HOUSE BILL NO. 160 "An Act relating to the licensing and regulation of athletic trainers." 10:06:15 AM Representative Thompson read his sponsor statement to the committee (copy on file): House Bill (HB) 160 would amend current statutes to establish licensing and regulation of athletic trainers in the State of Alaska. Athletic Trainers are health care professionals who collaborate with physicians to enhance the practice of sports medicine for patients and clients. This profession plays a significant role in the management, prevention, recognition and rehabilitation of injured athletes under the supervision of a licensed physician Athletic trainers are a vital resource in administering injury prevention and treatment programs, as well as immediate emergency care for the sport and athletic community. Alaska is one of the final two states that doesn't currently license athletic trainers. HB 160 will require athletic trainers to have a license to practice in the State of Alaska. HB 160 will hold athletic trainers accountable to the rigorous standards of the Board of Certification, INC; a national agency created to certify healthcare professions and assure the protection of the public. As Alaskans become increasingly more active the need for properly trained and licensed athletic trainers becomes imperative. Please support the passage of HB 160. Representative Thompson asked his staff to explain the bill in more detail. BRODIE ANDERSON, STAFF, REPRESENTATIVE THOMPSON, reviewed the sectional analysis. He reported that Section 1 added a new chapter for athletic trainers. Section AS 08.07.010 outlined the license requirements and Section AS 08.07.020 identified the qualifications, fee, and renewal. The scope of practice of an athletic trainer was referenced in Section AS 08.07.030. A new section was added Section AS 08.07.040 which defined the regulations and how they would be drafted as well as definitions. Athletic trainer was added to the list of "health care provider" in Section 3 AS 09.65.300 in which immunity was given for providing free health care services. Section 4 AS 47.17.290 was amended to add athletic trainer to the list of "practitioner of the healing arts." Finally, in Section 5 Uncodified Law, the applicability of the bill, was added. 10:10:22 AM Representative Holmes wanted to have a discussion on the record with the sponsor regarding concerns she heard from people that were not athletic trainers but coaches, fitness consultants, or personal trainers. They were concerned that the bill would somehow make their jobs illegal. She asked the representative to clarify that it was not the case and to address the concerns that were brought up. 10:11:15 AM Representative Thompson referenced a memo in the committee packet dated April 9, 2014 from Sara Chambers of Business and Professional Licensing, the director of the Division of Corporations. The memo explained that there were professions not currently licensed in the title that performed functions that were defined as athletic training and were in the scope of the professional training duties (i.e. physical trainers and coaches). He asked if the committee wanted him to read the letter. Co-Chair Stoltze verified with Representative Holmes that she wanted Representative Thompson to place the information on record. Representative Holmes responded affirmatively. Co-Chair Stoltze also wanted to make sure a letter from Peak Fitness in Palmer expressing similar concerns was included in the committee packet. He had received it the previous evening. 10:12:14 AM Mr. Anderson stated that Sara Chambers was in the audience. He identified the items that most significantly defined the differences between coaches and fitness trainers and the responsibilities of athletic trainers in the answers provided in questions two and three. He informed the committee that a person had to be acting under the direction of a physician or had to be using the title of "Athletic Trainer." If either criteria was applicable a person fell under the classification of "Athletic Trainer," and would be required by law to be licensed. 10:13:22 AM Representative Holmes expressed satisfaction with the answers. She stated that personal trainers and team coaches obviously tried to help prevent injury, to help encourage safety, and to refer people to healthcare providers when necessary. She wanted to clarify, that by doing the things she described, coaches and personal trainers would not be placed in a vulnerable position as a result of the legislation before the committee. 10:14:09 AM SARA CHAMBERS, DIRECTOR, DIVISION OF CORPORATIONS, BUSINESS AND PROFESSIONAL LICENSING, DEPARTMENT OF COMMERCE, COMMUNITY AND ECONOMIC DEVELOPMENT testified that the department's interpretation of the bill was that if one of the two criteria was met, licensure would be required. If a person worked under the scope of athletic training as defined, acted under the direction of a physician, or referred to themselves as an "athletic trainer," then they would be required to be licensed; referred to as title protection. Only people licensed would be able to use the title. A coach using the title "coach" or a personal trainer using the title "personal trainer" who did not work in a medical capacity under a physician who simply rendered first responder type of first aid, would not be required to have an athletic trainer license. 