The AT Compact: From Milestone to Momentum
For Athletic Trainers (ATs), practicing across state lines has historically meant navigating individual state licensure requirements. While state regulation remains important for protecting the public and regulating athletic training practice, the profession has become increasingly mobile.
ATs may provide event coverage, relocate for employment, support patients across geographic boundaries or pursue professional opportunities in multiple states. The AT Compact project was initiated to help address some of these challenges by providing a pathway for eligible ATs to practice in participating states through a compact privilege, while maintaining state regulatory authority.
From development to implementation
The AT Compact was developed through collaboration among the Board of Certification for the Athletic Trainer (BOC), the Council of State Governments (CSG), the U.S. Department of War and other allied groups. The development process included input from ATs, state regulators, state boards and agencies, attorneys, and other organizations such as the National Athletic Trainers’ Association (NATA).
Model legislation became available to states in 2025, providing a framework for states to consider joining the compact beginning with the 2026 legislative session.
In May 2026, the AT Compact reached a key milestone when seven states—Alabama, Iowa, Kansas, Kentucky, Nebraska, South Dakota and Virginia—enacted the compact legislation. Seven states is the minimum number required to activate the compact and begin the operationalization process. Since then, the AT Compact has reached double digits, further expanding its foundation for interstate practice.
Reaching the activation threshold represented an important transition. Since then, the work has shifted from establishing the compact in law to developing the rules, systems and processes needed to administer it.
What happens next?
The AT Compact commission will lead the compact’s implementation and administration phase. The commission’s work will include several foundational areas. The commission meets in November, providing an important opportunity to advance this work.
Developing rules and regulations
One of the commission’s first priorities is establishing the rules and regulations that will guide how the compact operates. These rules will translate AT Compact legislation into the operational framework needed to administer compact privileges consistently across participating states. They will address important processes related to eligibility, compact privileges, participation and other aspects of administering the AT Compact.
Building the data system
The AT Compact will also require a coordinated data system to support information exchange among participating states. The system will help states and the commission verify licensure information and share relevant regulatory information needed to administer compact privileges. It will also support the sharing of information related to adverse actions and other matters important to public protection.
While much of this work will occur behind the scenes, the data system will be an important part of creating a functional multistate practice system.
Establishing goals and resources
As implementation progresses, the commission will establish goals and priorities for the compact and develop the resources and processes needed to support participating states, regulators and ATs.
This includes determining how the compact will function in practice, communicating requirements and expectations, and providing resources to help stakeholders understand and use the system.
Implementation will take time. BOC currently anticipates an approximately 18- to 24-month operationalization period, with compact privileges potentially beginning to be issued as early as late 2027 or early 2028.
What could the AT Compact mean for ATs?
The AT Compact is intended to give eligible ATs greater flexibility for interstate practice while maintaining state sovereignty. Greater professional mobility could make it easier for ATs to practice in participating states without obtaining a separate traditional license in each state. This could benefit ATs who live or work in border cities, travel for work, provide event coverage or pursue employment and other professional opportunities across state lines.
The compact could also support continuity of care and emerging models of practice, including certain forms of digital health, where permitted by state law. For employers, a more mobile workforce could provide greater flexibility when hiring or deploying ATs across participating states. The compact may also reduce some of the administrative burden associated with maintaining multiple state licenses by creating a shared framework and system for eligible ATs practicing across state lines.
At the same time, the AT Compact does NOT create a national athletic training license or eliminate state regulation. An AT practicing under a compact privilege must follow the laws, rules and scope of practice of the state in which the AT is practicing. Participating states retain authority to regulate athletic training within their jurisdictions.
Supporting awareness state by state
As the AT Compact moves toward implementation, awareness, education and continued state participation will remain important. To continue support for the AT Compact, free state-specific AT Compact fact sheets are now available to download in an 8.5×11” PDF format.
The resources are designed for ATs, state regulators, state associations and others who want to learn more about the compact or help raise awareness in their state. ATs can use these fact sheets to understand the compact’s status in their state and share information with colleagues, employers, regulators and others.
The BOC AT Compact website provides the general and state-specific AT Compact fact sheets.
Looking ahead
Reaching the minimum number of states needed to operationalize the AT Compact was an important step. The next phase will focus on turning the compact’s legislative framework into a functioning system. The November commission meeting will be a major milestone as the commission begins its work on rules and regulations, the data system and other operational priorities.
Additional states may also enact the AT Compact legislation, expanding the number of jurisdictions where eligible ATs could eventually use compact privileges. For ATs, staying informed about the AT Compact and its status in their state will be important as implementation progresses. BOC will continue to provide updates and resources as more details become available.
The AT Compact represents a new approach to supporting interstate mobility while maintaining state regulatory authority. The work now underway will help determine how that framework functions in practice and, ultimately, how it may support ATs, employers and the patients they serve.
Additional information on AT Compact status and Frequently Asked Questions is available on the BOC AT Compact website or the AT Compact website.
