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After I finish my degree I plan on working as a secondary school administrator. I currently work as a Licensed Athletic Trainer. Gaining the tools from the M Ed in Student Development and Leadership, I hope to be a better leader and mentor.

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Exploration Option 1 - Top 5 According to a Current Professional

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Exploration Option 1 - Top 5 According to a Current Professional

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I spoke with the current Athletic Director for Richland Springs ISD Thomas Tipton.

#1: High schools and UIL are discussing ways to approach the matter of gender identity and sports participation.

#2: Schools have to maintain an understanding and regulatory standards of Title IX and gender equality within sports.

#3: Coaches face the arduous process of eliminating hazing customs that have been established within the sports for years.

#4: Athletic staff are facing issues implementing and training all staff in understanding and identifying the signs and symptoms of head injuries.

#5: Athletic Directors must help staff transition to an all online paperwork system while keeping all required guidelines established by UIL.

Tipton, T. (2018, August 23). Athletic Director. (C. Tipton, Interviewer)

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In an investigative piece, Amanda Ripley looks into how schools are cutting costs in other area such as academics but keep activities such a sports, which drain the budget.

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The United States routinely spends more tax dollars per high-school athlete than per high-school math student-unlike most countries worldwide. And we wonder why we lag in international education rankings?

Every year, thousands of teenagersmove to the United States from all over the world, for all kinds of reasons. They observe everything in their new country with fresh eyes, including basic features of American life that most of us never stop to consider.

One element of our education system consistently surprises them: "Sports are a big deal here," says Jenny, who moved to America from South Korea with her family in 2011. Shawnee High, her public school in southern New Jersey, fields teams in 18 sports over the course of the school year, including golf and bowling. Its campus has lush grass fields, six tennis courts, and an athletic Hall of Fame. "They have days when teams dress up in Hawaiian clothes or pajamas just because-'We're the soccer team!,' " Jenny says. (To protect the privacy of Jenny and other students in this story, only their first names are used.)

By contrast, in South Korea, whose 15-year-olds rank fourth in the world (behind Shanghai, Singapore, and Hong Kong) on a test of critical thinking in math, Jenny's classmates played pickup soccer on a dirt field at lunchtime. They brought badminton rackets from home and pretended there was a net. If they made it into the newspaper, it was usually for their academic accomplishments.

Sports are embedded in American schools in a way they are not almost anywhere else. Yet this difference hardly ever comes up in domestic debates about America's international mediocrity in education. (The U.S. ranks 31st on the same international math test.) The challenges we do talk about are real ones, from undertrained teachers to entrenched poverty. But what to make of this other glaring reality, and the signal it sends to children, parents, and teachers about the very purpose of school?

When I surveyed about 200 former exchange students last year, in cooperation with an international exchange organization called AFS, nine out of 10 foreign students who had lived in the U.S. said that kids here cared more about sports than their peers back home did. A majority of Americans who'd studied abroad agreed.

Even in eighth grade, American kids spend more than twice the time Korean kids spend playing sports, according to a 2010 study published in the Journal of Advanced Academics. In countries with more-holistic, less hard-driving education systems than Korea's, like Finland and Germany, many kids play club sports in their local towns-outside of school. Most schools do not staff, manage, transport, insure, or glorify sports teams, because, well, why would they?

When I was growing up in New Jersey, not far from where Jenny now lives, I played soccer from age 7 to 17. I was relieved to find a place where girls were not expected to sit quietly or look pretty, and I still love the game. Like most other Americans, I can rattle off the many benefits of high-school sports: exercise, lessons in sportsmanship and perseverance, school spirit, and just plain fun. All of those things matter, and Jenny finds it refreshing to attend a school that is about so much more than academics. But as I've traveled around the world visiting places that do things differently-and get better results-I've started to wonder about the trade-offs we make.

Nearly all of Jenny's classmates at Shawnee are white, and 95 percent come from middle- or upper-income homes. But in 2012, only 17 percent of the school's juniors and seniors took at least one Advanced Placement test-compared with the 50 percent of students who played school sports.

As states and districts continue to slash education budgets, as more kids play on traveling teams outside of school, and as the globalized economy demands that children learn higher-order skills so they can compete down the line, it's worth reevaluating the American sporting tradition. If sports were not central to the mission of American high schools, then what would be?

On October 12, 1900, the Wall School of Honey Grove played St. Matthew's Grammar School of Dallas in football, winning 5-0. The event was a milestone in Texas history: the first recorded football game between two high-school teams. Until then, most American boys had played sports in the haphazard way of boys the world over: ambling onto fields and into alleys for pickup games or challenging other loosely affiliated groups of students to a match. Cheating was rampant, and games looked more like brawls than organized contests.

Schools got involved to contain the madness. The trend started in elite private schools and then spread to the masses. New York City inaugurated its Public Schools Athletic League in 1903, holding a track-and-field spectacular for 1,000 boys at Madison Square Garden the day after Christmas.

