DEPARTMENT OF LICENSING AND REGULATORY AFFAIRS  
DIRECTOR'S OFFICE  
ATHLETIC TRAINERS GENERAL RULES  
Filed with the secretary of state on June 4, 2021  
These rules take effect immediately upon filing with the secretary of state unless adopted  
under section 33, 44, or 45a(6) 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 338.1325, R 338.1345,  
R 338.1349, R 338.1354, R 338.1355, R 338.1357, R 338.1369, and R 338.1378 of the  
Michigan Administrative Code are amended, R 338.1302 is added, and R 338.1321a is  
rescinded, as follows:  
PART 1. GENERAL PROVISIONS  
R 338.1301 Definitions.  
Rule 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.  
R 338.1302 Telehealth services.  
Rule 2. (1) Consent for treatment must be obtained before providing a telehealth service  
pursuant to section 16284 of the code, MCL 333.16284.  
(2) Evidence of consent for treatment must be maintained in a client’s medical record.  
(3) An athletic trainer providing any telehealth service shall do both of the following:  
(a) Act within the scope of his or her practice.  
(b) Exercise the same standard of care applicable to a traditional health care service.  
February 18, 2021  
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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 complete training in identifying victims of human  
trafficking that meets the following standards:  
(a) Training content must cover all of the following:  
(i) Understanding the types and venues of human trafficking in Michigan 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 may 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.  
(3) Pursuant to section 16148 of the code, MCL 333.16148, the requirements specified  
in subrule (1) of this rule apply to license renewals beginning 2019 and for initial licenses  
issued after April 22, 2021.  
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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, 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.  
R 338.1317 Licensure by endorsement.  
Rule 17. (1) 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, 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 immediately preceding the application for licensure.  
(b) Establish that he or she holds a current, valid BOC certification.  
(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.  
(2) An applicant’s license, registration, certification, or other athletic training  
professional endorsement recognized by the BOC must be verified by the licensing and  
regulatory agency of any state of the United States, province of Canada, or other country,  
in which the applicant holds or has ever held a license, registration, certification, or  
athletic training professional endorsement to practice as an athletic trainer or other  
athletic training professional recognized by the BOC for certification. Verification  
includes, but is not limited to, any disciplinary action taken against the license,  
registration, certification, or other athletic training professional endorsement.  
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 satisfy all of the following  
requirements:  
(a) Hold a national licensure, registration, certification, or other athletic training  
professional endorsement recognized by the BOC.  
(b) Pass the examination adopted in R 338.1325.  
(c) Be verified, on a form provided by the department, by the licensing or registration  
agency of any state of the United States, province of Canada, or other country in which  
the applicant holds a current license or registration or has ever held a license, registration,  
certification, or other athletic training professional endorsement to practice as an athletic  
trainer. This includes, but is not limited to, showing proof of any disciplinary action taken  
or pending disciplinary action imposed upon the applicant.  
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(d) 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.  
(2) If an applicant holds current certification by the BOC, the applicant is presumed to  
have satisfied the requirements of subrules (1)(a) and (1)(b) of this rule.  
R 338.1321a Rescinded.  
R 338.1325 Licensed athletic trainer examination; adoption; passing scores.  
Rule 25. The board adopts the BOC athletic trainer credentialing examination that is  
scored by the Scantron Corporation or its successor organization. A passing score on the  
examination is the passing score determined by the BOC.  
R 338.1345 Relicensure.  
Rule 45. 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 following requirements as noted by (√):  
(1) 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  
Lapsed 3  
years or  
more  
(a) Application and fee: Submit a completed  
application on a form provided by the  
department, together with the requisite fee.  
(b) Good moral character: Establish that he or  
she is of good moral character.  
(c) Fingerprints:  
Submit  
fingerprints  
as  
required in section 16174(3) of the code,  
MCL 333.16174.  
(d) BOC certification: Establish that he or she  
holds a current, valid BOC certification.  
(e) Training:  
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.  
(f) Continuing education: Have completed 75  
hours of approved CE credits, as provided under √  
R 338.1357, during the 3 years immediately  
preceding relicensure.  
