engaged in the scope of practice for which they are licensed in the other state;
             116          (b) modify, under the circumstances described in this Subsection (4) and Subsection
             117      (5), the scope of practice restrictions under this title for [persons] individuals who are licensed
             118      under this title as:
             119          (i) a physician under Chapter 67, Utah Medical Practice Act, or Chapter 68, Utah
             120      Osteopathic Medical Practice Act;
             121          (ii) a nurse under Chapter 31b, Nurse Practice Act, or Chapter 31c, Nurse Licensure
             122      Compact;
             123          (iii) a certified nurse midwife under Chapter 44a, Nurse Midwife Practice Act;
             124          (iv) a pharmacist, pharmacy technician, or pharmacy intern under Chapter 17b,
             125      Pharmacy Practice Act;
             126          (v) a respiratory therapist under Chapter 57, Respiratory Care Practices Act; and
             127          (vi) a dentist and dental hygienist under Chapter 69, Dentist and Dental Hygienist
             128      Practice Act;
             129          (c) suspend the requirements for licensure under this title and modify the scope of
             130      practice in the circumstances described in this Subsection (4) and Subsection (5) for medical
             131      services personnel or paramedics required to be certified under Section 26-8a-302 ;
             132          (d) suspend requirements in Subsections 58-17b-620 (3) through (6) which require
             133      certain prescriptive procedures; and
             134          (e) exempt or modify the requirement for licensure of [a person] an individual who is
             135      activated as a member of a medical reserve corps during a time of emergency as provided in
             136      Section 26A-1-126 .
             137          (5) [Persons] Individuals exempt under Subsection (4)(c) and [persons] individuals
             138      operating under modified scope of practice provisions under Subsection (4)(b):
             139          (a) [shall be] are exempt from licensure or subject to modified scope of practice for the
             140      duration of the emergency;
             141          (b) must be engaged in the distribution of medicines or medical devices in response to

             142      the emergency or declaration; and
             143          (c) must be employed by or volunteering for a local or state department of health.
             144          Section 2. Section 58-40a-101 is enacted to read:

Part 1. General Provisions

             147          58-40a-101. Title.
             148          This chapter is known as the "Athletic Trainer Licensing Act."
             149          Section 3. Section 58-40a-102 is enacted to read:
             150          58-40a-102. Definitions.
             151          In addition to the definitions in Section 58-1-102 , as used in this chapter:
             152          (1) "Adequate records" means legible records that contain, at a minimum:
             153          (a) the athletic training service plan or protocol;
             154          (b) an evaluation of objective findings;
             155          (c) the plan of care and the treatment records; or
             156          (d) written orders.
             157          (2) "Athlete" means an individual, referee, coach, or athletic staff member who
             158      participates in exercises, sports, or games requiring physical strength, agility, flexibility, range
             159      of motion, speed, or stamina, and the exercises, sports, or games are of a type generally
             160      conducted in association with an educational institution or professional, amateur, or
             161      recreational sports club or organization.
             162          (3) "Athletic injury" means:
             163          (a) an injury sustained by an athlete that affects the individual's participation or
             164      performance in sports, games, recreation, or exercise; or
             165          (b) a condition that is within the scope of practice of an athletic trainer identified by a
             166      directing physician or physical therapist as benefitting from athletic training services.
             167          (4) "Athletic trainer" means an individual who is licensed under this chapter and
             168      carries out the practice of athletic training.
             169          (5) "Board" means the Athletic Trainers Licensing Board created in Section

