HOUSE BILL NO. 1844 103RD GENERAL ASSEMBLY
INTRODUCED BY REPRESENTATIVE GALLICK.
4064H.01I JOSEPH ENGLER, Chief Clerk
AN ACT To amend chapter 334, RSMo, by adding thereto fourteen new sections relating to the athletic trainer compact.
Be it enacted by the General Assembly of the state of Missouri, as follows:
Section A. Chapter 334, RSMo, is amended by adding thereto fourteen new sections, 2 to be known as sections 334.1900, 334.1903, 334.1906, 334.1909, 334.1912, 334.1915, 3 334.1918, 334.1921, 334.1924, 334.1927, 334.1930, 334.1933, 334.1936, and 334.1939, to 4 read as follows: 334.1900. 1. Sections 334.1900 to 334.1939 shall be known and cited as the 2 Athletic Trainer Compact. The purposes of this compact are to expand mobility of 3 Athletic Training practice and improve public access to services by providing qualified 4 Licensed Athletic Trainers the ability to practice in other Member States. This compact 5 preserves the regulatory authority of States to protect public health and safety through 6 the current system of State licensure. 7 2. This compact is designed to achieve the following objectives: 8 (1) Increase public access to Athletic Training and enhance continuity of care by 9 providing for the mutual recognition of other Licenses issued by Member States; 10 (2) Provide an additional streamlined opportunity for interstate practice by 11 Licensed Athletic Trainers who meet compact uniform requirements; 12 (3) Promote mobility and workforce development by eliminating the necessity 13 for Licenses in multiple States by providing for the mutual recognition of other Licenses 14 issued by Member States;
EXPLANATION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is intended to be omitted from the law. Matter in bold-face type in the above bill is proposed language. HB 1844 2
15 (4) Reduce administrative burdens on Licensed Athletic Trainers and Member 16 States; 17 (5) Enhance the States' ability to protect the public's health and safety; 18 (6) Encourage the cooperation of Member States in regulating interstate practice 19 of Licensed Athletic Trainers; 20 (7) Support relocating Active Military Members and their spouses; 21 (8) Enhance the exchange of licensure, investigative, and disciplinary 22 information among Member States; 23 (9) Allow for the use of telehealth to facilitate increased access to Athletic 24 Training services; 25 (10) Support the uniformity of Licensed Athletic Trainer licensure requirements 26 throughout the States; 27 (11) Affirm the authority of all Member States to hold a Licensed Athletic 28 Trainer accountable for abiding by the Scope of Practice in the State in which the 29 patient is located at the time of care; and 30 (12) Require adherence to the Model Compact Language in order to promote 31 uniformity and ensure that all Member States have accepted and are mutually obligated 32 to the same terms. 334.1903. As used in this compact, unless the context requires otherwise, the 2 following definitions shall apply: 3 (1) "Active Military Member" means any individual with full-time duty status in 4 the active armed forces of the United States, including members of the National Guard 5 and Reserve. 6 (2) "Adverse Action" means any administrative, civil, equitable or criminal 7 action permitted by a State's laws which is imposed by a Licensing Authority or other 8 authority against a Licensee, including actions against an individual's License or 9 Compact Privilege such as revocation, suspension, probation, monitoring of the 10 Licensee, limitation on the Licensee's practice, or any other Encumbrance on licensure 11 affecting a Licensee's authorization to practice. 12 (3) "Alternative Program" means a non-disciplinary monitoring or practice 13 remediation process applicable to an Athletic Trainer approved by a State Licensing 14 Authority of a Member State in which the Athletic Trainer is licensed. This includes, 15 but is not limited to, programs to which Licensees with substance use, addiction, or 16 mental health conditions are referred in lieu of Adverse Action. 17 (4) "Athletic Training" means the prevention, examination, assessment, 18 treatment and rehabilitation of emergent, acute, or chronic injuries and medical 19 conditions as defined by applicable Member State laws and regulations. HB 1844 3