At the time, the United States was starting to educate its children for more years than most other countries, even while admitting a surge of immigrants. The ruling elite feared that all this schooling would make Anglo-Saxon boys soft and weak, in contrast to their brawny, newly immigrated peers. Oliver Wendell Holmes Sr. warned that cities were being overrun with "stiff-jointed, soft-muscled, paste-complexioned youth."

Sports, the thinking went, would both protect boys' masculinity and distract them from vices like gambling and prostitution. "Muscular Christianity," fashionable during the Victorian era, prescribed sports as a sort of moral vaccine against the tumult of rapid economic growth. "In life, as in a foot-ball game," Theodore Roosevelt wrote in an essay on "The American Boy" in 1900, "the principle to follow is: Hit the line hard; don't foul and don't shirk, but hit the line hard!"

Athletics succeeded in distracting not just students but entire communities. As athletic fields became the cultural centers of towns across America, educators became coaches and parents became boosters.

From the beginning, though, some detractors questioned whether tax money should be spent on activities that could damage the brain, and occasionally leave students dead on the field. In 1909, New York City superintendents decided to abolish football, and The New York Times predicted that soccer would become the sport of choice. But officials reversed course the next year, re-allowing football, with revised rules.

The National Collegiate Athletic Association had emerged by this time, as a means of reforming the increasingly brutal sport of college football. But the enforcers were unable to keep pace with the industry. Once television exponentially expanded the fan base in the mid-20th century, collegiate sports gained a spiritual and economic choke hold on America. College scholarships rewarded high-school athletes, and the search for the next star player trickled down even to grade school. As more and more Americans attended college, growing ranks of alumni demanded winning teams-and university presidents found their reputations shaped by the success of their football and basketball programs.

In 1961, the sociologist James Coleman observed that a visitor entering an American high school

would likely be confronted, first of all, with a trophy case. His examination of the trophies would reveal a curious fact: The gold and silver cups, with rare exception, symbolize victory in athletic contests, not scholastic ones ... Altogether, the trophy case would suggest to the innocent visitor that he was entering an athletic club, not an educational institution.

Last year in Texas, whose small towns are the spiritual home of high-school football and the inspiration for Friday Night Lights, the superintendent brought in to rescue one tiny rural school district did something insanely rational. In the spring of 2012, after the state threatened to shut down Premont Independent School District for financial mismanagement and academic failure, Ernest Singleton suspended all sports-including football.

To cut costs, the district had already laid off eight employees and closed the middle-school campus, moving its classes to the high-school building; the elementary school hadn't employed an art or a music teacher in years; and the high school had sealed off the science labs, which were infested with mold. Yet the high school still turned out football, basketball, volleyball, track, tennis, cheerleading, and baseball teams each year.

Football at Premont cost about $1,300 a player. Math, by contrast, cost just $618 a student. For the price of one football season, the district could have hired a full-time elementary-school music teacher for an entire year. But, despite the fact that Premont's football team had won just one game the previous season and hadn't been to the playoffs in roughly a decade, this option never occurred to anyone.

"I've been in hundreds of classrooms," says Singleton, who has spent 15 years as a principal and helped turn around other struggling schools. "This was the worst I've seen in my career. The kids were in control. The language was filthy. The teachers were not prepared." By suspending sports, Singleton realized, he could save $150,000 in one year. A third of this amount was being paid to teachers as coaching stipends, on top of the smaller costs: $27,000 for athletic supplies, $15,000 for insurance, $13,000 for referees, $12,000 for bus drivers. "There are so many things people don't think about when they think of sports," Singleton told me. Still, he steeled himself for the town's reaction. "I knew the minute I announced it, it was going to be like the world had caved in on us."

First he explained his decision to Enrique Ruiz Jr., the principal of Premont's only high school: eliminating sports would save money and refocus everyone's attention on academics. Ruiz agreed. The school was making other changes, too, such as giving teachers more time for training and planning, making students wear uniforms, and aligning the curriculum with more-rigorous state standards. Suspending sports might get the attention of anyone not taking those changes seriously.

Then Singleton told the school's football coach, a history teacher named Richard Russell, who'd been coaching for two decades. Russell had played basketball and football in high school, and he loved sports. But he preferred giving up the team to shutting down the whole district. He told Singleton to do whatever he needed to do, then walked over to the gym and told the basketball players, who were waiting for practice to begin. At first, the students didn't seem to understand. "What? Why?" asked Nathan, then a junior and a quarterback on the football team. "Would you rather have sports or school?," Russell replied.

Out by the tennis courts, Daniel, a junior who was in line to become a captain of the football team, was waiting for tennis practice to start when a teacher came out and delivered the news. Daniel went home and texted his friends in disbelief, hoping there had been some kind of mistake.

"We were freaking out," says Mariela, a former cheerleader and tennis and volleyball player. American kids expect to participate in school sports as a kind of rite of passage. "We don't get these years back," she told me. "I'm never going to get the experience of cheering as captain under the lights."

As the news trickled out, reporters from all over America came to witness the unthinkable. A photographer followed Nathan around, taking pictures of him not playing football, which the Corpus Christi Caller-Times ran in a photo essay titled "Friday Without Football in Premont."

