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EMS and HIPPA Guidelines

This article explains the basic information available regarding EMS coverage and seeks to assist Competition Management in obtaining the proper coverage for your venue.

Each recognized competition must comply with any Federal, State, County, Regional or Local laws which are applicable in connection with the competition. Some states, counties or municipalities have ordinances that require a certain amount of EMS coverage depending on the number of participants and spectators. It is the responsibility of each Competition Management to know and adhere to any such laws. Contact your local authorities for more information.

Prior to the start of your competition, make sure that you understand and are familiar with relevant federal, state, and local laws regarding emergency medical services (EMS) and health information. It is important that you discuss the role of the qualified medical personnel at your competition with them prior to their hiring to work at your competition so that issues such as relevant laws, including HIPAA, can be discussed ahead of time. It is important that everyone understands and is comfortable with their roles and responsibilities regarding the medical care at the competition prior to hiring and especially before the start of the competition. In particular, medical personnel need to be aware that providing the information requested on the Accident/Injury Report Form will be a part of their services to the competition.

It is a good idea to contact your Emergency Medical Services personnel and Veterinarian a few days before the start of your competition to verify everything. Make sure they know the date, location and time they are to be on grounds. This will help prevent late arrivals and/or no shows - remember the competition may not proceed without them.

You must hire qualified medical personnel that meet the minimum requirements as detailed in USEF’s General Rule 1211.5 and the medical personnel must also be working legally within their certified level in the state and/or local region that the competition will take place. For example an EMT (or, Paramedic, doctor or nurse) that is certified in one state is not always automatically certified to be employed at the same level in another state or location. Be aware that not every state requires that EMS personnel complete the National Registry (NREMT) certification and NREMT certification alone is not sufficient for certification in every state. Most states have laws that cover reciprocity of EMS certifications. You are not in compliance if you hire an EMT who can legally only provide First Aid where the show is located and the EMT is not legally or ethically in compliance if he or she is hired as an EMT but provides only First Aid services.

EMS personnel should be prepared to show their credentials and level of training when they arrive at your competition. Ask to see their driver’s license and their state and/or NREMT certifications to verify both their identity and their qualifications. EMS personnel are required to keep a copy of their certifications with them at all times. It is a good idea to make a copy of the certifications or at the least to record their license numbers for your records. It is also a good idea to verify the employment status of the qualified medical personnel that you have hired and to make sure that they will be working under a Medical Director (which will help to assure that you have hired qualified medical personnel who are legally able to perform the full scope of their skills).

HIPAA stands for the Health Insurance Portability and Accountability Act. According to HIPAA neither horse shows nor the USEF are defined as a covered entity (healthcare provider, health plan, or health care clearinghouses are defined as covered entities) that must follow the HIPAA laws. Additionally, according to HIPAA, protected health information may be released when it is authorized in writing by the individual. The USEF entry form includes a release of the information needed in order to complete an Accident/Injury Report form in the statement: “I AGREE that if I am injured at this competition, the medical personnel treating my injuries may provide information on my injury and treatment to the Federation on the official USEF accident/injury report form.” You may need to provide this information to the medical personnel at your competition.

The information requested on the Accident/Injury Form documents the narrative of the injury, the type of possible or suspected injury sustained, and the level of treatment given. This information is important for insurance and legal purposes as well as for statistics and determining preventative actions for USEF and your competition. When completing the form, the following should be kept in mind:

• Describe what happened to cause the injury, without assigning blame:
o “The horse refused the jump twice, on the third attempt the rider fell off when the horse ran-out to the left. The rider landed on her right arm.”

• Give a general idea of the type and severity of injury sustained:
o “The rider sustained a minor laceration on the right arm.”
o Or “The rider sustained a compound fracture of the right arm.”

• Keep in mind this is not a definitive diagnosis, or a detailed description of the condition of the injured person/horse. Use the words “possible” or “suspected” describe the type of injury if further diagnostic information is needed.

