427 Athletic trainers

STATE BOARD OF MEDICINE
STATE BOARD OF OSTEOPATHIC MEDICINE

[49 PA. CODE CHS. 16 AND 17]

Athletic Trainers

[36 Pa.B. 1233]

   The State Boards of Medicine and Osteopathic Medicine (Boards) propose to amend the regulations providing for the certification and regulation of athletic trainers in Chapters 16, 18 and 25 to read as set forth in Annex A.

A.  Effective Date

   The proposed amendments will be effective upon final-form publication in the Pennsylvania Bulletin.

B.  Statutory Authority

   Section 51.1(d) of the Medical Practice Act of 1985 (63 P. S. § 422.51a(d) and section 7.1 (d) of the Osteopathic Medical Practice Act (63 P. S. § 271.7a(d)) (medical practice acts) authorize the Boards to jointly promulgate regulations that establish approved education and training programs for certification and define the circumstances and protocol under which a certified athletic trainer may perform athletic training services.

C.  Background and Purpose

   Under the Physical Therapy Practice Act (formerly 63 P. S. §§ 1301, 1310.1 and 1310.2), the State Board of Physical Therapy certified and regulated athletic trainers in this Commonwealth.

   The acts of December 10, 2001 (P. L. 859, No. 92) and (P. L. 863, No. 93) (Acts 92 and 93) repealed these provisions insofar as they are inconsistent with the medical practice acts. Acts 92 and 93 added section 51.1(d) of the Medical Practice Act of 1985 and section 7.1(d) of the Osteopathic Medical Practice Act to provide for the certification and regulation of athletic trainers by the Boards. Acts 92 and 93, effective February 8, 2002, further provided that until the Boards adopt final regulations, the regulations of the State Board of Physical Therapy in 49 Pa. Code Chapter 40, Subchapter B (relating to athletic trainers) govern the activities of athletic trainers, which are not inconsistent with amendments to the medical practice acts. The Boards now propose these amendments to establish procedures for certification and protocols for the practice of athletic trainers.

D.  Description of Proposed Amendments

   With regard to the State Board of Medicine, the proposed rulemaking amends § 16.1 (relating to definitions) to define ''treatment regimen'' to describe the service provided by athletic trainers. This term is also of a broad enough nature that the clinical service provided by other State Board of Medicine-regulated practitioners could come under this umbrella term. It provides flexibility to the State Board of Medicine in regulating its licensees and ensures uniformity in regulation. The proposed rulemaking also amends § 16.61 (relating to unprofessional and immoral conduct) by replacing the term ''physician'' with ''Board-regulated practitioners'' so that athletic trainers and other practitioners licensed by the Board would be subject to the regulation.

   The Boards propose to amend §§ 16.13 and 25.231 (relating to licensure, certification, examination and registration fees; and schedule of fees) to carry-over of the fees currently in place under the regulations of the State Board of Physical Therapy in § 40.5 (relating to fees).

   The Boards also propose to add Chapter 18, Subchapter H and Chapter 25, Subchapter M (relating to athletic trainers).

   Sections 18.501 and 25.701 (relating to purpose) provide a general statement. Sections 18.502 and 25.702 (relating to definitions) define key terms used throughout the subchapters.

   Sections 18.503 and 25.703 (relating to certification requirement) set forth the requirement for certification of persons using the title of or performing athletic trainer services in this Commonwealth. These sections also provide for exclusions for persons authorized under other law, persons employed by visiting athletic teams or organizations competing in this Commonwealth and students in training.

   Sections 18.504 and 25.704 (relating to application for certification) delineate the documentation and information required for a completed application for certification.

   Sections 18.505, 18.506, 25.705 and 25.706 set forth the educational and examination requirements for certification. The requisite education could be met by having graduated from an accredited education program for athletic trainers or holding a current credential as a certified athletic trainer from the Board of Certification, Inc. (BOC) or another accrediting body approved by the Board. Applicants must achieve a passing score on the BOC examination or an equivalent examination approved by the Board.