Many observers predicted that Singleton's experiment would end in disaster. Premont was a speck on the map, an hour and a half southwest of Corpus Christi. The town's population had dwindled since the oil fields had dried up, and a majority of the 282 high-school students who remained were from low-income Hispanic families. How many football players would drop out? How many cheerleaders would transfer to the next town's school? How would kids learn about grit, teamwork, and fair play?

Last fall at Premont, the first without football, was quiet-eerily so. There were no Friday-night games to look forward to, no players and their parents cheered onto the field on opening night, no cheerleaders making signs in the hallway, no football practice 10 or more hours a week. Only the basketball team was allowed to play, though its tournament schedule was diminished.

More than a dozen students transferred, including four volleyball players and a football player. Most went to a school 10 miles away, where they could play sports. Two teachers who had been coaches left as well. To boost morale, Principal Ruiz started holding sports-free pep rallies every Friday. Classes competed against each other in drum-offs and team-building exercises in the school gym.

But there was an upside to the quiet. "The first 12 weeks of school were the most peaceful beginning weeks I've ever witnessed at a high school," Singleton says. "It was calm. There was a level of energy devoted to planning and lessons, to after-school tutoring. I saw such a difference."

Nathan missed the adrenaline rush of running out onto the field and the sense of purpose he got from the sport. But he began playing flag football for a club team on the weekends, and he admitted to one advantage during the week: "It did make you focus. There was just all this extra time. You never got behind on your work."

That first semester, 80 percent of the students passed their classes, compared with 50 percent the previous fall. About 160 people attended parent-teacher night, compared with six the year before. Principal Ruiz was so excited that he went out and took pictures of the parking lot, jammed with cars. Through some combination of new leadership, the threat of closure, and a renewed emphasis on academics, Premont's culture changed. "There's been a definite decline in misbehavior," says Desiree Valdez, who teaches speech, theater, and creative writing at Premont. "I'm struggling to recall a fight. Before, it was one every couple of weeks."

Suspending sports was only part of the equation, but Singleton believes it was crucial. He used the savings to give teachers raises. Meanwhile, communities throughout Texas, alarmed by the cancellation of football, raised $400,000 for Premont via fund-raisers and donations-money that Singleton put toward renovating the science labs.

No one knew whether the state would make good on its threat to shut the district down. But for the first time in many years, Premont had a healthy operating balance and no debt. This past spring, the school brought back baseball, track, and tennis, with the caveat that the teams could participate in just one travel tournament a season. "Learning is going on in 99 percent of the classrooms now," Coach Russell told me, "compared to 2 percent before."

In many schools, sports are so entrenched that no one-not even the people in charge-realizes their actual cost. When Marguerite Roza, the author of Educational Economics, analyzed the finances of one public high school in the Pacific Northwest, she and her colleagues found that the school was spending $328 a student for math instruction and more than four times that much for cheerleading-$1,348 a cheerleader. "And it is not even a school in a district that prioritizes cheerleading," Roza wrote. "In fact, this district's 'strategic plan' has for the past three years claimed that math was the primary focus."

Many sports and other electives tend to have lower student-to-teacher ratios than math and reading classes, which drives up the cost. And contrary to what most people think, ticket and concession sales do not begin to cover the cost of sports in the vast majority of high schools (or colleges).

Football is, far and away, the most expensive high-school sport. Many football teams have half a dozen or more coaches, all of whom typically receive a stipend. Some schools hire professional coaches at full salaries, or designate a teacher as the full-time athletic director. New bleachers can cost half a million dollars, about the same as artificial turf. Even maintaining a grass field can cost more than $20,000 a year. Reconditioning helmets, a ritual that many teams pay for every year, can cost more than $1,500 for a large team. Some communities collect private donations or levy a special tax to fund new school-sports facilities.

Many of the costs are insidious, Roza has found, "buried in unidentifiable places." For example, when teacher-coaches travel for game days, schools need to hire substitute teachers. They also need to pay for buses for the team, the band, and the cheerleaders, not to mention meals and hotels on the road. For home games, schools generally cover the cost of hiring officials, providing security, painting the lines on the field, and cleaning up afterward. "Logistics are a big challenge," says Jared Bigham, until recently the supervising principal of two schools in Copperhill, Tennessee, and a former teacher, coach, and player. "Even though the coaches are in charge of the budgets, I still have to oversee them and approve each expenditure. You're looking at 10 different budgets you have to manage."

That kind of constant, low-level distraction may be the greatest cost of all. During football season in particular, the focus of American principals, teachers, and students shifts inexorably away from academics. Sure, high-school football players spend long, exhausting hours practicing (and according to one study, about 15 percent experience a brain injury each season), but the commitment extends to the rest of the community, from late-night band practices to elaborate pep rallies to meetings with parents. Athletics even dictate the time that school starts each day: despite research showing that later start times improve student performance, many high schools begin before 8 a.m., partly to reserve afternoon daylight hours for sports practice.

American principals, unlike the vast majority of principals around the world, make many hiring decisions with their sports teams in mind-a calculus that does not always end well for students. "Every school in the entire country has done this," Marcia Gregorio, a veteran teacher in rural Pennsylvania, told me. "You hire a teacher, and you sometimes lower the standards because you need a coach."

