Can a Texas coach work as an athletic trainer without a license?

Plain-English summary

Texas licenses athletic trainers, the professionals who prevent and rehabilitate athletes' injuries, under V.T.C.S. article 4512d, overseen by the Advisory Board of Athletic Trainers within the Texas Department of Health. The department asked the Attorney General about people whose job title is "coach" but whose primary duties are working with or on injured athletes. Could such a person do athletic-trainer work without an athletic-trainer license?

The office said no. Section 8 of article 4512d says no person may hold themselves out as an athletic trainer, or perform any of the activities of an athletic trainer as defined in the act, without first getting a license (or a temporary license). The definition of "athletic trainer" (section 1(1)) covers carrying out the prevention or physical rehabilitation of athletes' injuries, including the use of "physical modalities" like heat, light, sound, cold, electricity, or mechanical devices.

The wrinkle was an older opinion. In 1971, Attorney General Opinion M-1012 had concluded that a coach whose profession is coaching, who is not compensated to perform athletic-trainer activities, and who does not hold himself out as an athletic trainer was exempt from article 4512d, and could use physical modalities on athletes as a necessary part of coaching. But that opinion rested on the version of section 8 that then prohibited performing athletic-trainer activities only "for compensation." In 1981 the Legislature deleted the phrase "for compensation" from section 8. The office reviewed the legislative history: the 1981 bill was meant to allow better training and regulation of athletic trainers, and a board witness testified that the reason for removing "for compensation" was to stop schools from having coaches do athletic-training work without paying or qualifying them as trainers.

Reading section 8 as amended, the office concluded that it now bars an unlicensed person from performing athletic-trainer activities regardless of pay. So whatever a person's official job title, they may not perform as an athletic trainer unless they are licensed or fall within one of the article's exemptions (section 1(4), which lists physicians, dentists, physical therapists, and others). Section 8 also still bars an unlicensed, non-exempt person from holding themselves out as an athletic trainer. The office overruled its earlier opinions (M-1012 and the two that relied on it, H-1306 (1978) and H-471 (1974)) to the extent they conflicted. It noted two questions of fact it could not resolve in an opinion: whether a particular coach who does athletic-training work as part of coaching and is paid for coaching is "compensated" for the trainer activities, and whether a coach could perform medical acts delegated by a physician under the Medical Practice Act (article 4495b, section 3.06(d)(1)).

Currency note

This opinion was issued in 1996. Subsequent statutory amendments, court decisions, or later AG opinions may have changed the analysis. Treat this page as historical context, not current legal advice. Verify current law before relying on any specific rule, deadline, or remedy mentioned here.

This opinion construed V.T.C.S. article 4512d and the Medical Practice Act (V.T.C.S. article 4495b) as they stood in 1996. Both have since been recodified (athletic-trainer regulation and the Medical Practice Act now live in the Occupations Code), the regulating bodies have been reorganized, and licensing requirements have changed. Read this page for the office's 1996 reasoning that the 1981 deletion of "for compensation" ended the unpaid-coach exemption, and verify the current statutes, rules, and regulating agency before relying on any specific section number here.

What the opinion meant at the time

For coaches doing athletic-training work: The opinion meant a coach who performed the activities of an athletic trainer needed an athletic-trainer license, even if the coach was not paid specifically for the trainer work. The earlier rule allowing uncompensated coaches to do trainer work no longer applied after the 1981 amendment.

For school districts and universities employing coaches: The opinion meant an employer could not avoid the licensing requirement by giving an athletic trainer's duties to someone titled "coach." Whatever the job title, the person had to be a licensed athletic trainer or exempt to perform trainer activities.

For licensed athletic trainers and the board: The opinion reinforced that athletic-trainer activities were reserved to licensed or exempt persons, who were subject to the board's rules on continuing education, conduct, and discipline.

For lawyers: The opinion turns on the 1981 deletion of "for compensation" from article 4512d, section 8, draws on the bill's legislative history, and overrules the compensation-based exemption recognized in M-1012 (1971) and the opinions following it (H-1306, H-471) to the extent inconsistent. It expressly left two matters as fact questions outside the opinion process.

Common questions

Did a Texas coach need an athletic-trainer license to work on injured athletes?
Yes, if the coach was performing the activities of an athletic trainer. The office concluded section 8 of article 4512d barred an unlicensed, non-exempt person, including a coach, from performing athletic-trainer activities.