   Sections 18.507 and 25.707 (relating to temporary certification) provide for temporary certification for applicants who have completed their education and have applied to take the examination. An applicant may practice under a temporary certificate under direct supervision for up to 1 year or until certification.

   Section 18.508 and 25.708 (relating to renewal of certification) provide for biennial renewal of certificates in accordance with the renewal period of each Board. The Boards would also adopt the continuing education requirement of the BOC. The continuing education would have to be completed during the first biennial period following the effective date of the final-form rulemaking to renew a certification for the following biennium. By adopting the continuing education requirements of a Nationally recognized professional organization, the Board can assure that state-of-the-art information and education will keep certificateholders in this Commonwealth at the forefront of clinical skills.

   Sections 18.509 and 25.709 (relating to practice standards for athletic trainers) contain provisions regarding referrals and protocols for treatment, retention of records and circumstances under which consultation or referral to a physician, dentist or podiatrist is required. Subsection (a) also makes these standards applicable to an athletic trainer certified by another state, commonwealth, Canadian province or territory or the District of Columbia when providing services to a team or organization in this Commonwealth.

   Sections 18.510(a) and 25.710(a) (relating to refusal, suspension or revocation of certificate) authorize the Boards to impose disciplinary action against athletic trainers under section 41 of the Medical Practice Act of 1985 (63 P. S. § 422.41), § 16.61 and section 15(b) of the Osteopathic Practice Act (63 P. S. § 271.15(b)). Subsection (b) provides for the applicability of 2 Pa.C.S. §§ 501--508 and 701--704 (relating to the Administrative Agency Law) to the activities of and proceedings before the Boards regarding athletic trainers. The language is included to direct applicants and certificateholders to the procedural provisions that govern the Boards' actions.

E.  Fiscal Impact and Paperwork Requirements

   The proposed rulemaking will have no adverse fiscal impact on the Commonwealth or its political subdivisions because it transfers regulatory authority over athletic trainers from the State Board of Physical Therapy to the Boards. For this reason also, the proposal will impose no additional paperwork requirements on the public sector.

F.  Sunset Date

   The Boards continuously monitor the effectiveness of their regulations. Therefore, no sunset date has been assigned.

G.  Regulatory Review

   Under section 5(a) of the Regulatory Review Act (71 P. S. § 745.5(a)), on March 8, 2006, the Board submitted a copy of this proposed rulemaking and a copy of a Regulatory Analysis Form to the Independent Regulatory Review Commission (IRRC) and to the Chairpersons of the Senate Consumer Protection and Professional Licensure Committee and the House Professional Licensure Committee. A copy of this material is available to the public upon request.

   Under section 5(g) of the Regulatory Review Act, IRRC may convey any comments, recommendations or objections to the proposed rulemaking within 30 days of the close of the public comment period. The comments, recommendations or objections must specify the regulatory review criteria which have not been met. The Regulatory Review Act specifies detailed procedures for review, prior to final publication of the rulemaking, by the Department, the General Assembly and the Governor of comments, recommendations or objections raised.

H.  Public Comment

   Interested persons are invited to submit written comments, recommendations or objections regarding the proposed rulemaking to Sabina I. Howell, Board Counsel, State Board of Medicine or Beth Sender Michlovitz, Counsel, State Board of Osteopathic Medicine, P. O. Box 2649, Harrisburg, PA 17105-2649 within 30 days following publication of the proposed rulemaking in the Pennsylvania Bulletin.

CHARLES D. HUMMER, Jr., M. D.,   
Chairperson
State Board of Medicine

OLIVER BULLOCK, D. O.,   
Chairperson
State Board of Osteopathic Medicine

   Fiscal Note: 16A-49155314. No fiscal impact; (8) recommends adoption.

