The West Virginia Athletic Trainers Association wants standardization and certification of those working with student athletes in the state.
The state Legislature says that would be inefficient and cumbersome.
The two sides of what many educators believe to be a critical issue have been at a near standstill on the matter for four years, making little headway. Now it seems there may be light at the end of what has become a very long tunnel.
A report by the state Legislative Auditor's Office Performance Evaluation & Research Division in November says licensing athletic trainers as proposed by the state trainers' group would impose more cost than benefits to society.
The state instead suggested that the group pursue other methods of certification. The report listed such possibilities as the organization working with physical therapists or chiropractors in the state.
"It comes down to the bottom line, and that's all there is to it," said Robert Cable, the past president of the state trainers group who filed the request for mandated state licensure of all athletic trainers within West Virginia.
"In our sunrise application, we had to show instances of public harm as a result of there being a lack of a required certification," Cable said. "There weren't enough instances of that kind of harm for them. They're concerned with how much money it would cost the state to actually license these professionals."
West Virginia is one of only three states that currently has no form of certification for those practicing as athletic trainers.
Maryland just adopted such a policy earlier this year, thus making the Mountain State the only state in the region without one.
"We've now become the dumping ground for those who can't live up to the standards in bordering states, and that's a big concern," said Ericka Zimmerman, the athletic training program Director at the University of Charleston.
"The concern is that we're finding individuals who are calling themselves an athletic trainer when they're not a certified athletic trainer, and there's a big difference. These are people who probably would have been caught had there been some sort of state process." Zimmerman offered a chilling hypothetical.
"Let's say I'm in this state, any state, and I lose my license because I've been abusing children," she said. "I can cross the border, and if that state doesn't have a policy, no one would ever know."
The report says such instances simply haven't occurred.
"There have been no cases of complaints, misrepresentation or revocation" in the past five years, according to the National Athletic Trainers Association Board of Certification, the report says.
The state report, written by Legislative Auditor Aaron Allred and Director John Sylvia, adds, "The West Virginia Department of Education, which certifies and employs athletic trainers in West Virginia, also had had no cases of complaints, misrepresentation or revocation in West Virginia."
Still, there were 39 examples of substantiated harm against the public by athletic trainers nationally in the 10 years prior to the application. Of the 39, only one occurred in West Virginia.
That case was in Wood County, where a parent sued the Wood County Board of Education because an athletic trainer placed the contact lens of a student athlete in an eye irrigation solution that caused a left corneal abrasion, according to the report.
There are 126 athletic trainers working in West Virginia that are not certified by the national board.
State officials have maintained certification would negatively affect both the Department of Education that most commonly employs trainers as well as other occupations that require them.
Cable said that figure and its assessment by the state are both misleading.
"The only sport that is required right now by the state to have an on-site athletic trainer is varsity football," Cable said. "Not junior varsity, not freshman or middle school even. All that is required for a person to earn West Virginia certification is the completion of two courses in the field."
There are 252 national board-certified athletic trainers currently working in the state. However, most are working within quick driving distance from West Virginia's largest population centers, Cable said.
"If you're in Monongalia, Marion or Taylor counties, you have easy access to an athletic trainer because WVU places graduates in the field in those areas," said Cable, the head athletic trainer at Fairmont State University. "It's the same thing with Charleston, or Huntington and Marshall's graduates.
"When you get out of those larger areas though, athletic trainers are much fewer and farther between."
Five colleges and universities in West Virginia have accredited athletic training programs. Wheeling Jesuit University will offer such a program for the first time in the 2008-09 school year.
WVU, UC, Marshall, Fairmont State and Alderson-Broaddus currently have accredited programs.
Cable added that exemptions are often given to first responders, EMT workers and nurses who serve as athletic trainers in areas where few trainers are available. Due to their lack of full training and understanding of the subject matter, he said, the likelihood of tragedy multiplies.
"A lot of the important things are in knowing when an athlete is ready to return to the field," Cable said. "Chuck Schofield was a perfect example of that and it might have been able to be avoided."
Schofield was a football player at Ritchie County High School in the early 1990s. One week after sustaining a head injury in 1994, he was cleared to play against Wirt County. Schofield collapsed and died during the game. The Rebels' home field is named in his honor.
The state trainers association is investigating the pros and cons of seeking certification under an existing state medical board, namely the Board of Chiropractic or the Board of Physical Therapy.
Cable is concerned about that possibility.
"We're worried that it might drastically limit our scope by going in with them," he said. "However, they seem to be a little more interested in working with us than they have been in the past."
Zimmerman, meanwhile, said many of the roadblocks to attaining certification stem from a wide misunderstanding of the nature of athletic training.
"There's been a process of a lot of education and there's been a lot of misinformation about what we do," Zimmerman said. "I think a lot of people still don't know what is meant by 'athletic trainer.'"
Still, cost remains the dominant issue. If individuals currently employed by school boards as uncertified athletic trainers are required to pass the national certification test to work within the state, they would incur an additional cost of $550 each.