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Regular Session, 2014 HOUSE BILL NO. 691 BY REPRESENTATIVE BROADWATER ATHLETICS/TRAINERS: Provides relative to athletic trainers AN ACT1 To amend and reenact R.S. 37:3301, 3302, 3303, 3304, and 3307, to enact R.S. 37:3305.1,2 3306.1, 3308.1, 3309.1, 3311(C), and 3313, and to repeal R.S. 37:3305, 3306, 3308,3 3309, and 3310, relative to the Louisiana Athletic Trainers Law; to provide for4 purpose of Chapter; to make changes to definitions; to provide relative to the powers5 and duties of the Louisiana State Board of Medical Examiners in regards to athletic6 trainers; to provide relative to fees; to provide relative to exemptions from civil7 liability; to provide for prohibited activities of athletic trainers; to establish8 qualifications and requirements for athletic trainers; to provide relative to9 exemptions; and to provide for related matters.10 Be it enacted by the Legislature of Louisiana:11 Section 1. R.S. 37:3301, 3302, 3303, 3304, and 3307 are hereby amended and12 reenacted and R.S. 37:3305.1, 3306.1, 3308.1, 3309.1, 3311(C), and 3313 are hereby13 enacted to read as follows:14 §3301. Short title; purpose15 A. This Chapter shall be known and may be cited as the Louisiana Athletic16 Trainers Law.17 B. The purpose of this Chapter is to provide for the protection of public18 health, safety and welfare by providing for the licensing and regulation of the19 practice of athletic trainers in this state.20 HLS 14RS-1045 REENGROSSED HB NO. 691 Page 2 of 13 CODING: Words in struck through type are deletions from existing law; words underscored are additions. §3302. Definitions 1 As used in this Chapter, the following words and phrases have the meanings2 hereinafter ascribed to them:3 (1) "Athlete" means an individual designated as such by the board, an4 educational institution, a professional athletic organization, or other board-approved5 organization who participates in an athletic activity sponsored by such institution or6 organization.7 (1)(2) "Athletic trainer" means a person an individual licensed by the board8 as an athletic trainer with the specific qualifications set forth in R.S. 37:3306 R.S.9 37:3306.1 who, under the direction and general supervision of a medical physician,10 carries out the practice of prevention, emergency management, and physical11 rehabilitation of injuries and sports-related conditions incurred by athletes. at, and12 any athletes participating in athletic competition or events sponsored by these13 organizations or other board sanctioned organization. In carrying out these14 functions, the athletic trainer shall use whatever physical modalities are prescribed15 by a team physician or consulting physician, or both.16 (2)(3) "Board" means the Louisiana State Board of Medical Examiners.17 (3)(4) "Board sanctioned approved" means such approved associations,18 including but not limited to the Amateur Athletic Union, the International Olympic19 Committee and its affiliates, the Pan American Committee Sports Organization, the20 National Collegiate Athletic Association, and the National Association of21 Intercollegiate Athletics, and college and university intramural sports, and National22 High School Athletic Association sports events. of the National Federation of State23 High School Associations. 24 (4) "Department" means the Louisiana Department of Health and Human25 Resources.26 (5) "BOC" means the Board of Certification, Inc. or its successor.27 (6) "CAATE" means the Commission on Accreditation of Athletic Training28 Education or its successor. 29 HLS 14RS-1045 REENGROSSED HB NO. 691 Page 3 of 13 CODING: Words in struck through type are deletions from existing law; words underscored are additions. (5)(7) "Educational institution" means a university, college, junior college,1 high school, junior high school, or grammar school, whether public or private. 2 (6)(8) "Emergency management" means the immediate care given to an3 injured athlete until the services of a physician can be obtained under the general4 supervision of the team or consulting physician. To accomplish this care, an athletic5 trainer may use such methods as accepted first aid procedures established approved6 by the American Red Cross, and the American Heart Association, and or protocol7 previously established by the athletic trainer and the team or consulting physicians.8 (9) "General supervision" means the service is furnished under a physician's9 overall direction and control, but the physician's presence shall not be required10 during the provision of service.11 (7)(10) "Medical physician Physician" means a person licensed to practice12 medicine by the board in the state who is qualified by training and experience to13 supervise an athletic trainer.14 (8)(11) "Physical rehabilitation" means the care given to athletes following15 injury and recovery. These treatments and rehabilitation programs may consist of16 preestablished methods of physical modality use and exercise as prescribed by a17 team physician, consulting