But here's the thing: most American principals I spoke with expressed no outrage over the primacy of sports in school. In fact, they fiercely defended it. "If I could wave a magic wand, I'd have more athletic opportunities for students, not less," Bigham, the former Tennessee principal, told me. His argument is a familiar one: sports can be bait for students who otherwise might not care about school. "I've seen truancy issues completely turned around once students begin playing sports," he says. "When students have a sense of belonging, when they feel tied to the school, they feel more part of the process."

Premont is not alone. Over the past few years, budget cuts have forced more school districts, from Florida to Illinois, to scale back on sports programs. But in most of these places, even modest cuts to athletics are viewed as temporary-and tragic-sacrifices, not as necessary adaptations to a new reality. Many schools have shifted more of the cost of athletics to parents rather than downsize programs. Others have cut basic academic costs to keep their sports programs intact. Officials in Pasco County, Florida, have considered squeezing athletic budgets for each of the past six years. They've so far agreed to cut about 700 education jobs, and they extended winter break in 2011, but sports have been left mostly untouched.

In these communities, the dominant argument is usually that sports lure students into school and keep them out of trouble-the same argument American educators have made for more than a century. And it remains relevant, without a doubt, for some small portion of students.

But at this moment in history, now that more than 20 countries are pulling off better high-school-graduation rates than we are, with mostly nominal athletic offerings, using sports to tempt kids into getting an education feels dangerously old-fashioned. America has not found a way to dramatically improve its children's academic performance over the past 50 years, but other countries have-and they are starting to reap the economic benefits.

Andreas Schleicher, a German education scientist at the Organization for Economic Cooperation and Development, has visited schools all over the world and is an authority on different regional approaches to education. (I profiled Schleicher for this magazine in 2011.) He is wary of the theory that sports can encourage sustained classroom engagement. "Our analysis suggests that the most engaging environment you can offer students is one of cognitive challenge combined with individualised pedagogical support," he told me in an e-mail. "If you offer boring and poor math instruction and try to compensate that with interesting sport activities, you may get students interested in sports but I doubt it will do much good to their engagement with school."

Though the research on student athletes is mixed, it generally suggests that sports do more good than harm for the players themselves. One 2010 study by Betsey Stevenson, then at the University of Pennsylvania, found that, in a given state, increases in the number of girls playing high-school sports have historically generated higher college-attendance and employment rates among women. Another study, conducted by Columbia's Margo Gardner, found that teenagers who participated in extracurriculars had higher college-graduation and voting rates, even after controlling for ethnicity, parental education, and other factors.

But only 40 percent of seniors participate in high-school athletics, and what's harder to measure is how the overriding emphasis on sports affects everyone who doesn't play. One study of 30,000 students at the University of Oregon found that the grades of men who did not play sports went down as the football team's performance improved. Both men and women reported that the better their football team did, the less they studied and the more they partied.

Exercise, without a doubt, is good for learning and living. But these benefits accrue to the athletes, who are in the minority. What about everyone else?

At Spelman College, a historically black, all-women's college in Atlanta, about half of last year's incoming class of some 530 students were obese or had high blood pressure, Type 2 diabetes, or some other chronic health condition that could be improved with exercise. Each year, Spelman was spending nearly $1 million on athletics-not for those students, but for the 4 percent of the student body that played sports.

Spelman's president, Beverly Daniel Tatum, found the imbalance difficult to justify. She told me that early last year, while watching a Spelman basketball game, "it occurred to me that none of these women were going to play basketball after they graduated. By that I don't mean play professionally-I mean even recreationally. I thought of all the black women I knew, and they did not tend to spend their recreational time playing basketball. So a little voice in my head said, Well, let's flip it."

That April, after getting approval from her board and faculty, she gathered Spelman's athletes and coaches in an auditorium and announced that she was going to cancel intercollegiate sports after the spring of 2013, and begin spending that $1 million on a campus-wide health-and-fitness program.

Many of Spelman's 80 athletes were devastated, needless to say, and it is too early to tell whether the new swim, aerobics, and Zumba classes, among other offerings, will lead to healthier students on campus. But Tatum's signal was clear: lifelong health habits matter more than expensive, elite sporting competitions with rival schools. One priority has real and lasting benefits; the other is a fantasy.

Imagine, for a moment, if Americans transferred our obsessive intensity about high-school sports-the rankings, the trophies, the ceremonies, the pride-to high-school academics. We would look not so different from South Korea, or Japan, or any of a handful of Asian countries whose hypercompetitive, pressure-cooker approach to academics in many ways mirrors the American approach to sports. Both approaches can be dysfunctional; both set kids up for stress and disappointment. The difference is that 93 percent of South Korean students graduate from high school, compared with just 77 percent of American students-only about 2 percent of whom receive athletic scholarships to college.