Annex A

TITLE 49. PROFESSIONAL AND
VOCATIONAL STANDARDS

PART I. DEPARTMENT OF STATE

Subpart A. PROFESSIONAL AND
OCCUPATIONAL AFFAIRS

CHAPTER 16. STATE BOARD OF MEDICINE--GENERAL PROVISIONS

Subchapter A. BASIC DEFINITIONS AND INFORMATION

§ 16.1. Definitions.

   The following words and terms, when used in this chapter and Chapters 17 and 18 (relating to State Board of Medicine--medical doctors; and State Board of Medicine--practitioners other than medical doctors), have the following meanings, unless the context clearly indicates otherwise:

*      *      *      *      *

   Treatment regimen--The provision of care and practice of a component of the healing arts by a Board-regulated practitioner.

*      *      *      *      *

Subchapter B. GENERAL LICENSE, CERTIFICATION AND REGISTRATION PROVISIONS

§ 16.13. Licensure, certification, examination and registration fees.

*      *      *      *      *

   (h)  Athletic Trainer:

   Application for certification                           $20

   Biennial renewal                                             $37

   (i)  Verification or Certification:

*      *      *      *      *

   [(i)] (j)  *   *   *

*      *      *      *      *

Subchapter E. MEDICAL DISCIPLINARY PROCESS AND PROCEDURES

COMPLAINTS

§ 16.61. Unprofessional and immoral conduct.

   (a)  A [physician] Board-regulated practitioner who engages in unprofessional or immoral conduct is subject to disciplinary action under section 41 of the act (63 P. S. § 422.41). Unprofessional conduct includes, but is not limited to, the following:

   (1)  Revealing personally identifiable facts, obtained as the result of a [physician] practitioner-patient relationship, without the prior consent of the patient, except as authorized or required by statute.

   (2)  Violating a statute, or a regulation adopted thereunder, which imposes a standard for the practice of [medicine] the healing arts as regulated by the Board in this Commonwealth. The Board, in reaching a decision on whether there has been a violation of a statute, rule or regulation, will be guided by adjudications of the agency or court which administers or enforces the standard.

   (3)  Performing a medical act or treatment regimen incompetently or performing a medical act or treatment regimen which the [physician] Board-regulated practitioner knows or has reason to know that [he] the practitioner is not competent to perform.

   (4)  Unconditionally guaranteeing that a cure will result from the performance of medical services or treatment regimen.

   (5)  Advertising of a medical business which is intended to or has a tendency to deceive the public.

   (6)  Practicing [medicine] the healing arts fraudulently, or with reckless indifference to the interests of a patient on a particular occasion, or with negligence on repeated occasions.

   (7)  Practicing [medicine] the healing arts while the ability to practice is impaired by alcohol, drugs or physical or mental disability.

*      *      *      *      *

   (9)  Continuing to practice while the [physician's] Board-regulated practitioner's license or certificate has expired, is not registered or is suspended or revoked.

*      *      *      *      *

   (13)  Charging a patient or a third-party payer for a medical service or treatment regimen not performed. This paragraph does not apply to charging for an unkept office visit.

*      *      *      *      *

   (18)  Failing to make available to the patient or to another designated health care practitioner, upon a patient's written request, the medical record or a copy of the medical record relating to the patient which is in the possession or under the control of the [physician] Board-regulated practitioner; or failing to complete those forms or reports, or components of forms or reports, which are required to be completed by the [physician] Board-regulated practitioner as a precondition to the reimbursement or direct payment of the medical expenses of a patient by a third party. Reasonable fees may be charged for making available copies, forms or reports. Prior payment for professional services to which the records relate--this does not apply to fees charged for reports--may not be required as a condition for making the records available. A physician may withhold information from a patient if, in the reasonable exercise of his professional judgment, the physician believes release of the information would adversely affect the patient's health.

