Justification for Adoption of Athletic Trainers Administrative Rules

JUSTIFICATION FOR ADMINISTRATIVE RULE ADOPTION
Athletic Trainers

16 TAC Chapter 110, amendment §§110.14, 110.20, 110.21, 110.23, 110.25, 110.30, 110.80, 110.90 and 110.95; new §110.1 and §110.10; and repeal of existing §110.1 and §110.19

The Texas Commission of Licensing and Regulation (Commission) adopts amendments to existing rules at 16 Texas Administrative Code, Chapter 110, §§110.14, 110.20, 110.21, 110.23, 110.25, 110.30, 110.80, 110.90 and 110.95; adopts new §110.1 and §110.10; and adopts the repeal of existing §110.1 and §110.19, regarding the Athletic Trainers program, without changes to the proposed text as published in the February 9, 2018, issue of the Texas Register (43 TexReg 690). The rules will not be republished.

The adopted rules implement House Bill 4007, 85th Legislature, Regular Session (2017), for the Athletic Trainers Program, which made several clean up changes to Texas Occupations Code, Chapter 451. The adopted rules are necessary to implement H.B. 4007; remove unnecessary provisions; make editorial corrections; and update the rule language to reflect current exam practices. The adopted rules also reduce the fees for license renewals and temporary licenses so that they are not more expensive than the initial license fee.

The adopted new §110.1 states the statutory authority for rulemaking.

The adopted repeal of current §110.1 moves the definitions used in the Athletic Trainers program to §110.10.

The adopted new §110.10 contains the definitions that were previously located in §110.1. The reference to “Board” was replaced with “Advisory Board.”

The adopted amendments to §110.14 make an editorial change to the title of the section.

The adopted repeal of §110.19 removes unnecessary provisions.

The adopted amendments to §110.20 remove an unnecessary provision related to HB 4007 and renumber the section accordingly.

The adopted amendments to §110.21 add clarifying language and change a reference from the Department to the Department of State Health Services.

The adopted amendments to §110.23 reword the section to reflect current exam processes, add clarifying language, restructure subsection (c) for clarity, and renumber the section accordingly.

The adopted amendments to §110.25 simplify and clarify the language regarding continuing education requirements and renumber the section accordingly.

The adopted amendments to §110.30 clarify the language regarding temporary license requirements.

The adopted amendments to §110.80 reduce fees for temporary licenses and license renewals to standardize those fees with initial license application fees, clarify that examination fees are paid to the Department’s designee rather than to the Department, add a fee for a duplicate/replacement license as is standard with all licenses administered by the Department, combine the initial license fee and initial application fees into one fee, and remove the returned check fee as it conflicts with the Department’s rules at 16 TAC §60.82 and §110.80(e) regarding dishonored payment devices.

The adopted amendments to §110.90 correct a reference to the statutory authority for imposing administrative penalties and sanctions.

The adopted amendments to §110.95 correct a reference to the Athletic Trainers program statute.

The Texas Department of Licensing and Regulation (Department) drafted and distributed the proposed rules to persons internal and external to the agency. The proposed rules were published in the February 9, 2018, issue of the Texas Register (43 TexReg 690). The deadline for public comment was March 12, 2018. The Department did not receive any comments during the 30-day public comment period.

The Advisory Board of Athletic Trainers (Board) met on April 23, 2018, and recommended the proposed rules be adopted without changes. At its meeting held on May 24, 2018, the Commission adopted the proposed rules without changes as recommended by the Board and the Department.

The new rules and amendments are adopted under Texas Occupations Code, Chapters 51 and 451, which authorize the Commission, the Department’s governing body, to adopt rules as necessary to implement these chapters and any other law establishing a program regulated by the Department.

The statutory provisions affected by the adoption are those set forth in Texas Occupations Code, Chapters 51 and 451. No other statutes, articles, or codes are affected by the adoption.

§110.1. Authority.

The sections in this chapter are promulgated under the authority of the Texas Occupations Code, Chapters 51 and 451.

§110.10. Definitions.

