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1/25/17
1
A Business Primer for Athletic Trainers Staffing Community Events
George Goodridge, MS, AT, ATC Scott Linaker, MS, AT, ATC John M. Valencia, AT, ATC, CSCS, ITAT Partners, Arizona Sports Care, LLC.
Objectives
Understand the benefits of community athletic training
Understand the legal issues involved in community athletic training
Understand best practices in providing athletic training services to the community
Provide tools for an athletic trainer to provide community athletic training services in a legal, ethical and positive manner for the advancement of the profession of athletic training.
Community Athletic Training
The provision of athletic training services to athletic teams, leagues, clubs, associations, events and schools, colleges or universities on a contract basis as an independent contractor.
Arizona Sports Care, LLC Events in 2016
DII College Softball Leadoff Classic
US Open Playoffs
USTA League National Championships
NJCAA Women’s Tennis National Championships
Western Region Rugby Championships (USA Rugby)
Tohono O’odham Community College
Marana Unified School District Cross Country Meet/Middle School
USA BMX Western Regionals
Arizona Sports Care, LLC has provided athletic training services at approximately 160 events from Winslow to Wilcox in 2016
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Our Philosophy
Events in our community, affect our entire community, so we represent the community we live in, as athletic trainers the best we can.
All athletes regardless of age and ability deserve the best sports health care available. Multi-disciplined evidence based practice.
Providing athletic training services in the community expands our contact base as a profession and promotes athletic training into areas previously unserved by ATs.
Employee vs Independent Contractor
Employee vs. Independent Contractor Employees:
W-2 (Taxes withheld) can file regular 1040
FICA (Soc. sec.) taxes paid by employer
Covered by workman’s comp. Insurance, professional liability ins., other benefits
Employers provides supplies and control work schedule.
Independent Contractors:
1099-Misc. responsible for self-employment tax and must do schedule C for Sole Proprietor,, other tax forms depending on type of business entity
No Social Security benefits Must purchase own insurance, prof. liab., W/comp., general liability, etc. Pay for own equipment and supplies. No benefits unless you purchase your own. Need business license(s).
Typically paid twice what employee makes!
Types of Business Entities
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Types of Business Entities
Sole Proprietor
Limited Liability Company
Professional Corporation
“S”-Corporation
“C”-Corporation
You need to decide what works best for you?
What are you worth?
Average mean salary for ATs in AZ May 2015
Maricopa County-$29,960-$42,110
Pima County-$50,550-$68,850
Approximately $20,000 difference. Why the difference?
Do we continue to take low paying jobs just to have a job?
Do you demand what you are worth at your job?
Will new DOL overtime rules bring ATs up ($47,476) ?
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AT pay difference between Pima and Maricopa Counties
Pima County:
Approximate hourly wage at low end of range is $24.30/hour.
Most HS ATs 5/5 AT duties, teaching is overload
Less new grads and licensed students
More longevity at positions, but is that due to more job satisfaction and less work hours?
Maricopa County:
Approximate hourly wage at low end of range is $14.40/hour.
Most HS AT split between teaching and AT duties for 5/5 contract
More turnover of ATs out of state due to low paying jobs and also student return to home state after AT school.
Are you worth more than a convenience store assistant manager?
AT in Maricopa County
Yearly pay $ $29,960-$42,110
Works 2100-2310 hours per year
$13.50-$18.97/hour
QT assistant manager in Arizona
Yearly pay $37,800 (with $3200 average bonus)
Work 2392 hours per year
Approximate hourly pay with bonus $15.80/hour.
Community AT pay, what are you worth?
Employee
Maricopa County $29,960-$42,110 approximately $14.40-$20.25/hour
Pima County $50,550-$66,850 approximately $24.30-$32.14/hour
Plus benefits, Social Security, medical ins., w/comp. ins., life insurance, 401k, ASRS, 403b, etc.
Independent Contractor
Maricopa County approx. $28.80-$40.50/hour
Pima County $48.60-$64.28/ hour
We have charged up to $45.00/hour.
Decreasing Liability
Liability Insurance, Medical Direction, SOP, Contracts, and Documentation
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Notre Dame Hit With Lawsuit October 13, 2016 On October 4, a lawsuit by Edelson PC accused the University of Notre Dame, along with the NCAA of “reckless disregard for the health and safety of generations of Notre Dame student-athletes,” through hiding information about the long-term effects of concussions.
According to The Observer, the complaint states that Gary Gray, who played football for Notre Dame from 2007 to 2011, experienced multiple concussions while on the team, and because he was not properly treated, he now has anxiety, depression, and mood swings. The complaint alleges that Notre Dame ordered players to ignore their symptoms and continue playing, and did not contact former players about the possibility of long-term brain damage.
