Medical Coverage to Meet the Increasing Needs/CHANGES in

California Community College Athletics

Alison Aubert MS, ATC

CCCATA PresidentAthletic Trainer, Solano College

Wendy Holt MA, ATC, CSCSAthletic Trainer, Diablo Valley College

Annie Martin MA, ATCAthletic Trainer, Los Medanos College

Warren Voyce MS, ATCAthletic Trainer, Foothill College

A Resource Allocation Proposal

California Community College Athletic Trainers’ Association (CCCATA) Statewide organization involved in providing the CCCAA

with information and recommendations for the development of policy and procedure in regards to the medical care of CCCAA Athletics

We are governed by : NATA (National Athletic Trainers Assoc)

CATA (California Athletic Trainers Assoc)

CCCAA (California CC Athletic Trainers Assoc)

Medical Guidelines (Bylaw 9) Contests and Seasons of Sport (Bylaw 3) http://www.cccaasports.org/services/constitution

Who are we?

Purpose:

To provide information to athletic administrators and athletic trainers about the increased need for medical coverage in California Community College athletics

Inform and EducateNew Interpretation of Legislation

Support AthleticsVoice for athletes, coaches and programs

Protect CollegesDecrease risk and liability

Provide Action Steps for Colleges to Consider

Why are we here?

Goals:

CCCAA has unanimously decided that Bylaw 9 (Medical Policies) applies to all sanctioned CCCAA contests including traditional season games, traditional season scrimmages, and non-traditional season scrimmages

Bylaw 3 (Contests and Seasons of Sport) establishes “TRADITIONAL” and “NON-TRADITIONAL” seasons of sport

Represents a Legal Duty for ATC to be present at defined events

These seasons now compete over 12 MONTHS (August 15th through 20 days of July) vs. 4-5 month traditional season. Establishes a period for colleges to provide athletic training

services.

What are the increasing needs?

Non-traditional seasons forMen’s BasketballMen’s Water PoloWomen’s Water Polo

Intercollegiate courses forFootball Baseball BadmintonGolfSoccer Softball Wrestling TrackVolleyball Swim/Dive X Country TennisWomen’s Basketball

Gap of Coverage June / July for Colleges with 10 month ATC position

Medical Services 30%Risk Minimization 30%Organizational/Administrative 20%Influence on Academic Success 10%Cost Containment 10%

VALUE OF YOUR ATHLETIC TRAINER

Reference: NATA

Injury Evaluation and TreatmentInjury Rehabilitation and ReconditioningOutside Medical Provider ServicesTeam Physician ServicesDiagnostic TestingInjury prevention programsAncillary medical services PREVENTION,

EVALUATION Re-Evaluations, TREATMENT, REHABILITATION,

PPE: Orthopedic, FMS, Gen Med.General Prevention: Orthopedic, GEN MED,

Nutritional, etc..

MEDICAL SERVICES 30% What we do. . .

Injury Prevention & Care PoliciesFirst Responder for home and visiting teamsEmergency Action PlansFacilitate PPEs (Physical Exams)Safe Facilities Create/Maintain appropriate medical referral systemDesign and application of preventive and post-injury

taping, bracing and paddingMake appropriate play/no-play decisions First Aid/CPR trainingPractice/event care and coverageUsing communication and interpersonal skills to create

trust between student-athletes, coaches, administrators and the athletic training staff

What we do . . . RISK MINIMIZATION 30%

Protective Equipment selection, fitting & useRecommendations for sport rule changesInfection controlBudget management to provide adequate

resources to purchase risk reduction suppliesEnvironmental monitoringFunctional movement assessments

/Assessment of pre-existing conditionsMental Health Counseling referralsNutrition suggestions and referral

RISK MINIMIZATION Con’t.

Injury and Evaluation recordsPhysical therapy program reviews and data

basePre-participation examination (PPE)Sports Medicine Team relationsEmergency Action Plans (EAPs) Insurance Quality ControlRisk Management Education

ORGANIZATIONAL/ ADMINISTRATIVE VALUE 20%

Student RetentionLife SkillsConditions Affecting Learning/Psychological issues

Counseling

How we help. . .ATC’S INFLUENCE ON ACADEMIC SUCCESS 10%

Insurance PremiumsStaffing and Workload Management

Medical Services

Budget ManagementAcademic SuccessContracts

How we help . . . COST CONTAINMENT 10%

Collection and review of physical forms?District liability forms?Declares medical eligibility?Medical emergencies?Non-emergency injury evaluation & treatment?Medical care during non-traditional games,

conditioning? Insurance claims and processing?Concussion legislation protocols?