physician, or both. Physical rehabilitation also includes18 working cooperatively with and under the direction general supervision of a medical19 physician in with respect to the following:20 (a) Reconditioning procedures.21 (b) Operation of therapeutic devices and equipment.22 (c) Fitting of braces, guards, and other protective devices.23 (d) Referrals to other physicians, auxiliary health services, and institutions.24 Referrals will be made with the agreement of the athlete or, in the case of a minor,25 with the agreement of a parent or guardian except when circumstances require26 emergency transfer and the parent or guardian is unavailable.27 (9)(12) "Practice of prevention" shall include but is not limited to the28 following:29 HLS 14RS-1045 REENGROSSED HB NO. 691 Page 4 of 13 CODING: Words in struck through type are deletions from existing law; words underscored are additions. (a) Working cooperatively with supervisors and coaches in establishing and1 implementing a program of physical conditioning for athletes.2 (b) Applying protective or injury-preventive devices such as taping, padding,3 bandaging, strapping, wrapping, or bracing.4 (c) Working cooperatively with supervisors, coaches, and a team physician5 or consulting physician in the selection and fitting of protective athletic equipment6 for each athlete and constantly monitoring that equipment for safety.7 (d) Counseling and advising supervisors, coaches, and athletes on physical8 conditioning and training such as diet, flexibility, rest, and reconditioning.9 §3303. Louisiana State Board of Medical Examiners; powers and duties10 A. The In addition to the powers and authority established by R.S. 37:1270,11 the board shall:12 (1) Keep a record of its proceedings regarding the regulation and13 certification licensure of athletic trainers in a book maintained for that purpose.14 (2) Keep a complete roster of all certified licensed athletic trainers and make15 a copy of the roster available to any person requesting it on payment of a fee16 established by the board as sufficient to cover the costs of the roster.17 (3) Certify License athletic trainers in a manner consistent with the18 provisions of this Chapter.19 (4) Adopt rules and regulations necessary for the performance of its duties.20 (5) Prescribe application forms for certification licensure. 21 (6) Establish guidelines for athletic trainers in the state.22 (7) Approve, deny, revoke, suspend, probate, and renew licensure of a duly23 qualified applicant.24 (8) Conduct administrative hearings on the denial, suspension, revocation,25 or refusal to issue or renew a license.26 B. The board shall conduct a certification examination at least once every27 year at a time and place fixed by the board. 28 HLS 14RS-1045 REENGROSSED HB NO. 691 Page 5 of 13 CODING: Words in struck through type are deletions from existing law; words underscored are additions. C. The board shall require continuing education units to maintain1 certification licensure.2 D. C. The board shall, collect the following fees: pursuant to the authority3 granted in R.S. 37:1281(A)(2), establish and collect fees in accordance with its rules4 for the purposes of carrying out the provisions of this Chapter.5 (1)Examination fee $ 75.006 (2)Athletic trainers certificate$ 35.007 (3)Renewal fee $ 25.008 (4)Issuance of duplicate certificate$ 5.009 E. D. The fees collected under pursuant to the provisions of this Chapter10 shall be credited to deposited in the treasury of the Louisiana State Board of Medical11 Examiners.12 §3304. Exemptions from civil liability 13 A. There shall be no liability on the part of and no action for damages14 against any No member of the board or its agents or employees shall be liable in any15 civil action for any act performed in good faith in the execution of his duties under16 this Chapter.17 B. No person, committee, association, organization, firm, or corporation18 shall be held liable for damages pursuant to any law of the state of Louisiana or any19 political subdivision thereof for providing information to the board without malice20 and under the reasonable belief that such information is accurate and, whether21 providing such information as a witness or otherwise.22 §3305.1. Prohibited activities; false representation23 A. A person who is not licensed pursuant to this Chapter as an athletic trainer24 or whose license has been suspended or revoked shall not perform any of the25 following:26 (1) Activities of an athletic trainer as defined in this Chapter.27 (2) Use in connection with his name or place of business the words "trainer",28 "licensed athletic trainer", "athletic trainer", "certified athletic trainer",29 HLS 14RS-1045 REENGROSSED HB NO. 691 Page 6 of 13 CODING: Words in struck through type are deletions from existing law; words underscored are additions. "teacher/trainer", "first aid trainer", "sports trainer", "sports medic", the abbreviations1 "LAT", "ATC", "AT," or any other words, letters, abbreviations, or insignia2 indicating or implying that he is an