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RULE PROPOSALS
VOLUME 44, ISSUE 8
ISSUE DATE: APRIL 16, 2012
LAW AND PUBLIC SAFETY
DIVISION OF CONSUMER AFFAIRS
STATE BOARD OF MEDICAL EXAMINERS


Proposed Amendments: N.J.A.C. 13:35-10.6 and 10.7

Practice Outside of Schools and Professional Teams; Scope of Practice
 
Authorized By: State Board of Medical Examiners, William Roeder, Executive Director.
 
[page=1182] Authority: N.J.S.A. 45:9-37.38.
 
Calendar Reference: See Summary below for explanation of exception to calendar requirement.
 
Proposal Number: PRN 2012-065.
 
Submit comments by June 15, 2012 to:
   William Roeder, Executive Director
   State Board of Medical Examiners
   P.O. Box 183
   Trenton, NJ 08625
 
The agency proposal follows:
 
Summary
The Board of Medical Examiners (Board) adopted amendments and new rules regarding the practice of licensed athletic trainers effective January 3, 2012, at 44 N.J.R. 104(a). The amendments and new rules, implementing P.L. 2007, c. 323, permit licensed athletic trainers to provide athletic training services outside of an interscholastic, intercollegiate, intramural, or professional athletic setting, only after a physician has examined the athlete and then refers him or her to the licensed athletic trainer. The Board received several comments on the amendments and new rules that opposed this referral requirement. The commenters contended that the referral requirement creates a two-tiered standard for practice that contradicts P.L. 2007, c. 323, which removed statutory limitations that prohibited licensed athletic trainers from working outside of the interscholastic, intercollegiate, intramural, or professional athletic setting. The commenters pointed out that the referral requirement is based solely on setting and not on the education or skill set of licensed athletic trainers. The commenters contended that the referral requirement would delay the provision of care to athletes injured on the field. Some of the commenters were concerned that the referral requirement would frustrate the purpose of having a licensed athletic trainer at athletic events. The commenters pointed out that, no matter the setting, a licensed athletic trainer works under the supervision of a physician and pursuant to a plan of care.
The Board agreed that licensed athletic trainers should be able to provide immediate response to injuries suffered by athletes during athletic events that are outside the interscholastic, intercollegiate, intramural, or professional athletic setting without a referral from a physician. This change necessitated additional notice and comment. The Board now proposes amendments to N.J.A.C. 13:35-10.6 and 10.7 to permit licensed athletic trainers to respond immediately to an injury suffered by an athlete during an athletic event outside of an interscholastic, intercollegiate, intramural, or professional athletic setting. After the licensed athletic trainer has provided this immediate response to the injuries, he or she must refer the athlete to a physician and cannot provide further athletic training services until a physician has referred the athlete for further athletic training services.
The Board proposes to amend N.J.A.C. 13:35-10.7 to recognize that licensed athletic trainers may respond immediately to injuries suffered during an athletic event outside of an interscholastic, intercollegiate, intramural, or professional athletic training setting. The Board also proposes to amend N.J.A.C. 13:35-10.7 to recognize that licensed athletic trainers may evaluate injuries and are permitted to provide preventative measures to uninjured parts of an athlete's body without a referral from a physician.
The Board has determined that the comment period for this notice of proposal shall be 60 days; therefore, pursuant to N.J.A.C. 1:30-3.3(a)5, this notice is excepted from the rulemaking calendar requirement.
 
Social Impact
The proposed amendments benefit the public by permitting licensed athletic trainers to respond immediately to injuries suffered during an athletic event outside of the interscholastic, intercollegiate, intramural, or professional athletic setting. This will ensure that the individuals who are best prepared to provide an immediate response are able to do so without waiting for a physician to examine the athlete. Providing such an immediate response can often significantly reduce the length of time it takes to recover from such injuries.
 
Economic Impact
The Board has determined that the proposed amendments will have a beneficial economic impact upon licensed athletic trainers. The proposed amendments will allow licensed athletic trainers to provide the immediate response to injuries suffered during athletic events outside of the interscholastic, intercollegiate, intramural, or professional athletic setting without a physician referral, making it more likely that they will be employed to provide services at such events. The proposed amendments will also benefit the entities that hold such athletic events as it is less expensive for a licensed athletic trainer to provide these services than it is for a physician to do so.
 
