DEPARTMENT OF LICENSING AND REGULTORY AFFAIRS

DIRECTOR'S OFFICE

ATHLETIC TRAINERS – GENERAL RULES

Filed with the secretary of state on March 23, 2023

These rules take effect immediately upon filing with the secretary of state unless adopted

under section 33, 44, or 45a(9) of the administrative procedures act of 1969, 1969 PA

306, MCL 24.233, 24.244, or 24.245a. Rules adopted under these sections become

effective 7 days after filing with the secretary of state.

(By authority conferred on the director of the department of licensing and regulatory

affairs by sections 16145, 16148, 16178, 16186, 16204, 16205, 16215, 16287, 17904, and

17905 of the public health code, 1978 PA 368, MCL 333.16145, 333.16148, 333.16178,

333.16186, 333.16204, 333.16205, 333.16215, 333.16287, 333.17904, and 333.17905

and Executive Reorganization Order Nos. 1991-9, 1996-2, 2003-1, and 2011-4, MCL

338.3501, 445.2001, 445.2011, and 445.2030)

R 338.1301, R 338.1303, R 338.1309, R 338.1317, R 338.1321, R 338.1345, R 338.1349,

R 338.1357, and R 338.1369 of the Michigan Administrative Code are amended, as

follows:

PART 1. GENERAL PROVISIONS

R 338.1301 Definitions.

Rule 1. (1) As used in these rules:

(a) "Board" means the Michigan athletic trainer board.

(b) “BOC” means the Board of Certification, Inc.

(c) "Code" means the public health code, 1978 PA 368, MCL 333.1101 to 333.25211.

(d) "Department" means the department of licensing and regulatory affairs.

(e) “Emergency cardiac care” means training in the performance or use of adult

cardiopulmonary resuscitation (CPR), pediatric CPR, second rescuer CPR, automated

external defibrillator, airway management, and barrier devices.

(2) Terms defined in the code have the same meanings when used in these rules.

PART 2. LICENSURE

R 338.1303 Training standards for identifying victims of human trafficking;

requirements.

Rule 3. (1) Pursuant to section 16148 of the code, MCL 333.16148, an individual

licensed or seeking licensure shall have completed training in identifying victims of

human trafficking that meets the following standards:

(a) Training content must cover all of the following:

October 24, 2022

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(i) Understanding the types and venues of human trafficking in this state or the United

States.

(ii) Identifying victims of human trafficking in health care settings.

(iii) Identifying the warning signs of human trafficking in health care settings for

adults and minors.

(iv) Resources for reporting the suspected victims of human trafficking.

(b) Acceptable providers or methods of training include any of the following:

(i) Training offered by a nationally recognized or state-recognized, health-related

organization.

(ii) Training offered by, or in conjunction with, a state or federal agency.

(iii) Training obtained in an educational program that has been approved by the board

for initial licensure, or by a college or university.

(iv) Reading an article related to the identification of victims of human trafficking

that meets the requirements of subdivision (a) of this subrule and is published in a peer

review journal, health care journal, or professional or scientific journal.

(c) Acceptable modalities of training include any of the following:

(i) Teleconference or webinar.

(ii) Online presentation.

(iii) Live presentation.

(iv) Printed or electronic media.

(2) The department may select and audit a sample of individuals and request

documentation of proof of completion of training. If audited by the department, an

individual shall provide an acceptable proof of completion of training, including either of

the following:

(a) Proof of completion certificate issued by the training provider that includes the

date, provider name, name of training, and individual’s name.

(b) A self-certification statement by an individual. The certification statement must

include the individual’s name and either of the following:

(i) For training completed pursuant to subrule (1)(b)(i) to (iii) of this rule, the date,

training provider name, and name of training.

(ii) For training completed pursuant to subrule (1)(b)(iv) of this rule, the title of

article, author, publication name of peer review journal, health care journal, or

professional or scientific journal, and date, volume, and issue of publication, as

applicable.

R 338.1309 Licensure by examination.

Rule 9. An applicant for an athletic trainer license by examination shall submit a

completed application on a form provided by the department with the requisite fee. In

addition to satisfying the requirements of the code and the rules promulgated under the

code, the applicant shall satisfy all of the following requirements:

(a) Have graduated from an athletic training program that satisfies the requirements of R

338.1354.

