University of Portland Athletics

Mission Statement
The mission of the University of Portland Sports Medicine Department is to create a seamless healthcare network for all of the University’s intercollegiate student-athletes and provide our patients, the student-athletes with access to high quality medical care.  The Sports Medicine Staff will operate within the policies outlined in the University of Portland Sports Medicine Policies and Procedures Manual, the NCAA Sports Medicine Handbook and the NCAA manual. Through an inclusive physical and psychological approach, as well as personal interaction, we strive to enhance the academic and athletic experience of each University of Portland student-athlete. This is accomplished by:

• Respecting the dignity of each student-athlete and recognizing differences in gender, race, sexual orientation, and cultural background.
• Maintaining confidentiality of both written and verbal information obtained from the student-athlete.
• Being cognizant of the total student-athlete, including his/her emotional, mental, and physical needs.
• Thoroughly and competently evaluating each student-athlete in accordance with the laws of the state of Oregon governing the practice of athletic training, and the Standards of Practice of the National Athletic Trainers’ Association, and referring the student-athlete to the designated team physician when necessary.
• Accurately and regularly documenting each student athlete’s healthcare and progress.
• Providing a multidisciplinary approach that utilizes the most up-to-date techniques in sports medicine. Our team includes physicians, certified athletic trainers, physical therapists, sports nutritionists, sports psychologists, chiropractic care, as well as specialists throughout the Portland area.
• Providing injury treatment and rehabilitation that is individually designed with emphasis on prevention of possible future injury, as well as returning the student-athlete to competition as quickly and safely as possible.
• Providing evidenced-based injury treatment and rehabilitation techniques and utilizing a variety of technology and philosophical approaches.
• Generating an atmosphere of mutual cooperation, respect, and support among the team physician(s), the athletic coaching staff, the athletic and University administration, and other University departments.
• Compliance with Department, University, West Coast Conference and NCAA rules.

 
Medical Clearance and Liability
The following information is provided so that there is a complete understanding of the basic policy regarding medical clearance and insurance of student-athletes.
No individual is to begin any phase of the athletic program, including conditioning or practice activities, without obtaining athletic clearance from the University of Portland Sports Medicine Staff and completing all required paperwork. This is very important so that in case of injury insurance coverage can be provided.
Each coach must provide to the Director of Compliance a completed list of names of all student-athletes, new and returning, who are on the team roster.  Once students have been certified by the Director of Compliance, the complete roster will be forwarded to the Sports Medicine Staff.  The Director of Compliance must approve any potential addition to this list before a student can practice or compete.
Freshman and Transfer Student-Athletes:
First time participants and/or transfer student-athletes must undergo a physical examination prior to their participation in intercollegiate athletics. The pre-participation examination must be completed before organized participation (practice) begins and must be completed by a University of Portland Team Physician.
Summer Physical Requirements:
New Student-Athletes are required to have a physical examination performed by a University of Portland team physician prior to participating in any summer training. This includes weight room and conditioning sessions, voluntary team practices, and use of the sports medicine facility.
Upper-Class Student-Athletes:
Student-athletes returning from the previous season must undergo an Annual Health Appraisal, otherwise known as a physical update. A University of Portland Certified Athletic Trainer will do the appraisal, which will be reviewed by a University of Portland Team Physician. Any identified problems will be referred to either the team physician or the University of Portland Student Health Services. Any student-athlete that has been out of collegiate competition for a year must undergo a complete physical examination prior to participation.
Coaches must understand that student-athletes who are not present at the specific time arranged for their team physicals may be delayed in receiving their clearance due to constraints of our team physicians. If a student-athlete misses the scheduled appointment time, they will be assigned another time at the convenience of the University of Portland team physicians, and they may be responsible for the cost of the make-up physical.

