Indicates Matter Stricken

Indicates New Matter

 

Committee Report

May 3, 2023

S. 397

 

Introduced by Senators Shealy, Setzler and Kimbrell

 

S. Printed 05/03/23--H.

Read the first time March 15, 2023

 

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The committee on HOUSE Medical, MILITARY, PUBLIC AND MUNICIPAL Affairs

To who was referred a Bill (S.397) to amend the South Carolina Code of Laws so as to repeal Chapter 75, Title 44 relating to the regulation of athletic trainers by the Department of Health and Environmental, etc., respectfully

Report:

That they have duly and carefully considered the same, and recommend that the same do pass:

 

SYLLESTE DAVIS for Committee.

 

statement of estimated fiscal impact

Explanation of Fiscal Impact

State Expenditure

This bill repeals Chapter 75, Title 44, which relates to the regulation of athletic trainers by DHEC and transfers the regulation of athletic trainers to the Board of Medical Examiners, which is under the administration of LLR. The bill also creates an Athletic Trainers' Advisory Committee consisting of nine members appointed by the Board of Medical Examiners. Two members must be physicians who are licensed in South Carolina, five must be licensed athletic trainers, and two must be members of the general public who are not certified or licensed in any health care field and are not connected in any way to athletic trainers. The Board of Medical Examiners, with the advice of the Athletic Trainers' Advisory Committee, must develop standards and promulgate regulations to implement the provisions of this bill and for the improvement of athletic training services. The Board of Medical Examiners may levy fees in an amount sufficient to administer the requirements of the bill.

Additionally, the bill specifies the requirements and certifications that an applicant must possess in order to obtain an initial athletic trainer license and for license renewal. Any person who holds himself out as an athletic trainer without being licensed is guilty of a misdemeanor and upon conviction must be fined not more than $300 or imprisoned for not more than ninety days, or both. The Board of Medical Examiners may apply to an administrative law judge as provided under Article 5, Chapter 23, Title 1 for an injunction enjoining an individual from providing services an as athletic trainer.

Further, the bill specifies that the programmatic cash balance, powers, functions, duties, responsibilities, and authority statutorily exercised by DHEC concerning the regulation of athletic trainers are transferred to and devolved upon the Board of Medical Examiners.

Department of Labor, Licensing and Regulation.  LLR indicates that due to the number of athletic trainers that will be licensed, the agency will require 1.0 FTE for an Administrative Assistant.  Salary and fringe benefits will total $58,753 in recurring expenses for the new position, and non-recurring expenses will total $1,000 for a desktop computer and accessories.  For miscellaneous services and supplies, along with additional expenses for the Board of Medical Examiners meetings, the agency will require $2,500 in recurring funds.  Thus, LLR will need to request an Other Funds authorization increase of 1.0 FTE as well as an Other Funds authorization increase of $62,253 in FY 2023-24. Expenses will decrease to $61,253 beginning in FY 2024-25.

Department of Health and Environmental Control.  DHEC indicates that transferring the regulation of athletic trainers to LLR will have no cost savings on the agency since the responsibilities of the 0.25 FTEs will be reallocated to other program areas within DHEC. 

Judicial.  The offense specified in the bill for any person who violates the provisions of the bill is currently in Chapter 75, Title 44, which is being repealed and added to Chapter 47, Title 40. RFA does not expect that the bill will alter the duties or responsibilities of Judicial. Therefore, we do not anticipate that the bill will have an expenditure impact on Judicial.

Administrative Law Court.  The bill allows the Board of Medical Examiners to apply to an administrative law judge as provided under Article 5, Chapter 23, Title 1 for an injunction enjoining an individual from providing services an as athletic trainer. We anticipate that the Administrative Law Court will be able to manage any increase in caseload with existing appropriations. We will update this impact statement if the agency provides a different response.

State Revenue

This bill repeals Chapter 75, Title 44, which relates to the regulation of athletic trainers by the DHEC and transfers the regulation of athletic trainers to the Board of Medical Examiners, which is under the administration of LLR. The Board of Medical Examiners may levy fees in an amount sufficient to administer the requirements of the bill. Additionally, the bill specifies that the programmatic cash balance, powers, functions, duties, responsibilities, and authority statutorily exercised by DHEC concerning the regulation of athletic trainers are transferred to and devolved upon the Board of Medical Examiners.

The Board of Medical Examiners falls under the Division of Professional and Occupation Licensing. Proviso 81.3 of the FY 2022-23 Appropriations Act requires LLR to remit annually to the General Fund an amount equal to 10 percent of expenditures unless the board has an overall negative ending cash balance. Based on LLR's estimated expenditures, the bill will increase General Fund revenue by $6,225 in FY 2023-24 and by $6,125 beginning in FY 2024-25.