             170      58-40a-201 .
             171          (6) "Directing physician" means a physician and surgeon licensed under Section
             172      58-67-301 , an osteopathic physician and surgeon licensed under Section 58-68-301 , a
             173      chiropractic physician licensed under Chapter 73, Chiropractic Physician Practice Act, a
             174      naturopathic physician licensed under Chapter 71, Naturopathic Physician Practice Act, or
             175      dentist licensed under Section 58-69-301 who, within the licensee's scope of practice and
             176      individual competency, is responsible for the athletic training services provided by the athletic
             177      trainer and oversees the practice of athletic training by the athletic trainer, as established by
             178      board rule.
             179          (7) The "practice of athletic training" means the application by a licensed and certified
             180      athletic trainer of principles and methods of:
             181          (a) prevention of athletic injuries;
             182          (b) recognition, evaluation, and assessment of athletic injuries and conditions;
             183          (c) immediate care of athletic injuries, including common emergency medical
             184      situations;
             185          (d) rehabilitation and reconditioning of athletic injuries;
             186          (e) athletic training services administration and organization; and
             187          (f) education of athletes.
             188          Section 4. Section 58-40a-103 is enacted to read:
             189          58-40a-103. Duties of directing physician.
             190          A directing physician shall provide direction to an athletic trainer by a verbal order
             191      when in the presence of the athletic trainer and by written order or by athletic training service
             192      plans or protocols when a directing physician is not present.
             193          Section 5. Section 58-40a-201 is enacted to read:
Part 2. Board

             195          58-40a-201. Board composition -- Duties and responsibilities.
             196          (1) There is created the Athletic Trainers Licensing Board consisting of four licensed
             197      athletic trainers, one member representative of the directing physicians referred to in

             198      Subsection 58-40a-102(6), and one member of the general public who has never been
             199      authorized to practice a healing art and never had a substantial personal, business, professional,
             200      or pecuniary connection with a healing art or with a medical education or health care facility,
             201      except as a client or potential client.
             202          (2) The board shall be appointed and serve in accordance with Section 58-1-201 .
             203          (3) The board shall carry out the duties and responsibilities in Sections 58-1-202 and
             204      58-1-203 , and shall designate one of its members on a permanent or rotating basis to:
             205          (a) assist the division in reviewing complaints concerning the unlawful or
             206      unprofessional conduct of a licensee under this chapter; and
             207          (b) advise the division of its investigation of these complaints.
             208          (4) A board member who has, under Subsection (3), reviewed a complaint or advised
             209      in its investigation may be disqualified from participating with the board when the board serves
             210      as a presiding officer in an adjudicative proceeding concerning the complaint.
             211          Section 6. Section 58-40a-301 is enacted to read:
Part 3. Licensing

             213          58-40a-301. Licensure required.
             214          (1) A license is required to engage in the practice of athletic training, except as
             215      specifically provided in Section 58-1-307 or 58-40a-305 .
             216          (2) The division shall issue to an individual who qualifies under this chapter a license
             217      in the classification of athletic trainer.
             218          (3) An individual may not use the title "licensed athletic trainer," or "athletic trainer,"
             219      or abbreviations or insignias to imply that the individual is an athletic trainer unless the
             220      individual is licensed under this chapter.
             221          Section 7. Section 58-40a-302 is enacted to read:
             222          58-40a-302. Qualifications for licensure.
             223          The division shall issue a license to practice as an athletic trainer to an applicant who:
             224          (1) has obtained a bachelor's or advanced degree from an accredited four-year college
             225      or university and meets the minimum athletic training curriculum requirement established by

             226      the board by rule;
             227          (2) has successfully completed the certification examination administered by the Board
             228      of Certification Inc. or equivalent examination approved or recognized by the board;
             229          (3) is in good standing with and provides documentation of current certification by the
             230      Board of Certification Inc. or a nationally recognized credentialing agency approved by the
             231      board;
             232          (4) submits an application to the division on a form prescribed by the division; and
             233          (5) pays the required licensing fee as determined by the department under Section
             234      63-38-3.2 .
             235          Section 8. Section 58-40a-303 is enacted to read:
             236          58-40a-303. Scope of practice.
             237          An athletic trainer may:
             238          (1) prevent injuries by:
             239          (a) designing and implementing physical conditioning programs, which may include:
             240          (i) strength and range of motion testing;
             241          (ii) nutritional advisement; and
             242          (iii) psychosocial intervention and referral;
             243          (b) performing preparticipation screening;
             244          (c) fitting protective equipment;
             245          (d) designing and constructing protective products; and
             246          (e) continuously monitoring changes in the environment;
             247          (2) recognize and evaluate injuries by:
             248          (a) obtaining a history of the injury;
             249          (b) inspecting an injured body part and associated structures;
             250          (c) palpating bony landmarks and soft tissue structures; and
             251          (d) performing clinical tests to determine the extent of an injury;
             252          (3) provide immediate care of injuries by:
             253          (a) initiating cardiopulmonary resuscitation;