Did it matter that the coach wasn't paid extra for the training work?
No, not after 1981. The earlier opinion (M-1012) had allowed uncompensated coaches to do trainer work, but it relied on the phrase "for compensation" in section 8, which the Legislature deleted in 1981. After that, pay was no longer the dividing line.

What about coaches who are exempt?
Article 4512d, section 1(4) lists exemptions (for example, physicians, dentists, and physical therapists). A person who falls within an exemption could perform the listed activities without an athletic-trainer license. The office did not decide whether any particular coach was exempt.

Did the office overrule its earlier opinions?
Yes, to the extent they conflicted. The office reconsidered Attorney General Opinion M-1012 (1971) and the two opinions that had cited it, H-1306 (1978) and H-471 (1974), in light of the 1981 amendment.

Background and statutory framework

V.T.C.S. article 4512d licenses athletic trainers through the Advisory Board of Athletic Trainers. Section 1(1) defines an athletic trainer as a person with specific qualifications who, on the advice and consent of a team physician, carries out the prevention or physical rehabilitation of athletes' injuries, using physical modalities such as heat, light, sound, cold, electricity, or mechanical devices. Section 8 bars any person from holding themselves out as an athletic trainer, or performing any of the activities of an athletic trainer, without a license or temporary license. Section 9 sets the qualifications for a license, and section 1(4) lists exemptions. The board's rules add education and certification requirements (25 T.A.C. section 313.5) and continuing-education, conduct, and discipline rules.

Attorney General Opinion M-1012 (1971) had read section 8, which then prohibited performing trainer activities only "for compensation," to exempt an uncompensated coach who did not hold himself out as an athletic trainer. In 1981 the Legislature deleted "for compensation" (Act of June 1, 1981, 67th Leg., R.S., ch. 437, § 2), with the stated purpose of allowing better training and regulation of athletic trainers; the legislative history reflected concern that schools were having coaches do athletic-training work without qualifying them as trainers. The office concluded the deletion removed compensation as the test, so an unlicensed, non-exempt person cannot perform athletic-trainer activities regardless of pay, and it overruled the contrary parts of M-1012, H-1306, and H-471. The office also declined, as fact questions outside the opinion process, whether a coach paid for coaching is "compensated" for trainer activities and whether a coach may perform physician-delegated medical acts under the Medical Practice Act (V.T.C.S. article 4495b, section 3.06(d)(1)).

Citations

Statutory and regulatory provisions discussed:

• V.T.C.S. article 4512d (athletic trainers), including section 1(1) (definition and physical modalities), section 1(4) (exemptions), section 8 (license required to perform or hold out as an athletic trainer), and section 9 (license qualifications)
• 25 T.A.C. section 313.5 (board education and certification requirements); board rules on continuing education, conduct, and discipline
• Act of June 1, 1981, 67th Leg., R.S., ch. 437, § 2 (1981 amendment deleting "for compensation" from section 8)
• V.T.C.S. article 4495b, section 3.06(d)(1) (Medical Practice Act; physician delegation) (noted as outside the question presented)

Cases discussed:

• Attorney General Opinions M-1012 (1971), H-1306 (1978), and H-471 (1974) (reconsidered and overruled in part)

No cases were cited in this opinion.

Source

• Landing page: https://www.texasattorneygeneral.gov/opinions/dan-morales/dm-0388
• Original PDF: https://www.texasattorneygeneral.gov/sites/default/files/opinion-files/opinion/1996/dm0388.pdf

Original opinion text

Best-effort transcription from a scanned PDF. Minor errors may remain (including footnote numbering; one inserted footnote within a quotation was not legible and is omitted) — the linked PDF is authoritative.

Office of the Attorney General
State of Texas

DAN MORALES
ATTORNEY GENERAL

April 30, 1996

David R. Smith, M.D.
Commissioner
Texas Department of Health
1100 West 49th Street
Austin, Texas 78756-3199

Opinion No. DM-388

Re: Whether, without being licensed as an athletic trainer under article 4512d, V.T.C.S., a coach may have as his or her primary job responsibility working with or on injured athletes and a related question (RQ-845)

Dear Dr. Smith:

You request that we consider V.T.C.S. article 4512d, which pertains to athletic trainers, to determine whether a coach may perform the activities of an athletic trainer without obtaining a license from the Advisory Board of Athletic Trainers (the "board"). You indicate that the board and the Texas Department of Health, of which the board is a part, have encountered individuals whose job title is "coach," but whose primary job responsibilities involve working with or on injured athletes, rather than coaching. You believe that these coaches thus may be performing duties included in the definition of the term "athletic trainer" in article 4512d, V.T.C.S.

