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CSMAS proposes the expansion of independent medical care

During its meeting June 15-17 in Dallas, the Committee on Competitive Safeguards and Medical Aspects of Sports approved a series of recommendations that build on legislation passed by the NCAA’s five autonomy conferences earlier this year and would establish athletic trainers and team physicians as unchallengeable decision-makers for medical management and return-to-play decisions related to student-athletes. The recommendations would also create a new designated position on campuses – an athletics health care administrator – which would ensure campuses are following established best practices for medical care.

“Over the last three years, the committee has consistently worked to empower primary athletics health care providers and championed organizational structures that ensure independent medical care for student-athletes,” said CSMAS chair Forrest Karr, athletics director at Northern Michigan University. “These recommendations are another step in the process. We envision a future where each member institution, in all three divisions, will designate an athletics health care administrator responsible for ensuring that their school’s policies and procedures follow inter-Association consensus recommendations and comply with all NCAA health and safety legislation.”

The committee crafted its recommendations after closely reviewing legislation that was passed by the five autonomy conferences in Division I at the 2016 NCAA Convention. That legislation became effective Aug. 1 and provides unchallengeable autonomous authority to the primary athletics health care providers, the team physicians and athletic trainers to determine medical management and return-to-play decisions related to student-athletes. The remaining 27 conferences in Division I currently have the option of applying that legislation.

The CSMAS recommendations aim to shape the intent of that legislation into a consistent standard across college sports. To get there, CSMAS made three recommendations:

  • Encouraged leagues outside the autonomy conferences in Division I to apply the autonomous legislation passed in January. The recommendation asks that those conferences opt in to the legislation by Aug. 1, 2017.
  • Asked the Division I autonomous conferences to clarify the bylaw passed in January by changing the name of its oversight position – called a director of medical services in that legislation – to athletics health care administrator. The name change was requested out of concern that the position could be confused with the title of “medical director,” which is established elsewhere in NCAA bylaws.
  • Requested that Divisions II and III sponsor legislation similar to that passed by the Division I autonomous conferences to establish the athletics health care administrator position and provide team physicians and athletic trainers with unchallengeable autonomous authority to determine medical management and return-to-play decisions related to student-athletes. The committee stressed that the health care administrator role may be given to an existing staff member rather than create an additional administrative position.

CSMAS recommendations follow those from other organizations in recent years, which called for physicians and athletic trainers to have the ability to make medical decisions without fear of interference from coaches or other athletics personnel.

In 2014, the Journal of Athletic Training published inter-Association best practices, which were endorsed by the NCAA’s Sport Science Institute, that called for giving physicians and athletic trainers authority to make medical decisions for student-athletes. That document was published at a time when a national survey conducted by the Chronicle of Higher Education documented that athletic trainers report getting heavy pressure from coaches: Thirty-two percent of respondents indicated the head coach influences their hiring; 42 percent reported feeling pressured to return a concussed athlete to play early; and 52 percent reported feeling pressured to return injured athletes early.

Lacrosse headgear standard

As of May 2016, women’s lacrosse rules permitted soft headgear to be used, but there was not a standard to follow. Over the last 18 months, US Lacrosse has worked toward the development of a standard that was finalized in the summer of 2015. US Lacrosse requested the NCAA adopt a modification to the existing rule to recognize the standard and asked that CSMAS make a recommendation on the standard being added to the existing rules.

CSMAS recommended to the NCAA Women’s Lacrosse Rules Committee a language change in the women’s lacrosse rule book that would require any protective headgear worn in competition to meet a new women’s lacrosse headgear standard adopted by the American Society for Testing and Materials. The final decision on the recommended changes was made by the Women’s Lacrosse Rules Committee and approved by the NCAA Playing Rules Oversight Panel.

Drug-testing protocol changed

CSMAS approved a change in its championships drug-testing protocol to allow teams whose games begin after 10 p.m. to defer their drug tests until the next morning at the arena testing site as long as the tests start by noon. The protocol previously required tests to start by 10 a.m.

The decision was made after the committee considered a request from the Division I Men’s Basketball Committee. The committee felt it was important to update championship drug-testing protocol to provide more flexibility for schools and to allow additional rest for student-athletes.