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N.C. Now Requiring Athletic Trainers at All H.S. Football Games, Practices

The North Carolina state board of education adopted a new policy Thursday requiring licensed athletic trainers or other trained first responders to attend all high school football practices and games in the state.

Under the new policy, each local education agency must designate a licensed athletic trainer or a trained first responder for each high school within its jurisdiction, to be employed either on a full-time, part-time, or volunteer basis. If a particular school cannot be assigned an athletic trainer, the first responder must maintain certification in cardiopulmonary resuscitation and first aid while completing training in concussion management and injury prevention and management. Each non-athletic trainer first responder must also complete 10 hours of staff development each school year, "specific to first aid, injury recognition and prevention." That time can be spent renewing or recertifying trainings.

The AT or first responder cannot also concurrently coach during the time in which he or she is serving each school. They must attend all high school football games and practices, unless otherwise excused by the district's superintendent due to emergency, and each district will "work toward having a licensed athletic trainer or first responder available for all school practices and games of all sports" at both the high school and middle school level. Each district would be responsible for enforcement of this new policy.

While the football coverage is a clear mandate, expanding coverage to all sports at the middle and high school levels is more along the lines of a recommendation, one with no firm timetable. That begs the question of whether other sports may get short shrift in terms of athletic-trainer coverage, as only roughly 70 percent of schools nationwide now have access to athletic-training services, according to a recent study published in the Journal of Athletic Training, with 37 percent of public high schools nationwide having a full-time athletic trainer on staff. Just over 4,000 of the 8,509 schools that responded to the survey reported having full practice coverage every afternoon. 

In all likelihood, this expansion of mandated athletic-trainer coverage is an improvement over the current status quo, in which schools were not required to have an athletic trainer or first responder present at every practice or game of any sport. However, by failing to implement a firm deadline in which all middle and high school sports should be covered, the state board did leave schools some wiggle room in that regard. 

The state school board also approved a set of penalties for schools who fail to comply with the state's youth-concussion law, which was signed back in 2011. The so-called Gfeller-Waller Concussion Awareness Act requires all student-athletes and their parents, coaches, school nurses, athletic directors, first responders, and volunteers to sign and return a concussion-information form annually; mandates all student-athletes suspected of a concussion to be removed from play and not allowed to return until they received medical clearance from a licensed health-care professional; and requires each school to have a venue-specific emergency action plan approved by a licensed athletic trainer in the state.

Failure to follow each component of the law now carries a fine for schools. The North Carolina High School Activities Association may charge a school $1,000 for failing to have documentation of a signed concussion information form for either student-athletes, parents, or coaches and other athletic staff members—failure to have the first two would require a student-athlete to be removed from play, while the latter would remove the athletic staff member from his or her duties "until the education component is completed." Schools also face a $1,000 fine for allowing a student to return to practice or play without a signed return-to-play form, which could lead to the program's suspension from further competition. Additionally, schools face a $1,000 fine for failure to have an emergency action plan for all athletic programs, which could lead to the school's entire athletic program being suspended from further participation. Schools would be subject to a $500 fine per venue for failing to post a venue-specific emergency action plan, with a maximum fine of $2,500.

The monetary fines aren't the only punishment schools would be subject to for failing to satisfy each component of the state's youth-concussion law, however. Any player who returns to practice or play without a signed return-to-play form would be suspended for an additional two games, while a failure to have a certified emergency action plan would lead to the entire athletic coaching staff being forced to attended a professional development session provided by the state's department of public instruction, with the school covering all expenses incurred.

"We did not have sanctions in place that if you broke the law we could do anything beyond our general penalties," high school association Commissioner Davis Whitfield told The Associated Press (via the Charlotte Observer). "The state board asked us to get involved and create sanctions for noncompliance."

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