Superintendent Starr and MCPS School Board: Please Include Athletic Trainer Funding in the FY 2014 Operating Budget

Below is an excerpt from my Jan. 17 testimony to MCPS Supt. Joshua Starr and the Board of Education urging them to include $500,000 in the FY 2014 Operating Budget to staff each of MCPS's 25 high schools with an athletic trainer.

I am also attaching a Maryland map reflecting my survey showing which local public school systems have trainers at their high schools.  Not on the map is Fairfax County, Virginia, just across the Potomac River, where each of its 25 high schools has two full-time trainers. 

Concussion expert Robert Cantu, MD and others say that if you can't afford trainers, maybe you can't afford to have a high school sports program.  This is especially true for high school football, which studies show accounts for half of all concussions in a high school sports program. 

(I recently heard a parent say that girls soccer has more concussions than football.  Um, no.  What this parent may be confused about is that studies show that girls soccer has more concussions that boys soccer.  Compared to football, girls soccer its pretty far behind.  So if you hear a parent say this, gently correct him.  If you hear a football coach say this, think twice about letting your son play in his program.)

Follow advocacy on this and other MCPS sports safety issues on Twitter, Concussion MCPS-Md, handle @concussionmcps

MCPS Supt. Josh Starr’s Proposed Operating Budget for FY 2014

(July 2013 to June 2014)

Recommendations by Tom Hearn

For Athletic Trainers at High Schools

January 17, 2013

(Updated January 27, 2013)

Good evening, Superintendent Starr and members of the Board of Education for Montgomery County [Maryland] Public Schools (MCPS).   My name is Tom Hearn and I am a parent of a student at an MCPS high school.   I want to speak to you about three aspects of the Operating Budget for FY 2014 that you will recommend to the Montgomery County Council: 

1. Athletic Trainers at Each MCPS High School
2. Whether to Include the Proposal for Concussion Baseline Testing;
3. Budget Neutral Ways that MCPS Can Improve Sports Safety

I have previously advocated for funding for athletic trainers in public comment to Supt. Starr and the Board of Education on April 30 and May 21, 2012.[1]

I make these recommendations mindful that:

• Athletic trainer funding must compete with other important funding choices in the MCPS budget, including chronic understaffing of school counselors and school psychologists;
• The County-funded portion of Supt. Starr’s $2.2 billion MPCS FY 2014 Operating Budget proposal is $1.458 billion, which is $10 billion more than the County is required to fund under: (1) Maryland’s requirement that county funding per student be no less than the previous year funding (the maintenance-of-effort requirement); and (2) the shift of teacher pension costs to the local school board; and
• the County Council must also fund equally critical county government functions, such as police and fire protection, provide care for the most vulnerable members of Montgomery County, and give services for all county residents such as libraries.

Nevertheless, the lack of certified athletic trainers at MCPS high schools represents a serious public safety issue.  High school athletics programs represent a significant source of concussions and other injuries to high school students who play sports.  Some concussion professionals say that if you can’t afford to have athletic trainers, maybe you can’t afford to have a sports program. 

So please find a way to work with the County Council to include funding for athletic trainers in the 2014 MCPS operating budget. 

Background

My son sustained a serious concussion playing JV football at Whitman High School in 2011.  While managing his recovery, I became interested in ways that MCPS could better align itself with best practices for dealing with sports concussions.  I testified to the MCPS Board of Education and to the Maryland State Board of Education between May and July of last year regarding concussion safety issues. 

As I engaged MCPS last year on ways to improve concussion safety, I became aware of other sports safety areas in which MCPS could better align itself with best practices, such as screening for pre-existing heart attack risk, female health issues, and concussion history in the annual sports physical.

In the coming months, I hope to advocate for MCPS to adopt best practices for managing the risk of heat stroke among football players and other athletes, especially during summer workouts.   As you know, three and a half years ago, Edwin “Dek” Miller of Northwest High School died of heat stroke during a no-pad conditioning workout with the school’s football team.  MCPS still does not currently appear to be following best practices for managing heat stroke.  You owe it to Dek Miller’s family to get this right so that his death would not have been in vain and so that none of our other sons or daughters are lost to what experts say is a completely preventable condition.  

 Certified Athletic Trainers

Please include in the recommended FY 2014 Operating Budget $500,000 for funding to pay for certified athletic trainers at each MCPS High School.  

I see three benefits to having an athletic trainer at each of MCPS’s 25 high school.  First, the trainer degree is a four-year college program and trainers must pass a national certification program.  Coaches are only required to take an injury course and watch a 30-minute online concussion awareness program.  So athletic trainers bring a deeper knowledge about concussions and other sports injuries.  Having trainers also allow coaches to, well, coach. 

Second, trainers maintain detailed records of injuries.  Such records allow administrators to see trends, e.g. football representing half of all concussions, boys versus girls concussion rates in the same sports.  Also, managing a student athlete's return to play involves several milestones such as the doctor's clearance and successful completion of the graduated return to play steps.  At Maryland high schools staffed with athletic trainers, the trainers perform this function.   This function does not appear to get done at MCPS high schools. 

