BILL ANALYSIS                                                                                                                                                                                                    





                            SENATE COMMITTEE ON EDUCATION
                                Alan Lowenthal, Chair
                              2011-2012 Regular Session
                                          

        BILL NO:       AB 25
        AUTHOR:        Hayashi
        AMENDED:       May 27, 2011
        FISCAL COMM:   No             HEARING DATE: June 22, 2011
        URGENCY:       No             CONSULTANT:    Lynn Lorber

         SUBJECT  :  Concussions and head injuries.
        
         SUMMARY
         
        This bill requires a school district that elects to offer athletics 
        to require that an athlete suspected of having a concussion or head 
        injury to be removed from the activity and be cleared by a health 
        care provider before returning to the activity.  Any group that uses 
        school facilities or grounds for supervised recreational activities 
        must also comply with these requirements.

         BACKGROUND
         
        Current law, known as the Civic Center Act:

        1)   Authorizes school districts to grant the use of school 
             facilities or grounds to various organizations and groups for 
             specified purposes, including supervised recreational 
             activities.  (Education Code  38131)

        2)   Requires school districts to grant the use of school facilities 
             or grounds to non-profit organizations and to clubs or 
             associations organized to promote youth and school activities, 
             including the Girl Scouts, Boy Scouts, Camp Fire, 
             parent-teachers' associations, and school-community advisory 
             councils.  (EC  38134)

        3)   Requires any school district that authorizes the use of 
             facilities or grounds to be liable for any injury resulting 
             from the negligence of the district in the ownership and 
             maintenance of those facilities or grounds.  Any group using 
             the facilities or grounds is liable for any injuries resulting 











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             from the negligence of that group during the use of those 
             facilities or grounds.  The districts and the group are each to 
             bear the cost of insuring against its respective risks, and 
             must each bear the costs of defending itself against claims 
             arising from those risks.  (EC  38134) 

        The California Interscholastic Federation's Bylaw 313 requires a 
        student-athlete who is suspected of sustaining a concussion or head 
        injury in a practice or game to be removed from competition at that 
        time for the remainder of the day.  A student-athlete who has been 
        removed from play is prohibited from returning to play until the 
        athlete is evaluated by a licensed health care provider trained in 
        education and management of concussion and receives written 
        clearance to return to play from that health care provider.  A 
        Question & Answer is listed below Bylaw 313, indicating that the 
        scope of practice for a "licensed health care provider" will limit 
        the evaluation to a medical doctor or doctor of osteopathy.

         ANALYSIS
         
         This bill  requires a school district that elects to offer athletics 
        to require that an athlete suspected of having a concussion or head 
        injury to be removed from the activity and be cleared by a health 
        care provider before returning to the activity.  Any group that uses 
        school facilities or grounds for supervised recreational activities 
        must also comply with these requirements.  Specifically, this bill:

        1)   Requires: 

             a)        A school district that elects to offer an athletic 
                  program to comply with all of the following:

                  i)             An athlete who is suspected of sustaining a 
                       concussion or head injury in an athletic activity 
                       shall be immediately removed from the activity for 
                       the remainder of the day.

                  ii)            The athlete shall not be permitted to 
                       return to the activity until he or she is evaluated 
                       by a licensed health care provider, trained in the 











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                       management of concussions, acting within the scope of 
                       his or her practice.  The athlete shall not be 
                       permitted to return to the activity until he or she 
                       receives written clearance to return to the activity 
                       from that licensed health care provider.  

                  iii)           On a yearly basis, a concussion and head 
                       injury information sheet shall be signed and returned 
                       by the athlete and the athlete's parent or guardian 
                       prior to the start of the athlete's season of 
                       practice or competition.  

             a)        Groups that utilize school district facilities or 
                  grounds for recreational activities to provide a statement 
                  of compliance with the policies for the management of 
                  concussion and head injury described above.

        1)   Exempts an athlete engaging in an athletic activity during the 
             regular schoolday or as part of a physical education course.

        STAFF COMMENTS
         
         1)   Purpose of the bill  .  According to the author, "What may appear 
             to be a minor blow to the head can have serious, even fatal, 
             consequences.  Concussions have serious immediate and long-term 
             effects, especially on young athletes.  While not all head 
             injuries can be prevented, the effects can be mitigated by 
             knowing when it is safe to return to play.  Although the 
             California Interscholastic Federation recently adopted a policy 
             requiring high school students suspected of sustaining a 
             concussion to leave play until they are appropriately 
             evaluated, this does not reach all student athletes."  