Walk-on or Open Tryouts: The Athletic Department will not be responsible for an injury that may occur during an audition or tryout prior to the preseason physical examination.  All participants in open tryouts or walk-ons must provide proof of insurance and a physical from any physician within the past six (6) months prior to their tryout period.  If the participant is selected by the coach to remain on the team after the tryout period, the student-athlete must receive a full pre-participation exam from a University of Portland team physician and complete all necessary paperwork.  The student-athlete will not be allowed to participate with the team until this has been completed.
 
Medical Decisions: The University of Portland (UP) sports medicine staff and its associated/affiliated team physicians are responsible for managing and caring for all the medical needs of UP student athletes. The UP sports medicine staff and team physicians take this responsibility extremely seriously and are dedicated to providing the highest standard of care to the student athletes of UP. Therefore, the UP sports medicine staff; in conjunction with the head team physician, have the unchallengeable authority in making all medical decisions for each UP student-athlete. All medical assessments including secondary opinions from orthopedic physicians, physical therapists, chiropractors, counselors and other allied health professionals will be considered by the UP sports medicine staff and head team physician when deciding on a course of treatment and a student athletes’ return to play; this includes practices, competitions and strength and conditioning sessions. Any questions, concerns or differing opinions from family members, coaches, athletic administrators and athletics’ support staff are to be discussed with the UP sports medicine staff and head team physician directly. Although all concerns, differing opinions and secondary medical opinions will be acknowledged, ALL final medical decisions will be determined by the UP sports medicine staff and head team physician.

Insurance Coverage Policy
All University of Portland student-athletes must be covered by some type of individual health insurance before participating in any practice, game, and/or competition.  The student-athlete’s insurance should cover athletic-related injuries and/or illnesses, and this shall be considered the PRIMARY insurance coverage for all athletic-related injuries and illnesses.  The student-athlete must complete an “ Insurance Questionnaire” as well as the “Student Authorization to Bill Insurance” form.  A copy of the front and back of all insurance cards (including prescription cards) will be required each academic year.  If a student-athlete does not have a primary insurance, they will automatically be signed up for the school’s insurance policy, and may be responsible for covering the cost of that insurance.  The student-athlete will not be cleared for participation in practices and/or competition until the Sports Medicine Staff has received a completed and signed “Insurance Questionnaire”, “Student Authorization to Bill Insurance” forms, as well as a photocopy of the front and back of their current insurance card.
The University of Portland provides medical and catastrophic coverage for its student-athletes.  This policy, however, is SECONDARY to, or in excess of, personal family medical insurance coverage, and covers only injuries, illnesses, and accidents that are a direct result of participation in the intercollegiate athletics program at the University of Portland.  Coverage during designated off-season workouts and voluntary workouts will be determined at the discretion of the Head Athletic Trainer.
It is the responsibility of each student-athlete and his/her parents(s)/guardian(s) to understand the conditions that apply to their policy and comply with any requests for information from the primary insurance company.  Any delinquent bills resulting in bad credit due to non-compliance with the requests of the insurance company may be the responsibility of the student-athlete and his/her parents(s)/guardian(s).
In the event that a student-athlete and his/her parent(s)/guardian(s) receives payment or reimbursement from their insurance company for services provided, it is the responsibility of the student-athlete and his/her parent(s)/guardian(s) to ensure that the providers receive payment for those services.  The University of Portland will not be held responsible for any late fees, etc., that are the result of inaction to provide payment to the provider after being reimbursed.

HMOs:
If the student-athlete’s primary insurance is an HMO, the University of Portland Sports Medicine Department strongly encourages the student-athlete to change their Primary Care Physician (PCP) to a University of Portland team physician.  This will allow the student-athlete to have access to a network of physicians within the Portland area.  The Athletic Department’s insurance coordinator will assist in this process if needed.

Insurance Coverage Changes:
Student-athletes are required to notify the University of Portland Sports Medicine Department of any changes to a health insurance policy as soon as they occur.  If proper notification is not provided, the University of Portland Athletic Department will not be responsible for delays in payment, late fees, collection notices, credit reports, etc., that may occur.