Federal Standards Statement
A Federal standards analysis is not required because the proposed amendments do not involve any Federal standards or requirements.
 
Jobs Impact
The Board does not believe that the proposed amendments will increase or decrease the number of jobs in New Jersey. It will likely make it more attractive to employ licensed athletic trainers during athletic events held outside of the interscholastic, intercollegiate, intramural, or professional athletic setting.
 
Agriculture Industry Impact
The Board does not believe that the proposed amendments will have any impact on the agriculture industry of this State.
 
Regulatory Flexibility Analysis
Since licensed athletic trainers are individually licensed by the Board, they may be considered "small businesses" under the Regulatory Flexibility Act, N.J.S.A. 52:14B-16 et seq.
The proposed amendments do not impose any costs and the Board does not believe that licensed athletic trainers will need to employ any professional services to comply with the proposed amendments. The proposed amendments do not impose any reporting or recordkeeping requirements, but do impose compliance requirements as discussed in the Summary above.
The proposed amendments protect the well-being of athletes who suffer injuries during athletic events outside of an interscholastic, intercollegiate, intramural, or professional athletic setting. Permitting licensed athletic trainers to respond immediately to such injuries will help to reduce the recovery time for such injuries and may ensure that such injuries result in less severe damage to an athlete. As such, the proposed amendments must be applied to all licensed athletic trainers regardless of the size of the business.
 
Housing Affordability Impact Analysis
The proposed amendments will have an insignificant impact on affordable housing in New Jersey and there is an extreme unlikelihood that the rules would evoke a change in the average costs associated with housing because the proposed amendments concern the professional practice of licensed athletic trainers.
 
Smart Growth Development Impact Analysis
The proposed amendments will have an insignificant impact on smart growth and there is an extreme unlikelihood that the rules would evoke a change in housing production in Planning Areas 1 or 2, or within designated centers, under the State Development and Redevelopment Plan in New Jersey because the proposed amendments concern the professional practice of licensed athletic trainers.
 
Full text of the proposal follows (additions indicated in boldface thus; deletions indicated in brackets [thus]):
 
SUBCHAPTER 10.    ATHLETIC TRAINERS
 
13:35-10.6   Practice outside of schools and professional teams
 
(a) [If] Except as provided in (b) below, if a licensed athletic trainer is working outside of an interscholastic, intercollegiate, intramural, or professional athletic setting, the licensed athletic trainer shall provide athletic training services only when a physician (who may, in this instance be licensed in another state) has referred the athlete for athletic training after physically examining the athlete.
 
[page=1183] (b) A licensed athletic trainer who is providing athletic training services during an athletic event outside of an interscholastic, intercollegiate, intramural, or professional athletic setting may evaluate an injury suffered by an athlete during that event and provide immediate athletic training services for that injury. After the initial response to the injury, the licensed athletic trainer shall refer the athlete to a physician for a physical examination. The licensed athletic trainer shall not provide any further athletic training services to such an athlete until a physician has referred the athlete for further athletic training services.
 
[(b)] (c) (No change in text.)
 
13:35-10.7   Scope of practice
 
(a) A licensed athletic trainer in an interscholastic, intercollegiate, intramural or professional athletic setting, in a setting where he or she is providing evaluation and immediate athletic training services for an injury suffered outside of the interscholastic, intercollegiate, intramural or professional athletic setting pursuant to N.J.A.C. 13:35-10.6(b) or in any other setting pursuant to a referral from a physician, may provide to an athlete:
 
1. Evaluation of injuries;
 
Recodify existing 1.-3. as 2.-4. (No change in text.)
 
(b) Notwithstanding (a) above, a licensed athletic trainer may provide bandaging, wrapping, taping, padding, bracing, and splinting procedures to uninjured parts of an athlete's body in any setting without a referral from a physician.
 
Recodify existing (b)-(e) as (c)-(f) (No change in text.)

 

 

 


 

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