PART 4. TEXAS DEPARTMENT OF LICENSING AND REGULATION

CHAPTER 110. ATHLETIC TRAINERS

16 TAC §§110.24, 110.30, 110.70

The Texas Department of Licensing and Regulation (Department) proposes amendments to existing rules at 16 Texas Administrative Code (TAC), Chapter 110, §§110.24, 110.30, and 110.70, regarding the Athletic Trainers program. These proposed changes are referred to as "proposed rules."

EXPLANATION OF AND JUSTIFICATION FOR THE RULES

The rules under 16 TAC, Chapter 110, implement Texas Occupations Code, Chapter 451, Athletic Trainers.

The proposed rules amend the license renewal process to add an affirmation by the licensee that all services provided will be directed by a qualified health professional, with those written directives kept current. The proposed rules also update the temporary licensing requirements to first require passage of the written examination, with the expiration of the temporary license coming on the last day of the month of the next scheduled practical examination. Finally, the proposed rules update the standards of practice to include a physician-delegated authority document. This document must be obtained before an athletic trainer practices, be kept on file with the athletic trainer's license, and be available for review. The physician-delegated authority document must have the contact information of the sponsoring physician. The document must also be renewed each time the sponsoring physician changes.

The proposed rules are necessary to improve safety standards, as clear documentation of the services that may be provided by the licensee will clarify expectations and eliminate confusion. By adding the qualification of passage of the written examination to the current educational and apprenticeship requirements, the proposed rules will help ensure that individuals with temporary licenses have the requisite knowledge of athletic training principles to be in the field. These proposed rules are supported by the Athletic Trainers Advisory Board.

Advisory Board Recommendations

The proposed rules were presented to and discussed by the Athletic Trainers Advisory Board at its meeting on December 2, 2024. The Advisory Board did not make any changes to the proposed rules. The Advisory Board voted and recommended that the proposed rules be published in the Texas Register for public comment.

SECTION-BY-SECTION SUMMARY

The proposed rules add §110.24(e) to include the requirement that, upon renewal of a license, a licensee must affirm that all services rendered will be under the direction of a licensed physician or qualified, licensed, health professional. That direction will be in the form of a current, written document.

The proposed rules add §110.30(a)(2) to introduce the requirement that an individual must also pass the written portion of the Athletic Trainer examination to the current requirements.

The proposed rules amend §110.30(b) to terminate the temporary license on the last day of the month of the next scheduled offering of the practical portion of the Athletic Trainer examination.

The proposed rules add §110.70(a)(1) to introduce the physician-delegated document. Athletic Trainers, under this proposed rule, will need to have a physical copy of this document before practicing.

The proposed rules add §110.70(a)(2) to require the physician-delegated document to be on file with the athletic trainer's license or identification card. Both documents must be available for review.

The proposed rules add §110.70(a)(3) to require the physician-delegated document held by the athletic trainer include identifying and contact information of the sponsoring physician. The physician-delegated document must be renewed each time the sponsoring physician changes.

FISCAL IMPACT ON STATE AND LOCAL GOVERNMENT

Tony Couvillon, Policy Research and Budget Analyst, has determined that for each year of the first five years the proposed rules are in effect, there are no estimated additional costs or reductions in costs to state or local government as a result of enforcing or administering the proposed rules.

Mr. Couvillon has determined that for each year of the first five years the proposed rules are in effect, there is no estimated increase or loss in revenue to the state or local government as a result of enforcing or administering the proposed rules.

Mr. Couvillon has also determined that for each year of the first five years the proposed rules are in effect, enforcing or administering the proposed rules does not have foreseeable implications relating to costs or revenues of state or local governments.

LOCAL EMPLOYMENT IMPACT STATEMENT

Because Mr. Couvillon has determined that the proposed rules will not affect a local economy, the agency is not required to prepare a local employment impact statement under Texas Government Code §2001.022.

PUBLIC BENEFITS

Mr. Couvillon has determined that for each year of the first five-year period the proposed rules are in effect, the public benefit will be the effective and efficient regulation of athletic trainers, which promotes the health, safety, and welfare of athletes across Texas. Specifically, the proposed rules require renewing licensees to affirm that all athletic training will be done under the direction of a licensed physician or another authorized qualified, licensed health professional, and the direction given will be in writing and kept current through a physician-delegated authority document, which gives evidence of the services the licensee can provide as approved by the directing physician or other qualified health professional. The proposed rules add passing the written examination to the requirements for a temporary license, which helps ensure the competency of temporary license applicants.

PROBABLE ECONOMIC COSTS TO PERSONS REQUIRED TO COMPLY WITH PROPOSAL

Mr. Couvillon has determined that for each year of the first five-year period the proposed rules are in effect, there are no anticipated economic costs to persons who are required to comply with the proposed rules.

