A new Delaware law creates compliance requirements and fees for athletic trainers who serve clients in multiple states.
Most Delaware health services owners don't realize that HB285—a bill focused on athletic trainer licensing—contains a provision that directly affects how they can deploy staff across state lines and what it will cost to do so.
Here's what changed: Delaware has joined the Interstate Compact for Athletic Trainers, a multi-state agreement that allows licensed athletic trainers to practice in other member states without obtaining separate licenses in each one. But that convenience comes with a compliance requirement that many small practices haven't budgeted for.
Under § 2604A of the Compact Privilege provision in HB285, any athletic trainer employed by a Delaware health service who works across state lines must:
Complete a criminal background check. This is a one-time requirement, but it must meet the Compact's standards.
Hold qualifying credentials. The trainer's license must be in good standing in their home state (Delaware, in most cases). Any disciplinary action or license encumbrance can block or revoke Compact Privilege, potentially interrupting service delivery.
Pay per-state Compact Privilege fees. These are recurring costs. Each state where a trainer practices charges its own fee. For a practice with multiple trainers working in multiple states, these fees add up quickly and recur annually.
If your health service employs athletic trainers who:
• Travel to treat clients in neighboring states
• Work for multi-state organizations or sports teams
• Provide services at events held outside Delaware
• Work for clinics with satellite locations across state lines
—then HB285 applies to you. Even part-time or occasional cross-state work triggers the requirement.
The Compact takes effect upon enactment by the seventh Member State. Delaware's participation is now part of that compact. If your organization later decides the Compact Privilege arrangement no longer works for your business model, withdrawal requires 180 days' notice—meaning you cannot exit quickly if circumstances change.
Audit your current staffing model. Identify which athletic trainers currently work or may work across state lines. Calculate the total annual Compact Privilege fees for those trainers and all states where they practice. Build this into your budget as a recurring compliance cost.
Ensure your trainers understand that any license discipline in their home state will affect their ability to practice in other states under the Compact. Make this part of your hiring and performance management conversations.
Review your service contracts and client agreements if they reference multi-state service delivery. You may need to update language to reflect the new licensing framework.
The Compact Privilege is designed to reduce red tape, but it replaces one set of requirements with another. Understanding those requirements now will help you avoid compliance gaps and unexpected costs later.
For a detailed breakdown of Compact Privilege fees by state and a compliance checklist specific to your practice type, contact your state health services association or legal counsel familiar with Delaware healthcare regulations.