BILL ANALYSIS                                                                                                                                                                                                    Ó



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          ASSEMBLY THIRD READING


          AB  
          2007 (McCarty)


          As Amended  April 26, 2016


          Majority vote


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          |Committee       |Votes|Ayes                  |Noes                |
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          |Arts            |5-0  |Chu, Levine, Low,     |                    |
          |                |     |Medina, Nazarian      |                    |
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          SUMMARY:  Would require amateur youth sports organizations to  
          adopt concussion treatment and recognition protocols similar to  
          those in existing law for student athletes, as specified.  Would  
          also require youth sports organizations to develop  
          return-to-play protocols, and provide yearly concussion and head  
          injury information sheets and education, as specified.  
          Specifically, this bill:


          1)Declares that a youth sports organization that elects to offer  
            an athletic program shall comply with all the following:
             a)   An athlete who is suspected of sustaining a concussion  
               or other head injury in an athletic activity shall be  








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               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. 
             b)   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 a  
               licensed health care provider. 


             c)   If the licensed health care provider determines that the  
               athlete sustained a concussion or other 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.


          2)Provides that if an athlete who is 17 years of age or younger  
            has been removed from athletic activity due to a suspected  
            concussion, the youth sports organization shall notify a  
            parent or guardian of that athlete of the time and date of the  
            injury, the symptoms observed, and any treatment provided for  
            the injury. 
          3)Requires, on a yearly basis, the youth sports organization  
            shall give a concussion and head injury information sheet to  
            each athlete.  The information sheet shall be signed and  
            returned by the athlete and, if the athlete is 17 years of age  
            or younger, shall also be signed by the athlete's parent or  
            guardian, before the athlete initiates practice or  
            competition.


          4)Further requires, on a yearly basis, that the youth sports  
            organization shall give concussion and head injury education  
            or educational materials or both to each coach and  
            administrator of the youth sports organization.


          5)States that the youth sports organization shall identify both  








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            of the following: 


             a)   An individual within the youth sports organization who  
               is responsible for ensuring compliance by the organization  
               with the requirements for providing concussion and head  
               injury education contained in paragraph (4). 
             b)   Details of the return-to-play protocol required pursuant  
               to paragraph (1).


          6)Contains the following definitions:
             a)   "Concussion and head injury education and educational  
               materials" and a "concussion and head injury education  
               information sheet" shall at a minimum include information  
               relating to all of the following:
             b)   Head injuries and their potential consequences.


             c)   The signs and symptoms of concussion.


             d)   Best practices for removal of an athlete from an  
               athletic activity after a suspected concussion.


             e)   Steps for returning an athlete to school and athletic  
               activity after a concussion or head injury. 


          7)"Licensed health care provider" means a licensed health care  
            provider who is trained in the evaluation and management of  
            concussions and is acting within the scope of his or her  
            practice.
          8)"Youth sports organization" means an organization, which may  
            include, but is not necessarily limited to, a business or  
            nonprofit entity or a local governmental agency, that sponsors  
            or conducts amateur athletic competitions, camps, or clubs in  
            which persons 17 years of age or younger participate.








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          9)Declares that this section shall not be construed to prohibit  
            a youth sports organization, 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.


          FISCAL EFFECT:  None.  This bill is keyed non-fiscal by the  
          Legislative Counsel.


          COMMENTS:  The author states, "With this legislation I intend to  
          mitigate the growing problem of injured athletes by creating  
          awareness of sports-related head injuries and having a proper  
          protocol for concussion detections, treatment, and  
          post-concussion management for youth sports leagues." As need  
          for such protection he points to a 2014 study, wherein the  
          Boston University School of Medicine found former NFL players  
          who began playing football before age 12 "demonstrate  
          significantly greater impairment" than those who started playing  
          later in life.  The bill's sponsors, the California Athletic  
          Trainers' Association state in their support, "This bill will  
          help close many loopholes in concussion management at the youth  
          sports level, and help protect our most vulnerable athletes by  
          providing similar safeguards that are afforded to high school  
          and college athletes."  The California State Parent Teachers  
          Association (PTA) draw attention in their letter of support to  
          the provisions of the bill which "assure that parents are  
          provided annually with a concussion and head injury information  
          sheet and that young athletes are removed immediately from an  
          athletic activity if they are suspected of sustaining a  
          concussion or other head injury." 


          Concussions have greater adverse effect on younger athletes:   
          Studies show that the human brain does not fully develop until a  
          person's mid-20s.  Therefore, young athletes experiencing head  








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          injuries are at greater risk of long-term brain damage if  
          injured during the critical stages of brain development.  From  
          2002 to 2012 the number of reported sports-related concussions  
          among student athletes doubled.  This increase in reported  
          concussions is attributed to various factors, including greater  
          awareness and recognition of traumatic brain injuries.  However,  
          research also shows that it is likely that self-reported  
          concussion symptoms are under diagnosed, which may lead athletes  
          to return to play prematurely.


          According to recent research, "Although most (80-90%)  
          concussions resolve within 7-10 days, the recovery process can  
          be longer and more complicated in children and adolescents.  
          Furthermore, younger athletes have a higher risk of severe  
          symptoms and cognitive decline? Due to the more complex recovery  
          process in young athletes, they need protection when they are  
          most vulnerable."  (Mukland and Serra, Concussions and Brain  
          Injuries in Youth Sports, December 2015, Rhode Island Medical  
          Journal).  


          In addition, studies show that the risk of a second concussion  
          if an athlete returns to play too soon is greater for youth,  
          both in likelihood and severity.  "Athletes who return to play  
          before their concussions have fully resolved may place  
          themselves at an increased risk for prolonged recovery.   
          Although very rare, the potential for catastrophic head  
          injuries, including what is sometimes called 'second impact  
          syndrome' is the primary concern.  While catastrophic head  
          injury is uncommon, it may occur more frequently in younger  
          athletes between the ages of 12 to 18 years."  (Graham, Rivara,  
          et al, Sports-Related Concussions in Youth:  Improving the  
          science, changing the culture, 2014, National Academy of  
          Sciences).


          Please see Assembly Arts, Entertainment, Sports, Tourism, and  
          Internet Media Committee analysis for a full discussion of the  








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          measure.




          Analysis Prepared by:                                             
                          Dana Mitchell / A.,E.,S.,T., & I.M. / (916)  
                          319-3450                                          
            FN: 0002852