As it becomes easier and more urgent to compare what kids around the world know and can do, more schools may follow Premont's lead. Basis public charter schools, located in Arizona, Texas, and Washington, D.C., are modeled on rigorous international standards. They do not offer tackle football; the founders deemed it too expensive and all-consuming. Still, Basis schools offer other, cheaper sports, including basketball and soccer. Anyone who wants to play can play; no one has to try out. Arizona's mainstream league is costly to join, so Basis Tucson North belongs to an alternative league that costs less and requires no long-distance travel, meaning students rarely miss class for games. Athletes who want to play at an elite level do so on their own, through club teams-not through school.

Basis teachers channel the enthusiasm usually found on football fields into academic conquests. On the day of Advanced Placement exams, students at Basis Tucson North file into the classroom to "Eye of the Tiger," the Rocky III theme song. In 2012, 15-year-olds at two Arizona Basis schools took a new test designed to compare individual schools' performance with that of schools from around the world. The average Basis student not only outperformed the typical American student by nearly three years in reading and science and by four years in math, but outscored the average student in Finland, Korea, and Poland as well. The Basis kid did better even than the average student from Shanghai, China, the region that ranks No. 1 in the world.

"I actually believe that sports are extremely important," Olga Block, a Basis co-founder, told me. "The problem is that once sports become important to the school, they start colliding with academics."

In a column published in 1927, Roy Henderson, the athletic director of the University Interscholastic League, a public-school sports organization in Texas, articulated the challenge of keeping sports and academics in balance: "Football cannot be defended in the high school unless it is subordinated, controlled, and made to contribute something definite in the cause of education."

The State of Texas announced in May that the Premont Independent School District could stay open. The district has a lot of work to do before its students can feel the kind of pride in their academics that they once felt in their sports teams. But Ernest Singleton, Enrique Ruiz, the teachers, and the students have proved their ability to adapt. Nathan, the one-time quarterback, started college this fall, as did Mariela, the cheerleader-and, as it turns out, the valedictorian. This fall, Premont brought back a volleyball team and a cross-country team, in addition to basketball, baseball, track, and tennis. But for now, still no football.

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The United States routinely spends more tax dollars per high-school athlete than per high-school math student-unlike most countries worldwide. And we wonder why we lag in international education rankings? Every year, thousands of teenagersmove to the United States from all over the world, for all kinds of reasons.

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Exploration Option 3 - The Sport Journal

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Exploration Option 3 - The Sport Journal

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An article in  The Sport Journal (Bell, Ratzlaff, & Murray, 2008) approaches the issue of patient privacy and how it effects athletes and their rights.

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Submitted by: Richard Bell, Mesa State College, United States Sports Academy National Faculty, Sarah Elizabeth Ratzlaff, Disney Sports, Steven Ross Murray, Mesa State College

Abstract

The Health Insurance Portability and Accountability Act (HIPAA) was enacted on August 21, 1996. Its fundamental purpose was to improve both the portability and the continuity of health insurance coverage. Title II of the act, intended to reduce paperwork, contained a clause called the Privacy Rule. The Privacy Rule is responsible for much confusion and controversy, particularly in collegiate sport settings. This paper identifies issues with the HIPAA Privacy Rule and suggests methods with which collegiate sport professionals can deal with those issues.

The Health Insurance Portability and Accountability Act (HIPAA) was enacted on August 21, 1996, by the 104th U.S. Congress as Public Law 104-191 (29 U.S.C. §18). The act amended both the Employee Retirement Income Security Act, or ERISA [29 U.S.C.§1182(a)(1)], and the Public Health Service Act [42 U.S.C.§ 6(a)]. Its main purpose was to improve both the portability and continuity of health insurance coverage for workers and their families, especially as individuals changed employers. Title II of the act was intended to reduce paperwork-making it easier to detect and prosecute fraud and abuse-and to streamline industry inefficiencies (Office of Civil Rights, 2003). However, one specific clause in title II part C, titled "Administrative Simplification," has had implications beyond the original intent of the act. This clause is referred to as the Privacy Rule; it was effective on October 15, 2002, and is responsible for much confusion and widespread controversy (Kuczynski & Gibbs-Whalberg, 2005), especially in collegiate sport settings.

"Standards for Privacy of Individually Identifiable Health Information" is the Privacy Rule (45 CFR parts 160 and 164). The Privacy Rule implements the privacy requirements of the Administrative Simplification subtitle of the Health Insurance Portability and Accountability Act of 1996. The Privacy Rule was added to the legislation at the request of the insurance industry. It was intended to be a confidentiality provision-controlling the use and disclosure of health information-by establishing for the first time a set of national standards for the protection of personal health information. Before the enactment of this act, an individual's health information was readily available and able to be shared among insurance companies. The resulting effect of this ethically questionable, yet legal, sharing of health information was across-the-board rejections of many persons who requested, and often needed, health insurance.

The Department of Health and Human Services is responsible for the enforcement and implementation of HIPAA. Being a federal agency, its power is far-reaching and at times intimidating. The passage of HIPAA and more specifically of the Privacy Rule has had an immediate impact on sporting organizations and personnel, especially with the normative method by which injuries are reported and information concerning athletes is released. The challenge facing sport professionals is determining if HIPAA applies to them, and if it does, establishing protocol for performing their duties adequately while being in compliance with the federal regulations. This paper will identify issues with the HIPAA Privacy Rule and suggest methods with which sport professionals can cope with these issues.