FISCAL IMPACT ON SMALL BUSINESSES, MICRO-BUSINESSES, AND RURAL COMMUNITIES

There will be no adverse economic effect on small businesses, micro-businesses, or rural communities as a result of the proposed rules. The rules will have no costs for license holders or small or micro-businesses. Because the agency has determined that the proposed rule will have no adverse economic effect on small businesses, micro-businesses, or rural communities, preparation of an Economic Impact Statement and a Regulatory Flexibility Analysis, as detailed under Texas Government Code §2006.002, is not required.

ONE-FOR-ONE REQUIREMENT FOR RULES WITH A FISCAL IMPACT

The proposed rules do not have a fiscal note that imposes a cost on regulated persons, including another state agency, a special district, or a local government. Therefore, the agency is not required to take any further action under Texas Government Code §2001.0045.

GOVERNMENT GROWTH IMPACT STATEMENT

Pursuant to Texas Government Code §2001.0221, the agency provides the following Government Growth Impact Statement for the proposed rules. For each year of the first five years the proposed rules will be in effect, the agency has determined the following:

1. The proposed rules do not create or eliminate a government program.

2. Implementation of the proposed rules does not require the creation of new employee positions or the elimination of existing employee positions.

3. Implementation of the proposed rules does not require an increase or decrease in future legislative appropriations to the agency.

4. The proposed rules do not require an increase or decrease in fees paid to the agency.

5. The proposed rules do not create a new regulation.

6. The proposed rules expand, limit, or repeal an existing regulation.

The proposed rules expand three regulations. First, §110.24 would be expanded to require a renewing licensee to also affirm all athletic training will be provided under the direction licensed physician or another authorized qualified, licensed health professional, with the direction in writing and kept current. The proposed rules would expand §110.30 by requiring an applicant for a temporary license to also pass the written examination in addition to current prerequisites. Finally, the proposed rules would expand §110.70 by adding requirements for a physician-delegated authority document.

7. The proposed rules do not increase or decrease the number of individuals subject to the rules' applicability.

8. The proposed rules do not positively or adversely affect this state's economy.

TAKINGS IMPACT ASSESSMENT

The Department has determined that no private real property interests are affected by the proposed rules and the proposed rules do not restrict, limit, or impose a burden on an owner's rights to his or her private real property that would otherwise exist in the absence of government action. As a result, the proposed rules do not constitute a taking or require a takings impact assessment under Texas Government Code §2007.043.

PUBLIC COMMENTS

Comments on the proposed rules may be submitted electronically on the Department's website at https://ga.tdlr.texas.gov:1443/form/gcerules ; by facsimile to (512) 475-3032; or by mail to Monica Nuñez, Legal Assistant, Texas Department of Licensing and Regulation, P.O. Box 12157, Austin, Texas 78711. The deadline for comments is 30 days after publication in the Texas Register.

STATUTORY AUTHORITY

The proposed rules are proposed under Texas Occupations Code, Chapters 51 and 451, which authorize the Texas Commission of Licensing and Regulation, 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 proposed rules are those set forth in Texas Occupations Code, Chapters 51 and 451, and Texas Education Code Chapter 38, §38.158. No other statutes, articles, or codes are affected by the proposed rules.

§110.24.License Renewal.

(a) - (d) (No change.)

(e) To renew a license, a licensee must affirm that the licensee will provide all athletic training under the direction of a licensed physician or another qualified, licensed health professional who is authorized to refer for health care services within the scope of the person's license, and that this direction will be in writing and kept current through a physician-delegated authority document.

§110.30.Temporary License.

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

(1) meets the educational and apprenticeship requirements of this chapter; and

(2) has passed the written examination.

(b) The temporary license entitles an applicant to perform the activities of an athletic trainer until the last day of the month of the next scheduled [results are released from the first] practical examination [administered at least 30 days after the temporary license is issued].

(c) - (d) (No change.)

§110.70.Standards of Conduct.

(a) An athletic trainer, when carrying out the practice of athletic training in accordance with §451.001(3) of the Act, shall work under the direction of a licensed physician or another qualified, licensed health professional, who is authorized to refer for health care services within the scope of the person's license.

(1) The athletic trainer must obtain their physician-delegated authority document before practicing.

(2) A physical copy of the physician-delegated authority document must be kept on file with the athletic trainer's license or current license identification card. Both documents must be made available for inspection upon request.

(3) The physician-delegated authority document must include the name, phone number, physical office address, and electronic mail address of the sponsoring physician. The authority document must be renewed each time the sponsoring physician changes.

(b) - (y) (No change.)

The agency certifies that legal counsel has reviewed the proposal and found it to be within the state agency's legal authority to adopt.

Filed with the Office of the Secretary of State on December 13, 2024.

TRD-202406012

Doug Jennings

General Counsel

Texas Department of Licensing and Regulation

Earliest possible date of adoption: January 26, 2025

For further information, please call: (512) 475-4879