20 (5) "Athletic Trainer Compact Commission" or "Compact Commission" means 21 the government agency whose membership consists of all States that have enacted this 22 compact, as described herein and which shall operate as an instrumentality of the 23 Member States to administer and implement the compact according to its terms. 24 (6) "BOC" means the Board of Certification, Inc. or any successor organization 25 thereto. 26 (7) "CAATE" means the Commission on Accreditation of Athletic Training 27 Education or any successor organization thereto. 28 (8) "Charter Member State" means any Member State which enacted and made 29 effective this compact by law before the compact effective date specified herein. 30 (9) "Commissioner" means the individual appointed by a Member State to serve 31 as the member of the Commission for that Member State. 32 (10) "Compact Privilege" means the legal authorization granted by a Remote 33 State, equivalent to a License, allowing a Licensee from another Member State to 34 provide Athletic Training services in a Remote State. 35 (11) "Compact Qualifying License" means a License that is not an Encumbered 36 License issued by a Member State to practice Athletic Training which qualifies the 37 Licensee to exercise a Compact Privilege pursuant to section 334.1909. 38 (12) "Continuing Competence" means a requirement, as a condition of License 39 renewal, to provide evidence of successful participation, and completion of, educational 40 and professional activities relevant to practice or area of work. For purposes of this 41 compact, evidence of active BOC certification may satisfy the meaning of Continuing 42 Competence as set forth herein. 43 (13) "Current Significant Investigative Information" means the existence of: 44 (a) Investigative Information that a Licensing Authority, after a preliminary 45 inquiry that includes notification and an opportunity for the subject Licensee to 46 respond, if required by State law, has reason to believe is not groundless and, if proven 47 true, would indicate more than a minor infraction; or 48 (b) Investigative Information that indicates that the subject Licensee represents 49 an immediate threat to public health and safety regardless of whether the subject 50 Licensee has been notified and had an opportunity to respond. 51 (14) "Criminal Background Check" means the submission of fingerprints or 52 other biometric-based information for a License applicant for the purpose of obtaining 53 that applicant's criminal history record information, as defined in 28 C.F.R. § 20.3(d) 54 from the Federal Bureau of Investigation and the State's criminal history record 55 repository as defined in 28 C.F.R. § 20.3(f). HB 1844 4
56 (15) "Data System" means the Commission's repository of information about 57 Licensees, including but not limited to examination, licensure, investigative, Compact 58 Privilege, Adverse Action, and Alternative Program. 59 (16) "Encumbrance" or "Encumbered" means a revocation or suspension of, or 60 any limitation or condition on, the full and unrestricted practice of Athletic Training. 61 (17) "Executive Committee" means a group of commissioners elected or 62 appointed to act on behalf of, and within the powers granted to them by, the compact 63 and Commission. 64 (18) "Investigative Information" means information, records, and documents 65 received or generated by a Licensing Authority pursuant to an investigation. 66 (19) "Jurisprudence Requirement" means the assessment of an individual's 67 knowledge of the laws and Rules governing the practice of Athletic Training, as 68 applicable, in a State. 69 (20) "License" means current authorization by a Member State to engage in the 70 practice of Athletic Training. 71 (21) "Licensee" or "Licensed Athletic Trainer" means an individual who 72 currently holds an active, unrestricted License and who meets all of the requirements 73 outlined in section 334.1909. 74 (22) "Licensing Authority" means the board or agency of a State, or equivalent, 75 that is responsible for the licensing and regulation of Athletic Trainers. 76 (23) "Model Compact Language" means the model language for the Athletic 77 Trainer Compact on file with The Council of State Governments or other entity as 78 designated by the Commission to which all Member States must substantively adhere 79 and adopt. 80 (24) "Member State" means a State that has enacted the compact. 81 (25) "Remote State" means a Member State other than the State of Qualifying 82 Licensure. 83 (26) "Rule" means a regulation promulgated by an authorized entity that has 84 the force of law. 85 (27) "Scope of Practice" means the procedures, actions, and processes an 86 Athletic Trainer licensed in a State is permitted to undertake in that State and the 87 circumstances under which the Licensee is permitted to undertake those procedures, 88 actions and processes. Such procedures, actions and processes and the circumstances 89 under which they may be undertaken may be established through means, including, but 90 not limited to, statute, regulations, case law, and other processes available to the State 91 Licensing Authority or other government agency. Scope of Practice shall include any HB 1844 5