athletic trainer, or in any way, orally, in writing,3 in print or by sign, directly or by implication, represent himself as an athletic trainer.4 B. However, nothing in this Chapter shall prevent an assigned athletic coach5 from administering and supervising his normal sports activities.6 §3306.1. Qualifications7 A. A person who applies for an athletic trainer license shall possess all of the8 following qualifications:9 (1) A certificate issued by the BOC evidencing the successful passage of the10 BOC Certification Examination or its successor.11 (2) A degree in athletic training from a CAATE accredited program, or such12 comparable degree accepted by the BOC and approved by the board.13 (3) Good moral character as determined by rules established by the board.14 B.(1) Any person certified by the board as a certified athletic trainer on the15 effective date of this Subsection shall be issued a license by the board, without16 meeting the requirements of Subsection A of this Section, upon the submission of a17 renewal license application and payment of the applicable renewal fee to the board.18 (2) After a period of one year from the effective date of this Subsection, no19 athletic trainer shall be licensed pursuant to the provisions of R.S. 37:3306.1(B)(1).20 §3307. Requirements for certification licensure 21 A. A person who wishes to apply for an athletic trainer certificate license22 shall apply to the board on forms in a manner prescribed by the board and shall pay23 the examination fee required by R.S. 37:3303(D).24 B. The applicant shall be entitled to an athletic trainer's certificate license if25 he possesses the qualifications enumerated in R.S. 37:3306 R.S. 37:3306.1, and the26 rules and regulations established by the board, successfully completes the27 examination administered by the board to the satisfaction of the board pays the28 certificate license fee required established by the board, by R.S. 37:3303(D), and has29 HLS 14RS-1045 REENGROSSED HB NO. 691 Page 7 of 13 CODING: Words in struck through type are deletions from existing law; words underscored are additions. not committed an act which constitutes grounds for denial of a certificate license1 under R.S. 37:3308 R.S. 37:3308.1.2 C. A certificate Every license issued under this Chapter shall expire and3 become null and void unless on June 30th of each year. Each certificate shall be4 renewed annually on or before June 30th of each year in accordance with the5 procedure established by the board and upon payment of the renewal fee. 6 §3308.1. Causes for denial, revocation, or suspension; imposition of restrictions;7 costs; fines8 A. The board may refuse to issue a license to an applicant or may suspend,9 or revoke or impose probationary terms, conditions, or restrictions on any license10 issued pursuant to this Chapter if the licensee or applicant has committed any of the11 following acts:12 (1) Has been convicted of or entered a plea of guilty or nolo contendere to13 a criminal charge constituting a felony under the laws of Louisiana, of the United14 States, or of the state in which such conviction or plea was entered.15 (2) Has been convicted of or entered a plea of guilty or nolo contendere to16 any criminal charge arising out of or in connection with the practice of an athletic17 trainer.18 (3) Commits perjury, fraud, deceit, misrepresentation, or concealment of19 material facts in obtaining a license to practice as an athletic trainer.20 (4) Provides false testimony before the board or provides false sworn21 information to the board.22 (5) Engages in habitual or recurring abuse of drugs, including alcohol, which23 affect the central nervous system and which are capable of inducing physiological24 or psychological dependence.25 (6) Solicits patients or self-promotion through advertising or communication,26 public or private, which is fraudulent, false, deceptive, or misleading.27 (7) Makes or submits false, deceptive, or unfounded claims, reports, or28 opinions to any patient, insurance company, indemnity association, company,29 HLS 14RS-1045 REENGROSSED HB NO. 691 Page 8 of 13 CODING: Words in struck through type are deletions from existing law; words underscored are additions. individual, or governmental authority for the purpose of obtaining anything of1 economic value.2 (8) Demonstrates cognitive or clinical incompetency.3 (9) Engages in unprofessional conduct.4 (10) Engages in continuing or recurring practice which fails to satisfy the5 prevailing and usually accepted standards of practice as an athletic trainer in this6 state.7 (11) Knowingly performs any act which in any way assists an unlicensed8 person to practice as an athletic trainer, or having professional connection with or9 lending one's name to an illegal practitioner.10 (12) Pays or gives anything of economic value to another person, firm, or11 corporation to induce the referral of injured athletes to an athletic trainer.12 (13) Has been interdicted by due process of law.13 (14) Has the inability to practice as an athletic trainer with