DHEC indicates that the current revenues of the program total approximately $14,500, and expenses are $10,400. Further, the cash balance to date is approximately $98,400. Therefore, this bill will shift $98,400 in Other Funds revenue of DHEC to Other Funds revenue of LLR in FY 2023-24. Additionally, since fees must be set in regulation by the Board of Medical Examiners, the additional impact on Other Funds revenue of LLR for fees is undetermined. For reference, DHEC reports there are currently 1,110 licensed athletic trainers in South Carolina.

 

Frank A. Rainwater, Executive Director

Revenue and Fiscal Affairs Office

 

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A bill

 

TO AMEND THE SOUTH CAROLINA CODE OF LAWS SO AS TO REPEAL CHAPTER 75, TITLE 44 RELATING TO THE REGULATION OF ATHLETIC TRAINERS BY THE DEPARTMENT OF HEALTH AND ENVIRONMENTAL CONTROL; AND BY ADDING ARTICLE 11, CHAPTER 47, TITLE 40, SO AS TO TRANSFER REGULATORY AUTHORITY OF ATHLETIC TRAINERS TO THE BOARD OF MEDICAL EXAMINERS.

 

Be it enacted by the General Assembly of the State of South Carolina:

 

SECTION 1.  Chapter 75, Title 44 of the S.C. Code is repealed.

 

SECTION 2.  Chapter 47, Title 40 of the S.C. Code is amended by adding:

 

    Article 11

 

    Athletic Trainer Act of South Carolina

 

    Section 40-47-1710.   (1) "Athletic trainer (AT)" means an allied health professional with specific qualifications set forth in Section 40-47-1740(A) who provides services under the direction of or in collaboration with a licensed physician in accordance with their education, training, and state law. Services provided by athletic trainers may include the prevention, identification, assessment, treatment, or rehabilitation of injuries and illnesses under the direction of a licensed physician as defined in Section 40-47-20; and, in carrying out these functions, the athletic trainer is authorized to use therapeutic interventions including, but not limited to, heat, light, sound, cold, electricity, or mechanical devices related to said functions.

    (2) "Board" means the Board of Medical Examiners for South Carolina.

    (3) "License" means official acknowledgement by the board that an individual has successfully completed educational and other requirements referred to in this act which entitle that individual to perform the functions and duties of an athletic trainer.

    (4) "BOC" means the Board of Certification for the Athletic Trainer or Board of Certification, Inc.

 

    Section 40-47-1720.   The board, with the advice of the Athletic Trainers' Advisory Committee, must develop standards and promulgate regulations to implement the provisions of this article and for the improvement of athletic training services in this State. This includes the authority to unify and set the biennial renewal date of licenses. All administrative responsibility for this program is vested in the board.

    (B)(1) An Athletic Trainers' Advisory Committee is created consisting of nine members appointed by the board. Two members must be physicians who are licensed to practice in South Carolina, five must be licensed athletic trainers, and two must be members of the general public who are not certified or licensed in any health care field and are not connected in any way with athletic trainers. Of the two physician members, at least one must regularly supervise an athletic trainer.

       (2) Membership on the committee is by appointment by the board.  The members appointed shall serve four-year terms and until their successors are appointed and qualify, except that the initial terms of two ATs, one consumer member, and one physician are for two years. Vacancies on the committee must be filled in the same manner of the original appointment for the unexpired portion of the term. Members may succeed themselves; however, no member may serve more than two consecutive terms or eight continuous years, whichever is greater, but he is eligible for reappointment four years from the date that the last full four-year term expires.

       (3) The committee must meet at least once each year to review the standards and regulations for improving athletic training services and to make recommendations to the board.

 

    Section 40-47-1730.   (A) A person may not hold himself out as an athletic trainer or perform, for compensation, any activities of an athletic trainer as defined in Section 40-47-1710 without obtaining a license.

    (B) Any person desiring licensure as an athletic trainer must apply to the board. The board must make a determination of the applicant's qualifications and issue the license to the applicant.

    (C) A license so issued is valid for a period not to exceed two years from the date of issuance and may be renewed subject to any requirements of this article and regulations promulgated by the board.

    (D) The board must suspend or revoke a license issued if it is determined that the holder no longer meets the prescribed qualifications set forth by the board or has failed to provide athletic training services of a quality acceptable by the board.

    (E) Any person whose application is denied, suspended, or revoked is entitled to a hearing before the board if he submits a written request to the board. Proceedings for denial, revocation, or suspension of a license must be conducted consistent with the Administrative Procedures Act.

 

    Section 40-47-1740.   (A) An applicant for an athletic trainer license must have satisfied the requirements to be an athletic trainer as determined by the BOC and hold a current BOC certification.

