Why use the AMCIA document?

The AMCIA document will help evaluate an institution’s ability to deliver health care to its student/athletes. It will outline strengths and areas in need of improvement both in health care delivery and in practice/game coverage. Use of this document demonstrates that an institution has done due diligence with self evaluation of the medical delivery system and that all stakeholders (AD, risk manager, CEO, athletic trainers, coaches and physicians) are on the same page and in agreement with the system in place.

What is the best way to use the AMCIA document?

The AMCIA document should be used as a resource to formulate an overall strategy for comprehensive medical coverage at an institution that offers intercollegiate athletics. It is not meant to be a stand alone document but to work in concert with each institution’s needs and emergency action plan. Examples are given in “Strategies for Using this Document.”

How was the 12 HCU per provider determined?

There was no indication in the literature as to number of health care providers to student/athletes that might be appropriate. The 12 HCU concept came from academia where the standard is 12 units equals one full time equivalent (1 FTE). The institution can change this if it wishes, but it is a good place to start.

Do I need to know how a Base Health Care Index for a team was determined?

The explanation is in the document itself. It would be useful to have a general understanding in case you are asked how a certain value was determined.

The base HCI seems low for outdoor track and field. Is this number accurate?

Remember, the figures used for calculation are based on aggregate numbers across all divisions and levels of intercollegiate competition. You have the choice to use the aggregate number, use divisional numbers published in the “Medical Coverage Needs of Student Athletes in a Collegiate Setting” by John Powell or use the numbers derived from your own record keeping.

How do you determine the days in a season?

In general, this is dictated by rule. Specifically, this would be the traditional season of the sport and any other time the sport has an official practice or competition.

How are exposures calculated?

This is simply the number of athletes on a team multiplied by the number of days in the season. One practice/game equals one exposure per athlete. 

Why is there an adjustment to the base HCI for Active Time of Year?

No sport practices and competes every single day of the year. Thus, to be realistic, the HCI is adjusted by the percentage of days/weeks that athletes are actively engaged in the sport.

What about all of the weight room, conditioning and individual sessions a sport might be allowed?

There is no data to support the work load this might create. To acknowledge this occurs and that someone on staff is responsible for this, the %, actively involved takes this into consideration. 

How are values calculated for administrative duties?

Administrative duties must be handled at the institutional level and are important to document as they take away from direct health care delivery. Drug testing duty at one institution may not be the same time commitment at another institution. The most accurate way to determine the unit value of an administrative duty is to track the actual amount of time it takes to do the administrative assignment(s). Remember, if a duty is assigned a value of 3 for instance, that means it takes 25% or at least 10+ hours a week for an individual to perform the task. If however, someone devotes 2 hours a week to purchasing for the department that would equate to 2/40 hr/wk x 12 units = .6 of a unit. It may take several administrative duties to equal one unit.

How is teaching to be handled by the document?

This will be handled as an administrative duty. Either add it as an administrative duty leaving only a portion of the 12 HCU available for direct health care, or say that only a portion of an individual is available for direct health care. For example, if an individual teaches 6 units, that is .5 FTE in academia leaving on 6 units available for direct health care. This is an important distinction to make to Athletic Directors and academic department heads. One cannot be a full-time health care provider and teach on top of this.

How do I account for multiple athletic training rooms? 

Ultimately, the institution is going have to decide how to do this as there is no direct recommendation or guideline in the document. One strategy might be to determine the load created by the sports working out of a given facility and considerate it as its own entity. For example, the athletic training room located in the basketball area creates a load of 30 HCU. That would require 2.5 individuals to cover. If, however travel requirements leave only one individual in the facility, the institution will have to decide to either send help to the facility or to have the uncovered athletes report to a different facility. The bottom line is that all involved will have to be in agreement that the plan in place is acceptable.

We have teams that practice/compete off campus. This detracts from the ability to provide care to teams remaining on campus. How is this accommodated?

Again, the institution must have to plan for this. The health care provider who travels off campus is unable to take the rest of the load (other sports) with him/her. This might be approached through the travel accommodation. For instance, the team practices off campus 100 days of the year for ½ a day each that would equal 50 travel days or 2.5 units. Again, this is important for the Athletic Director to understand.

Our institution always has a certified athletic trainer at women's volleyball and basketball. This document states these sports may be covered from the athletic training room. What should I do?

This is an institutional decision that is sometimes based on gender equity or the high profile nature of the sport. However, it may make a difference in coverage ability. Demonstrate the difference by presenting AMCIA profiles with and without this type of coverage.