Current through Register Vol. 51, No. 3, September 1, 2024
RELATES TO: KRS Chapter 13B, 311.591-311.593, 311.599, 311.900,
311.901(1), 311.903(2), 311.905, 311.911
NECESSITY, FUNCTION & CONFORMITY:
KRS
311.901(1) and
311.903(2)
require that the Kentucky Board of Medical Licensure promulgate administrative
regulations relating to the licensure and regulation of athletic trainers,
including procedures for eligibility and credentialing, procedures for license
renewal and reinstatement, procedures for complaints and disciplinary actions,
a code of ethical standards, standards of practice, objectives of athletic
training, procedures for name and contact information changes, procedures of
licensure renewal and reinstatement of active duty military individuals,
procedures for documentation standards, requirements for foreign-trained
athletic trainers, a formulary of legend medications that may be obtained,
transported, provided, and administered when providing athletic training
services, and requirements for invasive procedures. This administrative
regulation establishes the procedures for eligibility and credentialing of
US-trained and foreign-trained athletic trainers, procedures for license
renewal and reinstatement including for active duty military individuals,
procedures for complaints and disciplinary actions, a code of ethical
standards, standards of practice, objectives of athletic training, procedures
for name and contact information changes, procedures for documentation
standards, a formulary of legend medications that may be obtained, transported,
provided, and administered when providing athletic training services, and
requirements for invasive procedures.
Section
1. Definitions.
(1) "Athletic
injury" is defined by
KRS
311.900(2).
(2) "BLS" means basic life support.
(3) "Board" means the Kentucky Board of
Medical Licensure.
(4) "BOC" means
National Athletic Trainers Association Board of Certification, Inc.
(5) means the insertion of a dry solid
filiform needle, without medication, into a trigger point with the goal of
releasing or inactivating the trigger points for the treatment of myofascial or
musculoskeletal pain or soft tissue dysfunction.
(6) "IM" means intramuscular.
(7) "IV" means intravenous.
(8) "Legend drug" or "legend medication"
means any drug, except for Schedule II, III, IV, or V drugs as defined in the
Controlled Substances Act,
21
U.S.C. secs. 801 et seq., approved by the
U.S. Food and Drug Administration that can be dispensed to the public only with
a prescription from a medical doctor or other licensed practitioner.
(9) "OTC" means an over-the-counter
medication and is any medicine sold directly to a consumer without a
requirement for a prescription from a healthcare professional.
(10) "SubQ" means subcutaneous.
(11) "Supervising physician" is defined by
KRS
311.900(6).
(12) "Supervision" is defined by
KRS
311.900(7).
Section 2. Eligibility and
Credentialing for US-trained and Foreign-Trained Athletic Trainers. In order to
be eligible for licensure as an athletic trainer in the Commonwealth of
Kentucky, regardless of whether trained in the United States or abroad, an
applicant shall satisfy the requirements established in
KRS
311.905.
Section 3. Renewal and Reinstatement. The
procedures for renewal and reinstatement shall be as established in
KRS
311.905 and
201 KAR
9:305 and
201 KAR
9:307.
Section
4. Procedures for complaints and disciplinary actions. All
grievances, complaints and disciplinary proceedings against an athletic trainer
shall be conducted in accordance with the provisions of
KRS
311.591,
311.592,
311.593,
311.599,
and
311.911; KRS
Chapter 13B; and any related administrative regulations in 201 KAR Chapter 9
that apply to physicians shall also apply to athletic trainers.
Section 5. Ethical Standards. An athletic
trainer licensed to practice in the Commonwealth of Kentucky shall conform to
the National Athletic Trainers' Association's Code of Ethics (March
2018).
Section 6. Standards of
Practice. The standards of practice of an athletic trainer licensed to practice
in the Commonwealth of Kentucky shall conform to BOC Standards of Professional
Practice (October 2017), unless otherwise excluded by Kentucky statute or
administrative regulation including those under 201 KAR Chapter 9.
Section 7. Objectives of Athletic Training.
An athletic trainer licensed to practice in the Commonwealth of Kentucky shall
practice with the intent of preventing, recognizing, evaluating, managing,
disposing, treating, reconditioning, or rehabilitating athletic
injuries.
Section 8. Name and
Contact Information Changes.
(1) Any person
licensed to practice as an athletic trainer in the Commonwealth of Kentucky
shall report, in writing, to the Board:
(a)
His or her full and official name, maiden name, and any aliases;
(b) The primary address or addresses at which
he or she maintains an office or practices athletic training and may be served
correspondence from the Board;
(c)
The electronic email address or addresses at which he or she may receive
correspondence from the Board; and
(d) His or her supervising physician or
physicians.
(2) If
unknown at the time of initial licensure, any new licensee shall make the
report required in subsection (1) of this section within thirty (30) days after
commencing the practice of athletic training within this state.
