APPENDIX A

System Worksheet and Narrative

 

Application of the Health Care Unit system

 

 

NATA’s Recommendations and Guidelines for Appropriate Medical Coverage of Intercollegiate Athletics (Revised) offer college and university health care providers a system by which they can evaluate their current level of coverage for student-athletes. These recommendations have been created for the safety of student-athletes competing at the collegiate level. To that end, certified athletic trainers in these settings must have a thorough understanding of the recommendations before implementing the system.

 

Constants:  The following remain constant throughout the system regardless of the size of your program or the level of competition:

 

Ø      The estimated health care load for one ATC is 12 health care units (HCU). However, the institution may adjust this.

 

Ø      Each sport has an assigned base Health Care Index (HCI) value derived from injury rates (IR) for both time loss and non-time loss injuries, and the treatments associated with those injuries (Table 1).

 

Ø      Each sport has an assigned base HCI value to represent the risk of catastrophic injury (Table 3).

 

Ø      Full-service athletic training rooms should have a certified athletic trainer present during institution-declared hours of operation.

 

Variables:  Variable items affecting HCU totals that can be added (or omitted) at the discretion of the institution are:

 

Ø      Travel

 

Ø      Administrative Duties

 

Consider using these variables as negotiation points. For instance, after having applied the system at your institution, you determine that two additional ATCs (24 health care units) are needed in order to deliver appropriate medical coverage. Your administrator states that, at this time, you will only receive one additional staff member.  You can suggest reducing the length/vigor of non-traditional seasons, reducing squad size, eliminating travel requirements or reassigning time-consuming administrative duties to other areas. This would reduce total healthy care units, thus ensuring appropriate medical coverage.
 

Application of the System

 

  1. The Health Care Index for each sport is listed on the System Worksheet (Table 4), which will be used to calculate the total health care needs of your institution. Disregard those sports not offered at your institution. (Refer to Table 2 for the examples provided.)

 

  1. The load for an institution is not only based on the sports offered and their respective HCI, but on the actual athlete exposures, which is a function of squad size and number of practice/competitions. In Column C place the number of days (practices/competitions) for a given team. This number should reflect the number of days team members are active, both during the traditional and non-traditional seasons. (Depending on the perceived risk of injury, institutions may also wish to account for skill instruction sessions).  In Column D place the number of athletes on the roster for that team. Column E represents the total number of athlete exposures for a sport, which is derived by multiplying exposures (Column C) by the number of athletes (Column D).

 

Example:

 

Women’s soccer practices/competes for 132 days (based on allowable traditional + non-traditional practice days for NCAA Division I soccer) and has 30 athletes. Therefore, women’s soccer has 3,960 total exposures.

 

  1. Next, divide the total exposures (Column E) by 1,000 to obtain the exposure modifier and then place this value in Column F.

 

 

Example:

 

From above, women’s soccer has 3,960 total exposures, so the modifier is 3.96 when divided by 1,000 (rounded to 4.0 in the Sample Worksheet).

 

  1. The value in Column E now represents the HCI modifier for that sport at that institution. The value in Column F is then multiplied by the HCI in Column B to calculate the actual health care load for that sport. The institution adjusted HCI value is then placed in Column G.

 

Example:

 

The exposure modifier for women’s soccer from Column F is 4.0. This means that 4 times the number of exposures will actually occur in this sport than what is calculated in the base HCI. The base HCI for women’s soccer (Column B) is therefore multiplied by this value (Column F), to obtain the adjusted HCI for that sport (2.6 x 4.0 = 13.9). This value is then placed in Column G.

 

  1. Because the number of allowable participation days prevents sports from being actively engaged throughout the entire year, the unit values in Column G are too high to reflect the true health care demands of that sport. The assumption is made that the health care professional is providing care for that sport’s athletes for half of the year. Therefore, the value in Column G is divided by 50% (Column H) resulting in a new adjusted HCI/year (Column I). (The proportion in Column G should be adjusted by individual institutions if they anticipate that the sport will be actively engaged more or less than 50% of the year.)

 

 

Example:

 

Continuing with our example, women’s soccer has an adjusted HCI of 13.9. Half of 13.9 is 6.9 HCI/year.

 

  1. The last adjustment for each sport is to add in anticipated travel responsibilities. One (1) unit is assigned for every 20 days of travel or a portion thereof.

 

Example:

 

The adjusted HCI/year for women’s soccer is 6.9. The team travels 20 days, so the new value for women’s soccer is 7.9.

 

  1. Add all adjusted health care units (Column K) to determine a SUBTOTAL of health care units for the institution.

 

  1. Next list administrative duties carried out by the health care staff and assign each a value based on the time requirement for that duty. Remember, for an administrative duty to receive 3 units, it must account for 25% of the ATC’s total work time in a given year. (1 unit = 8.33%)

 

  1. Add all administrative units together.

 

  1. Add the administrative units to the health care unit subtotal.  This number represents the TOTAL health care units expended by the institution.