reasonable14 competence, skill, or safety to patients because of mental or physical illness,15 condition, or deficiency, including but not limited to deterioration through the aging16 process or excessive use or abuse of drugs, including alcohol.17 (15) Refuses to submit to an examination and inquiry by an examining18 committee of physicians appointed by the board to inquire into the applicant's or19 licensee's physical or mental fitness and ability to practice as an athletic trainer with20 reasonable skill or safety.21 (16) Practices or otherwise engages in any conduct or functions beyond the22 scope of practice of an athletic trainer as defined by this Chapter or the board's rules.23 (17) Refusal of the licensing authority or another state to issue or renew a24 license, permit, or certificate to practice as an athletic trainer in that state, or the25 revocation, suspension, or other restriction imposed on a license, permit, or26 certificate issued by such licensing authority which prevents, restricts, or conditions27 practice, or the surrender of a license, permit, or certificate issued by another state28 HLS 14RS-1045 REENGROSSED HB NO. 691 Page 9 of 13 CODING: Words in struck through type are deletions from existing law; words underscored are additions. when criminal or administrative charges are pending or threatened against the holder1 of such license, permit, or certificate.2 (18) Denial, revocation, suspension, probation, or other disciplinary sanction3 from the BOC or its successor for violation of the standards of professional practice.4 (19) Violation of any rules and regulations of the board, or any provisions5 of this Chapter.6 B. The board may, as part of a decision, consent order, or other agreed order,7 require the applicant or license holder to pay all costs of the board's proceedings and8 a fine not to exceed one thousand dollars.9 §3309.1. Hearing; consent order10 A. Denial, refusal to renew, suspension or revocation of a license, or the11 imposition of probationary terms, conditions, or restrictions upon a licensee, may be12 ordered by the board in a decision made after a hearing in accordance with13 procedures established by the Administrative Procedure Act, R.S. 49:950 et seq. or14 by consent of the parties.15 B. Any license suspended, revoked, or otherwise restricted may be reinstated16 by the board.17 §3311. Limitation Exemptions18 * * *19 C. The provisions of this Chapter shall not apply to any athletic training20 student pursuing a course of study leading to a degree in athletic training at an21 institution whose program is accredited, recognized, or approved by the CAATE, if22 such activities and services constitute a part of a supervised course of study and the23 individual's status is designated by a title which clearly indicates his status as an24 "athletic training student".25 * * *26 §3313. Display of license27 A license and renewal issued pursuant to the provisions of this Chapter shall28 be conspicuously displayed in the principal office of the licensee. Licensees shall,29 HLS 14RS-1045 REENGROSSED HB NO. 691 Page 10 of 13 CODING: Words in struck through type are deletions from existing law; words underscored are additions. upon request, present proof of state licensure when engaged in professional activities1 as a licensed athletic trainer (LAT).2 Section 2. R.S. 37:3305, 3306, 3308, 3309, and 3310 are hereby repealed.3 DIGEST The digest printed below was prepared by House Legislative Services. It constitutes no part of the legislative instrument. The keyword, one-liner, abstract, and digest do not constitute part of the law or proof or indicia of legislative intent. [R.S. 1:13(B) and 24:177(E)] Broadwater HB No. 691 Abstract: Revises the La. Athletic Trainers Law. Proposed law provides that La. Athletic Trainers Law has the purpose of protecting the public health, safety, and welfare by providing for the licensing and regulation of the practice of athletic trainers in the state. Present law provides for an athletic trainers certificate. Proposed law removes reference to an athletic trainers certificate and changes it to athletic trainers license. Present law provides for definitions. Proposed law revises definitions in present law. Present law requires the La. State Board of Medical Examiners (board) certify and keep a record of all persons certified as athletic trainers and collect examination fees ($75), athletic trainer certification fees ($35), renewal fees ($25), and issuance of duplicate license fee ($5). Proposed law requires the board to license and keep a record of all persons licensed as athletic trainers and establish and collect fees in accordance with its rules. Proposed law provides that the board shall approve, deny, revoke, suspend, probate, and renew licensure of a duly qualified candidate. Proposed law requires the board to conduct administrative hearings on the denial, suspension, revocation, or refusal to issue or to renew a license. Present law provides that no member of the board shall be liable in any civil