Operational Definitions

Personal health information is defined by HIPAA as individually identifiable health information. This includes any demographic or personally identifiable data relating to physical or mental health conditions, as well as information relating to the provision of health care and payment; however, patient information that is redacted for identifiable information is not subject to HIPAA guidelines (Jones, 2003). The Privacy Rule (also known as "Standards for Privacy of Individually Identifiable Health Information") is in title 45 of the Code of Federal Regulations, part 160 and subparts A and E of part 164. The full text of the Privacy Rule can be found at the HIPAA privacy website of the Office for Civil Rights, http://www.hhs.gov/ocr/hipaa.

The Privacy Rule specifies that all covered entities follow five steps to ensure the privacy of patients' health information (Dolan, 2003):

1. Notify patients about their rights and inform them of how their information will be used.

2. Adopt and implement privacy procedures.

3. Train employees on privacy procedures.

4. Designate an individual to be responsible for ensuring that privacy procedures are adopted and followed.

5. Ensure that patient records containing individual identifiable health information are secure.

Some of the problems encountered from the Privacy Rule are best reflected in the following two questions: What constitutes a covered entity, and how does HIPAA interact with the Family Educational Rights and Privacy Act of 1974 (FERPA) in the collegiate sport setting? In addition, the Privacy Rule also affects how information about an athlete's injury can be provided to the media as well as to coaches and athletic administrators (Wyatt & Carden, 2003).

Covered Entities

The Administrative Simplification standards adopted by the Department of Health and Human Services under HIPAA apply to any entity that is a health-care provider that conducts certain transactions in electronic form; or is a health-care clearinghouse; or is a health plan. An entity that is one (or more) of these types of entities is referred to as a "covered entity" in the Administrative Simplification regulations found at http://www.cms.hhs.gov/HIPAAGenInfo/06_AreYouaCoveredEntity.asp. Covered entities are expected to adhere to the policies of the Privacy Rule. Any organization that bills for medical services or transmits personal health information electronically will fall under the guidelines of the Privacy Rule.

A college, university, or high school, then, is not automatically a covered entity simply because it has an athletic trainer on staff. Only if the athletic trainer bills the student-athlete or the student-athlete's insurance plan for outside treatment may the institution become a covered entity. Further, a physician who bills, transmits claims to a health plan, or receives payments through some type of electronic form is considered a covered entity under HIPAA regulations (Magee, Almekenders, & Taft, 2003). Moreover, hybrid entities exist: organizations including some part that is a covered entity and another part that is not. This typically transpires in a university setting in which the student medical and health centers are covered entities, but the rest of the departments are not. HIPAA regulations allow an institution to designate which components are involved and which individuals are covered within the respective components. This allows the institution to place HIPAA requirements on a specific category of persons it has defined as its health-covered components (Hill, 2003).

Questions also have arisen about whether non-covered entities that interact and share information with covered entities consequently become covered. Though the distinction is a bit murky, the answer seems to be no. Information communicated from a covered entity to a non-covered entity is no longer subject to the Privacy Rule, and the non-covered entity does not change its status (Office of Civil Rights, 2003).

The Department of Health and Human Services (HHS), which oversees the regulation of HIPAA, has established the following website with information about the law along with a tool that can be used to see what qualifies as a covered entity: www.cms.hhs.gov/hipaa/hipaa2/support/tools/decisionsupport/default.asp. Additional online resources are available from HHS that provide a general overview and an explanation of individual rights; see the website www.hhs.gov/ocr/hipaa/consumer_rights.pdf.

HIPAA and FERPA

The interaction of HIPAA's Privacy Rule with the FERPA adds to the confusion surrounding HIPAA. FERPA applies to all schools receiving federal funding. The intent of the act is to allow parents access to information about their children, while safeguarding information from release to other parties. However, the act does allow for information to be released, without consent, to school officials who have a legitimate educational interest in the student (e.g., faculty advisors, registrars). Exempted from the definition are education records, as those are defined in and covered by FERPA, and also treatment records of students 18 years of age or older that are made and maintained by the student's treating physician or other medical professional and are available only to that physician or professional. Under HIPAA, protected health information excludes individually identifiable health information in education records that is covered by FERPA (Windley & Walueff, 2005). It appears that FERPA's application takes precedence over HIPAA (Pitz, 2003).

HIPAA and the Athlete

Within sport, it has been standard practice for information about players' injuries to be communicated to a wide range of individuals, from physicians and athletic trainers to coaches, school administrators, and even the media. The biggest concern for many sport organizations has been how the privacy act will affect these procedures. Professional teams have feared that athletes may withhold injury information before signing contracts (Jenkins, 2003). Both professional and college teams are unsure if information can be provided to trainers and coaches by team physicians. Another major concern for both types of teams is what, if any, information can be provided to the media (Elmore, 2002), as it disseminates information rapidly and readily to the populace as a whole.