Summer Insurance Coverage:
All student-athletes are required to have primary insurance coverage. The University of Portland school insurance policy (Regence Blue Cross Blue Shield of Oregon) generally covers students from the first day of the academic year until the last day of the academic year. If a student-athlete is participating in competitions, games, workouts, conditioning, etc., prior to or after the academic year, they MUST have primary insurance coverage during this time.
Primary insurance coverage may be provided by any carrier, and it is the student-athlete’s responsibility to secure this insurance coverage and provide this information to the Sports Medicine Staff. Failure to provide this information will result in the student-athlete not being able to participate until proof of insurance coverage is provided. If uninsured, student-athletes will also be held financially responsible for any associated medical costs during the lack of primary insurance coverage. Please consult with the Sports Medicine Insurance Coordinator to help set up this additional insurance coverage.
Freshman and Transfer Student-Athletes:
New student-athletes must also provide proof of primary insurance coverage. IF the student-athlete is not covered by their parent(s)/guardian(s) insurance policy they must purchase temporary coverage for the summer training session.
                Returning Student-Athletes
Returning student-athletes are also required to provide proof of primary insurance coverage. IF the student-athlete is not covered by their parent(s)/guardian(s) insurance policy they MUST purchase temporary coverage for the summer session. This would be specific for those student-athletes that are covered during the school year by the Aetna Student Health policy.
If you have not been cleared by a University of Portland team physician, the Student-Athlete will not be permitted to participate in any summer workouts. In addition, the University of Portland is not physically or financially responsible for those student-athletes that are injured participating in off campus summer training.

Insurance Coverage for International Student-Athletes:
All international student-athletes must have an insurance policy that covers them here in the United States.  A policy from another country that covers the student-athlete for emergencies only in the United States will not be sufficient.  All international student-athletes who do not have the appropriate health insurance will automatically be signed up for the school’s insurance policy.  The student-athlete may or may not be responsible for the cost of this insurance policy.
 
Medical Bills:
In the event that a student-athlete should receive a bill/statement for an injury/illness that occurred as a direct result of participation in intercollegiate athletics, the student-athlete must submit the bill/statement to a University of Portland athletic trainer or insurance coordinator in a timely manner.  Bills not received in a timely manner may be the responsibility of the student-athlete.  The University of Portland Athletic Department will not be responsible for any delays in payment, collections, credit reports, etc., that occur due to bills not being submitted.  Please submit bills to:
University of Portland
Athletics – Insurance Coordinator
5000 N Willamette Blvd
Portland, OR 97203

Physician Referral Policy and Second Opinion Policy
When an injury occurs from a result of participation in the student-athlete’s varsity sport, the student-athlete must notify the athletic trainer for their sport.  The athletic trainer will evaluate the injury and determine the best course of treatment for that injury.  This may include a referral to one of the team physicians.  In this instance, the University of Portland’s insurance policy will act as a secondary insurance for all costs that are associated with that injury.  This may include physician exam fees, diagnostic testing, laboratory work, and prescriptions.  The participation status for the student-athlete will be determined by the team physician and the Sports Medicine Staff.  Should a student-athlete seek medical care without receiving a referral from the Sports Medicine staff, the student-athlete will be held financially responsible for all associated costs for that injury and the University of Portland Athletic Department insurance WILL NOT be billed as a secondary insurance.  A University of Portland team physician will still have the final determination of the student-athlete’s clearance for participation.
If a student-athlete is referred to a University of Portland team physician for an athletic injury and they would like a second opinion, they must seek the approval of the Sports Medicine Staff prior to seeing another physician.  If the student-athlete receives approval from the Sports Medicine Staff, the University of Portland athletic insurance will serve as a secondary insurance for all associated medical costs from the second opinion.  Failure to receive approval from the Sports Medicine Staff will result in the student-athlete being held financially responsible for the costs associated with seeking a second opinion.  The team physician will still have the final determination for clearance for participation regardless of the outcome of the second opinion.