 

  1. Divide the total health care units by 12 (the recommended allowable load for one ATC). This value represents the number of full-time ATC equivalents needed to provide appropriate medical coverage for student-athletes at the institution.

 
 

Table 1:  Base Health Care Index by Sport

 

Sport                             IR               TX/I           IR*TX/I                HCI

 

Baseball                                  19.3                 11.5                    222                           1.7

Basketball-M                           29.3                 11.0                    322                          2.4

Basketball-W                           32.4                 16.3                    528                          4.0

Crew-M                                     7.2                 12.9                      93                           0.7

Crew-W                                   22.0                 13.0                    286                           2.2

Cross Country-M                    21.7                   8.6                    187                           1.4

Cross County-W                      23.7                   9.4                    223                           1.7

Fencing-M                               15.7                 16.2                    254                           1.9

Fencing-W                               24.1                 12.6                    304                           2.3

Field Hockey                           34.8                 10.8                    376                           2.8

Football                                    42.5                   9.7                    412                           3.1

Golf-M                                        6.5                   9.8                      64                           0.5

Golf-W                                      13.8                 11.0                    152                           1.2

Gymnastics-M                         29.0                 16.8                    487                           3.7

Gymnastics-W*                       48.1                 27.9                 1342                            4.0

Ice Hockey-M                          33.9                   7.2                    244                           1.8

Ice Hockey-W                          12.3                 10.7                    132                           1.0

Indoor Track-M                       31.9                 11.4                   364                            2.8

Indoor Track-W                       32.3                 11.8                    381                           2.9

Lacrosse-M                             23.9                 10.0                    239                           1.8

Lacrosse-W                             27.9                 11.8                    329                           2.5

Outdoor Track-M                    18.3                   8.0                    146                           1.1

Outdoor Track-W                    21.1                   7.1                    150                           1.1

Soccer-M                                 35.0                 10.7                    375                           2.8

Soccer-W                                 42.3                 11.2                    474                           3.6

Softball                                    28.1                 10.7                    301                           2.3

Swim & Diving-M                   12.8                   7.6                      97                           0.7

Swim & Diving-W                   15.5                   9.5                    147                           1.1

Tennis-M                                21.7                   9.3                    202                           1.5

Tennis-W                                24.5                 10.7                    262                           2.0

Volleyball-M*                           35.0                 22.7                   795                           4.0

Volleyball-W                            36.8                 12.6                    464                           3.5

Water Polo-M                           12.0                 18.3                    220                           1.7

Water Polo-W                           22.2                   7.9                    175                           1.3

Wrestling                                41.8                   9.1                    380                           2.9

 

 

To determine the maximum risk (value of 4), the IR*TX/I recorded for each sport was divided by the highest IR*TX/I recorded for any one sport where sufficient representative data was available (i.e., women’s basketball). Sports indicated by an (*) recorded higher IR*TX/I, but were based on limited data.

 

    

 

Table 2:  Sample Worksheet – Adjustments to Base Health Care Index

 

 

A

B

C

D

E

F

G

H

I

J

K

 

Sport

Base HCI

(Table 1)

#Days/

Season*

#Athletes/

Team

Total

Athlete

Exposures

(C*D)

Exposure

Modifier

(E/1,000)

Adjusted HCI

(B*F)

% of

Year

Adjusted

HCI/Yr

Travel

(20 days =

1 HCU)

Admin

Duties

 

 

 

 

 

 

 

 

 

 

 

Baseball

1.7

132

30

3960

4.0

6.7

50%

3.3

1.5

 

Basketball-M

2.4

132

15

1980

2.0

4.8

50%

2.4

1.5

 

Basketball-W

4.0

132

15

1980

2.0

7.9

50%

4.0

1.5

 

X-Country-M

1.4

144

10

1440

1.4

20.

50%

1.0

 

 

X-Country-W

1.7

144

10

1440

1.4

2.4

50%

1.2

 

 

Field Hockey

2.8

132

25

3300

3.3

9.4

50%

4.7

 

 

Football

3.1

120

100

12000

12.0

37.5

50%

18.7

0.5

 

Gymnastics-W

4.0

144

10

1440

1.4

5.8

50%

2.9

0.5

 

Lacrosse-M

1.8

132

30

3960

4.0

7.2

50%

3.6

0.5

 

Outdoor Trk-M

1.1

132

40

5280

5.3

5.9

50%

2.9

 

 

Outdoor Trk-W

1.1

132

40

5280

5.3

6.0

50%

3.0

 

 

Rowing-M

0.7

132

50

6600

6.6

4.6

50%

2.3

 

 

Soccer-M

3.6

132

30

3960

4.0

11.2

50%

5.6

1.0

 

Soccer-W

2.8

132

30

3960

4.0

14.2

50%

7.1

1.0

 

Softball

2.3

132

25

3300

3.3

7.5

50%

3.8

1.5

 

Volleyball-W

3.5

132

15

1980

2.0

7.0

50%

3.5

1.0

 

Wrestling

2.9

132

30

3960

4.0

11.4