(b) Have passed the examination adopted in R 338.1325.

(c) Have successfully completed emergency cardiac care training from a program that

satisfies the requirements of R 338.1355 within 3 years before licensure and hold an

unexpired emergency cardiac care certification.

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R 338.1317 Licensure by endorsement.

Rule 17. An applicant for an athletic trainer license by endorsement shall submit a

completed application on a form provided by the department with the requisite fee. In

addition to satisfying the requirements of the code and the rules promulgated under the

code, the applicant shall satisfy all of the following requirements:

(a) Be licensed, registered, or certified as an athletic trainer in another state of the

United States or licensed in a province of Canada immediately preceding the application

for licensure.

(b) Provide verification that he or she holds a current, valid BOC certification, which

includes verification from the BOC showing that disciplinary proceedings are not

pending against the applicant and sanctions are not in force at the time of application.

(c) Have successfully completed emergency cardiac care training from a program that

satisfies the requirements of R 338.1355 within 3 years before licensure by endorsement

and hold an unexpired emergency cardiac care certification.

(d) Comply with both of the following:

(i) Disclose each license, registration, or certification in a health profession or specialty

issued by any other state, the United States military, the federal government, or another

country on the application form.

(ii) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174, which

include verification from the issuing entity showing that disciplinary proceedings are not

pending against the applicant and sanctions are not in force at the time of application.

R 338.1321 Licensure of foreign-trained applicants.

Rule 21. (1) If an applicant was foreign-trained and does not meet the requirements of

R 338.1309 or R 338.1317, then the applicant shall submit a completed application on a

form provided by the department with the requisite fee, and in addition to satisfying the

requirements of the code and the rules promulgated under the code, satisfy all of the

following requirements:

(a) Provide verification that the applicant holds a national licensure, registration,

certification, or other athletic training professional endorsement recognized by the BOC,

which includes verification from the BOC showing that disciplinary proceedings are not

pending against the applicant and sanctions are not in force at the time of application.

(b) Pass the examination adopted in R 338.1325.

(c) Have successfully completed emergency cardiac care training from a program that

satisfies the requirements of R 338.1355 within 3 years before licensure and hold an

unexpired emergency cardiac care certification.

(d) Comply with both of the following:

(i) Disclose each license, registration, or certification in a health profession or

specialty issued by any other state, the United States military, the federal government, or

another country on the application form.

(ii) Satisfy the requirements of section 16174(2) of the code, MCL 333.16174, which

include verification from the issuing entity showing that disciplinary proceedings are not

pending against the applicant and sanctions are not in force at the time of application.

(2) If an applicant holds current certification in good standing by the BOC, the applicant

is presumed to have satisfied the requirements of subrules (1)(a) and (1)(b) of this rule.

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The applicant’s certification must be verified by the BOC. Verification from the BOC

must show that disciplinary proceedings are not pending against the applicant and

sanctions are not in force at the time of application.

R 338.1345 Relicensure.

Rule 45. (1) An applicant for relicensure whose Michigan license has lapsed, under the

provisions of section 16201(3) or (4) of the code, MCL 333.16201, as applicable, may

be relicensed by complying with the requirements of the code, the rules promulgated

and under code, and the following requirements as noted by (√):

(a) For an applicant who has let his or her Michigan

license lapse and who does not hold a current and

valid license, registration, certification, or other

athletic training professional endorsement recognized

by the BOC to practice as an athletic trainer or other

athletic training professional recognized by the BOC

for certification in another state of the United States,

province of Canada, or other country:

Lapsed

less than 3 years or

years

Lapsed 3

more

(i)

Submit a completed application on a form

provided by the department, together with the

requisite fee.

√

(ii) Establish that he or she is of good moral

character.

(iii) Submit fingerprints as required in section

16174(3) of the code, MCL 333.16174.

√

(iv) Establish that he or she holds a current, valid

BOC certification.

√

(v) Have successfully completed emergency cardiac

care training from a program that satisfies the

requirements of R 338.1355 within 3 years

before relicensure and hold an unexpired

emergency cardiac care certification.

