Currently, 49 states and the District of Columbia regulate the practice of athletic training. Individuals must be legally recognized by the appropriate state regulatory agency prior to practicing athletic training. The BOC exam is recognized by all Athletic Trainer state regulatory agencies to meet their exam requirement. Compliance with state regulatory requirements is mandatory and the only avenue to legal athletic training practice.
The Council of State Governments (CSG), through a cooperative agreement with the Department of Defense (DoD), is partnering with the BOC to support the need for mobility of licensed Athletic Trainers (ATs) through the development of a new interstate compact. An interstate compact will allow ATs to practice across state lines both physically and remotely (e.g. digital health) improving continuity of care.
Development of an Athletic Trainer interstate compact has been launched through the CSG’s National Center for Interstate Compacts.
Occupational licensure compacts represent the gold standard of policy options for states to improve licensure portability. This AT interstate compact will enhance reciprocity among compact member states to reduce the barriers to employment and delivery of care.
Through licensure compacts, states establish uniform standards to lower barriers to multi-state practice while preserving a state’s practice act and initial licensure process. Licensure compacts enhance public protection through a data system that allows compact member states to efficiently communicate licensure data, including disciplinary actions against licensees.
Licensure compacts are developed through an extensive stakeholder informed and consensus-based process from the existing policies across states and respond to the unique characteristics and needs of a profession. States join interstate compacts by agreeing to uniform provisions through the legislative process.
CSG has been a part of helping to drive change in state occupational licensure policy in recent years. Based on this experience, CSG believes interstate compacts provide the most effective means for achieving borderless practice for licensed practitioners and military spouses relieving the burdens of maintaining multiple state licenses.
A kick-off meeting to announce the AT interstate compact project was held on June 5, 2024. Anne Minton, CEO represented the BOC, providing an overview of the positive impact the compact would have for ATs and the profession overall.
Hundreds of ATs and other stakeholders tuned in, hearing from DoD officials, CSG staff and BOC leadership. Speakers mapped out the function of an AT interstate compact, the background and aspirations for the project, as well as the compact development process and timeline.
“The BOC was interested in applying for technical assistance with the development of an interstate compact to advance the athletic training profession itself, as well as enhance opportunities for AT professionals, ultimately maximizing patient care and protection of the public,” said Minton. “Creating transportability of BOC certifications domestically and worldwide through this AT compact expands access.”
ATs have the knowledge and skills to be effective in many health care settings, including remotely. Digital health opens doors for ATs and provides patients with increased access to qualified health care professionals. An interstate compact is the most efficient way for ATs to use digital health in multiple states.
An interstate compact is also a more efficient and effective way for AT regulators to exchange licensure and disciplinary data, which again would improve protection of the public.
The compact is currently under development. Once an initial draft is developed, it will be shared on the CSG site with the opportunity to provide feedback for stakeholder review. The BOC will provide updates to ATs, as well.
A recording of the kick-off meeting, as well as additional information and Frequently Asked Questions can be found on the CSG website.
The following pages outline some Frequently Asked Questions (FAQs) related to the Athletic Trainer Interstate Compact. The questions have been grouped in the following common categories:
Use the menu on the left to navigate through each of the categories.
For the latest updates and more information regarding the Athletic Trainer Interstate Compact please visit the Council for State Governments website.
Q: While most states recognize the BOC exam for those licensure applicants that are BOC-certified, some states have their own state exam that is given to applicants as well. How would this be handled in the compact?
A: This is yet to be determined.
Q: Is it true that as long as ATs are working with their own team/athletes, they are only held to their own state practice act, regardless of which state they travel to practice?
A: Typically ATs don’t need a license if traveling with a team, but you would need to comply with the state’s law in which you are traveling. Each state defines its own licensure requirements and exemptions, which varies state-to-state, on the amount of time a person may practice in a state without seeking licensure.
Q: Will the compact license ATs or just provide them the privilege to practice, and who decides that?
A: It is important to remember that states issue licenses and compact authorizations to practice (i.e. privileges to practice). Compact authorizations to practice provide the same benefits as licensure. Compacts are simply agreements between states about how those licenses and privileges are issued and regulated. The compact is still being developed, but ultimately, the members of the development teams and stakeholders in the profession will decide these and other issues related to the compact.
Q: Each state varies with its scope of practice, so which state practice act is the AT required to follow with the compact?
A: By practicing in a state using compact privileges, ATs will be required to follow the scope of practice, laws and rules/regulations of the state where you are practicing.
Q: Is the compact mandatory for ATs who do not travel or can they choose only to be licensed in a single state?
A: A regular state license is still required to practice in your home state. Obtaining compact privileges is optional, therefore is not required if an AT will not be practicing in other compact member states.
Q: What is the difference between a compact addressing ATs moving to a new state versus ATs traveling with their team/athletes/jobs?
A: ATs traveling with a team may be exempt from obtaining a license in a state in which their team is playing, as long as they are caring for their team’s athlete’s. ATs who move to the state will need to obtain a permanent license either through a regular license and/or a compact license.
Q: Does the compact allow for different state licensing or registering different endorsements, such as the Orthopedic Specialty mentioned on BOC’s website?
A: This is yet to be determined.
Q: Does an AT’s physician supervision follow them across state lines or will they need to establish physician oversight within each state?
A: This is yet to be determined.
Q: Can an AT work on a temporary license within the states if they change jobs within the compact states while waiting to get their license?