Article 4512d, section 1(1) describes an athletic trainer as "a person with specific qualifications . . . who, upon the advice and consent of his team physician[,] carries out the practice of prevention and/or physical rehabilitation of injuries incurred by athletes." An athletic trainer is authorized to use "physical modalities" such as: "heat, light, sound, cold, electricity, or mechanical devices related to rehabilitation and treatment." V.T.C.S. art. 4512d, § 1(1). Article 4512d, section 8 provides as follows:

No person may hold himself out as an athletic trainer or perform any of the activities of an athletic trainer as defined in this Act without first obtaining a license or a temporary license under this Act.[1]

Article 4512d, section 9 requires an applicant for an athletic trainer license to meet one of the following three qualifications:

(1) have met the athletic training curriculum requirements of a college or university approved by the board and give proof of graduation . . . ;

(2) hold a degree or certificate in physical therapy and have completed a basic athletic training course from an accredited college or university, and have completed an apprenticeship of 720 hours in two years under the supervision of a licensed athletic trainer acceptable to the board or upon board approval . . . ; or

(3) hold a degree in corrective therapy with at least a minor in physical education or health which included a basic athletic training course and meet apprenticeship or any other requirement established by the board.

The board requires an applicant for licensure as an athletic trainer to have a baccalaureate or postbaccalaureate degree with a major in athletic training or sports medicine. 25 T.A.C. § 313.5(b)(1)(A). In the alternative, an applicant may have a baccalaureate or postbaccalaureate degree, have completed the requisite number of semester hours in courses such as human anatomy and physiology, kinesiology, and athletic training, and have apprenticed in an athletic training program that meets the board's standards. Id. § 313.5(b)(1)(B). Furthermore, every applicant for licensure must be certified in either cardiopulmonary resuscitation or emergency medical services. Id. § 313.5(c).

In Attorney General Opinion M-1012 this office concluded that an individual whose profession or occupation is coaching, who is not compensated to perform the activities of an athletic trainer, and who does not hold him- or herself out as an athletic trainer is exempted from article 4512d. Attorney General Opinion M-1012 (1971) at 3. Thus, an athletic coach who is compensated for coaching and who does not hold him- or herself out as an athletic trainer may "use physical modalities on athletes as a necessary activity in the performance of [the coach's] duties." Id.

The conclusion of Attorney General Opinion M-1012 relies on section 8 of article 4512d, which, at the time this office issued the opinion, prohibited any person from holding "himself out as an athletic trainer or perform[ing], for compensation, any of the activities of an athletic trainer" without first obtaining a license under article 4512d.[3] Id. at 2 (emphasis added). In 1981, as you point out, the legislature amended article 4512d, section 8 to delete the phrase "for compensation." See Act of June 1, 1981, 67th Leg., R.S., ch. 437, § 2, 1981 Tex. Gen. Laws 1856, 1856. You therefore question the continued validity of Attorney General Opinion M-1012 and two opinions that cited Attorney General Opinion M-1012, Attorney General Opinions H-1306 (1978) and H-471 (1974).

The 1981 amendments to article 4512d were intended "to allow better training and better regulation of the athletic trainers." House Comm. on Health Services, Bill Analysis, H.B. 1689, 67th Leg., R.S. (1981). Among other things, House Bill 1689 proposed to authorize the board to impose continuing education requirements on athletic trainers. See id.; see also 25 T.A.C. § 313.9(a).

During a public hearing before the House Committee on Health Services, a witness testifying on behalf of the board indicated that the reason the bill proposed to remove the phrase "for compensation" was to disallow coaches from performing as athletic trainers. Hearings on H.B. 1689 Before the House Comm. on Health Services, 67th Leg., R.S. (Mar. 30, 1981) (testimony of Sparky Stephens, representing the board) (tape available from House Video/Audio Services Office). The witness stated, "A lot of [school districts and universities] are hiring . . . coaches, and [the coaches are] doing the athletic training work, but [the employing school districts and universities are] not paying [the coaches] as [athletic trainers]." Id. According to the witness, a coach is more likely than an athletic trainer to miss the fact that an athlete is injured. Id.

