CS FOR HOUSE BILL NO. 160(FIN) "An Act relating to the licensing and regulation of athletic trainers." 3:10:04 PM REPRESENTATIVE STEVE THOMPSON, stated that the legislation would amend current statutes to establish licensing and regulations of athletic trainers. He stated that athletic trainers were multi-skilled, midlevel medical care providers that provided a unique combination of injury and illness treatment, rehabilitation, and injury prevention. Athletic trainers were similar to nurse practitioners, midwives, physician assistants, neuropathic physicians, and physical therapists. He stressed that all of those positions were licensed in Alaska, in order to provide immunity for health care providers. Certification was provided through the National Organization of National Athletic Trainers Association. There were specific requirements before certification was issued: 1) mandatory post-secondary degree; 2) formal instructions in extensive basic and applied sciences; 3) specific professional content; and 4) comprehensive national examination through the Board of Certification Inc. He stated that HB 160 would require people using the title "Athletic Trainer" who were working cooperatively under the supervision of a doctor to be licensed. Alaska was one of two states that did not currently license athletic trainers. Athletic trainers in Alaska asked for the legislation, because they understood the need to be licensed in order to be recognized as health care providers. He urged the committee's support of the legislation. Vice-Chair Fairclough stated that her staff had met with the sponsor's staff regarding the current language. She felt that the legislation may have ramifications on school districts and other athletic programs for children and adults throughout the state. She wondered if that was the intent of the legislation. Representative Thompson deferred to Mr. Anderson. BRODIE ANDERSON, STAFF, REPRESENTATIVE STEVE THOMPSON, announced that he was working with the committee co-chairs' staff to draft a committee substitute that would directly address the concerns of fitness trainers and coaches, and the relationship in an exemption. Vice-Chair Fairclough thanked a constituent who had sent a solution to the issue via email. Co-Chair Meyer asked if Mr. Anderson was working with his staff on the committee substitute. Mr. Anderson replied in the affirmative. 3:14:30 PM LYNNE YOUNG, EXECUTIVE DIRECTOR, ALASKA ATHLETIC TRAINERS ASSOCIATION, JUNEAU, testified in support of the legislation. She remarked that athletic trainers were highly qualified, educated, and multi-skilled health professionals who collaborate with and work under the supervision of physicians. The services provided by athletic trainers consist of prevention, emergency care, clinical assessment, therapeutic intervention, and rehabilitation of injuries and medical conditions. Individuals who want to become athletic trainers must have a bachelor's degree at an accredited athletic training university. Once the individual meets the requirement, they were eligible to sit for the Board of Certification Inc. exam. Upon completion of the exam, the individual would be a certified athletic trainer. Once the individual was certified, they must maintain their credentials by taking 50 continuing education units (CEUs) every two years in addition to maintaining an emergency cardiac care course at the professional rescuer level or above. The CEUs were approved by the Board of Certification Inc., and ten of the CEUs needed to be evidence-based medical courses. Senator Bishop wondered if the CEUs could be conducted in the state. Ms. Young replied that there were over 300 accredited universities to become athletic trainers, but none of those universities were in Alaska. There were some online courses and clinics in the state that provided access to CEUs. 3:21:52 PM Vice-Chair Fairclough asked if the licensure would get different benefits from insurance providers and billing of hours. Ms. Young replied that there was current outreach through schools and universities, but did not directly bill insurance providers. She furthered that there were some athletic trainers that worked with physicians in the clinic setting, and if they were used to assist the provider was billed under "Incident 2." She explained that the specific in that bill was parallel with medical assistants, etc. She stated that athletic trainers had a national provider identifier that allowed them codes regarding billing for rehabilitation. Vice-Chair Fairclough wondered if the law to license would affect the billable hours. Ms. Young responded that the licensure would be recognized as a health care professional, but have no other association. LEEANNE CAROTHERS, PRESIDENT, ALASKA PHYSICAL THERAPY ASSOCIATION, JUNEAU, stated that she supported licensure of health care providers for the protection of the public, she announced some concerns with the bill. She looked at the use of the word "rehabilitation" in the proposed scope of practice and in definitions in Sections 8.07.030(d) and 08.07.090(4). She felt that use of the word "rehabilitation" would have potential to cause consumer confusion. She stated that physical therapists were currently considered the most qualified practitioners for rehabilitation. She suggested the inclusion of language that specifically limited the role of the athletic trainers to injuries sustained or exacerbated while participating in a sport or sports-related activity, and/or was designated for the purpose of returning the patient to athletic participation. She also expressed concern of the use of language with definitions as they pertain to illness. She urged the inclusion of language that clarified that the treatment of limited to injuries or conditions associated with participation in sport. There were significant differences in the education and training for athletic trainers and physical therapists. The entry level degree required for athletic trainers was a bachelor's degree and the entry level degree for physical therapists was a doctorate degree. 3:26:36 PM Co-Chair Meyer felt that there would be changes to the bill in a forthcoming committee substitute. Co-Chair Meyer CLOSED public testimony. Co-Chair Meyer looked at the fiscal note, and remarked that the fiscal note may not cover the actual cost of the legislation. Vice-Chair Fairclough stated that the Legislation Budget and Audit (LB&A) had created a joint subcommittee on the issue. CSHB 160(FIN) was HEARD and HELD in committee for further consideration.