BILL ANALYSIS Ó
Senate Appropriations Committee Fiscal Summary
Senator Christine Kehoe, Chair
AB 25 (Hayashi)
Hearing Date: 08/15/2011 Amended: 07/06/2011
Consultant: Jacqueline Wong-HernandezPolicy Vote: Education 9-0
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BILL SUMMARY: AB 25 requires any school district which offers
athletics to require that an athlete suspected of sustaining a
concussion or head injury to be removed from the activity, and
be evaluated and cleared by a licensed health care provider
before returning to the activity. This bill requires that any
group that uses school facilities or grounds for supervised
recreational activities must also comply with these
requirements, as specified.
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Fiscal Impact (in thousands)
Major Provisions 2011-12 2012-13 2013-14
Fund
Head injury requirements Potentially significant workload;
non-reimbursable Local
Medi-Cal/Healthy Families Potentially significant ongoing
costs General/Federal
Third party activities Likely minor workload;
non-reimbursable Local
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STAFF COMMENTS: This bill meets the criteria for referral to the
Suspense File.
This bill requires a school district that offers athletics to
comply with various new regulations regarding head injuries and
concussions. While the provisions of this bill do not constitute
a reimbursable state mandate, because school districts are not
required to offer athletics, it functionally mandates new
activities for the majority of school districts which provide
athletics in one or more schools; they must either comply or
cancel their athletics programs.
AB 25 (Hayashi)
Page 1
Specifically, this bill requires that an athlete suspected of
sustaining head injury or concussion: A) be removed from the
activity for the remainder of the day; and B) not be permitted
to return to the activity until he or she is evaluated by a
licensed health care provider, trained in the management of
concussions, acting within the scope of his or her practice.
This bill specifies that 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. Enforcement would be done by individual schools,
at the local level, and any enforcement activities would be
costs to those entities not reimbursable by the state. Staff
notes, however, that schools are primarily funded by Proposition
98/General Fund, and this bill would add cost pressure to school
budgets.
These requirements are virtually identical to the California
Interscholastic Federation (CIF) Bylaw 313, which all high
schools who are members of CIF (virtually all California high
schools participating in athletics) are required to follow as a
condition of membership and competition. A clarification listed
below Bylaw 313 in CIF's published rules indicates that the
scope of practice for a "licensed health care provider" will
limit the evaluation to a medical doctor or doctor of
osteopathy. Schools already in compliance with CIF rules should
not incur additional costs for this provision.
While most participating high schools likely comply with the CIF
bylaws, this bill is intended to give greater force to the
specified safety measures. The intent is to increase compliance
by raising the issue to a state law rather than a competition
membership requirement; the practice would have force of law.
This bill also applies to elementary and middle schools; most
middle schools (and some elementary schools) also offer
athletics, but are not CIF members (as its jurisdiction is over
high school athletics). It is not known how many middle or
elementary school students suffer head injuries during
athletics, but these students would be subject to the new
requirements. Staff notes that the medical evaluation
requirements apply to any student who "is suspected of
sustaining a head injury," not only students specifically
suspected of sustaining concussions.
By increasing the enforcement of medical examinations for middle
AB 25 (Hayashi)
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and high school athletes, this bill will likely result increased
state costs in the Medi-Cal and Healthy Families programs; these
programs provide no-cost and low-cost (respectively) medical
coverage for children whose families meet certain income
eligibility requirements. There are more than 2 million
school-aged children enrolled in Medi-Cal statewide, and the
program generally receives 50% federal and 50% state (General
Fund) funding. Approximately 850,000 children under 19 are
enrolled in Healthy Families, which receives approximately 35%
federal and 65% state (General Fund) funds. It is not known how
many of these school-aged participants also participate in
school athletics programs, nor how many of them sustain head
injuries each year and would, thus, require doctors'
evaluations. To the extent that additional office visits are
required of children enrolled in Medi-Cal and Healthy Families,
those costs would be borne in part by the General Fund.
This bill also requires: A) that school districts provide
specified information to parents, as specified; and B) that the
school enforce compliance by third parties utilizing school
facilities for athletics, by requiring a form be filed with the
school agreeing to comply. Both requirements on schools would
likely result in workload increases to develop policies and
train staff on new rules. While schools are only required to
receive and retain forms, it is likely that they will need to
verify information and completeness of forms filed to avoid
potential liability. Any enforcement activities and costs would
not be reimbursable.