Amended in Assembly April 13, 2016

Amended in Assembly March 29, 2016

California Legislature—2015–16 Regular Session

Assembly Bill No. 2182

Introduced by Assembly Member Mullin

February 18, 2016

An act to begin delete amend Section 49475 of end delete begin insert add Section 49475.6 to, and to add and repeal Section 49475.5 of, end insert the Education Code, relating to school athletics.

LEGISLATIVE COUNSEL’S DIGEST

AB 2182, as amended, Mullin. School athletics: neurocognitive testing.

(1) 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.

begin delete

Existing law further provides that, if a 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.

end delete

This bill would express legislative findings and declarations relating to concussions or traumatic injuries sustained by pupils participating in high school interscholastic athletics and the value of neurocognitive testing.

The bill would begin delete require a school district, charter school, or private school that offers an athletic program to pay for neurocognitive testing, or provide in-house end delete begin insert establish the Neurocognitive Testing Pilot Grant Program to commence in the 2017-18 school year. The bill would require the State Department of Education to develop an application for school districts interested in participating in the pilot program. A participating school district would be required to commit to participating in the pilot program for 4 school years in order to track pupils tested in grade 9 through completion of high school. The bill would provide that grant funds, based on an appropriation in the annual Budget Act or another statute, would be used for baseline end insert neurocognitive testing, as defined, for pupils who participate in interscholastic athletics in any of 12 designated sports. begin delete The bill would require this neurocognitive testing to be conducted by a licensed health care provider, as specified. end delete The bill would require this testing to take place at the beginning of an athletic season before any competitions have taken place and after any head injury, and would require that this baseline neurocognitive testing be repeated at intervals not exceeding 24 months for as long as the athlete is enrolled at the school.

The bill would begin delete require that end delete begin insert also provide that grant funds could be used for training of personnel and consultation with experts, as specified. The bill would further provide that, under the pilot program, end insert the parent or guardian of each athlete participating in any of the 12 interscholastic sports listed in the bill begin insert would end insert be notified, in writing, that the results of baseline and postinjury neurocognitive testing conducted on his or her child begin delete is end delete begin insert are end insert available to the child’s parent or guardian, or could be shared with the athlete’s physician, upon request.

begin insert

The bill would also provide that grant funds could be used for reporting specified data relating to the baseline neurocognitive testing to the appropriate county office of education. The bill would require the State Department of Education to submit a report containing specified information to the appropriate policy committees of the Legislature on or before December 31, 2021.

end insert begin insert

These provisions would be repealed on January 1, 2022.

end insert begin insert

(2) Existing law provides that, if a licensed health care provider determines that an athlete sustained a concussion or a head injury while engaging in an athletic activity, 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.

end insert begin delete

The

end delete

begin insert This end insert bill would require a school district, charter school, or private school that offers an begin insert interscholastic end insert athletic program to collect and maintain data on traumatic brain injuries and concussions sustained by any of its pupils during an begin insert interscholastic end insert athletic begin delete competition. The bill would require postinjury neurocognitive testing to be conducted within 72 hours of the occurrence of the injury. end delete begin insert activity. end insert The bill would require that this data be reported periodically to the appropriate county office of education, and would require the county office of education to compile and retain the data for summary and analysis as it deems necessary. By imposing new duties on county offices of education, the bill would impose a state-mandated local program.

begin delete

(2)

end delete

begin insert (3) end insert  The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.

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

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

SECTION 1.  

The Legislature finds and declares all of the
following:

(a) The California Interscholastic Federation (CIF), California’s
governing body for high school sports, requires that, if it is
suspected that a pupil has sustained a concussion or traumatic brain
injury in an athletic competition, the pupil must be removed from
competition immediately and required to receive written clearance
from a begin delete physician end delete begin insert licensed health care provider end insert before returning
to competition.

(b) Section 49475 of the Education Code, as it was amended
by Assembly Bill 2127 of the 2013-14 Regular Session of the
Legislature effective January 1, 2015, provides that a pupil athlete
who has been diagnosed with a concussion cannot return to play
sooner than seven days after having been evaluated and diagnosed
by a begin delete physician. end delete begin insert licensed health care provider. end insert

(c) The value of neurocognitive testing is that it establishes a
baseline of each athlete’s normal neurocognitive functioning before
beginning athletic activity. By establishing this baseline, an athlete
with a suspected head injury can then be retested to help assess
the degree of injury.

(d) Following any kind of head injury, athletes retake the test
and have the results judged against the baseline test. This is
especially important when an athlete experiences numerous hits
to the head.

begin delete

SEC. 2.  

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 all of the following:

(1) The school district, charter school, or private school to which
this section is applicable shall pay for neurocognitive testing, or
provide in-house neurocognitive testing, for pupils who participate
in interscholastic athletics in any of the following sports:

(A) Baseball.

(B) Basketball.

(C) Cheerleading.

(D) Field hockey.

(E) Football.

(F) Ice hockey.

(G) Lacrosse.

(H) Rugby.

(I) Soccer.

(J) Softball.

(K) Volleyball.

(L) Wrestling.

(2) The neurocognitive testing required by this section shall be
conducted by a licensed health care provider with proper training
in, or experience with, neurocognitive testing, or both, who is able
to interpret the results of the required testing. The baseline
neurocognitive testing shall take place at the beginning of an
athletic season before any competitions have taken place and after
any head injury, and shall be repeated at intervals not exceeding
24 months for as long as the athlete is enrolled at the school.

(3) (A) (i) 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. 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. Postinjury
neurocognitive tests shall be conducted within 72 hours of the
occurrence of the injury.