The following words and terms, when used in these rules shall have the following meanings unless the context clearly indicates otherwise. Words and terms defined in the Athletic Trainers Act shall have the same meaning in these rules:

(1) Act--Texas Occupations Code, Chapter 451.

(2) Advisory Board--the Advisory Board of Athletic Trainers.

(3) Athlete--A person who participates in an organized sport or sport-related exercise or activity, including interscholastic, intercollegiate, intermural, semiprofessional, and professional sports activities.

(4) Commission--the Texas Commission of Licensing and Regulation.

(5) Department--the Texas Department of Licensing and Regulation.

(6) Executive Director--the executive director of the department.

(7) Licensee--A person who holds a current license or a temporary license as an athletic trainer issued by the department under the Act.

(8) Temporary license--A license issued under §110.30.

§110.14. Advisory Board Membership.

The Advisory Board of Athletic Trainers consists of five members appointed by the presiding officer of the commission with the approval of the commission as follows:

(1) three members who are athletic trainers; and

(2) two members who represent the public.

§110.20. Application Requirements.

(a) Unless otherwise indicated, an applicant must submit all required information and documentation of credentials on department-approved forms.

(b) An applicant must submit the following required documentation:

(1) a completed application on a department-approved form;

(2) official transcript(s)/documentation of all relevant college work showing successful completion of education requirements and apprenticeship hours;

(3) the form providing information regarding other state licenses, certificates, or registrations that an applicant holds or held, if applicable;

(4) proof of successfully completing the jurisprudence examination no more than six months prior to the date of application; and

(5) the fee(s) required under §110.80.

(c) The applicant must successfully pass a criminal history background check.

(d) The department will notify the applicant regarding whether the applicant qualifies to take the license examination.

(e) Pursuant to Texas Occupations Code, Chapters 51 and 451, the commission or the executive director may deny the application for a violation of the Act.

(f) If after review the department determines that the application should not be approved, the department shall give the applicant written notice of the reason for the proposed decision and of the opportunity for a hearing under Texas Government Code, Chapter 2001.

§110.21. License Requirements.

(a) Applicants qualifying under the Act, §451.153(a)(1), shall have:

(1) a baccalaureate or post-baccalaureate degree, which includes at least 24 hours of combined academic credit from each of the following course areas:

(A) human anatomy;

(B) health, disease, nutrition, fitness, wellness, emergency care, first aid, or drug and alcohol education;

(C) kinesiology or biomechanics;

(D) physiology of exercise;

(E) athletic training, sports medicine, or care and prevention of injuries;

(F) advanced athletic training, advanced sports medicine, or assessment of injury; and

(G) therapeutic exercise, therapeutic rehabilitation, or therapeutic modalities; and

(2) an apprenticeship in athletic training meeting the following requirements:

(A) the program shall be under the direct supervision of and on the same campus as a Texas licensed athletic trainer, or if out-of-state, the college or university's certified or state licensed athletic trainer;

(B) the apprenticeship must be a minimum of 1,800 hours. It must be based on the academic calendar and must be completed during at least five fall and/or spring semesters. Hours in the classroom do not count toward apprenticeship hours;

(C) the hours must be completed in college or university intercollegiate sports programs. A maximum of 600 hours of the 1,800 hours may be accepted from an affiliated setting which the college or university's athletic trainer has approved. No more than 300 hours may be earned at one affiliated setting. These hours must be under the direct supervision of a licensed physician, licensed or certified athletic trainer, or licensed physical therapist;

(D) 1,500 hours of the apprenticeship shall be fulfilled while enrolled as a student at a college or university; and

(E) the apprenticeship must offer work experience in a variety of sports. It shall include instruction by a certified or state-licensed athletic trainer in prevention of injuries, emergency care, rehabilitation, and modality usage.

(b) In place of the requirements in subsection (a), applicants qualifying under the Act, §451.153(a)(1) shall hold a baccalaureate or post-baccalaureate degree and one of the following:

(1) current licensure, registration, or certification as an athletic trainer issued by another state, jurisdiction, or territory of the United States; or

(2) current national certification as an athletic trainer issued by the Board of Certification, Inc. (BOC).

