Analysis

Topic: Athletic Trainers
SPONSOR: Palamara
HOUSE COMMITTEE: Health Policy
POSITION: The department does not support this bill.

BACKGROUND: The bill is designed to establish a registered occupation of athletic trainers within the Public Health Code. Athletic trainers in Michigan have become more interested in attaining professional registration to protect their occupation. Their concern is that without appropriate regulation, people with limited or no training may declare themselves to be "athletic trainers."

BILL CONTENTS: The bill would amend Section 16131 and add Section 16336 and Part 179 to the Public Health Code. The intent of the bill is to register the profession of athletic training by providing regulatory title protection.

The proposed professional standards and levels of registration for athletic trainers would be those used by the National Athletic Trainers Association and the National Athletic Trainers Board of Certification entitled "National Athletic Trainers Association Code of Ethics and Membership Standards" and the "NATABOC Standards for Athletic Training" and are incorporated by reference.

Board: Part 179 creates the Michigan Board of Athletic Training. The board would consist of five voting members who serve four year terms. Three of the members are to be registered athletic trainers that meet the qualifications of Part 179 and the other two are public members.

Scope of Practice: The bill generally defines the scope of practice which covers the prevention and medical determination of an athletic injury or illness as well as providing rehabilitation and reconditioning.

Professional Standards: Under the bill, only registered athletic trainers could use the terms; "Athletic Trainer, Registered Athletic Trainer, Certified Athletic Trainer, Athletic Trainer Certified," or the designations "A.T., A.T.R., C.A.T., and A.T.C.", when denoting their profession.

Part 179 would also establish the professional standards for the practice of athletic training. The standards of the National Athletic Trainers Association and National Athletic Trainers Association Code of Ethics and Membership Standards are incorporated by reference as the standards of practice for athletic trainers in Michigan.

Registration Requirements: The bill defines the educational requirements for registration as a baccalaureate degree in a program approved by the board and goes on to define the course work to be included in an approved program. Although clinical experience is mentioned as a requirement , none is defined. Other requirements include passing an examination, being of good moral character, and applying to the Department and paying the appropriate fees.

Section 333.17907 would grant a "grandfather" registration - without examination - to those individuals who are actively engaged as athletic trainers. Those individuals must be registered by the National Athletic Trainers Association Board on the effective date of this Part, submit an application within one year of the effective date of this Part, and pay the registration fee.

Section 333.17906 states that the registration issued by the board is renewed upon payment of the registration renewal fee and proof of completion of three units of continuing education.

Fees: The application fee is $20.00 and annual renewal fees are $60.00. These fees are consistent with the registered profession of occupational therapy.

Related Bills: Two related bills were recently introduced in the Michigan Legislature. House Bill 5737 amends the Worker's Disability Compensation Act of 1969 by clarifying reimbursement of registered athletic trainer services. House Bill 5736 amends the Nonprofit Health Care Corporation Act by clarifying that a health care corporation is not required to provide benefits or reimburse for athletic trainer services.

SUMMARY OF ARGUMENTS
Pro: Insuring the professional competency of those caring for the hundreds of college and high school athletes injured each year is important not only to the parents but also to the long-term health of these young people. Prompt recognition of the nature of any injury and the provision of appropriate procedures is essential to reducing the long-term effects of an injury. Research has shown that the severity of injuries at schools providing the services of a certified athletic trainer have decreased.

Con: The regulation of the profession of athletic training does not respond to any known problems. Generally, for an occupation to be added to the control of the Public Health Code, there needs to be a threat to the public health or safety. There appears to be no such threat to the public if athletic trainers are not registered and regulated by the State. Also, athletic trainers are currently certified at the national level by the National Athletic Trainers' Association Board of Certification. The certification examination consists of a written portion with multiple choice questions; an oral/practical section which evaluates skills; and a written simulation test. Athletic trainers who pass the certification test may use the designation "ATC".

Board: Boards generally have a minimum of seven members to prevent voting attendance and quorum problems; this bill proposes a five-member board.

Scope of Practice: Contrary to the historical distinctions between registered and licensed occupations in the Public Health Code, Section 17901 of Part 179 of this bill defines a scope of practice for athletic trainers. The other two registered occupations in the Public Health Code, Registered Sanitarian and Registered Occupational Therapist, serve to protect the title of the occupation in Michigan but do not define the scope of practice.

Professional Standards: To place legislated standards on a "registered" occupation is unusual, as registration is typically limited to providing title protection. The bill would protect titles and designations for what appear to be national certifications but does not establish corresponding differentiation among the titles.

The bill also mentions clinical experience as a requirement for registration as an athletic trainer. The bill describes the educational requirements and certain clinical courses but does not define practical clinical training.

SUPPORTERS/OPPONENTS: No information is available at this time.

FISCAL INFORMATION: The revenues received under this regulation would need to be sufficient to provide for administration regulation and board costs. Because the number of athletic trainers is unknown, it is difficult to estimate annual revenue.

ECONOMIC IMPACT: The bill could increase worker's compensation costs. The bill's definition of "injury or illness" would provide statutory recognition for athletic trainers in dealing with the range of soft tissue problems disproportionately found among worker's compensation cases. By recognizing athletic trainers as a health care profession the bill would make them eligible for direct reimbursement by worker's compensation carriers. Soft tissue cases already represent 60% of the services and 30% of the dollars in the worker's compensation system.