*      *      *      *      *

   (b)  Immoral conduct includes, but is not limited to, the following:

   (1)  Misrepresentation or concealment of a material fact in obtaining a license [to practice medicine] or a certificate issued by the Board or a reinstatement thereof.

*      *      *      *      *

CHAPTER 18. STATE BOARD OF MEDICINE--PRACTITIONERS OTHER THAN MEDICAL DOCTORS

   (Editor's Note: The following text is new and is printed in regular type to enhance readability.)

Subchapter H. ATHLETIC TRAINERS

Sec.

18.501	Purpose.
18.502	Definitions.
18.503.	Certification requirement.
18.504.	Application for certification.
18.505.	Educational requirements.
18.506.	Examination requirement.
18.507.	Temporary certification.
18.508.	Renewal of certification.
18.509.	Practice standards for athletic trainers.
18.510.	Refusal, suspension or revocation of certificate.

§ 18.501. Purpose.

   This subchapter implements section 51.1 of the act (63 P. S. § 422.51a) to provide for the certification and practice standards of athletic trainers.

§ 18.502. Definitions.

   The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:

   Approved athletic training education programs--An athletic training education program that is accredited by a Board-approved Nationally recognized accrediting agency.

   Athletic training services--The management and provision of care of injuries to a physically active person, with the direction of a licensed physician.

   (i)  The term includes the rendering of emergency care, development of injury prevention programs and providing appropriate preventative and supportive devices for the physically active person.

   (ii)  The term also includes the assessment, management, treatment, rehabilitation and reconditioning of the physically active person whose conditions are within the professional preparation and education of a certified athletic trainer.

   (iii)  The term also includes the use of modalities such as: mechanical stimulation, heat, cold, light, air, water, electricity, sound, massage and the use of therapeutic exercise, reconditioning exercise and fitness programs.

   (iv)  The term does not include surgery, invasive procedures or prescription of any controlled substance.

   BOC--The Board of Certification, Inc., a National credentialing organization for athletic trainers.

   Certified athletic trainer--A person who is certified to perform athletic training services by the Board or by the State Board of Osteopathic Medicine.

   Direction--Supervision over the actions of a certified athletic trainer by means of referral by prescription to treat conditions for a physically active person from a licensed physician, dentist or podiatrist or written protocol approved by a supervising physician, dentist or podiatrist, except that the physical presence of the supervising physician, dentist or podiatrist is not required if the supervising physician, dentist or podiatrist is readily available for consultation by direct communication, radio, telephone, facsimile, telecommunications or by other electronic means.

   Physically active person--An individual who participates in organized, individual or team sports, athletic games or recreational sports activities.

   Referral--An order from a licensed physician, dentist or podiatrist to a certified athletic trainer for athletic training services. An order may be written or oral, except that an oral order must be reduced to writing within 72 hours of issuance.

   Standing written prescription--A portion of the written protocol or a separate document from a supervising physician, dentist or podiatrist, which includes an order to treat approved individuals in accordance with the protocol.

   Written protocol--A written agreement or other document developed in conjunction with one or more supervising physicians, which identifies and is signed by the supervising physician and the certified athletic trainer, and describes the manner and frequency in which the certified athletic trainer regularly communicates with the supervising physician and includes standard operating procedures, developed in agreement with the supervising physician and certified athletic trainer, that the certified athletic trainer follows when not directly supervised onsite by the supervising physician.

§ 18.503. Certification requirement.

   (a)  A person may not use the title ''athletic trainer'' or ''certified athletic trainer'' or use any abbreviation including ''A.T.,'' ''A.T.C.'' or ''C.A.T.'' or any similar designation to indicate that the person is an athletic trainer, or perform the duties thereof, unless that person has been certified by the Board.

   (b)  Subsection (a) does not apply to the following:

   (1)  A person trained and licensed or certified under any other law from engaging in the licensed or certified practice in which the person is trained.