(c) Applicants qualifying under the Act, §451.153(a)(2) or (a)(3), shall have a baccalaureate or post-baccalaureate degree or a state-issued certificate in physical therapy or a baccalaureate or post-baccalaureate degree in corrective therapy with at least a minor in physical education or health. Applicants who hold such degrees must complete three semester hours of a basic athletic training course from an accredited college or university. An applicant shall also complete an apprenticeship in athletic training meeting the following requirements.

(1) The program shall be a minimum of 720 hours. It must be based on the academic calendar and must be completed during at least three fall and/or spring semesters. The hours must be under the direct supervision of a college or university's Texas licensed athletic trainer or if out-of-state, the college or university's certified or state-licensed athletic trainer. The apprenticeship includes a minimum of 360 hours per year. Hours in the classroom do not count toward apprenticeship hours.

(2) Actual working hours shall include a minimum of 20 hours per week during each fall semester. A fall semester includes pre-season practice sessions. The apprenticeship must offer work experience in a variety of sports.

(3) The apprenticeship must be completed in a college or university's intercollegiate sports program. A maximum of 240 hours of the 720 hours may be earned at a collegiate, secondary school, or professional affiliated setting which the college or university's athletic trainer has approved. No more than 120 hours may be earned at one affiliated setting.

(d) In place of the requirements in subsections (a) and (b), an applicant qualifying under the Act, §451.153(a)(1), shall have a baccalaureate or post-baccalaureate degree in athletic training from a college or university, which held accreditation, during the applicant’s matriculation at the college or university and at the time the degree was conferred, from a nationally recognized accrediting organization that is approved by the department.

(e) Certification required. An applicant must have:

(1) current certification in the techniques of professional rescuer cardio-pulmonary resuscitation and the use of an automated external defibrillator; or

(2) current certification for Emergency Medical Services (EMS) with the Department of State Health Services or its successor agency.

(f) Each applicant must have a baccalaureate or post-baccalaureate degree from a college or university, which held accreditation, at the time the degree was conferred, from a regional educational accrediting association that is approved by the department.

(g) The relevance to the licensing requirements of academic courses, the titles of which are not self-explanatory, must be substantiated through course descriptions in official school catalogs or bulletins or by other means acceptable to the department.

(h) The department shall not accept courses, which an applicant's transcript indicates, were not completed with a passing grade for credit.

§110.23. Examination for Licensure.

(a) The department shall offer examinations at least two times a year at times and at places established and announced by the department.

(b) The examination required under the Act, §451.156 consists of a written examination, a practical examination, and a jurisprudence examination prescribed by the department.

(1) An applicant must pass the written examination prior to taking the practical examination.

(2) An applicant must complete the jurisprudence examination no more than six months prior to the date of application.

(c) An applicant is eligible for examination if the applicant meets one of the following three options:

(1) the applicant:

(A) is within 30 semester hours of graduation;

(B) has completed or is currently pre-registered or enrolled in the courses listed in §110.21; and

(C) has completed at least 1,300 hours of the required 1,800 hours and the apprenticeship program is in progress;

(2) the applicant is currently enrolled in, and within two semesters of graduating from, an athletic training program at a college or university which holds accreditation from a nationally recognized accrediting organization that is approved by the department, if the applicant qualifies under the Act, §451.153(a)(1); or

(3) the applicant has completed at least 600 hours of the required 720 hours and the apprenticeship program is in progress, if the applicant qualifies under the Act, §451.153(a)(2) or (a)(3).

(d) The department shall review all applications prior to the examination. An applicant meeting the requirements of subsection (c) or of §110.21 shall be approved to take the examination.

(e) The department shall notify an applicant whose application has been approved for examination. Applications which are received incomplete or late may cause the applicant to miss the examination registration deadline.

(f) Examinations shall be graded by the department's designee.

(g) The department’s designee shall notify each applicant of the results of the examination within 30 days of the date of the examination.

(h) The following procedures relate to applicants who fail the examination prescribed by the department.