(3) Every athletic trainer who, after
notifying the Board of the information required in subsections (1) and (2) of
this section, moves, changes, or obtains a new name, address, electronic
address, or supervising physician, shall notify the Board, in writing, within
ten (10) business days thereof.
Section 9. Documentation Standards. An
athletic trainer licensed to practice in the Commonwealth of Kentucky shall
maintain an appropriate and reasonable medical record of patients receiving
athletic training services, which may include:
(1) Record of the athletic trainer's
evaluation of the patient;
(2)
Inclusion of pertinent medical history;
(3) Record of oral orders from a referring or
supervising physician;
(4) A
description of services provided by the athletic trainer;
(5) A plan of care including referral to
other medical providers;
(6) Record
of follow up care and/or ongoing treatment; and
(7) Documentation of significant changes in
patient status, if any.
Section
10. Formulary of Legend Medications that may be Obtained,
Transported, Provided, and Administered if Providing Athletic Training
Services.
(1) An athletic trainer licensed to
practice in the Commonwealth of Kentucky may, in coordination with a
supervising physician, obtain, transport, provide, and administer the following
legend drugs:
(a) Albuterol for administration
via meter dose inhaler;
(b)
Albuterol Nebule for administration via small volume nebulizer or oxygen-driven
nebulizer prepackaged;
(c) Atrovent
Nebule for administration via small volume nebulizer or oxygen-driven
duonebulizer prepackaged;
(d)
Oxygen;
(e) Nitroglycerin for
administration via spray or tab;
(f) Epinephrine 1:1000 for administration via
IM or Epi-Pen for treatment of anaphylaxis;
(g) The following fluids for IV
administration:
1. Normal Saline;
and
2. Lactated Ringers;
(h) Naloxone for IM or nasal
administration;
(i) Glucagon for IM
administration in the event of a diabetic emergency;
(j) D50-Dextrose 50% and D25- Dextrose 25%
for IV administration in the event of a diabetic emergency;
(k) Flu Vaccine to any person nine (9) years
of age or older;
(l) Lidocaine (1%
or 2%) for administration via injection, with or without Epinephrine;
(m) Bupivacaine (.5%) for administration via
injection, with or without Epinephrine;
(n) Lidocaine Topical; and
(o) Dermabond tissue
adhesive.
(2) An athletic
trainer licensed to practice in the Commonwealth of Kentucky may, in
coordination with a supervising physician, obtain, transport, provide, and
administer OTC medications in accordance with the manufacturer's
recommendations or upon order of a supervising physician.
(3) Unless there is a risk of death, physical
disability, or impairment to the athlete, an athletic trainer licensed to
practice in the Commonwealth of Kentucky shall not administer a legend drug or
an OTC medication to a person under the age of eighteen (18) years without
express parental or guardian consent and physician oversight.
Section 11. Invasive
Procedures.
(1) An athletic trainer licensed
to practice in the Commonwealth of Kentucky may, in coordination with a
supervising physician, perform the following invasive procedures:
(a) Rectal thermometry;
(b) IM, IV or SubQ medication administration
injections;
(c) Airway adjuncts, if
in conformity with BLS protocols and instruments;
(d) Dry needling, if:
1. The athletic trainer has completed at
least fifty-four (54) classroom hours of BOC-approved dry needling training,
which includes instruction in the clinical application of dry
needling;
2. The procedure is
ordered by a supervising physician; and
3. The treatment is administered in a
designated room or facility separate from a gymnasium, locker room, sports
field, or sideline;
(e)
Phlebotomy;
(f) Capillary finger
sticks for purpose of testing blood glucose levels;
(g) Repair or closure of superficial
lacerations involving only skin or subcutaneous tissues, if performed in a
designated room or facility separate from a gymnasium, locker room, sports
field, or sideline; and
(h)
Draining of blisters.
(2) Unless there is a risk of death, physical
disability, or impairment to the athlete, an athletic trainer licensed to
practice in the Commonwealth of Kentucky shall not perform an invasive
procedure on a person under the age of eighteen (18) years without express
parental or guardian consent and physician oversight.
Section 12. Incorporation by Reference.
(1) The following material is incorporated by
reference:
(a) The "National Athletic
Trainers' Association's Code of Ethics", March 2018; and
(b) "BOC Standards of Professional Practice",
October 2017.
(2) This
material may be inspected, copied, or obtained, subject to applicable copyright
law, at the Kentucky Board of Medical Licensure, 310 Whittington Parkway, Suite
1B, Louisville, Kentucky 40222, Monday through Friday, 8:00 a.m. to 4:30
p.m.
(3) This material may also be
obtained on the board's Web site at kbml.ky.gov.
STATUTORY AUTHORITY:
KRS
311.901(1),
311.903(2)
