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Winter
2000 Newsletter
Special Edition
In this Issue...
Athletic Trainer
Legislation
Information Packet
This packet has been developed by the Colorado Athletic Trainers Association (CATA)
Executive Board to educate CATA members on current athletic training legislation.
It is the hope of the executive board to have a well-informed membership body, so that in
our annual state business meeting at the Rocky Mountain Athletic Trainers Association
(RMATA) we can discuss athletic training legislation and how it applies to Colorado.
Please read all the information provided in this mailing. If you have any questions,
comments or concerns please feel free to contact an executive board member.
Letter
from the President
Dear Athletic Trainer,
Over the course of the last few months, the executive board and volunteers have been
working to compile and investigate current options regarding athletic training
legislation. In an effort to educate all CATA members, we have compiled the information
included in this newsletter. Please take the time to read through this information. It is
the hope of the board of directors to discuss this issue at the annual business meeting,
which will be held in conjunction with the RMATA meeting March 24-26,2000. The CATA
business meeting will be held Saturday March 25 from 6:00 p.m. to 7:30 p.m. Please plan on
attending to voice your opinion regarding legislation. The board of directors will only
proceed in the direction that the majority of the membership chooses. I look foreword to
seeing you in March.
Sincerely,
Kelli Lotito
President
Summary of CATA Current Legislative Actions
For the past five years a very hot topic in the profession of athletic training has
been state legislation that defines and regulates athletic trainers. Some state
athletic-training associations have been actively pursuing legislation, many have
succeeded in passing some form of regulation, and some have tried and failed. Other states
have decided to take a "wait and see" approach.
Just as the geography and culture of each state is different so are the forms of
athletic-training legislation. Currently 39 states have some form of athletic-training
legislation, whether it be licensure, specific exemption, registration or certification.
The executive board of the Colorado Athletic Trainers Association has identified pursuing
further athletic-training legislation as one of its top priorities for this term; that is,
if the membership so chooses. The obvious first step in this process was to poll the
members of the CATA and learn what they as an association thought of Colorado's current
athletic trainer legislation, and if they felt that additional legislation would be
desirable.
In August and September, 1999, a five-question survey was made available to members of the
CATA via the association's web page. The results of the survey, compiled from the 55 valid
surveys that were received, are as follows:
Prior to reading the information on this web site, were you aware of your legal
practice status?
Yes 36 (67%)
No 18 (33%)
After reading this, do you have a better understanding of your current legal practice
status?
Yes 45 (83%)
No 9 (17%)
Do you feel we are protected by our current exemption act?
Yes 17 (31%)
No 37 (69%)
Do you feel we would be better protected by licensure?
Yes 44 (83%)
No 9 (17%)
Do you think stronger efforts need to be made in providing this information to outside
groups?
Yes 52 (98%)
No 1 (2%)
In addition, many athletic trainers included their comments in the surveys. Due to space
considerations, they are not included in this article, but an extensive synopsis of the
comments is available on the CATA website.
With the information obtained from the survey, the CATA executive board decided the
next logical step was to contact athletic-trainer associations in states that have
successfully enacted some form of athletic-training legislation and "interview"
their representatives regarding their legislative efforts. In October, members of the CATA
executive board contacted various executive board members in those states and posed the
following questions to them:
a.. Approximately what was the cost of the legislation to the state organization?
b.. What does it cost athletic trainers in your state to maintain their licenses?
c.. What would you consider some pros and cons of athletic training licensure as it
applies to the athletic trainer?
d.. What would you consider some pros and cons for athletic trainer legislation as it
applies to the public?
e.. In hindsight, do you consider licensure for your state a good move?
f.. Who regulates any violations that occur?
Representatives from Minnesota, New Mexico, Florida, Tennessee, Kansas, Georgia,
Missouri, Texas, Ohio and Nebraska responded to the survey questions. Each state
representative provided some very beneficial insight into the legislative process.
The cost to the state athletic training associations for their legislative efforts
ranged from $5,000 to $20,000, with one state spending $10,000 on a failed attempt.
About half of the states mentioned that they continue to employ lobbyists on an ongoing
basis. That costs the organizations an average of $1,200 a month. Other states said they
feel no need to hire and maintain lobbyists because their bills have no specific
opposition.