92 State requirements regarding supervision or direction, if required by such State and as 93 further defined by such State's statutes and regulations. 94 (28) "Single State License" means a License issued by any State that authorizes 95 practice only within the issuing State. 96 (29) "State" means any state, commonwealth, district, or territory of the United 97 States of America. 98 (30) "State of Qualifying Licensure" means the Member State who has issued a 99 Compact Qualifying License to a Licensee pursuant to this compact. 100 (31) "Unencumbered License" means a License that authorizes a Licensee to 101 engage in the full and unrestricted practice of Athletic Training. 334.1906. 1. To be eligible to join this compact and to maintain eligibility as a 2 Member State, a State must: 3 (1) Enact and maintain a statute that is not materially different from the Model 4 Compact Language; 5 (2) License and regulate the practice of Athletic Training; 6 (3) Require that Licensees in that State maintain Continuing Competence 7 standards as part of their State practice act or Rules; 8 (4) Have a mechanism in place for receiving and investigating complaints about 9 Licensees; 10 (5) Grant the Compact Privilege to a Licensee who meets all the requirements 11 outlined in section 334.1909 in accordance with the terms of the compact and any Rules 12 promulgated thereunder; 13 (6) Participate fully in the Compact Commission's Data System, including using 14 the unique identifier as defined in Rules; 15 (7) Notify the Compact Commission, in compliance with the terms of the 16 Compact and Rules, of any Adverse Action or the availability of Current Significant 17 Investigative Information regarding a Licensee; 18 (8) Within a time frame established by Rule, implement or utilize procedures for 19 considering the criminal history records of applicants for a Compact Qualifying License 20 which includes receiving the results of the Federal Bureau of Investigation record search 21 and shall use those results in making licensure decisions. These procedures shall include 22 the submission of fingerprints or other biometric-based information by applicants for 23 the purpose of obtaining an applicant's criminal history record information from the 24 Federal Bureau of Investigation and the agency responsible for retaining that State's 25 criminal records; and HB 1844 6
26 (a) A Member State must fully implement a Criminal Background Check 27 requirement in order to participate in the issuance and acceptance of Compact 28 Privileges. 29 (b) Communication between a Member State and the Compact Commission or 30 among Member States regarding the verification of eligibility for licensure through the 31 compact shall not include any information received from the Federal Bureau of 32 Investigation relating to a federal criminal records check performed by a Member 33 State; 34 (9) Comply with and enforce the Rules of the Compact Commission. 35 2. Member States may set and collect a fee for issuance and renewal of a 36 Compact Privilege to applicants. 37 3. Individuals without a Compact Qualifying License shall continue to be able to 38 apply for a Member State's Single-State License as provided under the laws of each 39 Member State. 40 4. Nothing in this compact shall affect the requirements established by a 41 Member State for the issuance of a Single State License. 42 5. A Compact Qualifying License shall be recognized by each Remote State as 43 authorizing that Licensee to engage in the practice of Athletic Training, under a 44 Compact Privilege, in another Member State in accordance with the requirements in 45 section 334.1909. 334.1909. 