For professional teams, health and injury information is considered criteria for employment, because of the nature of the job. Therefore, an injured athlete would not be able legally to withhold injury information from a team to whom he or she is contractually obliged. This also means that health and treatment information could be shared with coaches and team owners (Magee, Almekinders, & Taft, 2003).

Depending upon the status of a team physician for college teams, there are different stipulations about what information can be shared. Some team physicians conduct part of their practice through the student health center. In this case, the physician falls under the guidelines of FERPA and should be allowed to share information with coaches and athletic trainers. A physician not employed by a university-run health center will be subject to the HIPAA guidelines. In this case it is possible that, in order for any information to be released to athletic trainers, an authorization form would need to be signed. An exception to HIPAA exists that specifically states that information can be released to another provider for treatment purposes. What is unclear, however, is whether or not a trainer is considered a provider under HIPAA guidelines (Hill, 2003).

For coaches and other school administrators, an authorization would need to be provided before this information could be shared. Another concern is on-field evaluations information. Can this be shared with the necessary parties? The answer, it seems, is that these evaluations would fall under the category of emergency evaluations, for which prior authorization is unnecessary.

Finally, regarding the sharing of information with the media, this issue is clear-cut. Under HIPAA, personal health information can be provided to sports information staff or the media only with authorization from the athlete (Magee et al., 2003).

Solutions

Any sport entity that is covered under HIPAA needs to review its existing practices, policies, and procedures. Relationships with other businesses also will need to be reviewed as they fall under HIPAA guidelines. Utilizing experienced legal counsel to determine status under HIPAA and also to recommend authorization forms, privacy notices, and business-associate contracts is recommended (Kibbe, 2005).

One way that some schools are fulfilling the authorization constraint is by requiring athletes to sign authorization forms in order to participate in athletics. Signing the form is mandatory if the student-athlete wants to participate in athletics. Surprisingly, HHS approved this measure (Hill, 2003). Other schools that have not implemented such a policy suggest always getting permission from athletes when reporting to the media. Even when an athlete has consented to the sharing of information with one media outlet, consent should be given for each media entity that subsequently becomes involved.

Schools choosing to opt for signed consent and authorization should ensure that their forms meet the requirements of HIPAA. Authorization forms should contain a statement about what information will be shared and with whom and for how long; moreover, the form must have an expiration date. The form should be specific about who may disclose the information and about what information may be disclosed and to whom. The form also should state that the athlete cannot be denied treatment for refusing to sign and that, if information is disclosed to a non-covered entity, it may no longer be protected under HIPAA. The form also needs to contain a statement that an athlete has a right to revoke authorization at any time (Hill, 2003).

Consequences of Inappropriate Release of Information

The Department of Health and Human Services has stated that most of its enforcement will be compliance-driven and that the rule focuses on seeking voluntary compliance and providing technical assistance to covered entities. Entities found in violation will be given opportunities to demonstrate compliance or to submit a corrective action plan. However, HHS has outlined both a civil penalty of up to $25,000 per person per year per standard, and the following criminal penalties for knowingly disclosing information (Jones, 2003): knowing disclosure, $50,000 and 1 year imprisonment; false pretenses, $100,000 and 5 years' imprisonment; intent to sell, $250,000 and 10 years' imprisonment.

HHS has released information about filing a complaint against a covered entity that is non-compliant. Individuals who believe their privacy rights have been violated must file complaints in writing, either electronically or on paper, within 180 days of when they knew or should have known that the act or omission occurred. A form was developed by HHS to assist anyone who wants to file a complaint and is available at www.hhs.gov/ocr/hipaa.

To safeguard protected information, covered entities need to ensure that personal health information is secure. Any records need to be kept in locked file cabinets. When athletic trainers treat athletes, they need to make sure information about the athletes is not discussed where others can hear it. Any consultation with parents or other involved parties needs to be done with a degree of privacy. Moreover, computer security measures must comply with the HIPAA standards.

HIPAA and Sport Managers and Their Employers

The largest concern for most institutions relates to treatment and injury information for student-athletes. Sport managers need to investigate their institutions' status as a covered entity and review their compliance with HIPAA and the Privacy Rule. If an institution is a covered entity, the sport manager will need to fully understand the implications of HIPAA and insure that the department is in compliance by safeguarding personal health information, training staff, and obtaining the appropriate authorizations. A further implication of HIPAA concerns the status of sport facilities. If medical information about patron accidents is kept or if a facility employs a nurse or EMT unit, then it is considered a covered entity.

Though HIPAA and the Privacy Rule may seem daunting, most institutions and organizations have only had to make a few changes to their policies to be in compliance. As the act is relatively new, however, sport managers need to continue to update their knowledge of HIPAA to ensure full compliance.

References

Dolan, T. G. (2003). PTs respond to HIPAA: The real world experience. PT Magazine of Physical Therapy, 11(7), 52-56.

Elmore, L. (2002). Law injects confusion into injury reporting. Street and Smith's Sports Business Journal, 5(26), 30.

General Overview of Standards for Privacy of Individually Identifiable Health Information, 45 CFR Part 160 and Subparts A and E of Part 164 (2003).

Hill, D. (2003). A matter of privacy. Athletic Management, 15(2), 37-42.