Cost for the athletic trainer to maintain his/her license, registration, or certification
also varied greatly from state to state. On the average, the cost was $92 per year, with
some states requiring payment for two years at a time. Thirty percent of states required a
one-time initial registration fee, ranging from $60 to $300.
The state representatives who responded to the survey related that the legislation had
provided a multitude of benefits. Many said it greatly increased their potential for
third-party reimbursement. It also increased the credibility and professionalism of
athletic trainers. And virtually all the states said that the clinical athletic trainers
reaped the greatest benefit from their athletic training legislation.
One state association executive felt that their state regulation was particularly
beneficial in the high school setting, because it ensured that only people who were
certified athletic trainers would be working in high schools. He felt it would eliminate
people who represent themselves as a certified athletic trainers when they actually are
not. This was apparently a large problem in his state.
State executives identified four primary drawbacks to their athletic training
legislation. 1) It created more paperwork, by having to maintain license, registration,
certification, etc. 2) The specific practice acts that were implemented in their
legislation often were found to be too limiting. 3) The required fees, in addition to dues
to the NATA, district and state organizations, and liability insurance can add up to a
substantial amount of money. 4) Athletic trainers sometimes don't understand their
specific legislation and continue to practice outside their act, or aren't compliant with
maintaining their license/registration/certification.
In hindsight, all of the state executives felt that their specific legislation was
beneficial to them and their profession. Some did note that they would not have made their
act so "restrictive" if they had the opportunity to repeat the process.
Nearly three quarters of the states reported that regulation of their legislation was done
by a board of control, most of which were comprised of members who had to be appointed by
the governor. Those boards usually were made up of athletic trainers, who worked in
various settings, team physicians, and members of the general public. Only one state
reported knowing of any case that was actually sent to any of these boards of regulation.
Most state executives suggested that the state athletic trainers association should work
closely with related groups throughout the entire legislative development and
implementation process. They reported great success and a much easier route to the final
goal when they worked openly and in conjunction with their state medical associations and
state physical therapy associations.
In fact, one state association actually failed on its first attempt to pass legislation
when it attempted to push the legislation through without educating the state physical
therapy association as to what it entailed. When it changed its strategy to a teamwork and
cooperative approach, its second attempt went very smoothly.
State executives also felt that using the association's legislative contacts was very
important to their success. Many reported that they asked their members to approach their
community legislators, some of whom might have been former patients/athletes, or parents
of current/former athletes, and express to them the need for athletic-training
legislation.
In response to that advice, the executive board has included a list of all current
Colorado legislators in this information packet . Look over the list and see if you
recognize any names. If you know any of the state representatives, please contact the
executive board.
The CATA executive board has been working very diligently to provide accurate information
to educate its members on the topic of athletic training legislation. It is the hope of
the executive board to have a well-informed membership body, so that in our annual state
meeting, which will be held at the Rocky Mountain Athletic Trainers Association (RMATA)
meeting in March we can discuss athletic training legislation and how it applies to
Colorado.
Current CATA Financial Assets for Legislative
Action
The CATA currently has $18,441 deposited among three separate
investment accounts. This money is intended for the sole use of athletic training
licensure for the state of Colorado.
Costs Associated With Athletic Training Boards
by Larry Willock
All Boards must be self-supporting. All financial costs must be born by the profession
it regulates. These costs can be as follows:
1. A percentage of the Salary of an Administrator.( New Mexico pays 20%)
2. A percentage of the Office Costs of the Administrator ( office furniture, rent,
computers, phone, etc. )
3. Cost of all correspondence related to the Board or its actions ( Telephone calls or
written correspondence ).
4. Cost of all investigative expenses commissioned by the Board in prosecuting
non-compliant professionals.
5. The cost of filing all yearly reports and archiving of all documents associated with
the Board.
6. Per diem costs of the Board members to attend all meetings - usually a minimum of two
meetings per year.
7. Most Boards must represent different areas of those regulated, (Ex. Professional,
University, Secondary Education, Industrial, Clinic) Also depending on the size of the
Board, a proportionate number of Public Members. Example: 5 member Boards would have 2
public members and three professional 3 member Boards would have 1 public member and two
professional
8. The cost of establishing and administrating Examinations and the issuing and production
of certificates which designate the individual appropriately recognized by the State.
