THE GENERAL ASSEMBLY OF PENNSYLVANIA

SENATE BILL

INTRODUCED BY TOMLINSON, ARGALL, ALLOWAY, M. WHITE, FARNESE, BOSCOLA AND FERLO, MAY 3, 2011

SENATOR CORMAN, APPROPRIATIONS, RE-REPORTED AS AMENDED, SEPTEMBER 19, 2011   

AN ACT

Amending the act of October 5, 1978 (P.L.1109, No.261), entitled

"An act requiring the licensing of practitioners of

osteopathic medicine and surgery; regulating their practice;

providing for certain funds and penalties for violations and

repeals," further providing for definitions, for State Board

of Osteopathic Medicine, for athletic trainers and for

reasons for refusal, revocation or suspension of license.

The General Assembly of the Commonwealth of Pennsylvania

hereby enacts as follows:

Section 1.  The definitions of "athletic training services,"

"board-regulated practitioner," "certified athletic trainer,"

"direction," "referral" and "written protocol" in section 2 of

the act of October 5, 1978 (P.L.1109, No.261), known as the

Osteopathic Medical Practice Act, amended or added December 10,

2001 (P.L.863, No.93) and July 4, 2008 (P.L.589, No.46), are

amended and the section is amended by adding a definition to

read:

Section 2.  Definitions.

The following words and phrases when used in this act shall

have, unless the context clearly indicates otherwise, the

meanings given to them in this section:

* * *

"Athletic training services."  The management and provision

of care of injuries to a physically active person as defined in

this act with the direction of a licensed physician. The term

includes the rendering of emergency care, development of injury

prevention programs and providing appropriate preventative and

supporting devices for the physically active person. 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] licensed athletic trainer. 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 exercises, reconditioning

exercise and fitness programs. Athletic training services shall

not include surgery, invasive procedures or prescription of any

controlled substance. 

* * *

"Board-regulated practitioner."  An osteopathic physician,

physician assistant, respiratory therapist or [certified] 

licensed athletic trainer or an applicant for a license or

certificate issued by the board. 

* * *

["Certified athletic trainer."  A person who is certified to

perform athletic training services by the State Board of

Medicine or the State Board of Osteopathic Medicine.]

* * *

"Direction."  Supervision over the actions of a [certified] 

licensed athletic trainer via 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 via other electronic means. 

* * *

"Licensed athletic trainer."  A person who is licensed to

perform athletic training services by the State Board of

Medicine or the State Board of Osteopathic Medicine.

* * *

"Referral."  An order from a licensed physician, dentist or

podiatrist to a [certified] licensed 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.

* * *

"Written protocol."  A written agreement developed in

conjunction with one or more supervising physicians which

identifies and is signed by the supervising physician and the

[certified] licensed athletic trainer. It describes the manner

and frequency in which the [certified] licensed athletic trainer

regularly communicates with the supervising physician. It

includes standard operating procedures developed in agreement

with the supervising physician and [certified] licensed athletic

trainer that the [certified] licensed athletic trainer follows

when not directly supervised on site by the supervising

physician. 

Section 2.  Section 2.1(a) of the act, amended July 4, 2008

(P.L.589, No.46), is amended to read: 

Section 2.1.  State Board of Osteopathic Medicine.

(a)  The State Board of Osteopathic Medicine shall consist of

the Commissioner of Professional and Occupational Affairs or his

designee; the Secretary of Health or his designee; two members

appointed by the Governor who shall be persons representing the

public at large; one member appointed by the Governor who shall

be a respiratory therapist, a perfusionist, a physician

assistant or a [certified] licensed athletic trainer; and six

members appointed by the Governor who shall be graduates of a

legally incorporated and reputable college of osteopathic

medicine and shall have been licensed to practice osteopathic

medicine under the laws of this Commonwealth and shall have been

engaged in the practice of osteopathy in this Commonwealth for a

period of at least five years. All professional and public

members of the board shall be appointed by the Governor with the

advice and consent of a majority of the members elected to the

Senate. The Governor shall assure that respiratory therapists,

perfusionists, physician assistants and [certified] licensed 

athletic trainers are appointed to four-year terms on a rotating

basis. 

Section 3.  Section 7.1 of the act, added December 10, 2001

(P.L.863, No.93), is amended to read: 

Section 7.1.  Athletic trainers.

(a)  An athletic trainer [certified] licensed by the board

may, under the direction of a physician, podiatrist or dentist,

provide athletic training services to a physically active person

under the care of a physician, dentist or podiatrist. An

athletic trainer [certified] licensed under this section shall

refer a physically active person with conditions outside the

scope of athletic training services to a physician, dentist or

podiatrist.

[(b)  Any athletic trainer who holds a valid certificate

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issued by the State Board of Physical Therapy under the act of

October 10, 1975 (P.L.383, No.110), known as the "Physical

Therapy Practice Act," relating to the practice of athletic

training, prior to the effective date of this act shall, on and

after the effective date hereof, be deemed to be [certified] 

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licensed by the State Board of Medicine or State Board of

Osteopathic Medicine as provided for in this act.]

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(b.1)  Applicability.--Subsection (b) shall not apply in the

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case of a certification that has expired or been revoked prior

to the effective date of the subsection.