√

(vi) Have completed 75 hours of approved CE

credits, as provided under R 338.1357, during

the 3 years immediately preceding relicensure.

(vii) An applicant who is or has ever been licensed,

registered, or certified in a health profession or

specialty by any other state, the United States

military, the federal government, or another

country, shall do both of the following:

√

(A) Disclose each license, registration, or

certification on the application form.

(B) Satisfy the requirements of section 16174(2)

of the code, MCL 333.16174, which include

verification from the issuing entity showing that

disciplinary proceedings are not pending against

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the applicant and sanctions are not in force at the

time of application.

(b) For an applicant who has let his or her Michigan

license lapse and who holds a current and valid

license, registration, certification, or other athletic

training professional endorsement recognized by the

BOC to practice as an athletic trainer or other athletic

training professional recognized by the BOC for

certification in another state of the United States,

province of Canada, or other country:

Lapsed

less than 3 years or

years

Lapsed 3

more

(i)

Submit a completed application on a form

provided by the department, together with the

requisite fee.

√

(ii) Establish that he or she is of good moral

character.

(iii) Submit fingerprints as required in section

16174(3) of the code, MCL 333.16174.

√

(iv) Establish that he or she holds a current, valid

BOC certification.

√

(v) Have successfully completed emergency cardiac

training from a program that satisfies the

requirements of R 338.1355 within 3 years

before relicensure and hold an unexpired

emergency cardiac care certification.

√

(vi) Have completed 75 hours of approved CE

credits, as provided under R 338.1357, during

the 3 years immediately preceding relicensure.

(vii) An applicant who is or has ever been licensed,

registered, or certified in a health profession or

specialty by any other state, the United States

military, the federal government, or another

country, shall do both of the following:

(A) Disclose each license, registration, or

certification on the application form.

√

(B) Satisfy the requirements of section 16174(2)

of the code, MCL 333.16174, which include

verification from the issuing entity showing that

disciplinary proceedings are not pending against

the applicant and sanctions are not in force at the

time of application.

(2) If relicensure is granted and it is determined that a sanction has been imposed by

another state, the United States military, the federal government, or another country, the

disciplinary subcommittee may impose appropriate sanctions under section 16174(5) of

the code, MCL 333.16174.

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R 338.1349 License renewal requirements; adoption of BOC continuing education

standards.

Rule 49. (1) Until the end of the applicant’s current renewal cycle, an applicant for

license renewal shall satisfy the requirements of R 338.7001 to R 338.7005 and both of

the following requirements within the 3-year renewal cycle:

(a) Complete emergency cardiac care training from a program that satisfies the

requirements of R 338.1355 and hold an unexpired emergency cardiac care certification.

(b) Before the expiration date of the license, complete a total of 75 hours of continuing

education that comply with R 338.1357, including a minimum of 3 hours of continuing

education hours in pain and symptom management, as required under section 16204 of

the code, MCL 333.16204.

(2) Beginning with the licensee’s first renewal cycle following promulgation of these

rules, an applicant for license renewal shall satisfy the requirements of R 338.7001 to R

338.7005 and both of the following:

(a) The continuing education standards established by the BOC in the publication titled

Certification Maintenance Requirements for Certified Athletic Trainers, Reporting Period

Ending December 31, 2021, which are adopted by reference in these rules as required

under section 17905(2) of the code, MCL 333.17905. This document is available free of

charge from the BOC at https://bocatc.org/athletic-trainers/maintain-

certification/continuing-education/continuing-education or at a cost of 10 cents per page

from the Department of Licensing and Regulatory Affairs, Bureau of Professional

Licensing at 611 West Ottawa Street, P.O. Box 30670, Lansing, Michigan 48909.

(b) As a part of the continuing education required under subpart (a) of this subrule,

complete a minimum of 3 hours of continuing education in pain and symptom

management, as required under section 16204 of the code, MCL 333.16204.

(3) Submission of an application for renewal of a license constitutes the applicant's

certification of compliance with this rule.

(4) The board may require the licensee to submit evidence to demonstrate compliance

with this rule.

(5) The licensee shall retain documentation of satisfying the requirements of this rule for

a period of 4 years from the date of applying for license renewal.