A: Compacts generally remove the need for temporary or provisional licensure because a compact authorization is legally equivalent to a license. Additionally, some compacts contain provisions allowing licensees to “transfer” their home state license if moving between member states.
Q: Where can draft legislation of the compact be found, along with a list of states that have passed, opposed or supported it?
A: Development of the AT Compact is in progress and all of this has yet to be determined.
Q: How does the compact apply to states like California, which are licensed through the Department of Education?
A: California does not have licensure and would not qualify to be part of the compact until the state enacts a state licensure law for athletic trainers. To be a compact member state, each state must have an existing licensure law for athletic trainers.
Q: How long will it take for the compact to be adopted by more than 50% of states after the initial phases are completed?
A: Typically compacts in occupational licensure must have 7-10 states participate to become active, however this has yet to be determined.
Q: Are states obligated to pass compact legislation?
A: States are not obligated to join a compact. Compact member states must be willing to pass compact legislation and abide by the legislative requirements imposed by the compact.
Q: When is the legislation likely to become an option for ATs?
A: Model legislation is expected to be ready for introduction for the 2026 legislation session.
Q: How can ATs find out if the compact is recognized by their state?
A: Licensees would be notified of the compact option.
Q: Will each state need to maintain the compact on an ongoing basis, or is it a one-and-done effort?
A: It is typically one-and-done.
Q: Is there inter-professional opposition to many compacts, and how is resistance from other professions handled?
A: The compact development teams (comprised of AT state regulators, professionals, and other stakeholders) are responsible for creating the policies contained in the compact’s model legislation. In nearly every interstate licensure compact, each member state retains authority over scope of practice. Further, states can’t force other states to change their scope of practice through the compact and states alone determine their respective practice acts. It is not a federal issue.
Because the compact is a piece of legislation, it is subject to public input. CSG will release the initial draft of the model legislation to the public as part of the stakeholder review process. During this time ATs, and any member of the public, can review the model legislation and provide feedback (including any potential inter-professional opposition). The compact development teams will review and incorporate feedback as appropriate. Further, as the legislation will be introduced in state legislatures, members of the public can voice their opinions about each individual bill.
Q: How many ATs are expected to utilize the compact, and how long is the wait for each state?
A: This is yet to be determined.
Q: Will the compact help ATs that are working internationally in the DHA/DoD?
A: The AT Compact is domestic only.
Q: Will ATs be required to pay licensure fees within each state or is there a single fee for the compact?
A: All compacts authorize member states to charge initial licensure and license renewal fees. Details regarding compact fees (how much and how often) have not been determined as the compact is still in development.
Q: Are additional CEUs required for this compact?
A: Typically, you will still be required to comply with any continuing education requirements for the license of your home state.
Q: Who monitors if an AT is practicing within the scope of practice and who can report it?
A: ATs will be required to follow the scope of practice, laws and rules/regulations of the state where you are practicing. The same complaint and discipline process applies.
Q: Have you established a fee for the compact and will the state board need to create an application process?
A: No. This has yet to be determined.
Q: Does this compact project solely focus on military spouses?
A: No.
Q: Will the compact also assist the professional licensing boards of each state in expediting and approving licensure?
A: Compacts reduce the application processing burden on licensing boards because member states can instantly verify through the shared compact data system that licensees and applicants for a compact authorization to practice have met uniform requirements.
Q: What can or should ATs do to help support the passing of the compact legislature?
A: During the compact development process, there will be opportunities for all stakeholders to provide input and feedback.
Q: Will state organizations receive support from this group for how to get the compact enacted in individual states?
A: Yes.
Q: Some states, like Texas, have a clause that allows out-of-state ATs to practice for an approved period of time without additional licensing requirements. How does the compact improve on that?
A: This limits the AT to care for only their team. If they were to have a compact license and Texas was part of that, they would be able to provide care to anyone.
We would like to recognize a BOC friend who recently passed away, Brad Sherman. Brad was instrumental in developing this conference in the beginning. To honor Brad and continue his legacy, we are renaming the CARE Conference to the BOC’s Brad Sherman Regulatory Conference. Brad was a lifelong servant to the athletic training profession. As a member of the BOC Board of Directors from 1986-1997 he served as the president of the organization from 1995-1997, as well as serving on the BOC’s Athletic Trainer Regulatory Conference Advisory Panel from 2004–2009. “Brad will be missed by many,” said Anne Minton, CEO of the BOC. “He was a longtime friend and mentor to the BOC staff and was a driving factor in our first BOC state regulatory conference.” In addition to being active with the BOC, Brad served as one of the charter members and founders of the Wisconsin Athletic Trainers’ Association (WATA) serving on numerous state committees and as a state representative to District 4 of the National Athletic Trainers’ Association (NATA). He received the WATA Distinguished Service Award in 1987 and he was a member of the NATA since 1993. Brad served from 1982 to 1988 on the NATA Research and Injury Committee and as the general chairperson for the NATA District 4 Annual Symposium in 1989 and 1996. Brad was inducted into the WATA Hall of Fame in 1997 and served as a member of the Wisconsin Athletic Trainers Affiliated Credentialing Board from 2001-2005. Click below to learn more information about Brad’s legacy.
In this tab you will find the Regulatory conference archives that date back to the 2019 conference. Click the links provided to view the PowerPoint presentation for that speaker.
The following program and conference materials were included in the 2024 conference, which was held July 9-10 in Omaha, Nebraska.