   (2)  An athletic trainer from another state, province, territory or the District of Columbia, who is employed by an athletic team or organization that is competing in this Commonwealth only on a visiting basis, from providing athletic training services, provided the practice of the athletic trainer is limited to the members of the team or organization.

   (3)  An athletic training student practicing athletic training that is coincidental to required clinical education and is within the scope of the student's education and training.

   (c)  Athletic training certificateholders certified under the Physical Therapy Practice Act (63 P. S. §§ 1301--1313) prior to _____ (Editor's Note: The blank refers to the effective date of adoption of this proposed rulemaking.) are deemed certified by the Board.

   (d)  Athletic training certificateholders certified by the State Board of Osteopathic Medicine are deemed certified by the Board.

§ 18.504. Application for certification.

   (a)  The applicant shall submit the following on forms supplied by the Board:

   (1)  A completed application and the fee set forth in § 16.13 (relating to licensure, certification, examination and registration fees).

   (2)  Verification of professional education in athletic training in accordance with § 18.505 (relating to educational requirements).

   (3)  Documentation of passage of the National examination in accordance with § 18.506 (relating to examination requirement).

   (4)  Documentation of practice as an athletic trainer, if licensed or certified in any other jurisdiction, and verification as to whether there has been any disciplinary action taken in that jurisdiction.

   (b)  To qualify for certification, an applicant shall be at least 20 years of age and may not be addicted to alcohol or hallucinogenic, narcotic or other drugs which tend to impair judgment or coordination.

§ 18.505. Educational requirements.

   An applicant for certification shall comply with one of the following:

   (1)  Be a graduate of an accredited educational program for athletic trainers.

   (2)  Hold and maintain current credentialing as a certified athletic trainer (ATC®) from the BOC or another credentialing body approved by the Board.

§ 18.506. Examination requirement.

   An applicant for a certificate to practice as a certified athletic trainer shall submit to the Board written evidence that the applicant has passed the BOC certification examination for athletic trainers, or its equivalent as determined by the Board.

§ 18.507. Temporary certification.

   An applicant who is a graduate of an approved athletic training program accredited by the Commission for Accreditation of Allied Health Education Programs (CAAHEP), and who has applied to take the certification examination may be granted a temporary certificate to practice athletic training under the onsite direct supervision of a certified athletic trainer. The temporary certification expires 1 year from issuance or upon certification as an athletic trainer by the Board, whichever comes first.

§ 18.508. Renewal of certification.

   (a)  A certification issued under this subchapter expires on December 31 of every even-numbered year unless renewed for the next biennium.

   (b)  Biennial renewal forms and other forms and literature to be distributed by the Board will be forwarded to the last mailing address given to the Board.

   (c)  To retain the right to engage in practice, the certificateholder shall renew certification in the manner prescribed by the Board and pay the required fee prior to the expiration of the next biennium.

   (d)  When a certification is renewed after December 31 of an even numbered year, a penalty fee of $5 for each month or part of a month of practice beyond the renewal date will be charged in addition to the renewal fee.

   (e)  Continuing education requirements are as follows.

   (1)  Beginning with the biennial period commencing on the next biennial renewal period following _____ (Editor's Note: The blank refers to the effective date of adoption of this proposed rulemaking.), athletic trainers shall complete the continuing education requirements prescribed by the BOC.

   (2)  Applicants for renewal of a certificate shall provide a signed statement verifying that the continuing education requirement has been met.

   (3)  Proof of completion of the required continuing education shall be retained for 2 years after completion.

§ 18.509. Practice standards for athletic trainers.

   (a)  Athletic trainers certified by the Board or by the proper licensing authority of any other state, province, territory or the District of Columbia shall comply with the following:

   (1)  Ensure that the physically active person has secured a written referral or is subject to a written protocol for treatment by a certified athletic trainer from a licensed physician, dentist or podiatrist.

   (2)  Comply strictly with conditions or restrictions that may be placed on the course of athletic training services by the referring physician, dentist or podiatrist.

