BILL ANALYSIS Ó 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 AB 25 Page 2 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 AB 25 Page 3 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 AB 25 Page 4 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? AB 25 Page 5 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 AB 25 Page 6 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