Maryland Code § HO-14-5D-11

Section HO-14-5D-11
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(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.

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