   (3)  Ensure that the physically active person has undergone a medical diagnostic examination or has had the results of a recently performed medical diagnostic examination reviewed by a licensed physician.

   (4)  Keep a copy of the referral and the results of the medical diagnostic examination in the physically active person's file.

   (5)  Consult promptly with the referring physician, dentist or podiatrist regarding a new ailment or condition or a worsened ailment or condition of the physically active person.

   (6)  Consult with the referring physician, dentist or podiatrist upon request of either the referring physician, dentist or podiatrist or the physically active person.

   (7)  Refer a physically active person with conditions outside the scope of athletic training services to a licensed physician, dentist or podiatrist.

   (b)  Athletic trainers certified by the Board, or by the proper licensing authority of any other state, province, territory or the District of Columbia who are working in a team setting, treating injuries which arise in the course of practices or team sports events, may treat the participant at the events under the conditions of the referral, or the standing written prescription or written protocol.

   (c)  An athletic trainer shall obtain the standing written prescription or protocol annually from the supervising physician, dentist or podiatrist and review it annually. The standing written prescription or written protocol shall be retained at or near the treatment location or facility. An individual referral from a supervising physician, dentist or podiatrist is required in the absence of a standing written prescription or written protocol.

§ 18.510. Refusal, suspension or revocation of certificate.

   (a)  The Board may refuse to issue a certificate, and after notice and hearing, may suspend or revoke the certificate of a person who is subject to disciplinary action under section 41 of the act (63 P. S. § 422.41) as set forth in § 16.61 (relating to unprofessional and immoral conduct).

   (b)  Actions taken by the Board regarding the refusal, suspension or revocation of a certificate are taken subject to the right of notice, hearing and adjudication and appeal under 2 Pa.C.S. §§ 501--508 and 701--704 (relating to the Administrative Agency Law).

CHAPTER 25. STATE BOARD OF OSTEOPATHIC MEDICINE

Subchapter F. FEES

§ 25.231. Schedule of fees.

   An applicant for a license, certificate, registration or service shall pay the following fees at the time of application:

*      *      *      *      *

Uncertified verification of any license, certification or permit                              $15

Certification of any licenses, certifications, examination grades or hours               $25

Application for athletic trainer certification                                                $20

Biennial renewal--athletic trainer                                                         $37

*      *      *      *      *

   (Editor's Note: The following text is new and is printed in regular type to enhance readability.)

Subchapter M. ATHLETIC TRAINERS

Sec.

25.701.	Purpose.
25.702.	Definitions.
25.703.	Certification requirement.
25.704.	Application for certification.
25.705.	Educational requirements.
25.706.	Examination requirement.
25.707.	Temporary certification.
25.708.	Renewal of certificate.
25.709.	Practice standards for athletic trainers.
25.710.	Refusal, suspension or revocation of certificate.

§ 25.701. Purpose.

   This subchapter implements section 7.1 of the act (63 P. S. § 271.7a) to provide for the certification of athletic trainers.

§ 25.702. Definitions.

   The following words and terms, when used in this subchapter, have the following meanings, unless the context clearly indicates otherwise:

   Approved athletic training education programs--An athletic training education program that is accredited by a Board-approved Nationally recognized accrediting agency.

   Athletic training services--The management and provision of care of injuries to a physically active person, with the direction of a licensed physician.

   (i)  The term includes the rendering of emergency care, development of injury prevention programs and providing appropriate preventative and supportive devices for the physically active person.

   (ii)  The term also includes the assessment, management, treatment, rehabilitation and reconditioning of the physically active person whose conditions are within the professional preparation and education of a certified athletic trainer.

   (iii)  The term also includes the use of modalities such as: mechanical stimulation, heat, cold, light, air, water, electricity, sound, massage, and the use of therapeutic exercise, reconditioning exercise and fitness programs.