(6) A request for a waiver under section 16205 of the code, MCL 333.16205, must be

received by the department before the expiration date of the license.

PART 4. CONTINUING EDUCATION

R 338.1357 Limitations for accumulating continuing education; approved continuing

education.

Rule 57. (1) Until the end of the applicant’s current renewal cycle, a licensee who

accumulates the 75 hours of continuing education required pursuant to R 338.1349 for the

renewal of an athletic trainer license is subject to all of the following limitations:

(a) A licensee may not accumulate more than 12 credit hours of continuing education

during 1 24-hour period.

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(b) A licensee may not carry forward the continuing education hours earned during 1

renewal cycle to the next renewal cycle for activities listed in subrule (5)(b) to (g) of this

rule.

(c) A licensee may not earn continuing education credit for completing a program or

activity that is identical or substantially identical to a program or activity for which the

licensee has already earned credit during the same renewal cycle.

(d) A licensee may not earn more than 50 hours of continuing education per renewal

cycle for activities listed in subrule (5)(d) to (g) of this rule.

(2) Approved courses for accumulating continuing education hours in pain and

symptom management, as required in R 338.1349(1)(b) or R 338.1349(2)(b), as

applicable, include, but are not limited to, courses in behavior management, psychology

of pain, pharmacology, behavior modification, stress management, clinical applications,

and drug interventions as they relate to professional practice.

(3) Until the end of the applicant’s current renewal cycle, the board approves and adopts

by reference the standards of the BOC set forth in the publication titled “Practice

Analysis, 7^thEdition, Outline: Domains and Tasks,” effective for April 2017 exam and

January 1, 2018 continuing education. This document is available free of charge from the

BOC at https://bocatc.org/system/document_versions/versions/24/original/boc-pa7-

content-outline-20170612.pdf?1497279231 or at a cost of 10 cents per page from the

Department of Licensing and Regulatory Affairs, Bureau of Professional Licensing at

611 West Ottawa Street, P.O. Box 30670, Lansing, Michigan 48909.

(4) Until the end of the applicant’s current renewal cycle, any continuing education

program approved by the BOC is considered approved by the board.

(5) Until the end of the applicant’s current renewal cycle, the board approves all of the

following for continuing education credit:

Activity and Proof of Completion

Number of continuing education hours

granted/permitted for each activity

(a) Maintenance of BOC certification during each Seventy five hours of continuing

year of the renewal cycle.

education are earned for this activity in

each renewal cycle.

If audited, the licensee shall provide evidence

from the BOC that the licensee held a valid

BOC certification during each year of the

renewal cycle.

(b) Attendance at or participation in a continuing The number of continuing education

education program or activity related to the hours earned for a specific program or

practice of athletic training, which includes but activity is the number of hours approved

is not limited to, live and in person programs; by the sponsor or the approving

interactive or monitored teleconference, audio- organization for the specific program or

conference, or web-based programs; online activity.

programs; and journal articles or other self-

study programs approved or offered by any of

the following:

 The BOC.

 Another state or provincial board of

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athletic trainers.

 A state or provincial board related to

the practice of medicine, osteopathic

medicine and surgery, or physical

therapy.

If audited, the licensee shall submit a copy of a

letter or certificate of completion showing the

licensee’s name, number of continuing

education hours earned, sponsor name or the

name of the organization that approved the

program or other activity for which the

continuing education credit was given, and the

date on which the program or activity was

completed.

(c) Initial presentation of continuing education Ten hours of continuing education credit

program related to the practice of athletic are earned for each 50 to 60 minutes of

trainer to a state, regional, national, or presentation. No additional credit is

international athletic training organization.

earned for preparation of a presentation.

A maximum of 50 hours of continuing

To receive credit, the presentation must not be education may be earned for this activity

a part of the licensee’s regular job description in each renewal cycle.

and must be approved or offered for continuing

education credit by any of the following:

 Another state or provincial board of

athletic trainers.

 A state or provincial board related to

the practice of medicine, osteopathic

medicine and surgery, or physical

therapy.

If audited, the licensee shall submit a copy of

the presentation notice or advertisement

showing the date of the presentation, the

licensee’s name listed as a presenter, and the

name of the organization that approved or

offered the presentation for continuing

education credit.