Health Insurance Portability and Accountability Act (HIPAA)
The University of Portland has a privacy and patient confidentiality standard in place to ensure appropriate access to or disclosure of protected health information.  A federal law, the Health Insurance Portability and Accountability Act (HIPAA), also provides additional safeguards for ensuring that health information is adequately protected.  HIPAA requires the University of Portland to provide a Notice of Privacy Practices (Notice) which explains how protected medical information may be used and disclosed, and it also explains patient rights related to personal medical information.
The Chiles Center Athletic Training Room and all certified athletic trainers are covered entities for HIPAA regulations.  In compliance with HIPAA regulations and University of Portland policies, our student-athletes are provided annually with a Notice of Privacy Practices.  The notice explains how the athletic training room staff may use and disclose student-athlete protected health information to carry out treatment, payment for services, and health care operations.  Other reasons to use and disclose protected information as permitted or required by law are also referred to in the notice.  The notice also explains student-athlete rights to review and control protected health information and explains the responsibility of the athletic training room staff has to protect student-athlete information.
The Sports Medicine Staff is committed to protecting medical information about our student-athletes.  All student-athlete medical information and charts are to be kept in the strictest confidence in accordance with HIPAA regulations.  The health status of any student-athlete will not be discussed to anyone other than those individuals whom the student-athlete has authorized us to discuss with.  Student-athlete’s charts will be kept in a locked cabinet, and personal charts will be kept in this file when not in use.  Furthermore, a student-athlete’s chart will not leave the athletic training room for any reason.  Authorized information to be shared with our health care team will be copied and sent to the provider.  Personal information will not be shared over non-secured emails, text messages, etc.  All injury documentation will be stored on the computers in the athletic training room.  The program is secured with a login and password for each staff member.  The injury documentation software will not be left open on any computer for any reason. 
Any violation of this policy by staff members, athletic trainers, or coaches should be immediately reported to the Head Athletic Trainer or HIPAA compliance coordinator for the university.  No health information will be provided to any member of the press.  All violations are subject to all applicable federal fines and penalties.

Concussion Management Policy
A concussion has been defined as a clinical syndrome that is characterized by immediate and transient posttraumatic impairment of neural functions after receiving a blow to the head.  This is commonly seen in contact sports such as football, ice hockey, field hockey, lacrosse, etc.  However, concussions are becoming more prevalent in all types of athletic activities.
A direct blow to the head can come in one of two ways.  An athlete may be struck in the head by another object such as a baseball, soccer ball, etc.  The second occurs when an athlete is struck by a fixed object such as a goalpost, the floor, another player, etc.  Regardless of the source of the blow to the head, the athlete’s brain will experience acceleration, deceleration, rotational, and/or shear forces that produce movement of the brain within the skull and may cause a disruption in neural function.  This disruption cannot be seen, but detected by a thorough evaluation.
The signs and symptoms of a concussion can be variable depending on the nature of the blow to the head.    Common signs and symptoms of a concussion include, but are not limited to:
-  Headache                        - Ringing in the ears (tinnitus)             - Nausea
-  Irritability                         - Confusion                                                 - Disorientation
- Dizziness                           - Loss of Consciousness                         - Loss of memory (Amnesia)
- Blurred Vision                 - Difficulty concentrating                      - Sleep disturbance
The University of Portland Sports Medicine department has adopted the following policy for the management of concussions. Each concussion will be managed on an individual basis. Every student athlete will complete a baseline ImPACT test (Neurocognitive exam). The baseline ImPACT test should be completed prior to the first official practice of the student athletes first year on campus. When a concussion is suspected a member of the Sports Medicine Team will immediately evaluate the student athlete utilizing the SCAT3.  No student athlete who is diagnosed with a concussion or thought to have a concussion will be allowed to return to participation that same day. Once the student athlete has been diagnosed with a concussion, they will undergo a period of mental and physical rest. Each subsequent day the student athlete will fill out a post-injury symptom score sheet. Once the student athlete is symptom free for a full twenty-four (24) hours, they may begin a gradual progression back into activity. The gradual progression into activity will be as follows:
1.Rest until asymptomatic at rest (24 hours)
2.Light aerobic exercise for 15-20 minutes
3.Moderate intensity aerobic exercise (30 mins)
4.Sport specific training (ball handling, passing, light running, etc)
5.Non-contact training drills, including full exertion interval training (may start resistance training)
6.Full contact training*
7.Return to competition
 