(ii) If the 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. In the event of an abnormal postinjury neurocognitive
test result, follow-up neurocognitive testing may be conducted as
the discretion of a licensed health care provider.

(iii) 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 subparagraph.

(B) A school district, charter school, or private school to which
this section is applicable shall collect and maintain data on
traumatic brain injuries and concussions sustained by any of its
pupils during an athletic competition. This data shall include an
overview of the baseline neurocognitive testing conducted for each
of the sports listed in paragraph (1), and an overview of normal,
abnormal, and followup postinjury neurocognitive tests. This data
shall be reported periodically to the appropriate county office of
education, but the names of the injured pupils shall be kept
confidential. The county office of education shall compile and
retain the data for summary and analysis as it deems necessary.

(4) 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. The parent or guardian of each athlete participating
in any of the sports listed in paragraph (1) shall also be notified,
in writing, that the results of baseline and postinjury neurocognitive
testing conducted on his or her child is available to the child’s
parent or guardian upon request. These neurocognitive testing
results may also be shared with the athlete’s physician upon the
request of the athlete’s parent or guardian.

(b) As used in this section, the following terms have the
following meanings:

(1) “Licensed health care provider” means a licensed health
care provider who is trained in the management of concussions or
other head injuries and is acting within the scope of his or her
practice.

(2) “Neurocognitive testing” means a comprehensive evaluation
of a person’s cognitive status by specific neurologic domains,
including, but not necessarily limited to, memory, attention,
problem solving, language, visuospatial, processing speed, motor,
and emotion.

(c) 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.

end delete

begin insert

begin insert SEC. 2. end insert   

end insert

begin insert Section 49475.5 is added to the end insert begin insert Education Code end insert begin insert , to
read: end insert

begin insert

begin insert 49475.5. end insert   

(a) The Neurocognitive Testing Pilot Grant Program
is hereby established, commencing with the 2017-18 school year.
The department shall develop an application for school districts
interested in participating in the pilot program. A participating
school district shall commit to participating in the pilot program
for four school years in order to track pupils tested in grade 9
through completion of high school.

(b) Grant funds, based on an appropriation in the annual Budget
Act or another statute, shall be used for the following:

(1) (A) Baseline neurocognitive testing of pupils attending
grades 9 to 12, inclusive, participating in interscholastic athletics
in any of the following sports:

(i) Baseball.

(ii) Basketball.

(iii) Cheerleading.

(iv) Field hockey.

(v) Football.

(vi) Ice hockey.

(vii) Lacrosse.

(viii) Rugby.

(ix) Soccer.

(x) Softball.

(xi) Volleyball.

(xii) Wrestling.

(B) The baseline neurocognitive testing conducted pursuant to
this subdivision shall take place at the beginning of an athletic
season before any competitions have taken place and after any
head injury, and shall be repeated at intervals not exceeding 24
months for as long as the athlete is enrolled at the school.

(2) Postinjury neurocognitive testing of an athlete who is
suspected of sustaining a concussion or head injury in an
interscholastic athletic activity. Postinjury neurocognitive tests
shall be conducted within 72 hours of the occurrence of the injury.

(3) Training of personnel or to consult with experts on the
interpretation of postinjury test results. The parent or guardian
of each athlete participating in any of the sports listed in paragraph
(1) shall also be notified, in writing, that the results of baseline
and postinjury neurocognitive testing conducted on his or her child
are available to the child’s parent or guardian upon request. These
neurocognitive testing results may also be shared with the athlete’s
physician upon the request of the athlete’s parent or guardian.

(4) Reporting to the county office of education data that includes
an overview of the baseline neurocognitive testing conducted for
each of the sports listed in paragraph (1), and an overview of
normal, abnormal, and followup postinjury neurocognitive tests.
The data shall also include the number of athletes who discontinue
participation in the sport following a concussion and postinjury
testing.

(c) For purposes of this section, “neurocognitive testing” means
a comprehensive evaluation of a person’s cognitive status by
specific neurologic domains, including, but not necessarily limited
to, memory, attention, problem solving, language, visuospatial,
processing speed, motor, and emotion.

(d) (1) The department shall, based on the data collected by
the county offices of education located in the area of participating
school districts, prepare a report including, but not necessarily
limited to, all of the following information:

(A) The number of athletes who received the baseline tests.

(B) The number of athletes who received the postinjury tests.

(C) The number of athletes who had taken the tests and
discontinued participation in any of the sports set forth in
subdivision (b) due to concussion injuries.

(2) The report prepared pursuant to this subdivision shall be
submitted to the appropriate policy committees of the Legislature
on or before December 31, 2021, and shall comply with Section
9795 of the Government Code.

(e) This section shall remain in effect only until January 1, 2022,
and as of that date is repealed, unless a later enacted statute, that
is enacted before January 1, 2022, deletes or extends that date.

end insert

begin insert

begin insert SEC. 3. end insert   

end insert

begin insert Section 49475.6 is added to the end insert begin insert Education Code end insert begin insert , to
read: end insert

begin insert

begin insert 49475.6. end insert   

A school district, charter school, or private school
that elects to offer an interscholastic athletic program shall collect
and maintain data on traumatic brain injuries and concussions
sustained by any of its pupils during an interscholastic athletic
activity. This data shall be reported periodically to the appropriate
county office of education, but the names of the injured pupils shall
be kept confidential. The county office of education shall compile
and retain the data for summary and analysis as it deems
necessary.

end insert

begin delete SEC. 3. end delete

begin insert SEC. 4. end insert   

If the Commission on State Mandates determines that
this act contains costs mandated by the state, reimbursement to
local agencies and school districts for those costs shall be made
pursuant to Part 7 (commencing with Section 17500) of Division
4 of Title 2 of the Government Code.