         2)   Existing policy for high school athletics  .  The California 
             Interscholastic Federation's (CIF) Bylaw 313 is nearly 
             identical to this bill's provisions relative to the removal of 
             an athlete from play and clearance from a health care provider. 
              The CIF rules govern high school athletics; this bill 
             essentially extends the CIF rules to all K-12 athletics (team 
             sports), as well as to all supervised recreational activities 











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             held on school grounds.  

         3)   Civic Center Act  .  This bill requires any group that uses 
             school facilities or grounds for supervised recreational 
             activities to comply with the policies for the management of 
             concussion and head injury established in this bill.  This bill 
             appears to apply to groups such as sports leagues and after 
             school programs rather than the Girl Scouts, but it is not 
             clear what "supervised recreational activities" includes.  If 
             the Girl Scouts ever do any type of organized group physical 
             activity, will they be required to comply with this bill?  
             Should after school programs required to comply?  Should this 
             bill apply only to sports teams and leagues that use fields at 
             schools?  Staff recommends that the scope of this bill be 
             clarified.

         4)   Liability  .  Current law provides that school districts are 
             liable for any injury resulting from the negligence of the 
             district in the ownership and maintenance of the facilities or 
             grounds, and groups using the facilities or grounds are liable 
             for any injuries resulting from the negligence of that group 
             during the use of those facilities or grounds.  This bill 
             requires groups using school facilities or grounds to provide a 
             statement of compliance with policies for the management of 
             concussion and head injury.  Concerns have been raised that 
             districts could be held responsible for ensuring groups using 
             school facilities or grounds are actually in compliance, 
             although the bill does not specifically require districts to 
             ensure outside groups comply.  Staff recommends an amendment to 
             specify that districts are to collect the statements of 
             compliance but are not required to ensure that groups using 
             school facilities or grounds are in compliance with concussion 
             policies.  

         5)   Recognizing a concussion or head injury  .  This bill requires an 
             athlete suspected of having a concussion or head injury to be 
             removed from the activity for at least the remainder of the 
             day.  This bill does not address training in the recognition of 
             concussions or head injuries.  Will coaches and other 
             supervising adults know how to recognize a concussion? 











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         6)   Fiscal impact  .  While this bill is flagged as being non-fiscal, 
             according to the Assembly Appropriations Committee analysis, 
             this bill would impose:

             a)        General Fund (Proposition 98) costs, of at least 
                  $150,000, to school districts to develop a concussion and 
                  head injury policy for grades K-12.  The majority of these 
                  costs would be one-time, but there would be on-going costs 
                  for record keeping duties.  
             Even though school districts participating in CIF sports adhere 
                  to a similar policy, there is a potential for them to file 
                  a state mandate claim for the development of the policy 
                  and on-going record keeping associated with the 
                  requirements of this bill.  These General Fund 
                  (Proposition 98) costs would be in the range of $150,000 
                  to $200,000 and in addition to the costs referenced above.

             b)        General Fund administrative costs to the California 
                  Department of Education (CDE), of approximately $50,000, 
                  to ensure school districts are complying with requirements 
                  of this bill.  

             c)        Potential increased liability costs in the tens to 
                  hundreds of thousands of dollars to school districts 
                  regarding compliance with the requirements added to the 
                  Civic Center Act by this bill.  Current law requires 
                  school districts to be liable for any injuries resulting 
                  from the negligence in the ownership and maintenance of 
                  their facilities or grounds.  This bill requires school 
                  districts to ensure any organization using their 
                  facilities under the Civic Center Act provide a statement 
                  of compliance regarding a concussion/head injury policy 
                  for athletes.  This requirement expands the liability 
                  issues for school districts to potentially include the 
                  injury of an athlete if the organization does not comply 
                  with the concussion/head injury policy.   

         7)   Prior legislation  .  AB 1646 (Hayashi, 2010) and AB 533 
             (Hayashi, 2009) each would have required training for athletic 











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             coaches in the identification of symptoms of head and neck 
             injury.  Both bills were held on the Assembly Appropriations 
             Committee's suspense file.

         SUPPORT
         
        American Federation of State, County and Municipal Employees
        California Chiropractic Association
        California Interscholastic Federation
        California Optometric Association
        California School Employees Association
        California Speech-Language-Hearing Association
        California State PTA
        San Francisco Unified School District

         OPPOSITION

         Contra Costa County Superintendents' Coalition
        Riverside County School Superintendents' Association
        Riverside Unified School District