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New sickle cell trait proposal enters 2013 Convention cycle

By Gary Brown
NCAA.org

Division III Management Council members at their meeting on Monday agreed to submit a new legislative proposal regarding sickle cell trait status that emphasizes an educational component and a phased-in confirmation approach.

The new legislation, which because of its broad effect on the division will require sponsorship from the Division III Presidents Council, includes the following concepts:

• Required baseline education regarding sickle cell trait for all students-athletes.
• Required confirmation of sickle cell trait status for all student-athletes no later than the 2014-15 academic year, including mandatory confirmation of status for all incoming student-athletes (first year and transfers) in the 2013-14 academic year. Confirmation would be acquired either through documentation of a previous test or testing as part of the mandatory preseason medical exam.
• Required additional education regarding the risks, impact and precautions related to sickle cell trait for student-athletes who opt out of confirming their status. The proposal also allows student-athletes to participate in athletically related activities before the results of their test are known, as long as they receive additional education.

The Management Council sees these concepts as new-and-improved over the proposal that was referred from the 2012 Convention floor to the NCAA Committee on Competitive Safeguards and Medical Aspects of Sports for further review. This new proposal comes with CSMAS endorsement.

“The key for this new proposal is its educational umbrella,” said Management Council chair Jeff Martinez. “What medical experts agree on is the importance of student-athletes knowing their sickle cell trait status before they participate in college sports, and the accommodations institutions make for those student-athletes who are either sickle cell positive or awaiting confirmation of their status. This proposal ensures that all student-athletes are aware of the importance of knowing their status, and of the risks those who opt out are taking.”

The 2012 proposal was simply to require a sickle cell solubility test to be offered as part of the mandatory medical examination, unless documented results of a prior test were provided to the institution or the student-athlete declined the test and signed a written release.

That came with Presidents Council support, but Convention delegates were skittish about the unknowns, including the costs associated with testing, the burdens that testing might place on under-manned staffs, and the uncertainty about the timing, especially with fall sports. People also were confused why sickle cell trait was being singled out from other medical conditions.

Since then, Division III leaders have scoured the membership for more details about those concerns, all the while knowing that the Presidents Council isn’t likely to back off its stance that the sickle cell issue is among its highest student-athlete health and safety priorities.

In June, Presidents Council chair Jim Schmotter of Western Connecticut State University and several national office staff members brought new concepts to the competitive-safeguards committee, both to seek CSMAS support and to gauge whether the concepts would offer more of a comfort level for Division III members. The concepts ended up framing the new legislative proposal.

The idea of additional mandatory education for student-athletes who opt out of confirming their status resonated in particular with the CSMAS.

“That’s a different element, certainly from what was proposed last year but also from what has already been adopted in Divisions I and II,” said Martinez, the athletics director at the University of Redlands. “It maintains the waiver option without diluting the greater purpose of the proposal, which is to ensure that all student-athletes know their status.”

Also different is the pace at which the entirety of the student-athlete population is confirmed. The 2012 proposal applied to all student-athletes – both current and incoming. The 2013 version requires schools to initially address incoming student-athletes and transfers in the first year, followed by the rest of their student-athletes the next year. Schools can choose to apply the requirements of the legislation to all student-athletes that first year if they want.

The legislation Division I adopted in 2010 required schools to confirm sickle cell trait status in incoming student-athletes and transfers each year. The policy Division II adopted at the 2012 Convention required all student-athletes’ status to be confirmed. The Division III proposal essentially offers a middle ground.

Another distinction is allowing student-athletes who have taken the test but don’t know their results yet to participate in practice, as long as the institution provides education and precautions for the student-athlete until results are known..

The CSMAS endorsed that concept after a lengthy discussion on how to safely manage student-athletes during that waiting period. Serious sickle cell trait incidents and other causes of sudden death most frequently occur during the initial days of preseason practices when student-athletes’ bodies are becoming conditioned to the rigors of training. The thought is that if student-athletes are accommodated in the interim with appropriate precautions similar to an SCT-positive student-athlete, it may encourage them to seek testing rather than go the waiver route. A similar standard related to additional education and precautions would be provided to student-athletes who opt to waive the provision of test results.

Martinez said the new proposal blends membership feedback with presidential priorities and provides schools some flexibility in treating their student-athlete population. He also noted the ample outreach in the last several months with Division III constituencies and stakeholders – from presentations at Regional Rules Seminars and conference meetings to webinars designed specifically for presidents.

“Last year’s proposal already had Presidents Council backing, but the governance structure perhaps under-communicated the nuances of what was being proposed,” Martinez said. “If we’re going to make another run at this – and obviously we are, given the Presidents Council’s position on this as a student-athlete well-being priority – then it’s critical that our members know that we’ve heard their concerns and have tailored this new proposal accordingly.”

The proposal, still in draft form, now heads to the Presidents Council for review at that group’s Aug. 9 meeting. It will be thoroughly vetted after that, both through the governance structure and within the membership.

“Nobody wants a repeat of 2012 when voters at the Convention claimed they didn’t know enough about what was being proposed,” Martinez said. “Between the outreach that’s already been done and what is yet to be done to get the membership to understand the importance of this measure, I’ll be surprised if anyone at the 2013 Convention can honestly say they didn’t know this was coming.”

The proposal

Intent: To provide education regarding sickle cell trait for all students-athletes and provide additional mandatory education for those that do not confirm their status. Further, require confirmation of sickle cell trait status for all student-athletes no later than the 2014-15 academic year, including mandatory confirmation of status of all incoming student-athletes (first year and transfers) in the 2013-14 academic year.

An institution shall confirm the sickle cell trait status of student-athletes, before participation in intercollegiate athletics in one of the following manners:

• Documentation: The student-athlete may provide documented results of a sickle cell solubility test administered prior to participation;
• Pending documentation: A student-athlete who has taken a sickle cell solubility test but whose results are not yet confirmed may participate provided the student-athlete engages in mandatory education and receives appropriate precautions as set forth by the institution; or
• Waiver: The student-athlete may sign a waiver declining confirmation of sickle cell trait status. Before signing a waiver, the student-athlete shall be provided education regarding the implications of exercising the waiver option. Before athletics participation, a student-athlete who signs a waiver under this provision shall engage in mandatory education regarding sickle cell trait status.

Student-athletes who have been tested, but do not have confirmed results documented or have signed a waiver, shall be provided additional education regarding the risks, impact, and precautions associated with sickle cell trait.

Effective date: Aug. 1, 2013, for all incoming (first year and transfers) student-athletes; Aug. 1, 2014, for all student-athletes.
Source: NCAA Division III Presidents Council [Management Council (Committee on Competitive Safeguards and Medical Aspects of Sports)].