2023 Maryland Statutes › Health Occupations › Title 14 - Physicians › Subtitle 5D - Athletic Trainers › Section 14-5D-11 - Supervision Required; Evaluation and Treatment Protocol

(a)    Nothing in this title may be construed to authorize an athletic trainer to practice except under the supervision of a licensed physician.
(b)    Before an athletic trainer may practice athletic training, the athletic trainer shall:
(1)    Obtain a license under this subtitle;
(2)    Enter into a written evaluation and treatment protocol with a licensed physician; and
(3)    Except as provided in § 14–5D–11.3(a) of this subtitle, submit an original, signed copy of the evaluation and treatment protocol for Board approval.
(c)    An evaluation and treatment protocol shall:
(1)    Describe the qualifications of the licensed physician and licensed athletic trainer;
(2)    Describe the physician supervision mechanisms that the physician will use to give direction to the athletic trainer;
(3)    Describe the treatment procedures the athletic trainer may perform;
(4)    Describe tasks the athletic trainer may not perform;
(5)    Describe specialized tasks the supervising physician is delegating to the athletic trainer to perform with documentation of competencies, certification, credentials, or any other requirements established by the Board to support the delegation of the specialized tasks;
(6)    Indicate whether the athletic trainer may accept outside referrals from nonsupervising physicians and other licensed health care practitioners;
(7)    Designate an alternate supervising physician, if appropriate or necessary; and
(8)    Contain an attestation that states the supervising physician will be responsible for providing ongoing and immediately available instruction that is adequate to ensure the safety and welfare of a patient and is appropriate to the setting.
(d)    An athletic trainer may accept an outside referral from a nonsupervising physician or licensed health care practitioner if:
(1)    The supervising physician specifies in the evaluation and treatment protocol that the athletic trainer may accept referrals from a nonsupervising physician or licensed health care practitioner;
(2)    The nonsupervising physician or licensed health care practitioner has seen the athletic individual and has written an order for the care of the athletic individual; and
(3)    The treatment procedures to be used by the athletic trainer are:
(i)    Within the scope of practice of an athletic trainer; and
(ii)    Included in the evaluation and treatment protocol that the athletic trainer has entered into with the supervising physician.
(e)    (1)    An athletic trainer may provide treatment for not more than 14 days to an athletic individual with an injury that affects job function or job–related activity unless the athletic trainer has received a referral from a health care provider licensed under this article other than under this subtitle to treat the individual.
(2)    For the purpose of paragraph (1) of this subsection, preventive care is not considered treatment.
(f)    Subject to the notice required under § 14–5D–11.2 of this subtitle, an athletic trainer may terminate an evaluation and treatment protocol filed with the Board under this section at any time.
(g)    (1)    In the event of the sudden departure, incapacity, or death of the primary supervising physician of an athletic trainer, or change in license status that results in the primary supervising physician being unable to legally practice medicine, an alternate supervising physician designated under subsection (c) of this section may supervise the athletic trainer for not longer than 15 days following the event.
(2)    If there is no designated alternate supervising physician or the designated alternate supervising physician does not agree to supervise the athletic trainer, the athletic trainer may not practice until the athletic trainer receives approval of a new evaluation and treatment protocol under § 14–5D–11.3 of this subtitle.
(3)    An alternate supervising physician or other licensed physician may assume the role of primary supervising physician by submitting a new evaluation and treatment protocol to the Board for approval under subsection (b) of this section.
(4)    The Board may terminate an evaluation and treatment protocol if:
(i)    The athletic trainer has a change in license status that results in the athletic trainer being unable to legally practice athletic training;
(ii)    At least 15 days have elapsed since an event listed under paragraph (1) of this subsection if there is an alternate supervising physician designated under subsection (c) of this section; or
(iii)    Immediately after an event listed under paragraph (1) of this subsection if there is no alternate supervising physician designated under subsection (c) of this section.
(h)    An athletic trainer whose evaluation and treatment protocol is terminated may not practice athletic training until the athletic trainer receives preliminary approval of a new evaluation and treatment protocol under § 14–5D–11.3 of this subtitle.
(i)    In the event of a sudden departure, incapacity, or death of a supervising physician, a designated alternate supervising physician may assume the role of the supervising physician by submitting an evaluation and treatment protocol to the Board within 15 days of the event.