(b.1)  Transitional rule.--

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(1)  Any athletic trainer who holds a valid certificate

issued by the board or the State Board of Medicine, relating

to the practice of athletic training, prior to the effective

date of this subsection shall, on or after the effective date

of this subsection, be deemed to be licensed by the board or

the State Board of Medicine as provided in this act.

(2)  Paragraph (1) shall not apply in the case of a

certification that was expired or revoked prior to the

effective date of this subsection.

(c)  An athletic trainer who meets the requirements of this

section shall be certified, may use the title "athletic trainer"

or the abbreviation for the title, ["A.T.C.,"] "A.T.L.," and may

perform athletic training services. A person who is not

[certified] licensed under this section may not use the

designation of [certified] licensed athletic trainer, athletic

trainer or any of the listed abbreviations for that title,

including ["C.A.T." or "A.T.C.,"] "L.A.T." or "A.T.L.," or any

similar designation. This section shall not prohibit any person

trained and licensed or certified under any other law from

engaging in the licensed or certified practice in which the

person is trained.

(d)  The State Board of Osteopathic Medicine and the State

Board of Medicine shall jointly promulgate regulations which:

(1)  establish approved education and training programs

for [certification] licensure; and

(2)  define the circumstances and protocol under which a

[certified] licensed athletic trainer may perform athletic

training services.

[Until such regulations are promulgated by the State Board of

Osteopathic Medicine and the State Board of Medicine, the

athletic trainer shall be regulated by the regulations, duly

promulgated by the State Board of Physical Therapy prior to the

enactment of this amendatory act governing the activities of

certified athletic trainers, which are not inconsistent with

this act.]

(e)  Notwithstanding any provision of this act to the

contrary, doctors of medicine may supervise and direct the

activities of athletic trainers to the same extent as physicians

regulated by this act.

(f)  The State Board of Osteopathic Medicine shall be

responsible for the [certification] licensure of athletic

trainers. Jurisdiction will be determined by the type of

physician who supervises and directs the [certified] licensed 

athletic trainer. [Certified] Licensed athletic trainers

supervised by a doctor of osteopathy shall fall within the

jurisdiction of the State Board of Osteopathic Medicine.

Section 4.  Section 15(b) of the act, amended July 4, 2008

(P.L.589, No.46), is amended to read: 

Section 15.  Reasons for refusal, revocation or suspension of

license.

* * *

(b)  The board shall have authority to refuse, revoke or

suspend the license of a physician assistant [or], respiratory

therapist, or [the certification of a certified] athletic

trainer for any or all of the following reasons:

(1)  Failing to demonstrate the qualification for

licensure or certification contained in this act or

regulations of the board.

(2)  Making misleading, deceptive, untrue or fraudulent

representations in his serving as a physician assistant;

practicing fraud or deceit in obtaining a license to serve as

a physician assistant; or making a false or deceptive

biennial registration with the board.

(3)  Conviction of a felony in this Commonwealth or any

other state, territory or country. Conviction as used in this

paragraph shall include a finding or verdict of guilt, an

admission of guilt or a plea of nolo contendere, or receiving

probation without verdict, disposition in lieu of trial, or

an Accelerated Rehabilitative Disposition in the disposition

of felony charges.

(4)  Having his license to serve as a physician assistant

revoked or suspended or having other disciplinary action

taken, or his application for licensure refused, revoked or

suspended by the proper certifying authority of another

state, territory or country.

(5)  Being unable to serve as a physician assistant with

reasonable skill and safety to the physician's patients by

reason of illness, drunkenness, excessive use of drugs,

narcotics, chemicals, or any other type of material, or as a

result of any mental or physical condition.

(6)  In enforcing paragraph (5), the board shall, upon

probable cause, have authority to compel a physician

assistant to submit to a mental or physical examination by

physicians designated by it. Failure of a physician assistant

to submit to such examination shall constitute an admission

of the allegations against him unless the failure is due to

circumstances beyond his control, consequent upon which a

default and final order may be entered without the taking of

testimony or presentation of evidence. A physician assistant

affected under this paragraph shall at reasonable intervals

be afforded an opportunity to demonstrate that he can resume

the competent assistance of a physician in the physician's

practice of medicine, with reasonable skill and safety to the

physician's patients.

(7)  Violating a lawful regulation promulgated by the

board or violating a lawful order of the board, previously

entered by the board in a disciplinary proceeding.

(8)  Knowingly rendering medical care and services except

under the supervision and direction of the supervising

physician.

(9)  Being guilty of immoral or unprofessional conduct

shall include any departure from, or the failure to conform

to, the standards of acceptable and prevailing practice for

physician assistants, in which proceeding actual injury to a

patient need not be established.

* * *

Section 5.  References in the current regulations to

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certification or certified athletic trainers shall be deemed to

be references to licensure of athletic trainers or licensed

athletic trainers after the effective date of this act.

Section 5.  References to certification or certified athletic

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trainers contained in regulations promulgated under this act and

in effect on the effective date of this section shall be deemed

to be references to licensure or licensed athletic trainers

after the effective date of this section.

Section 6.  This act shall take effect in 60 days.