action performed in good faith in the execution of his duties. Proposed law provides that there shall be no liability on the part of and no action for damages against any member of the board, its agents or employees, in any civil action for any act performed in good faith. Proposed law provides that no person, committee, association, organization, firm or corporation shall be held liable for damages pursuant to any law of the state of La., or any political subdivision thereof for providing information to the board without malice and under the reasonable belief that such information is accurate and, whether providing such information as a witness or otherwise. HLS 14RS-1045 REENGROSSED HB NO. 691 Page 11 of 13 CODING: Words in struck through type are deletions from existing law; words underscored are additions. Present law provides that no person shall hold himself out as an athletic trainer or perform, for compensation or any other means of remuneration, any of the activities of an athletic trainer without first obtaining a certificate, but can be a student-trainer, assistant trainer, teacher-trainer, or any similar position. Present law does not require the certification of athletic trainers at nonpublic schools. Present law does not prevent an assigned athletic coach from administering and supervising his normal sports activities. Proposed law repeals present law and provides that a person who is not licensed as an athletic trainer or whose license has been suspended or revoked shall not perform any of the following: (1)Activities of an athletic trainer as defined in proposed law. (2)Use in connection with his name or place of business the words "trainer", "licensed athletic trainer", "athletic trainer", "certified athletic trainer", "teacher/trainer", "first aid trainer", "sports trainer", "sports medic", the abbreviations "LAT", "ATC", "AT", or any other words, letters, abbreviations, or insignia indicating or implying that he is an athletic trainer, or in any way, orally, in writing, in print or by sign, directly or by implication, represent himself as an athletic trainer. Proposed law shall not prevent an assigned athletic coach from administering and supervising his normal sports activities. Present law provides that a person who applies for an athletic trainer certificate must possess at least one of the following qualifications: (1)Meet the athletic training curriculum requirements of a college or university approved by the board and provide proof of graduation. (2)Hold a degree in physical therapy from a school approved by the board and shall have completed a basic athletic training course, a first aid course as approved by the American Red Cross, a cardiopulmonary resuscitation course as approved by the American Heart Association or American Red Cross, and a nutrition course, and the applicant shall have spent two years in association with an athletic team, show proficiency in acute athletic care, and have letters of recommendation from a physician and a licensed athletic trainer. (3)Complete, beyond the secondary school level, either as an undergraduate or graduate student, at least four years as an apprentice athletic trainer at a college or university under the direct supervision of an athletic trainer approved by the board. Three of the four years shall be consecutive years under such supervision, military duty excepted. An applicant for certification shall provide proof of graduation from an accredited college or university and of successful completion of courses in athletic training, first aid, cardiopulmonary resuscitation, and nutrition. Present law provides that the board may certify as an athletic trainer in this state after a written examination given by the board a person who has been so certified or licensed in another state of the United States and who meets all requirements of present law. Proposed law repeals present law and provides that a person who applies for an athletic trainer license shall possess all of the following qualifications: (1)A certificate issued by the National Athletic Trainers' Association Board of Certification, Inc (BOC) evidencing the successful passage of the BOC Certification Examination or its successor. HLS 14RS-1045 REENGROSSED HB NO. 691 Page 12 of 13 CODING: Words in struck through type are deletions from existing law; words underscored are additions. (2)A degree in athletic training from a Commission on Accreditation of Athletic Training Education (CAATE) accredited program, or such comparable degree accepted by the BOC and approved by the board. (3)Good moral character, as determined by rules established by the board. Proposed law provides that a person currently certified by the board as a certified athletic trainer on the effective date of proposed law shall be issued a license by the board, without meeting the qualification requirements of proposed law, upon the submission of a renewal application and payment of the applicable renewal fee to the board during the year immediately following the effective date