Fees to support the Board and its Administrator are divided by the number of individuals
regulated. Should the anticipated income not meet the costs associated with the Board, an
assessment is charged to all individuals regulated at the end of the year, or prior to the
next years credentials being administered.
Bottom Line: No tax payers funds will be utilized to pay for the Regulation of a
Profession.
Summary
and Analysis of Colorado's Current Athletic Training Legislation
*Currently athletic trainers are allowed to work in Colorado and practice under what is
called an exemption to the medical practitioners act
* We are regulated by the state board of medical examiners. If any athletic trainer
violates the
exemption it is the state board of medical examiners that will discipline the person in
violation.
*Industrial and corporate athletic trainers are not covered in the exemption. An
athletic trainer must have a formal affiliation with the areas listed in the exemption (
see legal interpretation on the CATA web
site www.prolynx.com/cata ).
* A "qualified athletic trainer" is one who has a baccalaureate degree in
athletic training or a related field and has completed a certain number of hours of
supervised clinical experience or internship training.
* "Athletic trainer scope of practice" refers repeatedly to the treatment of
"athletes". The rules and regulations concerning athletic trainers clarify that
the treatment provided may include typical professional activities of a certified athletic
trainer ( see legal interpretation on the CATA web site).
* There is no requirement for certification or other competency testing to practice as
a certified athletic trainer in Colorado. Therefore, an individual who chooses to not take
or fails the NATABOC, Inc. certification exam can lawfully practice in the same manner as
a certified athletic trainer.
* The statute specifically states that it does not authorize athletic trainers to
practice, or to hold themselves out through advertisement or billing.
* There is no title protection for athletic trainers in the state of Colorado .
Summary
of Rick Ball’s Presentation at the CATA Annual Meeting May 1999
There are four different approaches or options regarding legislation for athletic
trainers in Colorado. Each one involves different levels of monetary involvement. In order
to pursue any one of these a lobbyist must be hired which would require a monetary
commitment.
1. Change the language of the existing exemption
* if we wanted to change the wording of our current exemption it opens it up from attack
of any group. This means we could end up with more or less than what we wanted
2. Registration (statute)
* you must register to practice athletic training in Colorado
* CATA would regulate violations to a certain degree. Once the state association has taken
the appropriate steps then it would be passed onto the state board of medical examiners.
* you can gain title protection
* this is not much of a change from what we have right now
3. Certification
* this is a higher level of enforcement to handle violations
* An advisory committee that would report to the state board of medical examiners (the
CATA would be responsible for the support monetarily of this committee)
* EMT's are an example of this group
* you can gain title protection
4. Licensure
* highest level of regulation
* an independent state agency must be formed to regulate athletic training (the CATA would
be responsible for the support monetarily of this committee)
* you can gain title protection
* we would have to pay a fee to the state on a yearly basis to help run the regulatory
agency
* we may need to retain a lobbyist on a yearly basis to help protect our interests
* every 5 years we must defend our licensure to the Sunset committee
* it would require an individual to pass a state exam or just the NATABOC, Inc. exam in
order to work as a certified athletic trainer in the state of Colorado
Some things that are important to know:
* There is no guarantee that the wording of our proposal for any of the above options
would pass. We could end up with a more limited scope of practice or exactly what we want.
* Third party billing will only occur when the various insurance companies decide to
accept billing for the services of certified athletic trainers. Third party billing is NOT
tied into licensure. It is a completely different statute that is unrelated and does
not go hand in hand with any of the option listed above. The intent of the legislation
options listed in this newsletter is NOT to obtain third party billing.
Working with the State Physical
Therapy Association
When interviewing the states that have some form of athletic training legislation many
state representatives recommended that we work with and not against our state physical
therapy association. Some reported that when they either teamed with the state association
or openly communicated with them, the legislation process went much easier.
Kelli Lotitio is in the process of contacting the representatives from the Colorado
APTA chapter. She has been soliciting feedback from their association and physical
therapist many of us work with in regards to athletic trainer legislation . She is also
inquiring about their current legislation activities and asking for any words of advice
that might aid the CATA if and when we begin the legislation process.
By the time this newsletter had to go to "press" no representative had yet to
get back to Kelli. We will have more information regarding their reactions or comments at
the time of the annual business meeting.
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