Third, a trainer is not authorized to clear a concussed student for return to play, a trainer may override a doctor's clearance if the trainer thinks that the student is not ready.   I have heard numerous instances of doctors clearing students for RTP where a trainer later found the student to still be exhibiting symptoms.[2]

            Other Maryland School Systems Have Athletic Trainers

The map of Maryland counties at this link reflects my survey of athletic trainer staffing at Maryland’s 24 local school systems.

http://www.scribd.com/doc/120598273/Map-Athletic-Trainers-at-Maryland-Public-High-Schools

As you can see, numerous other school systems, including Howard, Anne Arundel, and Frederick Counties have athletic trainers at each high school.  Not on the map is Fairfax County, Virginia, just across the Potomac River, where each of its 25 high schools is staffed with two full-time certified athletic trainers.  

I am attaching an October 15, 2012 memorandum from Supt. Starr to the Board of Education responding to Board member Mike Durso’s request at the September 24, 3012 Board meeting for information about the cost of athletic trainers.[3]  Supt. Starr estimates $500,000 for the cost of staffing athletic trainers at each of MCPS’s 25 high schools.  

Note that this figure is for each of the 25 high schools to have a part-time trainer hired through a local medical practice or physical therapy group.  If MCPS were to staff each of its 25 high schools with a full-time trainer, Supt. Starr estimated that the cost would be close to $1.5 million. 

              Disclose to Parents the Risks of Not Having Trainers

If such funding is not included in the FY 2014 Operating Budget, please have staff evaluate whether it is safe for MCPS to operate interscholastic football and other high contact sports such as lacrosse and soccer in FY 2014. Robert Cantu MD, a leading concussion expert, and others have said, “if you can’t afford to have athletic trainers, you probably can’t afford to have a sports program.” 

If MCPS does go forward with football and other high contact sports programs, it should specifically disclose to parents the heightened risk of allowing their children to participate in such sports without athletic trainers on staff.  Such disclosure needs to be given at off-season meetings held by coaches to give parents information about the sport. 

In the coming weeks, MCPS high school football coaches will hold informational meetings for parents of middle school eight graders.  Coaches of football and other high contact sports should be required to disclose the lack of athletic trainers at these informational meetings so that parents can make informed decisions about whether to allow their child to participate in the sport. 

Next Blog:  Supt. Starr's $75,000 Proposal for Baseline Concussion Testing at MCPS High Schools--If That Money is Available, Are There Higher Sports Safety Priorities?

[1] Testimony to MCPS Supt. Starr and Board of Education, April 30, 2012

http://www.scribd.com/doc/122435826/Sports-Concussions-Parent-Testimony-to-MCPS-Supt-Starr-and-Bd-of-Ed-April-30-2012 ;

Testimony to MCPS Supt. Starr and Board of Education, May 21, 2012

http://www.scribd.com/doc/97421191/Sports-Concussions-Parent-Testimony-to-Montgomery-Cty-Md-Board-of-Ed-May-21-2012-Comparison-of-Sports-Concussion-Surveillance-in-Mont-Cty-and-Fair

[2] While having a certified athletic trainer for a high school athletics program greatly improves student safety, it does not guarantee it.  In 2010, Austin Trenum, a high school student in Prince William County, Virginia committed suicide two days after sustaining a concussion playing football.  Trenum’s high school sports program was staffed with athletic trainers.

http://www.washingtonian.com/articles/people/did-football-kill-austin-trenum/ 

Similarly, in 2011, Derek Sheely died from head trauma sustained in football practice at Frostburg State University in Maryland.  Frostburg State’s athletic program was staffed with certified athletic trainers.  (More information about Derek and his families efforts to raise awareness about sports concussion can be found at http://www.thedereksheelyfoundation.org/  )

Finally, the benefits of having an athletic trainer on staff can be undone by a weak sports safety culture among coaches.  In 2007, Scotty Eveland sustained a serious brain injury playing high school football in Mission Hills, California.   It was alleged that the high school football coach disregarding concerns raises by an athletic trainer about Eveland’s continuing to play after reporting concussion symptoms.  (For more information see the account here http://concussioninc.net/?p=5535 ).

Nevertheless, having athletic trainers on staff significantly increases the safety of students who play sports. 

[3] http://www.scribd.com/doc/122380238/10-15-12-Memo-MCPS-Supt-Starr-to-BOE-Re-Cost-of-Providing-Athletic-Trainers-at-25-High-Schools .  I had also asked for such information in my October 4, 2012 email (at following link) to Supt. Starr and the Board of Education after the Athletic Director at Walt Whitman High School had indicated to the school’s Booster Club that the cost or staffing trainers at all high schools would be $2 million to $3 million per year.

http://www.scribd.com/doc/122435296/10-04-12-Email-to-MCPS-Supt-Starr-and-Bd-of-Ed-Requesting-Info-on-Cost-of-Athletic-Trainers-at-MCPS-s-25-High-Schools