10:15:27 AM Representative Wilson asked about an injury treated in Fairbanks. Ms. Chambers replied that if a person that held a medical license acted within the scope of their license to treat a patient, then they would not be required to hold an additional license. Representative Wilson gave the example of a basketball coach helping to administer care to a player under the direction of a physician. She asked whether or not a coach would be required to have a license. Ms. Chambers replied that if the coach worked under the supervision of a medical doctor, they would be required to have an athletic trainer license. However, if the patient received care and the coach was not working under medical supervision, then seeking proper medical care was the responsibility of the patient rather than the coach. Representative Holmes asked what it meant to be working under the supervision of a medical physician. Mr. Anderson replied that testifiers were available. 10:19:49 AM Representative Gara pointed out that an "and" or an "or" needed to be included in the following section of the bill starting on page 1, line 10 through page 2 line 4: (1) is a student in an accredited athletic trainer program who is practicing athletic training under the supervision of an athletic trainer or a person licensed to practice medicine or osteopathy under AS 08.64;12 (2) is licensed, certified, or registered as an athletic trainer in another state and is present in the state for not more than 90 days in a calendar year for a specific athletic event or series of athletic events with an individual or group not based in the state; (3) is in the military service of the United States or as an employee of the federal government performing athletic training services within the scope of the individual's official duties. Representative Gara wanted clarification whether all three or only one of the conditions needed to be met. Mr. Anderson suggested that the word "or" needed to be inserted. However, he would get back to the committee with a definite answer. 10:20:43 AM Co-Chair Austerman discussed the fiscal note. He surmised that the $48 thousand was to establish the program. He wanted to know the cost for an ongoing program and the cost of the licensing fee. Ms. Chambers replied that the department was working on clarifying costs. She suggested that based on 60 licensees and another $26 thousand in costs to the state, licensing fees were estimated between $110 and $180. The higher end of licensing fees would be used to cover larger initial set-up costs. As the costs decreased and the expenses lowered the licensing fees would be adjusted downward. The figures were estimates. The actual activity of the program would dictate the fee. The estimate was based on the naturopath licensing program which had a similar amount of licensees. 10:23:17 AM LYNNE YOUNG, SECRETARY/TREASURER, ALASKA ATHLETIC TRAINERS ASSOCIATION (AATA), spoke in favor of HB 160. She informed the committee that athletic trainers were highly qualified healthcare professionals who collaborated and worked under the direction of physicians. She described some of the care provided by athletic trainers including prevention, emergency care, clinical assessment, therapeutic intervention, and rehabilitation of injuries and medical conditions. She clarified that simply working under the direction of a physician and using the title of athletic trainer did not require a license. She furthered that to become an athletic trainer a person had to attend an accredited athletic training curriculum and pass a board of certification national exam. Athletic trainers had one nationally recognized board of certification called BOC, Inc. She asserted that the state did not need a separate board; BOC, Inc. governed practical standards, professional requirements, and continuing education for athletic trainers. She conveyed that athletic trainers were required to maintain continuing education units; a minimum of 50 hours every two years, 10 hours of which had to be evidence based. In addition, trainers had to maintain currency in emergency cardiac care at the professional medical rescuer level or above. Ms. Young reported that Alaska was one of two states that did not regulate athletic training. She stressed that AATA was proactive in ensuring that individuals taking care of the public were athletic trainers that met the minimum standards set forth by its board of certification. She pointed out that HB 160 did not prevent a person from working in the capacity that they were trained. She cited the example of a physician assistant working under the direction and supervision of a physician. She reported that they did not attend a four-year athletic training curriculum even though they provided similar services as delivered by athletic trainers. However, they did not call themselves athletic trainers. She referenced other examples. The Alaska State Activities Association required coaches to take a fundamental coaching class, a sports injury course, and a free 20-minute concussion course. She reiterated that HB 160 regulated individuals in the state that called themselves as athletic trainers. She closed by urging the committee to support HB 160. Co-Chair Stoltze commented that he planned to hear HB 160 again on the same day at 6:00 PM. 10:29:07 AM DR. JILL VALERIUS, PHYSICIAN, WASILLA (via teleconference), testified as an athletic trainer and physician. She stated her support for the legislation. She asserted that HB 160 protected the public by ensuring that those who called themselves athletic trainers were trained, certified and worked under a collaborative agreement with a physician. She relayed her concern for people getting the quality of care they deserved. She attested that certified athletic trainers worked diligently to become certified. She stated the importance of practicing within the scope of a person's training and how that applies to all of the many different types of providers. She reiterated her support of HB 160.