             254          (b) administering basic or advanced first aid;
             255          (c) removing athletic equipment; and
             256          (d) immobilizing and transporting an injured athlete;
             257          (4) determine whether an athlete may return to participation or, if the injury requires
             258      further definitive care, refer the athlete to the appropriate directing physician;
             259          (5) rehabilitate and recondition an injury by administering therapeutic exercise and
             260      therapeutic and physical modalities, including cryotherapy, thermotherapy, and intermittent
             261      compression, electrical stimulation, ultra sound, traction devices, or mechanical devices as
             262      directed by established, written athletic training service plans or protocols or upon the order of
             263      a directing physician;
             264          (6) provide athletic training services administration, including:
             265          (a) implementing athletic training service plans or protocols;
             266          (b) writing organizational policies and procedures;
             267          (c) complying with governmental and institutional standards; and
             268          (d) maintaining records to document services rendered; and
             269          (7) educate athletes to facilitate physical conditioning and reconditioning by designing
             270      and implementing appropriate programs to minimize the risk of injury.
             271          Section 9. Section 58-40a-304 is enacted to read:
             272          58-40a-304. Term of license -- Expiration -- Renewal.
             273          (1) (a) The division shall issue each license for an athletic trainer in accordance with a
             274      two-year renewal cycle established by rule in accordance with Title 63, Chapter 46a, Utah
             275      Administrative Rulemaking Act.
             276          (b) The division may, by rule, extend or shorten a renewal period by as much as one
             277      year to stagger the renewal cycles it administers.
             278          (2) Each license automatically expires on the expiration date shown on the license
             279      unless the licensee renews it in accordance with Section 58-1-308 .
             280          Section 10. Section 58-40a-305 is enacted to read:
             281          58-40a-305. Exemptions from licensure.

             282          In addition to the exemptions from licensure in Section 58-1-307 , this chapter does not
             283      require the licensure of a medical assistant as defined in Section 58-67-102 or 58-68-102 or an
             284      individual who assists in an emergency or in providing services for which no fee is
             285      contemplated, charged, or received, provided the individual does not hold himself out as an
             286      athletic trainer.
             287          Section 11. Section 58-40a-401 is enacted to read:
Part 4. License Denial and Discipline

             289          58-40a-401. Grounds for denial of license.
             290          The division may refuse to issue a license to an applicant, refuse to renew the license of
             291      a licensee, revoke, suspend, restrict, or place on probation the license of a licensee, issue a
             292      public or private reprimand to a licensee, and issue cease and desist orders in accordance with
             293      Section 58-1-401 .
             294          Section 12. Section 58-40a-501 is enacted to read:
Part 5. Unprofessional Conduct

             296          58-40a-501. Unprofessional conduct.
             297          In addition to the provisions of Subsection 58-1-501 (2), "unprofessional conduct"
             298      includes:
             299          (1) failing to report to the board an act or omission of a licensee, applicant, or any other
             300      individual which violates a provision of this chapter;
             301          (2) interfering with an investigation of a disciplinary proceeding by willful
             302      misrepresentation of facts or by use of threats or harassment against a client or witness to
             303      prevent that individual from providing evidence in a disciplinary proceeding, investigation, or
             304      other legal action;
             305          (3) failing to maintain client confidentiality unless otherwise required by law;
             306          (4) promoting an unnecessary device, treatment, intervention, or service for financial
             307      gain by the athletic trainer or a third party; and
             308          (5) failing to maintain adequate records.

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