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(g) Proof of license verification from another  
jurisdiction: An applicant’s license, registration, √  
certification, or other athletic training  
professional endorsement recognized by the  
BOC for certification must be verified by the  
licensing agency of any state or territory of the  
United States, province of Canada, or other  
country in which the applicant has ever held a  
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.  
Verification must include the record of any  
disciplinary  
action  
taken  
or  
pending  
against the applicant.  
(2) 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  
Lapsed  
less than 3  
years  
Lapsed 3  
years or  
more  
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:  
(a) Application and fee: Submit a completed  
application on a form provided by the  
department, together with the requisite fee.  
(b) Good moral character: Establish that he or  
she is of good moral character.  
(c) Fingerprints:  
Submit  
fingerprints  
as  
required in section 16174(3) of the code,  
MCL 333.16174(3).  
(d) BOC certification: Establish that he or she  
holds a current, valid BOC certification.  
(e) Training:  
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.  
(f) Continuing education: Have completed 75  
hours of approved CE credits, as provided under √  
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R 338.1357, during the 3 years immediately  
preceding relicensure.  
(g) Proof of license verification from another  
jurisdiction: An applicant’s license, registration, √  
certification, or other athletic training  
professional endorsement recognized by the  
BOC for certification must be verified by the  
licensing agency of any state or territory of the  
United States, province of Canada, or other  
country in which the applicant has ever held a  
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.  
Verification must include the record of any  
disciplinary  
action  
taken  
or  
pending  
against the applicant.  
R 338.1349 License renewal requirements.  
Rule 49. (1) An applicant for license renewal shall satisfy 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) Submission of an application for renewal of a license constitutes the applicant's  
certification of compliance with this rule.  
(3) The board may require the licensee to submit evidence to demonstrate compliance  
with this rule.  
(4) 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.  
(5) 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 3. EDUCATIONAL AND TRAINING AND CERTIFICATION PROGRAMS  
R 338.1354 Educational program standards; adoption by reference.  
Rule 54. (1) The board adopts by reference the standards for accrediting athletic training  
programs adopted by the Commission on Accreditation for Athletic Training Education  
(CAATE) in the document entitled “Standards for the Accreditation of Professional  
Athletic Training Programs,” July 1, 2012, as revised February 16, 2018, which is  
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training program that is accredited by CAATE is approved by the board.  
(2) The board adopts by reference the procedures and criteria for recognizing  
accrediting organizations of the Council of Higher Education Accreditation (CHEA),  
effective September 24, 2018, and the procedures and criteria for recognizing accrediting  
agencies of the United States Department of Education, effective July 1, 2010, as  
contained in 34 CFR part 602 (2010). The CHEA recognition standards may be obtained  
from CHEA, One Dupont Circle NW, Suite 510, Washington, DC 20036-1110, or from  
the council’s website at http://www.chea.org at no cost. The federal recognition criteria  
may be obtained at no cost from the United States Department of Education’s website at:  
(3) Copies of the standards and criteria adopted by reference in this rule are available for  
inspection and distribution at a cost of 10 cents per page from the Michigan Board of  
Athletic Trainers, Department of Licensing and Regulatory Affairs, Bureau of  
Professional Licensing, 611 W. Ottawa St., P.O. Box 30670, Lansing, Michigan 48909.  
R 338.1355 Approved emergency cardiac care training.  
Rule 55. (1) The board approves emergency cardiac care training offered or approved by  
the following organizations:  
(a) American Red Cross.  
(b) American Heart Association.  
(c) National Safety Council.  
(d) American Safety and Health Institute.  
(e) Emergency Care and Safety Institute.  