A second witness also addressed the proposed deletion of the phrase "for compensation." See id. (testimony of Al Wilson, athletic trainer for Killeen High School). According to this witness, a school district must select coaches from among its faculty, which may mean, for example, that a business teacher coaches a team. See id. Thus, the witness pointed out, not all coaches studied physical education in college; indeed, according to the witness, some coaches have had absolutely no training in physical education. Id.

By deleting the phrase "for compensation," the legislature apparently intended to preclude an individual from performing any of the activities of an athletic trainer unless the individual is licensed as an athletic trainer, regardless of whether the individual is compensated for performing athletic trainer activities. Disallowing an individual who is not a licensed athletic trainer from performing athletic trainer activities is consistent with the legislature's stated purpose for the 1981 bill to allow better training and better regulation of athletic trainers. Even a coach who is not licensed as an athletic trainer but who performs the activities of an athletic trainer does so with little, if any, training, unless the coach has received appropriate training as part of his or her college or postgraduate education or on his or her own. Furthermore, if a coach may perform as an athletic trainer without a license, the coach is not subject to the board's rules governing athletic trainers. See V.T.C.S. art. 4512d, § 5(c); 25 T.A.C. §§ 313.13, .15, .16 (prescribing continuing education requirements, guidelines for conduct, and procedure for discipline).

We therefore conclude that article 4512d, section 8 prohibits an individual who is not a licensed athletic trainer from performing "any of the activities of an athletic trainer," even though the individual is not compensated to perform as an athletic trainer.[4] Thus, whatever an individual's official job title, the individual may not perform as an athletic trainer unless he or she is licensed as an athletic trainer or is exempt from article 4512d. See V.T.C.S. art. 4512d, § 1(4) (listing exemptions). Of course, section 8 also prohibits an unlicensed, nonexempt individual from holding him- or herself out as an athletic trainer. To the extent they are inconsistent with this opinion, Attorney General Opinions H-1306, H-471, and M-1071 are overruled.[5]

SUMMARY

Article 4512d, section 8, V.T.C.S., prohibits an individual, including a coach, who is not a licensed athletic trainer from performing as an athletic trainer, even though the individual is not compensated to perform as such. Section 8 also prohibits such a coach from holding him- or herself out as an athletic trainer. To the extent they are inconsistent with this opinion, Attorney General Opinions H-1306 (1978), H-471 (1974), and M-1071 (1971) are overruled.

DAN MORALES
Attorney General of Texas

JORGE VEGA
First Assistant Attorney General

SARAH J. SHIRLEY
Chair, Opinion Committee

Prepared by Kymberly K. Oltrogge
Assistant Attorney General

[1] You ask only about a coach who performs the activities of an athletic trainer; you do not ask about a coach who holds him- or herself out as an athletic trainer. Accordingly, we assume that the coaches about which you ask do not hold themselves out as athletic trainers.

[3] The opinion noted that athletic coaches are not specifically exempt from article 4512d along with physicians, dentists, physical therapists, and others. Attorney General Opinion M-1012 (1971) at 2; see V.T.C.S. art. 4512d, § 1(4).

[4] Whether a coach who performs the activities of an athletic trainer as part of his or her coaching and who is compensated for coaching is actually compensated for performing the activities of an athletic trainer is a question of fact that is inappropriate to the opinion process. See, e.g., Attorney General Opinions DM-98 (1992) at 3, H-56 (1973) at 3, M-187 (1968) at 3, O-2911 (1940) at 2.

[5] You do not ask whether, pursuant to section 3.06(d)(1) of the Medical Practice Act, V.T.C.S. article 4495b, a coach may perform medical acts that a treating physician has delegated to the coach. Section 3.06(d)(1) authorizes "a person licensed to practice medicine" . . . . Whether, for purposes of V.T.C.S. article 4495b, section 3.06(d)(1), a coach is a "qualified and properly trained person" who may perform medical acts under a physician's supervision is a question of fact that is inappropriate to the opinion process. See, e.g., Attorney General Opinions DM-98 (1992) at 3, H-56 (1973) at 3, M-187 (1968) at 3, O-2911 (1940) at 2. We also do not consider whether a coach's performance of the delegated act under section 3.06(d)(1) violates any other statute. See V.T.C.S. art. 4495b, § 3.06(d)(1).