Amended in Assembly May 1, 2014

Amended in Assembly April 1, 2014

California Legislature—2013–14 Regular Session

Assembly Bill No. 2127

Introduced by Assembly Member Cooley

February 20, 2014

An act to amend Section 49475 of, and to add Section 35179.5 to, the Education Code, relating to interscholastic sports.

LEGISLATIVE COUNSEL’S DIGEST

AB 2127, as amended, Cooley. Interscholastic sports: full-contact begin insert football end insert practices: concussions and head injuries.

(1) Existing law establishes a system of public elementary and secondary schools operated by local educational agencies throughout this state. Under existing law, public and private secondary schools participate in interscholastic sports, and are authorized to enter into associations or consortia to enact and enforce rules relating to eligibility for, and participation in, these activities. Existing law acknowledges the role of the California Interscholastic Federation in the regulation of interscholastic sports in this state.

This bill would express legislative findings and declarations relating to head injuries sustained by high school pupil-athletes, particularly those who play football. The bill would prohibit high school and middle school football teams of school districts, charter schools, or private schools that elect to offer an athletic program from conducting more than 2 full-contact practices, as defined, per week during the preseason and regular season, as begin delete defined, and end delete begin insert defined. The bill would also prohibit the full-contact portion of a practice end insert from exceeding 90 minutes in any single day begin delete the full-contact portion of a practice end delete , and completely prohibit full-contact practice during the off-season, as defined. The bill would urge the California Interscholastic Federation to develop and adopt rules to implement this provision.

The bill would provide that these provisions do not prohibit the California Interscholastic Federation, an interscholastic athletic league, a school, a school district, or any other appropriate entity from adopting and enforcing rules intended to provide a higher standard of safety for athletes than the standard established under the bill.

(2) Existing law requires a school district, charter school, or private school, if it offers an athletic program, to immediately remove an athlete from an athletic activity for the remainder of the day if the athlete is suspected of sustaining a concussion or head injury, and prohibits the athlete from returning to the athletic activity until the athlete is evaluated by a licensed health care provider, trained in the management of concussions and acting within the scope of his or her practice, and the athlete receives written clearance from the licensed health care provider to return to the athletic activity. Existing law also requires, on a yearly basis, a concussion and head injury information sheet to be signed and returned by the athlete and athlete’s parent or guardian before the athlete initiates practice or competition.

This bill would provide that an athlete suspected of sustaining a concussion or head injury is prohibited from returning to the athletic activity until the athlete is evaluated by a licensed health care provider, begin insert as defined to mean a licensed health care provider end insert trained in the management of concussions and acting within the scope of his or her practice, and the athlete receives written clearance from begin delete the end delete begin insert a end insert licensed health care provider. The bill would further provide that, if begin delete the end delete begin insert a end insert licensed health care provider determines that the athlete sustained a concussion or a head injury, the athlete is required to complete a graduated return-to-play protocol of no less than 7 days in duration under the supervision of a licensed health care provider. The bill would urge the California Interscholastic Federation to develop and adopt rules and protocols to implement this provision.

Vote: majority. Appropriation: no. Fiscal committee: no. State-mandated local program: no.

The people of the State of California do enact as follows:

SECTION 1.  

The Legislature finds and declares all of the
following:

(a) Concussions and other mild traumatic brain injuries affect
thousands of California’s high school pupil-athletes each year.
Many concussions or head injuries go undetected due to a lack of
recognition of symptoms or intentional underreporting of
symptoms.

(b) Most concussions do not involve a loss of consciousness,
according to the federal Centers for Disease Control and
Prevention.

(c) The symptoms of concussions vary, and most symptoms are
not necessarily specific to concussion. Symptoms may include
dizziness, sensitivity to light, and loss of consciousness.

(d) Pupil-athletes who suffer a concussion are more likely to
suffer an additional concussion than someone who has never been
concussed.

(e) Children and adolescents are skeletally immature, and are
thus more likely to be concussed or suffer a brain injury than adults.

(f) Many athletes want to keep playing despite a concussion or
head injury. In a study published by the American Academy of
Pediatrics in October 2012, 32 percent of high school football
players reported that they had experienced symptoms of concussion
but did not pursue medical attention.

(g) Many high schools lack the standard of care afforded to
college and professional players. At the collegiate and professional
level, neurologists and other physicians are available. High schools
cannot afford this. In California, coaches or athletic trainers are
required to remove any player from practice or competition if that
player is exhibiting signs or symptoms of a concussion or head
injury.