   (iv)  The term does not include surgery, invasive procedures or prescription of any controlled substance.

   BOC--The Board of Certification, Inc., a National credentialing organization for athletic trainers.

   Certified athletic trainer--A person who is certified to perform athletic training services by the Board or the State Board of Medicine.

   Direction--Supervision over the actions of a certified athletic trainer by means of referral by prescription to treat conditions for a physically active person from a licensed physician, dentist or podiatrist or written protocol approved by a supervising physician, dentist or podiatrist, except that the physical presence of the supervising physician, dentist or podiatrist is not required if the supervising physician, dentist or podiatrist is readily available for consultation by direct communication, radio, telephone, facsimile, telecommunications or by other electronic means.

   Physically active person--An individual who participates in organized, individual or team sports, athletic games or recreational sports activities.

   Referral--An order from a licensed physician, dentist or podiatrist to a certified athletic trainer for athletic training services. An order may be written or oral, except that an oral order must be reduced to writing within 72 hours of issuance.

   Standing written prescription--A portion of the written protocol or a separate document from a supervision physician, dentist or podiatrist which includes an order to treat approved individuals in accordance with the protocol.

   Written protocol--A written agreement or other document developed in conjunction with one or more supervising physicians, which identifies and is signed by the supervising physician and the certified athletic trainer, describes the manner and frequency in which the certified athletic trainer regularly communicates with the supervising physician and includes standard operating procedures, developed in agreement with the supervising physician and certified athletic trainer, which the certified athletic trainer follows when not directly supervised onsite by the supervising physician.

§ 25.703. Certification requirement.

   (a)  A person may not use the title of ''athletic trainer'' or ''certified athletic trainer'' or use any abbreviation including ''A.T.C.,'' ''C.A.T.'' or ''A.T.'' or any similar designation to indicate that the person is an athletic trainer, or perform the duties thereof, unless that person has been certified by the Board.

   (b)  Subsection (a) does not apply to the following:

   (1)  A person trained and licensed or certified under any other law from engaging in the licensed or certified practice in which the person is trained.

   (2)  An athletic trainer from another state, province, territory or the District of Columbia, who is employed by an athletic team or organization that is competing in this Commonwealth on a visiting basis, who provides athletic training services to the members of their respective athletic team or organization.

   (3)  An athletic training student who practices athletic training that is coincidental to required clinical education and is within the scope of the student's education and training.

   (c)  Former athletic training certificateholders under the Physical Therapy Practice Act (63 P. S. §§ 1301--1313) prior to _____ (Editor's Note: The blank refers to the effective date of adoption of this proposed rulemaking.) are deemed certified by the Board. Renewal of certification may be accomplished through renewal with the Board or with the State Board of Medicine.

   (d)  Athletic training certificateholders certified by the State Board of Medicine are deemed certified by the Board.

§ 25.704. Application for certification.

   (a)  The applicant shall submit the following on forms supplied by the Board:

   (1)  A completed application and the fee set forth in § 25.231 (relating to schedule of fees).

   (2)  Verification of professional education in athletic training in accordance with § 25.705 (relating to educational requirements).

   (3)  Documentation of passage of the national examination in accordance with § 25.706 (relating to examination requirement).

   (4)  Documentation of practice as an athletic trainer, if licensed or certified an any other jurisdiction, and verification as to whether there has been any disciplinary action taken in that jurisdiction.

   (b)  To qualify for certification, an applicant shall be at least 20 years of age and may not be addicted to alcohol or hallucinogenic, narcotic or other drugs which tend to impair judgment or coordination.

§ 25.705. Educational requirements.

   An applicant for certification shall comply with one of the following:

   (1)  Be a graduate of an accredited educational program for athletic trainers.

   (2)  Hold current credentialing as a Certified Athletic Trainer (ATC®) from the BOC or another credentialing body approved by the Board.

§ 25.706. Examination requirement.