COACHES . . . . . ? ATHLETIC DIRECTORS. . . .?NOBODY . . . . ?

When the ATC is gone in June & July, WHO takes take of . . .

We have found that Community Colleges that offer:Prevention of Injury techniques Sports Medicine Team (physicians that

volunteer services)Have multiple ATC’s on staffOffer rehabilitation/ Physical Therapy on site

…saves in Athletic Insurance costs.Which might…PAY for another ATC on

staff

Athletic Insurance Savings

• Injury evaluation (consultation) 99215 $269 for 40 min

• Ultrasound 97035 $195 up to 15 min

• Electrical stimulation (unattended) G0283 $75

• Joint Mobilization (manual therapy) 97140 $75

• Soft Tissue Mobilization 97001 and 02 $50

• Gait analysis 97002 $50 97003 and 04 after 15 min $75

• Therapeutic Exercise (dry land ) 97110 $75

• Therapeutic Exercise (water) 97112 $75

• Moist Hot Pack• Cold therapy• Therapeutic Modality $50

Services provided by in-house ATCs produce no costs to insurance

Costs of out sourcing medical services in June and July?COST CONTAINMENT EXAMPLE: OUTSOURCED UTILIZING COLLEGE INSURACE POLICY

Schools address this issue in several ways:Limit hours the teams can participate to

decrease needPay overtime to pay certified AT for needed

nights and weekends (use this money to hire an additional ATC)

Offer Comp time for overtime hours worked (difficult for most ATC’s to use, since they are needed on holidays, breaks, and summer…especially 10 month ATC’s).

Burn Out is very common due to the 50+ hours per week needed when there is only one ATC on staff, with No breaks all year long.

Overtime Issue

PAIRING THE INSTITUTION’S NEEDS WITH THE VALUE OF A CETIFIED ATHLETIC TRAINER!

CCCATA RecommendationsAction Steps• Increase classified ATC’s from 10 month position

to to 12 month position.

• Increase number of ATC’s for proper care. • Look at part time positions ($ 35 +pay rate per

hour) used to pay assistants. • Increase supply budgets to meet increased

demands• Work with athletic directors, coaches to ensure

appropriate scheduling of events to allow for necessary coverage within the resources allocated

# of high risk sports offered NATA STUDY FOR APPROPRIATE MEDICAL CARERealizing that we are not NCAA programs…

we suggest appropriate medical care (ATC positions, for coverage only/not including educational component) should be:

Components which affect this coverage

1.5 AT’S Small-Athletics Programs- < 75 participants (1-5 teams)

2-2.5 Medium- Athletics Programs- 75-200 participants (5-12 teams).

2.5 TO 5 Large- Athletics Programs- > 200 participants (12-20+teams).

COMPETITORS = Athletes recorded on Form 3 PARTICIPANTS = Form 3, red / grey shirts, cuts, quit etc.NOTE: 1 ATC = one full time 12 month position,

.5 = a half of full time position (ex. 20 hours per week)

Proper Care for Athletes bySize of Programs

FALL SPORTS COMPETITOR/ PARTICIPANT TOTAL

FOOTBALL 74/34 108 VOLLEYBALL 11/ 9

20 SOCCER 21/4

25 MENS XC14/4 18 WOMENS XC 8/ 0 8 MENS POLO 21/3 24 WOMEN S POLO 12/6 18 MEN BASKETBALL 12/7 19 WOM BASKETBALL 12/5

17

TOTAL 185/72 257

TOTAL 444 Athletes=

BASEBALL 24/16 40

SOFTBALL 12/1 13

MENS TENNIS 11/4 15

WOMENS TENNIS 6/3 9

MENS TRACK/FIELD 28/6 34

WOMEN TRACK/FIELD 9/10 19

MENS SWIM/DIVE 27/4 31

WOMENS SWIM/DIVE 20/6 26

TOTAL 137/50 187

*One -10 month ATC with Part Time ATC at 40%

Example Sports/AthletesREFERENCE DVC 2013-2014 statistics

SPRING SPORTS COMPETITOR /PARTICIPANT TOTAL

We all agree that Athletics is a positive addition to all Campuses!

We hope to educate you on the Risk and how to Manage the Risk within Athletics.

We offer assistance in to any program that needs additional ATC staff

These are low costs changes that will protect the liability of the college, ensure a safe and secure environment for our athletes, and assure parents that their children are cared for.

Conclusion

We are educating the public on what we do