(2) The board adopts by reference the standards for certification in basic and advanced  
cardiac life support set forth by the American Heart Association in the standards and  
guidelines for cardiopulmonary resuscitation and emergency cardiac care for professional  
providers and published in "2020 American Heart Association Guidelines for  
Cardiopulmonary Resuscitation and Emergency Cardiovascular Care ("Circulation,"  
Volume 142, Issue 16 Supplement 2, October 20, 2020). A copy of the guidelines for  
cardiopulmonary resuscitation and emergency cardiac care may be obtained from the  
American Heart Association, 7272 Greenville Avenue, Dallas, Texas 75231 or from the  
association's  
website  
at  
copy of this document is available for inspection and distribution at a cost of 10 cents per  
page from the Michigan Department Licensing and Regulatory Affairs, Bureau of  
Professional Licensing, 611 West Ottawa Street, P.O. Box 30670, Lansing, Michigan  
48909.  
(3) An organization that provides training that uses the standards specified in subrule (2)  
of this rule is considered an approved provider.  
PART 4. CONTINUING EDUCATION  
R 338.1357 Limitations for accumulating continuing education; approved continuing  
education.  
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Rule 57. (1) 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.  
(b) A licensee may not carry forward the continuing education hours earned during 1  
renewal cycle to the next renewal cycle.  
(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), 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) The board approves and adopts by reference the standards of the BOC set forth in  
the publication entitled “Practice Analysis, 7th Edition, Outline: Domains and Tasks,”  
effective for April 2017 exam and January 1, 2018 continuing education, available at  
outline-20170612.pdf?1497279231.  
(4) Any continuing education program approved by the BOC is considered approved by  
the board.  
(5) 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.  
Twenty-five  
education are granted for each year that  
If audited, the licensee shall provide evidence the licensee maintained BOC  
from the BOC that shows the time period that certification. A maximum of 75 hours of  
hours  
of  
continuing  
the licensee held a valid certification.  
continuing education may be earned for  
this activity in each renewal cycle.  
(b) Attendance at or participation in a continuing The number of continuing education  
education program or activity related to the hours for a specific program or activity is  
practice of athletic training, which includes but the number of hours approved by the  
is not limited to, live and in person programs; sponsor or the approving organization for  
interactive or monitored teleconference, audio- the specific program or activity. A  
conference, or web-based programs; online maximum of 75 hours of continuing  
programs; and journal articles or other self- education credit may be earned for this  
study programs approved or offered by any of activity in each renewal cycle.  
the following:  
Another state or provincial board of  
athletic trainers.  
A state or provincial board related to  
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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 granted for each 50 to 60 minutes of  
trainer to a state, regional, national, or presentation. No additional credit is  
international athletic training organization.  
granted 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 granted for serving as a primary  
demonstration to an athletic training presenter. Five hours of continuing  
organization.  
education are granted for serving as a  
secondary presenter. No additional credit  
To receive credit, the presentation must not be is granted for preparation of the  
part of the licensee’s regular job description or presentation. The maximum number of  
performed in the normal course of the credit hours permitted per renewal cycle  
10  
licensee’s employment.  
for this 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 granted for serving as a primary author.  
journal.  
Ten hours of continuing education are  
granted 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 granted 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 granted 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.  
PART 5. DELEGATION AND ADOPTION BY REFERENCE OF  
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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) A licensee who delegates an act, task, or function related to the practice of athletic  
training shall provide supervision as follows:  
(a) If the delegatee is licensed under the code and the act, task, or function is within the  
delegatee’s scope of practice, the supervision shall be general supervision as defined in  
section 16109(2) of the code, MCL 333.16109.  
(b) If the delegatee is unlicensed or the act, task, or function does not fall within the  
delegatee’s licensed scope of practice, the supervision shall be direct supervision. As  
used in this subdivision, “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.  
R 338.1378 Professional standards.  
Rule 78. (1) The board adopts by reference the BOC’s “Standards of Professional  
Practice” effective January 2021. The standards are available, free of charge on the  
discipline/standards-of-professional-practice, or a copy may be obtained at a cost of 10  
cents per page, from the Board of Athletic Trainers, Department of Licensing and  
Regulatory Affairs, Bureau of Professional Licensing, 611 W. Ottawa St., P.O. Box  
30670, Lansing, Michigan 48909.  
(2) A licensee shall comply with the standards adopted in subrule (1) of this rule.  
;