1. To be eligible for a Compact Privilege under the terms and 2 provisions of the compact, the Licensee shall complete a Criminal Background Check 3 performed by the Licensing Authority in the State of Qualifying Licensure prior to 4 entry in the compact and shall: 5 (1) Satisfy one of the following two pathways: 6 (a) Hold a valid current active certification through the BOC, or its successor 7 organization; or 8 (b) If a Licensee does not meet the requirements of paragraph (a) of this 9 subdivision, the following must be completed: 10 a. An education program which is either: 11 (i) At least a bachelor's degree with a major course of study in Athletic Training, 12 or an equivalent course of study from a college or university accredited at the time of 13 graduation by CAATE, or its successor organization; 14 (ii) An academic degree from a college or university in a foreign country 15 equivalent to the degree described in item (i) of this subparagraph with a major course 16 of study as described in item (i) of this subparagraph that is accredited by CAATE, or 17 its successor organization; or HB 1844 7
18 (iii) The substantial equivalent of the foregoing which the Commission may 19 determine by Rule. 20 b. Successful completion of the exam administered by the BOC, or its successor 21 organization, preceding the date of the Licensee's application for Licensure in their 22 State of Qualifying Licensure or the substantial equivalent of the foregoing requirement 23 which the Commission may determine by Rule; 24 (2) Hold a Compact Qualifying License; 25 (3) Have not had any Encumbrance against any license or Compact Privilege to 26 practice Athletic Training within the previous two (2) years; 27 (4) Be eligible for a Compact Privilege in any Member State in accordance with 28 section 334.1909; 29 (5) Notify the Compact Commission that the Licensee is seeking the Compact 30 Privilege within a Remote State or States; 31 (6) Pay any applicable fees, including any State fee, for the Compact Privilege; 32 (7) Meet only the Continuing Competence requirements established by the State 33 of Qualifying Licensure; 34 (8) Comply with any requirements of the State of Qualifying Licensure as set 35 forth in section 334.1906; 36 (9) Meet any Jurisprudence Requirements established by the Remote State or 37 States in which the Licensee is seeking a Compact Privilege; and 38 (10) Report to the Compact Commission any Adverse Action, Encumbrance, or 39 restriction on a license taken by any non-Member State within 30 days from the date the 40 action is taken. 41 2. The Compact Privilege is valid until the expiration date of the Compact 42 Qualifying License. To maintain a Compact Privilege, renewal of the Compact Privilege 43 shall be congruent with the renewal of the Compact Qualifying License as the Compact 44 Commission may define by Rule. The Licensee must comply with the requirements of 45 this section to maintain the Compact Privilege in the Remote State. A Licensee may 46 apply for and hold Compact Privileges in multiple Member States. 47 3. A Licensed Athletic Trainer must follow the Scope of Practice of the Member 48 State where the patient is located. A Licensee engaging in the practice of Athletic 49 Training in a Remote State under the Compact Privilege shall adhere to the Scope of 50 Practice laws and regulations of the Remote State. Licensees shall be responsible for 51 educating themselves on, and complying with, any and all Scope of Practice laws and 52 regulations and State laws relating to the remote practice of Athletic Training, as 53 applicable. HB 1844 8
54 4. A Licensee engaging in the practice of Athletic Training in a Remote State is 55 subject to that State's regulatory authority. A Remote State may, in accordance with 56 due process and that State's laws, remove a Licensee's Compact Privilege in the Remote 57 State for a specific period of time, impose fines, or take any other necessary actions to 58 protect the health and safety of its citizens. Any Member State which undertakes such 59 an action shall promptly notify the Member State and the Commission as specified in 60 the Rules. The Licensee may be deemed to be ineligible to exercise the Compact 61 Privilege by any Member State until the specific time for removal has passed and all 62 fines are paid. 63 5. All Member State disciplinary orders that impose Adverse Action against a 64 Compact Qualifying License shall result in deactivation of the Licensee's Compact 65 Privilege in all Member States during the pendency of the order. If a Compact 66 Qualifying License is Encumbered, the Licensee shall lose the Compact Privilege in any 67 Remote State until the following occur: 68 (1) The Compact Qualifying License is no longer Encumbered; and 69 (2) The Licensee has not had any En