Health Care Issues Could Mean Collapse of NCAA as We Know It

Nov 19, 2013 | Updated Jan 23, 2014

Mark my words, "The NCAA's negligence in setting health care standards, particularly with regards to traumatic brain injuries, may result in its demise." OK, that may be a bit over the top, but hear me out...

The NFL just agreed to pay out $765 million for injury settlements, medical monitoring, and care for former players who suffered concussions and other brain injuries. NFL players are walking away from the game in order to protect their mental and physical health. Hall of Famer Tony Dorsett and two other former NFL players were recently diagnosed with signs of Chronic Traumatic Encephalopathy (CTE), the degenerative brain disease linked to concussions and repetitive brain trauma. While the NCAA may be turning a blind eye, college athletes are starting to take notice. Yet another mediation session began last week over a class-action lawsuit filed against the NCAA for ignoring concussion ramifications for decades.

What's most alarming is the staggering number of players who could be affected. According to the NCAA's injury surveillance system, more than 29,000 concussions were reported in college sports between 2004 and 2009 with that number expected to increase by at least 7 percent each year. Those statistics could be a prelude to an onslaught of athlete lawsuits that would egregiously effect the NCAA's bottom line (not to mention the direct ramifications to individual conferences and schools which could potentially shut down entire programs leaving only the elite, financially stable programs standing).

Ironic how the organization, formed in 1906, 'largely in response to the number of young men who lost their lives playing football,' could potentially end up paying out hundreds of millions to athletes for NOT protecting them.

The two major requests for reform revolve around "return-to-play guidelines and a program to provide medical monitoring and care for former athletes."(**) Interestingly enough, the NCAA will be considering proposals in January of 2014, focused on the DI level which would include the following requirements:

• Require at least three continuous hours of recovery time for student-athletes between any sessions (including practices and walk-throughs) occurring during the preseason practice period and after the five-day acclimatization period.

• Require schools to designate a licensed physician to serve as team physician for each of its teams.

• Require head coaches and all full-time coaches (including strength and conditioning coaches) to be certified in first aid, CPR, and automatic external defibrillator use.

• Require strength and conditioning coaches (both full-time and part-time employees) to maintain certification through a nationally recognized certification program. Institutions will have the discretion to choose which certification program to use.

• Require schools to submit student-athlete catastrophic death and injury data to the NCAA annually through an online portal.

While this may be a step in the right direction from the NCAA's first adaptation of its concussion plan in August of 2010, in requiring overarching guidelines and principles for ALL DI schools to follow, there are still significant shortfalls and shortsightedness. Many of the potential new requirements are superficial, inadequate, and still won't prevent ongoing or untreated injuries threatening athletes' quality of life after college.

What's even scarier is that the current plan leaves the specifics of education, testing, and determining when a player can return to competition up to the individual schools. The current overarching rules simply require "each member school had to adopt its own plan for dealing with head injuries." The current guidelines set forth by the NCAA require that all college athletes get training each year on the signs and symptoms of concussions and sign a statement taking responsibility for reporting concussions, which is laughable. That all athletes who exhibit signs or symptoms of a concussion be evaluated by a member of the school's medical staff with experience in the evaluation and management of concussions. Hello, that's a no-brainer. That all athletes diagnosed with concussions be held out of competition for at least the remainder of that day. WOW. And, finally that all athletes diagnosed with a concussion be cleared by a physician or the physician's designee before returning to competition. No need for additional comment.

Since the current NCAA health care standards aren't comprehensive or proactive in addressing injury prevention and treatment, my team at Recruiting Sports Network has researched and compiled several recommendations, based on experiences and insight from both the collegiate coach and athlete perspective. We believe the NCAA should take note and work to implement these across ALL levels of play.

RSN Recommendations:

• Each institution must report detailed injury statistics, types of injuries, response time, and recovery rate yearly to an open and public forum (to live on the NCAA AND individual schools' athletic websites).

• Each institution must convey and provide a listing of training and medical staff, and physicians along with their level of presence and coverage per sport and season on the school's athletic homepage.

• NCAA to establish guidelines in conjunction with an independent board of certified medical and athletic training experts.

• Each school must apply for and receive certification of its comprehensive athletic health care program and staffing in accordance with NCAA guidelines or receive penalties and/or be declared noncompliant.

• Implement an overarching injury prevention plan through strength and conditioning and preventative care programs across all sports in association with certified athletic training standards.

• Define exact levels of medical coverage which will be provided by the school's health insurance for athletic injuries highlighting ALL specific instances in which an athlete would be responsible for bearing any financial burden or medical choices for certain injuries -- publicize and distribute to recruits, student athletes, and parents.

• Require strict yearly inspections of all play, training, and locker room facilities to ensure each are cleaned to a safe, sanitary standard and in compliance with equipment maintenance policies (to prevent issues such as STAF infections and MRSA) as well as the prevention of common serious issues such as concussion and sudden cardiac arrest.

• Require each institution to submit venue-specific emergency action plans and testing proving doctors, nurses, athletic trainers, emergency medical technicians, and other school-based athletic personnel are aware of this plan and meet regularly before each practice or competition to review the venue to ensure a decisive, coordinated emergency response and outcome.

• Require institutions to educate athletic trainers, emergency medical technicians, and other school-based athletic personnel on mandatory emergency equipment (such as an automatic defibrillator) at each venue.

• Plan of action to define the nearest hospital and how an ambulance/outside medical team can and will get to an injured student-athlete efficiently.

• Each school to sign a statement ensuring that all athletes will receive the highest standard of athletic training and health care -- publicize and distribute to recruits, student athletes, and parents.

• Require an adequate team to medical staff ratio of 10 athletes to 1 physician.

• Require one team physician present at all games and at least one available during practice/school hours each day.

• Establish a rating system for institutions to work towards and boast commitment to health care as a recruiting tool -- much like academic standards (APR).

• NCAA to require a weighted percentage of each institutions' athletic program revenue (based on a tiered approach,) to fund a post-collegiate athletic health care program for non-professional athletes up to five years post-graduation. NCAA to support schools as needed from general revenues and BCS earnings in order to cover directly related, previously incurred and documented sports injuries (as defined and documented above). Granted this is an entirely different issue, dilemma, blog post, and argument.

Without an overarching NCAA approach to athletic health care, it is imperative for future athletes to have this information in order to assess each school's capability and commitment to medical treatment, staffing, care and prevention. College athletics are a privilege to play. However, participating student athletes also help generate millions of dollars towards their schools and the NCAA. Although it's heartbreaking that professional athletes are dealing with post-career issues like CTE, they at least understand the risk and reap the (cash) benefits of doing so year in and year out. The majority of collegiate athletes' athletic careers are over upon graduation, which is why the NCAA needs to do better by its mission of 'protecting young people from the dangerous and exploitive athletics practices of the time.' (*) Times have changed. It's time to get this right.

(***) NCAA -- Safety package enters Division I pipeline