(1) An applicant who fails the examination may take a subsequent examination after paying the examination fee.

(2) The department will make available a copy of the department's policy concerning examination review to an applicant who fails an examination.

(i) An applicant who fails to take the examination within a period of two years after the initial examination approval notice sent by the department, shall have such approval withdrawn and the application for licensure voided.

(j) An applicant who has failed the state examination described in subsections (a) - (l), must successfully complete that examination in order to be issued a license. If the application has been voided as described in subsection (i), the person shall submit a new application, and the provisions of subsection (m) shall apply.

(k) Applicants who have passed the examination and do not have a degree, will have 90 days from their graduation date to submit all documents and fees necessary to show compliance with this chapter and complete the licensing procedure. If the application process is not completed within 90 days of the graduation date, the applicant shall be required to file a new application and retake the examination successfully in order to qualify for licensure.

(l) A first-time applicant must apply for examination within five years from the date on which the applicant's qualifying degree was conferred or the apprenticeship was completed, whichever is later. An applicant may submit an application after this time period upon successful completion of remedial coursework or apprenticeship, as approved by the department.

(m) If an applicant has successfully completed the examination administered by the Board of Certification, Inc. (BOC) on or after January 1, 2004, the applicant shall not be required to complete the state examination described in subsections (a) - (l), unless the applicant has previously held a license issued by the department. The applicant must furnish to the department a copy of the test results indicating that the applicant passed the examination.

(n) If an applicant has completed the examination administered by the Board of Certification, Inc. (BOC) before January 1, 2004, the applicant shall be required to complete the state examination described in subsections (a) - (l).

§110.25. Continuing Education Requirements.

(a) To renew a license, a licensee must complete 40 clock-hours of continuing education during each license term.

(1) The continuing education must include two clock-hours of training in concussion management.

(2) In addition to the number of continuing education clock-hours required under this subsection, a licensee must also show proof of current Emergency Cardiac Care certification at the Basic Life Support for Healthcare Providers/Professional Rescuers and Healthcare Providers level or beyond, which shall be maintained throughout each license term.

(b) Continuing education taken by a licensee for renewal, shall be acceptable if the experience falls in one or more of the following categories:

(1) academic courses at a regionally accredited college or university related to sports medicine;

(2) clinical courses related to athletic training and/or sports medicine;

(3) in-service educational programs, training programs, institutes, seminars, workshops and conferences in sports medicine or athletic training;

(4) instructing or presenting education programs or activities without compensation at an academic course, in-service educational programs, training programs, institutes, seminars, workshops and conferences in athletic training or sports medicine, not to exceed five clock-hours each continuing education period;

(5) publishing a book or an article in a peer review journal relating to athletic training or sports medicine, not to exceed five clock-hours each continuing education period;

(6) serving as a skills examiner at the state licensure examination, not to exceed one clock-hour of continuing education credit for each examination date for a maximum of four clock-hours of credit each continuing education period; or

(7) successful completion of an online or distance education program in athletic training or sports medicine.

(c) Continuing education experience shall be credited as follows:

(1) Completion of course work at or through an accredited college or university shall be credited for each semester hour on the basis of two clock-hours of credit for each semester hour successfully completed for credit or audit, as evidenced by a certificate of successful completion or official transcript.

(2) Parts of programs which meet the criteria of subsection (b)(2) or (3), shall be credited on a one-for-one basis, with one clock-hour of credit for each clock-hour spent in the continuing education experience.

(3) Successful completion of courses described in subsection (b)(7), is evidenced by a certificate of completion presented by the sponsoring organization of the online or distance education program.

(4) Approval by the department must be obtained for each continuing education program as described in subsection (b), unless continuing education credit is granted by a national, regional or state health care professional association.

(5) Successful completion of courses related to athletic training and/or sports medicine as described in subsection (b)(2) and (3), is evidenced by a certificate of completion or attendance that is issued by the sponsoring organization of the course.