    (B) An applicant for the renewal of a license must have completed the biennial continuing education requirements as determined by the BOC, be in good standing with the BOC, and complete two continuing education courses approved by the board in consultation with the Athletic Trainers' Advisory Committee.

 

    Section 40-47-1750.   A license may be issued to any qualified athletic trainer holding a license in any other state if such other state recognizes the license of this State in the same manner.

 

    Section 40-47-1760.   The board may levy fees in an amount sufficient to administer the requirements of this article.

 

    Section 40-47-1770.   (A) Nothing in this article prevents:

    (1) licensed, registered, or certified professionals such as physicians, nurses, physical therapists, and chiropractors from practicing their professions if they do not hold themselves out to the public by any title or description as being athletic trainers;

    (2) the continued employment of persons employed on the effective date of Act 441 of 1984 by the State Department of Education, local boards of education, or private secondary or elementary schools for the treatment of injuries received by students participating in school sports activities; or

    (3) any person from serving as an athletic training student or in any similar position if service is carried out under the supervision of a physician or certified athletic trainer.

    (B) The provisions of this article shall not apply to any athletic trainer who is employed in another state by an educational institution or athletic organization when the athletic trainer accompanies the athletes or team of such institute or organization in the State for the purpose of an athletic contest or exhibition.

 

    Section 40-47-1780.   For purposes of this article, a person is engaged as an athletic trainer if the person is employed on a salary or contractual basis by an educational institution, hospital, rehabilitation clinic, physician's office, industry, performing arts group, professional athletic organization, military, governmental agency, or other bona fide organization which employs or serves a physically active population and performs the duties of athletic trainer as a major responsibility of this employment.

 

    Section 40-47-1790.   Nothing in this article may be construed to require school districts to hire licensed athletic trainers.

 

    Section 40-47-1800.   (A) It is unlawful for a person who is not licensed under this article to hold himself out as an athletic trainer.  A person who holds himself out as an AT without being licensed under this article, during a period of suspension, or after his license has been revoked by the board is guilty of a misdemeanor and, upon conviction, must be fined not more than three hundred dollars or imprisoned for not more than ninety days, or both.

    (B) For the purpose of any investigation or proceeding under the provisions of this article, the board or a person designated by the board may administer oaths and affirmations, subpoena witnesses, take testimony, and require the production of any documents or records which the board considers relevant to the inquiry.

    (C) If the board has sufficient evidence that a person is violating a provision of this article, the board, in addition to all other remedies, may order the person to immediately desist and refrain from such conduct. The board may apply to an administrative law judge as provided under Article 5, Chapter 23, Title 1 for an injunction enjoining the person from such conduct. An administrative law judge may issue a temporary injunction ex parte and upon notice and full hearing may issue any other order in the matter it considers proper. No bond may be required of the board by an administrative law judge as a condition to the issuance of any injunction or order contemplated by the provisions of this section.

    (D) Investigations and disciplinary proceedings under this article must be conducted in accordance with the provisions of Article 1.

    (E) No provision of this article may be construed as prohibiting the respondent or his legal counsel from exercising the respondent's constitutional right of due process under the law or prohibiting the respondent from normal access to the charges and evidence filed against him as a part of due process under the law.

 

SECTION 3.  The programmatic cash balance, powers, functions, duties, responsibilities, and authority statutorily exercised by the Department of Health and Environmental Control concerning the regulation of athletic trainers are transferred to and devolved upon the Board of Medical Examiners for South Carolina. Any regulations promulgated by the Department of Health and Environmental Control under former provisions of law pertaining to the regulation of athletic trainers are continued and are considered to be promulgated under the authority of present provisions of law pertaining to the same.

 

SECTION 4.  The repeal or amendment by this act of any law, whether temporary or permanent or civil or criminal, does not affect pending actions, rights, duties, or liabilities founded thereon, or alter, discharge, release or extinguish any penalty, forfeiture, or liability incurred under the repealed or amended law, unless the repealed or amended provision shall so expressly provide.  After the effective date of this act, all laws repealed or amended by this act must be taken and treated as remaining in full force and effect for the purpose of sustaining any pending or vested right, civil action, special proceeding, criminal prosecution, or appeal existing as of the effective date of this act, and for the enforcement of rights, duties, penalties, forfeitures, and liabilities as they stood under the repealed or amended laws.

SECTION 5.  The Department of Labor, Licensing and Regulation shall assume the licensure of athletic trainers upon the effective date of new regulations promulgated by the Department of Labor, Licensing and Regulation related to this article. The regulations shall include a fee schedule and a provision to create a uniform renewal date for all athletic trainers' licenses.

 

SECTION 6.  This act takes effect upon approval by the Governor.

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