* Prior to the student athletes first day of contact practice they will re-take the ImPACT test in addition to a physical evaluation by a member of the Sports Medicine Team.
Should the student athlete have any increase in signs or symptoms of a concussion during any stage of the aforementioned progression, they will immediately halt the activity and rest for the remainder of that day.  They will continue the progression once they are asymptomatic and they will begin the progression at the step prior to where the signs and symptoms returned.  Once they have completed steps 1-6 and have been cleared to do so by a member of the Sports Medicine team they may return to full participation.
In some cases symptoms of concussion may last for weeks to even months following injury. In cases where student athletes are still experiencing concussion symptoms for three (3) weeks following their injury will be referred to the Providence Concussion Program.

Return to Learn
Student athletes who have been diagnosed with a concussion are required to meet with the Academic Services department the day after injury to discuss academic progress through their injury. The Sports Medicine team will work directly with the Academic Services department to communicate progress and assist with any academic accommodations that may be needed for each student athlete who has suffered a concussion.

Nutritional Supplement Policy
A dietary supplement is defined as a product taken by mouth that contains “dietary ingredients” that are intended to supplement the diet.  “Dietary ingredients” generally consist of vitamins, minerals, herbs and other botanical substances, amino acids, enzymes, and metabolites.  Dietary supplements are available in a variety of ways including drinks, powders, tablets, capsules, and soft gels. 
In the United States, dietary supplements are under-regulated by the Food and Drug Administration.  Because they are not strictly regulated, substances may be in the supplement without being listed on the ingredient list.  Therefore, the purity of the contents cannot be guaranteed.  A positive drug test may result if a student-athlete is taking a dietary supplement that contains a banned substance, whether or not that substance is listed on the label of the supplement.
Because of the impurity of dietary supplements, no member of the University of Portland Athletic Department will recommend that any student-athlete take any dietary supplement.  Any student-athlete that wishes to take a dietary supplement does so at their own risk.  The ingredients of a dietary supplement may be screened through the Resource Exchange Center on the Drug Free Sport website.  However, this screening will only verify the ingredients that are listed on the label.  A positive drug test is still possible even after the screening has been performed.  All questions regarding dietary supplements should be directed to the Sports Medicine Staff.

Body Piercing Policy
Any body piercing (i.e. ears, nose, tongue, eyebrows, etc.) may not be worn during participation in intercollegiate athletics at the University of Portland.  Any injury resulting from wearing a piercing is the sole responsibility of the student-athlete.

Pregnant Student-Athlete Policy
A student-athlete who becomes pregnant must report her pregnancy to a University of Portland team physician and/or Sports Medicine Staff member as soon as possible to eliminate any health risks to both the mother and unborn child.  All information pertaining to the pregnancy will remain confidential.  Only those individuals that the student-athlete consents to will be informed.  The student-athlete, her personal physician, and the University of Portland team physician will weigh the danger of athletic participation.  If the decision is made to allow the pregnant student-athlete to participate, a document of understanding and a waiver must be signed by the student-athlete and team physician prior to her participation in athletics.