Decreasing Liability
Negligence, Athletic Trainers at Heart of Football Lawsuit Colter Rios was playing in a junior varsity football game for Grossmont (Calif.) High School in 2008 when he felt a pop in his right ankle as he was tackled. Although he complained of pain when he tried to stand up, his coaches sent him back into the game without having the ankle examined. Colter was eventually removed from the game and sent to the athletic trainer to get his ankle taped. The athletic trainer, Keoki Kamau, was not there, so Adrian Dunn, a college athletic training student who had been assisting Kamau on a volunteer basis, examined Colter's ankle. Dunn found no bruising, deformity or other abnormality and, after taping Colter's ankle, had him jog, zigzag, sprint and backpedal. Colter told the trainer he felt fine and was then cleared to return to the game. Upon returning, however, Colter fractured two of his cervical vertebrae and injured his spinal cord when he was tackled. The injuries prompted Rios' mother to file suit against the Grossmont Union High School District, alleging that the district was negligent to allow Colter to continue to play after injuring his ankle, and that the initial injury caused him to subsequently sustain permanent and debilitating injuries.
Decreasing Liability
Negligence, Wrongful Death, Concussion Protocol > Former High School Athlete wins $4.4 Million Settlement Against Negligent Athletic Trainers > Lawsuit: New Trier athletic trainer failed to seek medical help for injured cheerleader > Trial Date Set For Wrongful Death Lawsuit Of Frostburg Football Player > Lawsuit Claim: Concussion Protocol Missteps Led To
Paralysis > October 2016 - NCAA facing 43 concussion lawsuits - D1 football
Decreasing Liability
Decreasing Liability
● JB case
● OL case
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Professional Liability Insurance
Professional Liability Insurance
Have Your Own versus Rely on Employer?
JB case - no personal representation
OL case - “Trust” representation
Professional Liability Insurance
● Occurrence versus Claims-made
○ occurrence - covers any injury that occurred within the life of the policy, even if claim is filed after policy has been canceled
○ claims-made - covers any injury that occurred within the life of the policy, except when a retroactive date is applied to the policy (purchase of “tail” coverage)
Professional Liability Insurance
● Keeping track of hours for IC work
○ as when engaging in volunteer, moonlighting or self-employed activities
○ must be within a specific % of total athletic training services of full time employment
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Professional Liability Insurance
● Purchasing Policy
○ Proliability administered by Mercer (NATA preferred provider)
○ Healthcare Providers Service Organization (HPSO) ○ CPH and Associates ○ American Professional Agency, Inc ○ CM&F Group Inc
Other Insurance
Other Insurance
Umbrella general liability policy (ASC)
Provides protection against catastrophic losses
Workman’s compensation insurance (ASC)
Provides wage replacement & medical benefits to injured employees
Disability insurance
Provides income protection for long term disability
Medical Direction and SOP’s Licensing and Regulating the practice of the Arizona Athletic Trainer > A.R.S. - Title 32, Chapter 41 Athletic Trainers > Rules - Title 4. Professions & Occupations Chapter 49. Board of Athletic Training
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Medical Direction
Instrument of Direction
Daily guidelines/SOPs
Communication guidelines and Philosophy/Mission Statement
NATA Code of Ethics
BOC Standards of Professional Practice
Medical Direction
Address Position Statements
Concussion Protocol
Local protocols or guidelines
AED Medical Direction
Referral to Physician
Referral
Medical direction
Physician/Urgent Care referrals/locations
TOI After Hours Clinic
Massage/acupuncture/non traditional
JB Case - Direct Referral?
Federal Anti-Kickback Statute of 1972
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Communications
Communications
Medical direction
Physician/Urgent Care referrals
Host AT
Other ATs at event (or other venue)
Medical timeout
Communications
Event administrators/officials (comms on site)
Coaches
Parents
Athlete’s regular AT
Emergency Action Plans
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Emergency Action Plan
A proactive approach to emergency preparedness will ensure you are implementing the right policies to help reduce injuries and catastrophic outcomes.
Develop an EAP for managing serious and or potentially life-threatening injuries that is venue specific.
Best Practices for Staffing Community Events
Best Practices
Greeting Coaches/Event Administrators/officials/etc
Venue package (treatment table, supply table, tent, ice chest, supply kit, etc.)
Equipment for loan/purchase
Shift change/advising following AT for continuity of care
Focused vigilance
Health education for participant
Best Practices
Signage
Treating adults versus minors (OL case - Coach present)
Documentation
Emergency equipment (AED, splints, etc.)
AT to athlete/field/court/mat ratio
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Documentation
Documentation
A.R.S. § 32-4103 (B) - post injury treatment guidelines
- § 32-4153 (18) - grounds for disciplinary action: failure to maintain adequate records regarding treatment JB Case - Sworn deposition 3 years & 5 months post surgery - Tx record concerning all other injuries questioned OL Case - Lawsuit, sworn deposition and jury trial 3 years & 7 months after
Incident WSC Case - Knee MCL/meniscus claimed occurred during football
Documentation
Injury reports
Concussion documentation Rehabilitation Progress documentation
Daily treatment records
Injury Management Recommendations
(Hard copy, electronic, photo and HIPAA)
Contracts/Agreements
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You need some kind of agreement!
Verbal is not acceptable!
Some clients provide agreements of their own.
Some clients ask for you to provide.
What if a client does not want a contract
Invoice Terms? 30 days net?
Supplies? Ice? Shelter?
OL Case
Now what?
Is community athletic training right for you?
● Are you willing to take the risks as an independent contractor?
● Are you willing to put in the extra time and effort to do it right?
● Are you willing to negotiate an appropriate fee for your professional and expert services?
Thank you!