(d) Initial presentation of a scientific exhibit, Ten hours of continuing education are

poster,

scientific

paper,

or

clinical earned for serving as a primary presenter.

demonstration to an athletic training Five hours of continuing education are

organization.

earned for serving as a secondary

presenter. No additional credit is granted

To receive credit, the presentation must not be for preparation of the presentation. The

part of the licensee’s regular job description or maximum number of credit hours

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performed in the normal course of the permitted per renewal cycle for this

licensee’s employment.

activity is subject to subrule (1)(d) of this

rule.

If audited, the licensee shall submit a copy of

the document presented with evidence of

presentation or a letter from the program

sponsor verifying the length and date of the

presentation.

(e) Initial publication of an article related to the Fifteen hours of continuing education are

practice of athletic training in a peer-reviewed earned for serving as a primary author.

journal.

Ten hours of continuing education are

earned for serving as a secondary author.

If audited, the licensee shall submit a copy of The maximum number of credit hours

the publication that identifies the licensee as permitted per renewal cycle for this

the author of the publication or an acceptance activity is subject to subrule (1)(d) of this

letter.

rule.

(f) Initial publication of a chapter related to the Ten hours of continuing education are

practice of athletic training in any of the earned for serving as a primary or

following:

contributing author. The maximum

number of credit hours permitted per

renewal cycle for this activity is subject

to subrule (1)(d) of this rule.

 A professional or health care textbook.

 A peer-reviewed textbook.

 A book related to the practice of

athletic training.

If audited, the licensee shall submit a copy of

the publication that identifies the licensee as

the author or a publication acceptance letter.

(g) Passing an academic course or residency Ten hours of continuing education are

program related to the practice of athletic earned for each course. A maximum of

training that is offered by either of the 50 hours per renewal cycle may be

following:

earned for this activity.

 An athletic training program that

satisfies the standards adopted in R

338.1354(1).

 A

accredited by an organization that

satisfies the standards of

338.1354(2).

higher

education

institution

R

If audited, a licensee shall submit a copy of the

transcript showing credit hours of the

academic course related to athletic training.

(6) Beginning with the licensee’s first renewal cycle following promulgation of these

rules, an applicant for license renewal shall comply with all BOC continuing education

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standards adopted by reference in R 338.1349(2)(a). If audited, the licensee shall provide

evidence of 1 of the following:

(a) Verification from the BOC that the renewal applicant held a valid BOC

certification during each year of the renewal cycle.

(b) Proof that during the 3-year license renewal cycle the renewal applicant completed

the BOC continuing education standards for the renewal of a 2-year certification and the

BOC requirements for the renewal of a 1-year certification. The proof must be a copy of

the letter or certificate issued by the BOC-approved continuing education provider, which

must include all of the following:

(i) The participant’s name.

(ii) The number of continuing education hours earned.

(iii) The sponsor’s name and BOC approval number.

(iv) The date or dates the licensee participated in the program or activity.

PART 5. DELEGATION AND ADOPTION BY REFERENCE OF

PROFESSIONAL STANDARDS

R 338.1369 Delegation and supervision; requirements.

Rule 69. (1) Pursuant to section 16215(1) of the code, MCL 333.16215, a licensee may

delegate the performance of an athletic training act, task, or function if the licensee

maintains a record of the name of the individual to whom the act, task, or function was

delegated. The record must be maintained pursuant to section 16213 of the code, MCL

333.16213.

(2) The licensee shall provide direct supervision if the licensee delegates an act, task, or

function related to the practice of athletic training to a delegatee who is unlicensed or

licensed and the act, task, or function does not fall within the delegatee’s licensed scope

of practice. As used in this subrule, “direct supervision” means the licensee is physically

present and immediately available for face-to-face direction and supervision at the time

the act, task, or function is performed and the licensee has direct contact with the

individual upon whom the act, task, or function was performed.

(3) A licensee shall not delegate a job, task, or function to a secondary-school student

that requires the secondary-school student to engage in the practice of athletic training.

(4) At any given time, the number of unlicensed individuals to whom a licensee may

provide direct supervision must not exceed 8 individuals.