Jenkins, D. (2003, September 12). Hiding the hurt: Privacy act puts twist on obtaining injury reports. Chattanooga Times Free Press, p. D5.

Jones, D. (2003). HIPAA: Friend or foe to athletic trainers? Athletic Therapy Today, 8(2), 17-19.

Kibbe, D. C. (2005). 10 steps to HIPAA security compliance. Family Practice Management, April, 2005, 43-49.

Kuczynski, K., & Giggs-Wahlberg, P. (2005). HIPAA the health care hippo: Despite rhetoric, is privacy still an issue? Social Work, 50(3), 283-287.

Magee, J. T., Almekinders, L. C., & Taft, T. N. (2003). HIPAA and the team physician. Sports Medicine Update, March-April, 2003, 4¬-7.

Office for Civil Rights. (2003). Summary of the HIPAA privacy rule, (May 2003). Retrieved March 28, 2007. http://www.hhs.gov/ocr/privacysummary.pdf

Pitz, S. M. (2003). HIPAA and the sports media: Separating fiction from reality. Nevada Lawyer, 11(8), 12-14.

Windley, V. R., & Walueff, G. (2005, June). HIPAA, right to privacy, contracts. NAEB Journal, 4-6. Retrieved from the Internet March 28, 2007. http://wikis.oet.udel.edu/uapp667sinesummer05/index.php/Main/HIPAA

Wyatt, B. M., & Carden, K. E. (2003, April). The HIPAA privacy regulations and access to athletes' medical information. Ropes & Gray Sports Law Newsletter, 6-7. Retrieved from the Internet March 28, 2007. http://www.ropesgray.com/files/Publication/3b22be16- 0237-4e05-9e11-af29b45830aa/Presentation/PublicationAttachment/0e23970d-d944- 4ace-acce-893ed0f9dba7/Newsletter_April%202003_Sports%20Law%20Group.pdf

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The Impact of the HIPAA Privacy Rule on Collegiate Sport Professionals

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Submitted by: Richard Bell, Mesa State College, United States Sports Academy National Faculty, Sarah Elizabeth Ratzlaff, Disney Sports, Steven Ross Murray, Mesa State College Abstract The Health Insurance Portability and Accountability Act (HIPAA) was enacted on August 21, 1996. Its fundamental purpose was to improve both the portability and the continuity of health insurance coverage.

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Legal and Ethical Issue of Interest to Me - High schools and UIL are discussing ways to approach the matter of gender identity and sports participation.

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Legal and Ethical Issue of Interest to Me - High schools and UIL are discussing ways to approach the matter of gender identity and sports participation.

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I chose this issue not only due to the fact that it is a very hot topic within sports but our community as a whole at the moment. It crosses lines of fairness and and what is acceptable within a gender. It creates new questions for myself being a health professional such as how do we approach PEDs within this realm if it isn't used for gain but for medical purposes.

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Researching High schools and UIL are discussing ways to approach the matter of gender identity and sports participation.

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Researching High schools and UIL are discussing ways to approach the matter of gender identity and sports participation.

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The internet search of this issue presented many resources. The one that jumped out to me is the 2011 National

School Climate Survey

The Experiences of Lesbian, Gay, Bisexual and Transgender Youth

in Our Nation’s Schools. This study presented the data showing the mental effects of this population participating in sports.

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Researching High schools and UIL are discussing ways to approach the matter of gender identity and sports participation.

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Researching High schools and UIL are discussing ways to approach the matter of gender identity and sports participation.

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During my library search I came across a journal article found in the British Journal of Sports Medicine. The authors discuss the use of biological markers to determine sex instead of only using physical characteristics.

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Gender identity and sport: is the playing field level?

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This review examines gender identity issues in competitive sports, focusing on the evolution of policies relating to female gender verification and transsexual participation in sport. The issues are complex and continue to challenge sport governing bodies, including the International Olympic Committee, as they strive to provide a safe environment in which female athletes may compete fairly and equitably.

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What I Learned About Gender Identity and Sport Participation

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What I Learned About Gender Identity and Sport Participation

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Gender identity and sport participation is an issue rocking our nation. Many people have strong opinions on this issue. Does a person born male have to participate with male teams even though that person identifies as female? After looking into these issues I myself am left asking even more questions.

In the biological science realm it has been shown that certain hormones will give an athlete more of an edge during competition (Reeser, 2005). These hormones such as testosterone are found naturally in the body but can also be supplemented. If a person is supplementing due to an orientation transition is it being used for athletic gains?

When it comes to the mental state of those who identify differently than their birth gender there are many obstacles they must overcome. These issues are even more compounded when you add the competition of the athletic world.

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Bell, R., Ratzlaff, S. E., & Murray, S. R. (2008, April). The Impact of the HIPAA Privacy Rule on Collegiate Sport Professionals. The Sport Journal.

Reeser, J. (2005). Gender identity and sport: is the playing field level? British Journal of Sports Medicine, 695-699.

Ripley, A. (2013, October). The Case Against High-School Sports. The Atlantic.

Tipton, T. (2018, August 23). Athletic Director. (C. Tipton, Interviewer)