(d) Requests for approval of continuing education experience should address the following criteria:

(1) relevance of the subject matter to increase or support the development of skill and competence in athletic training;

(2) objectives of specific information or skill to be learned;

(3) subject matter, educational methods, materials, and facilities utilized, including the frequency and duration of sessions and the adequacy to implement learner objectives; and

(4) sponsorship and leadership of programs; including the name of the sponsoring individual(s) or organization(s), and program leaders or faculty, if different from sponsors and contact person.

(e) The department shall employ an audit system for continuing education reporting. The license holder shall be responsible for maintaining a record of his or her continuing education experiences. The certificates, diplomas, or other documentation verifying earning of continuing education hours are not to be forwarded to the department at the time of renewal, unless the license holder has been selected for audit.

(f) The audit process shall be as follows:

(1) The department shall select for audit a random sample of license holders for each renewal month. License holders will be notified of the continuing education audit when they receive their renewal documentation.

(2) If selected for an audit, the licensee shall submit copies of certificates, transcripts or other documentation satisfactory to the department, verifying the licensee's attendance, participation and completion of the continuing education. All documentation must be provided at the time of renewal.

(3) Failure to timely furnish this information or providing false information during the audit process or the renewal process are grounds for disciplinary action against the license holder.

(4) A licensee who is selected for a continuing education audit may renew through the online renewal process. However, the license will not be considered renewed until the required continuing education documents are received, accepted and approved by the department.

(5) Licenses will not be renewed until continuing education requirements have been met.

(g) The department may not grant continuing education credit to any licensee for:

(1) education incidental to the regular professional activities of a licensee, such as learning occurring from experience or research;

(2) professional organization activity, such as serving on committees or councils or as an officer;

(3) any continuing education activity completed before or after the period of time described in subsection (a); or

(4) performance of duties that are routine job duties or requirements.

§110.30. Temporary License.

(a) A temporary license may be issued to an individual who meets the educational and apprenticeship requirements of this chapter.

(b) The temporary license entitles an applicant to perform the activities of an athletic trainer until the results of the first practical examination, which the applicant is eligible to take, are released.

(c) An applicant who failed an examination administered by the department, shall not be eligible for a temporary license. If a temporary license has previously been issued, it shall be voided and the applicant shall not be eligible for another temporary license.

(d) A person who was licensed as an athletic trainer but is no longer eligible to late renew the license, may be eligible for a temporary license upon submission and approval of a new application for licensure. The expiration of a temporary license issued under this subsection will be in accordance with subsection (b).

§110.80. Fees.

(a) All fees paid to the department are nonrefundable.

(b) The schedule of fees is as follows:

(1) initial license application fee (includes two-year license)--$160;

(2) temporary license fee--$160;

(3) renewal license application fee (includes two-year license)--$160; and

(4) duplicate/replacement fee for licenses issued under this chapter--$25.

(c) The fees for the written examination, practical examination, and the jurisprudence examination are set by and payable to the department’s designee.

(d) Late renewal fees for licenses issued under this chapter are provided under §60.83 of this title (relating to Late Renewal Fees).

(e) The dishonored/returned check or payment fee is the fee prescribed under §60.82 of this title (relating to Dishonored Payment Device).

(f) The fee for a criminal history evaluation letter is the fee prescribed under §60.42 of this title (relating to Criminal History Evaluation Letters).

§110.90. Administrative Penalties and Sanctions.

If a person or entity violates any provision of Texas Occupations Code, Chapters 51 or 451, this chapter, or any rule or order of the executive director or commission, proceedings may be instituted to impose administrative penalties, administrative sanctions, or both in accordance with the provisions of Texas Occupations Code, Chapter 51 and any associated rules.

§110.95. Enforcement Authority.

The enforcement authority granted under Texas Occupations Code, Chapters 51 and 451 and any associated rules may be used to enforce Texas Occupations Code, Chapter 451 and this chapter.

[§110.1. Definitions.]

[§110.19. Reimbursements.]

This agency hereby certifies that the adoption has been reviewed by legal counsel and found to be a valid exercise of the agency’s legal authority.

Filed with the Office of the Secretary of State, on June 4, 2018.


Brian E. Francis
Executive Director
Texas Department of Licensing and Regulation