• Briefly document the treatment given:
o “The qualified medical personnel examined the rider from head to toe and cleaned the wound, placed a bandage over it, and recommended follow-up care with the family physician, if needed.”
o Or “The qualified medical personnel examined the rider from head to toe and stabilized the right arm with a sling and swath; then transferred care to the fire department for transport by ambulance to the hospital for x-rays.”

• HIPAA - http://www.hhs.gov/ocr/privacy/index.html
• National Registry of Emergency Medical Technicians (NREMT): https://www.nremt.org/nremt/about/nremt_news.asp
• Check Emergency Medical Personnel National Registry Status: https://www.nremt.org/nremt/about/checkEmtStatus.asp
• State EMS Agency Information Directory: https://www.nremt.org/nremt/about/emt_cand_state_offices.asp

IMPORTANT REMINDER – Platinum Performance/USEF Show Jumping Talent Search Class:

EQ113 Requirements for Specific Classes.
g. The jumping phase of the class shall be held first over a course of at least ten fences from 3’7” to 3’9” (1.10 - 1.15m.) in height with spreads to 4’11” (1.50m.). Each course must contain at least three fences set at 3’9” in height and none lower than 3’6”. The course must include a double and a triple combination, or 3 doubles. Additional spread fences are required elsewhere on the course. At “AA” rated outdoor competitions, a water-filled obstacle with a 10’ (3.05m) to 12’ (3.30m) spread (with or without a pole) must be included. At all other rated competitions a liverpool is required. At both East and West Coast Finals, a water obstacle of at least 10’ (3.05m) is required. The course should be of the type used in a Junior Jumper class. Time allowed will be figured at 350 meters per minute; may be timed either electronically or manually. To be judged on style and execution. Time and jumping faults should be taken into consideration in the judge’s evaluation of the rider. Two refusals will incur elimination.

A Presidential Modification has been granted to EQ113.14.g. This Presidential Modification will be effective retroactively from September 1, 2011 until April 1, 2012 and will waive the requirement of a Liverpool for the USEF Show Jumping Talent Search class at all rated competitions, other than “AA” rated outdoor events.

Attention all Jumper Judges: 2012 NAJYRC Certificates of Capability for US Show Jumping

Please note that a 3 meter open water jump, i.e. without a rail over the water, is required to be part of the course for this year’s NAJYRC Certificates of Capability. Riders and trainers may be requesting that 1.40m and 1.45m courses at your show include an open water obstacle to fulfill this requirement. Riders must verify their Certificate of Capability in writing from the horse show office with a signed judge’s card that indicates which jump is the open water or utilize the Certificate of Capability form. Click here for information about the 2012 NAJYRC and the Certificates of Capability. For more information, contact Jennifer Haydon, Director of Show Jumping National Programs at jhaydon@usef.org

Veterinary Education Update - 1 December 2011

FEI Veterinary Regulations (Article 1003) currently require that Veterinarians accessing the stable area at FEI events must be listed with the FEI by January 2012. To facilitate the implementation of this new system, the Bureau at the 2011 General Assembly approved postponing the enforcement of Article 1003 until 1 June 2012.
The intention of identifying FEI listed Veterinarians is in line with the Clean Sport initiative and the requirement to ensure there is a clear understanding of the FEI Veterinary and Equine Anti-Doping Regulations adopted in 2010. All veterinarians who must be listed will be invited to take a short multiple choice examination online. Free access to FEI Veterinary Regulations and all other resources will be permitted.
Further updates on the approach required for Veterinarians accessing the stable area at FEI events (including existing FEI Official Veterinarians) and the basic online examination will be issued by the FEI in 2012. In the meantime, all relevant categories of Veterinarians should start familiarising themselves with the 2012 FEI Veterinary Regulations.
If you have further queries at this time regarding the new education system and online examination, please contact Victoria Unt or Graeme Cooke .