of proposed law. An athletic trainer granted a license pursuant to this provision of proposed law shall be required to meet all requirements of proposed law prior to renewal upon expiration of the license issued pursuant to this provision of proposed law. Present law requires a person who wishes to apply for an athletic trainer certificate to apply to the board on forms prescribed by the board and pay the examination fee required. Present law provides that the applicant shall be entitled to an athletic trainer's certificate if he possesses the qualifications enumerated in present law, successfully completes the examination administered by the board to the satisfaction of the board, pays the certificate fee required, and has not committed an act which constitutes grounds for denial of a certificate under present law. Present law provides that a certificate issued pursuant to present law shall expire on June 30th of each year. Each certificate shall be renewed on or before June 30th of each year in accordance with the procedure established by the board and upon payment of the renewal fee. Proposed law repeals present law. Proposed law provides that the board may refuse to issue a license to an applicant or may suspend, or revoke or impose probationary terms, conditions or restrictions on any license issued under proposed law if the license issued or applicant has committed any one of a list of acts. Proposed law provides that the board may, as part of a decision, consent order, or other agreed order, require the applicant or license holder to pay all costs of the board's proceedings and a fine not to exceed one thousand dollars. Present law provides that any person whose application for a certificate or for renewal of a certificate is denied shall be entitled to a hearing in accordance with procedures established by the Administrative Procedure Act (APA). Proposed law repeals present law. Proposed law provides that denial, refusal to renew, suspension or revocation of a license, or the imposition of probationary terms, conditions, or restrictions upon a licensee, may be ordered by the board in a decision made after a hearing in accordance with procedures established by the APA or by consent of the parties. Present law authorizes the board to suspend or revoke a certificate for any cause stated in present law, but only after notice and opportunity for a hearing are provided to the certificate holder. Proceedings for such revocation or suspension of a certificate shall be commenced by filing charges against the certificate holder in writing and under oath with the board. Proposed law repeals present law. HLS 14RS-1045 REENGROSSED HB NO. 691 Page 13 of 13 CODING: Words in struck through type are deletions from existing law; words underscored are additions. Proposed law provides that any license suspended, revoked, or otherwise restricted may be reinstated by the board. Proposed law provides that provisions of the La. Athletic Trainers Law shall not apply to any athletic training student pursuing a course of study leading to a degree in athletic training at an institution whose program is accredited, recognized, or approved by the CAATE, if such activities and services constitute a part of a supervised course of study and the individual's status is designated by a title which clearly indicates his status as an "athletic training student". Proposed law provides that a license and renewal issued pursuant to present and proposed law shall be conspicuously displayed in the principal office of the licensee. Licensees shall, upon request, present proof of state licensure when engaged in professional activities as a licensed athletic trainer (LAT). (Amends R.S. 37:3301, 3302, 3303, 3304, and 3307; Adds R.S. 37:3305.1, 3306.1, 3308.1, 3309.1, 3311(C), and 3313; Repeals R.S. 37:3305, 3306, 3308, 3309, and 3310) Summary of Amendments Adopted by House Committee Amendments Proposed by House Committee on Health and Welfare to the original bill. 1. Made technical corrections. 2. Added a definition for athlete. 3. Corrected the names of referenced organizations. 4. Removed the assessment component from the definition of emergency management. 5. Clarified that an athletic trainer may use methods approved by any of the following: the American Red Cross, the American Heart Association, or protocol previously established by the athletic trainer and the team or consulting physicians. 6. Clarified that an athletic trainer previously certified by the board shall be issued a renewal license without having to meet the qualification requirements of proposed law only during the year immediately following the effective date of proposed law. 7. Changed the prohibited act of engaging in cognitive or clinical conduct to the demonstration of cognitive or clinical incompetency. House Floor Amendments to the engrossed bill. 1. Made technical changes. 2. Deleted requirement that a physician, other than a team physician, prescribing treatment be a consulting physician for the team or athletic organization.