(h) Medical experts recommend that the recovery and
rehabilitation process from a concussion proceed conservatively.
Experts suggest begin insert that the recovery and rehabilitation process should
have end insert six stages, which should be supervised begin delete , end delete begin insert and end insert should last at
least 24 hours each, and that athletes should be prohibited from
proceeding until they are asymptomatic. According to the American
Academy of Pediatrics, adolescents suffer from post-concussive
symptoms longer than adults or college students.

(i) Researchers agree that there is no way to “condition” the
brain for hits to the head. Researchers strongly contend that hits
to the brain should be minimized as much as possible.

(j) Several academic and scientific studies have asserted that
the cumulative effects of sub-concussive blows to the brain due
to football may contribute to long-term brain damage and
early-onset dementia, including chronic traumatic encephalopathy
(CTE).

(k) A Boston University study in 2012 studied the brains of 85
deceased athletes and military veterans with histories of repeated
mild traumatic brain injuries. Eighty percent of those studied had
CTE. Six of the deceased were football players who had not played
past high school.

(l) In 2010, a 21-year-old University of Pennsylvania football
player committed suicide. After a subsequent brain study, he was
found to have early stages of CTE. The athlete had never been
diagnosed with a concussion, and had never even complained of
a headache. Doctors contend that his CTE must have developed
from concussions he dismissed or from the thousands of
sub-concussive collisions he endured while playing football, most
of which occurred while his brain was still developing.

(m) Nineteen states have banned off-season full-contact high
school football practices. California allows each of its 10 sections
to make its own determination. Several of those sections still allow
full-contact summer and spring practices.

(n) Several states have limited full-contact practices during the
preseason and regular season.

(o) Maryland and Connecticut require that a supervised
return-to-play protocol be followed in the event of a concussion
or head injury.

SEC. 2.  

Section 35179.5 is added to the Education Code, to
read:

35179.5.  

(a) (1) If a school district, charter school, or private
school elects to offer an athletic program, it shall comply with all
of the following:

(A) A high school or middle school football team shall not
conduct more than two full-contact practices per week during the
preseason and regular season.

(B) The full-contact portion of a practice shall not exceed 90
minutes in any single day.

(C) A high school or middle school football team shall not hold
a full-contact practice during the off-season.

(2) For purposes of this section, a team camp session shall be
deemed to be a practice.

(b) The California Interscholastic Federation is urged to develop
and adopt rules to implement this section.

(c) As used in this section:

(1) “Full-contact practice” means a practice where drills or live
action is conducted that involves collisions at game speed, where
players execute tackles and other activity that is typical of an actual
tackle football game.

(2) “Off-season” means a period extending from the end of the
regular season until 30 days before the commencement of the next
regular season.

(3) “Preseason” means a period of 30 days before the
commencement of the regular season.

(4) “Regular season” means the period from the first
interscholastic football game or scrimmage until the completion
of the final interscholastic football game of that season.

(d) This section shall not prohibit the California Interscholastic
Federation, an interscholastic athletic league, a school, a school
district, or any other appropriate entity from adopting and enforcing
rules intended to provide a higher standard of safety for athletes
than the standard established under this section.

SEC. 3.  

Section 49475 of the Education Code is amended to
read:

49475.  

(a) If a school district, charter school, or private school
elects to offer an athletic program, the school district, charter
school, or private school shall comply with both of the following:

(1) An athlete who is suspected of sustaining a concussion or
head injury in an athletic activity shall be immediately removed
from the athletic activity for the remainder of the day, and shall
not be permitted to return to the athletic activity until he or she is
evaluated by a licensed health care provider begin delete who is trained in the
management of concussions and is acting within the scope of his
or her practice end delete . The athlete shall not be permitted to return to the
athletic activity until he or she receives written clearance to return
to the athletic activity from begin delete that end delete begin insert a end insert licensed health care provider. If
begin delete a end delete begin insert the end insert licensed health care provider determines that the athlete
sustained a concussion or a head injury, the athlete shall also
complete a graduated return-to-play protocol of no less than seven
days in duration under the supervision of a licensed health care
provider. The California Interscholastic Federation is urged to
work in consultation with the American Academy of Pediatrics
and the American Medical Society for Sports Medicine to develop
and adopt rules and protocols to implement this paragraph.

(2) 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 before the athlete initiates practice or
competition.

begin insert

(b) As used in this section, “licensed health care provider”
means a licensed health care provider who is trained in the
management of concussions and is acting within the scope of his
or her practice.

end insert begin delete

(b)

end delete

begin insert (c) end insert  This section does not apply to an athlete engaging in an
athletic activity during the regular schoolday or as part of a physical
education course required pursuant to subdivision (d) of Section
51220.