Sickle Cell Policy
Sickle Cell Anemia is a genetic blood disorder that alters the shape of red blood cells in the body and restricts the body’s ability to distribute oxygen.  Normal red blood cells are shaped round and can easily move throughout the body.  The red blood cells of someone who has sickle cell anemia will be in the shape of a farmer’s sickle.  Because of this sickle shape, these red blood cells will have difficulty moving throughout the body; thus, vital oxygen is not distributed efficiently.   The prevalence of this disease in the United States is approximately 1 in every 500 African Americans, and 1 in every 10,000 Caucasians. 
Signs and symptoms of sickling during activity include unusual fatigue, shortness of breath, dizziness, headache, coldness in the hands and/or feet, pale skin color, chest pain, and sudden pain throughout the body.  The symptoms of the disease will vary from individual to individual, and the severity may vary as well.
The University of Portland has adopted the following policy regarding sickle cell anemia.  All student-athletes at their initial physical will be given the opportunity to be tested.  The University will cover all costs associated with the screening for those student-athletes who are receiving athletic aid.  Those student-athletes who are not receiving athletic aid will be responsible for the cost of the test.  Student-athletes who choose to be tested will have the test performed as soon as possible.  If the test is negative, no further action will take place.  Should the test be positive, the following precautions will be taken to ensure safe participation in collegiate athletics:

• The student-athlete and their coaches will be educated on the disease.
• The student-athlete will have a gradual progression into weight training, conditioning, and practice.
• The student-athlete will not be required to participate in timed conditioning drills such as timed mile runs, timed sprint drills, etc.
• The student-athlete will be removed from participation immediately once signs and symptoms of complication begin to occur during any activity.

Student-athlete who decline to be tested for sickle cell will participate at their own risk.

Medication Policy
Any request for over the counter (OTC) medications (such as ibuprofen, acetaminophen, cold medicines, etc.) should be brought to the attention of the Sports Medicine Staff.  Upon approval from a staff member, the student-athlete will be dispensed 1 or 2 doses of a medication.  No student-athlete is allowed to have access to any medication without approval from a staff member.  Furthermore, no student-athlete is allowed to dispense this medication on their own.  Either a staff member or an athletic training student aid must provide the medication to the student-athlete.  All dispensed medication will be recorded on the appropriate form.
If a student-athlete is given a prescription for medication that is from an athletic related injury, the Sports Medicine Staff will cover the cost of the medication after their insurance has been billed.  In order for the student-athlete to be reimbursed, they must first determine that the prescription will be covered by authorization from the Sports Medicine Staff.  The student-athlete must get the prescription filled and pay for it up front.  They are then required to return the receipt to the Sports Medicine Staff.  The student-athlete will then be reimbursed for the cost of the prescription.  The athletic training staff will not cover the cost of any prescription if it is for an illness, a non-athletic related injury, or if the student-athlete failed to provide their insurance information.

ADD/ADHD Medications
The NCAA has a policy on Medical Exceptions during drug testing for those athletes using prescription, banned drugs to treat ADD/ADHD.  In order for a student athlete to be granted a medical exception for the use of a medication that appears on the banned substance list, the student athlete must do the following:
1.  The student-athlete must declare the use of the banned medication to the University of Portland Sports Medicine Staff.
2.  The student-athlete’s physician must document that alternative medications that are not on the NCAA Banned substance list have been considered.
3.  The student-athlete in conjunction with their physician must present documentation of the diagnosis of their condition to the Athletic Training Room at the start of the school year, or as soon as diagnosed.  This includes the diagnosing physician’s notes as well as all testing and other documentation that helped lead to the diagnosis.
4.  The student-athlete must provide documentation to the Athletic Training Room from the prescribing physician explaining the course of treatment and the current prescription for the medication.
**Ritalin and Adderall are two of the most common medications that appear on the NCAA banned substance**
If you have any questions, please contact the University of Portland Sports Medicine Staff at (503) 943-7462.