   An applicant for a certificate to practice as a certified athletic trainer shall submit to the Board written evidence that the applicant has passed the BOC certification examination for athletic trainers or its equivalent, as determined by the Board.

§ 25.707. Temporary certification.

   An applicant who is a graduate of an accredited education program for athletic trainers and who has applied to take the certification examination may be granted a temporary certificate to practice athletic training under the on site direct supervision of a certified athletic trainer. The temporary certification expires 1 year from issuance or upon certification as an athletic trainer by the Board, whichever comes first, and may not be renewed.

§ 25.708. Renewal of certificate.

   (a)  A certificate issued under this subchapter shall be renewed biennially. An application form will be mailed to the most recent address of the certificateholder as it appears on the records of the Board. The certificateholder shall complete the renewal application and return it to the Board with a renewal fee before October 31 of the year in which the application was received. Certificates other than temporary certificates shall expire on October 31 of each even-numbered year. Upon receipt of an application and renewal fee, the Board will verify the accuracy of the application and issue to the applicant a certificate of renewal for the next biennial period.

   (b)  Continuing education requirements are as follows:

   (1)  Beginning with the biennial period commencing on the next biennial renewal period following _____ (Editor's Note: The blank refers to the effective date of adoption of this proposed rulemaking.), athletic trainers shall complete the continuing education requirements prescribed by the BOC.

   (2)  Applicants for renewal of a certificate shall provide a signed statement verifying that the continuing education requirement has been met.

   (3)  Proof of completion of the required continuing education shall be retained for 4 years after completion.

§ 25.709. Practice standards for athletic trainers.

   (a)  Athletic trainers certified by the Board or by the proper licensing or certification authority of any other state, province, territory or the District of Columbia shall comply with the following:

   (1)  Ensure that the physically active person has secured a written referral or is subject to a written protocol for treatment by a certified athletic trainer from a licensed physician, dentist or podiatrist.

   (2)  Comply strictly with conditions or restrictions that may be placed on the course of athletic training services by the referring physician, dentist or podiatrist.

   (3)  Ensure that the physically active person has undergone a medical diagnostic examination or has had the results of a recently performed medical diagnostic examination reviewed by a licensed physician, dentist or podiatrist.

   (4)  Keep a copy of the referral and the results of the medical diagnostic examination in the physically active person's file.

   (5)  Consult promptly with the referring physician, dentist or podiatrist regarding a new ailment or condition or a worsened ailment or condition of the physically active person.

   (6)  Consult with the referring physician, dentist or podiatrist upon request of either the referring physician, dentist or podiatrist or the physically active person.

   (7)  Refer a physically active person with conditions outside the scope of athletic training services to a licensed physician, dentist or podiatrist.

   (b)  Athletic trainers certified by the Board or by the proper licensing authority of any other state, province, territory or the District of Columbia who are working in a team setting, treating injuries which arise in the course of practices or team sports events, may treat the participant at the events under the conditions of the referral, the standing written prescription or written protocol.

   (c)  The supervising physician, dentist or podiatrist shall provide the standing written prescription or written protocol annually to the athletic trainer and review it annually. This standing written prescription or protocol must be in writing and retained at or near the treatment location or facility. An individual referral from a supervising physician, dentist or podiatrist is required in the absence of a written protocol.

§ 25.710. Refusal, suspension or revocation of certificate.

   (a)  The Board may refuse to issue a certificate, and after notice and hearing, may suspend or revoke the certificate of a person who is subject to disciplinary action under section 15(b) of the act (63 P. S. § 271.15(b)).

   (b)  Actions taken by the Board regarding the refusal, suspension or revocation of a certificate are taken subject to the right of notice, hearing and adjudication and appeal under 2 Pa.C.S. §§ 501--508 and 701--704 (relating to Administrative Agency Law).

[Pa.B. Doc. No. 06-427. Filed for public inspection March 17, 2006, 9:00 a.m.]