BILL ANALYSIS Ó
AB 2182
Page 1
Date of Hearing: April 6, 2016
ASSEMBLY COMMITTEE ON EDUCATION
Patrick O'Donnell, Chair
AB 2182
(Mullin) - As Amended March 29, 2016
[Note: This bill is doubled referred to the Assembly Arts,
Entertainment, Sports, Tourism, and Internet Media Committee and
will be heard by that Committee as it relates to issues under
its jurisdiction.]
SUBJECT: School athletics: neurocognitive testing
SUMMARY: Adds neurocognitive testing to concussion and head
injury requirements applying to students playing interscholastic
sports. Specifically, this bill:
1)Requires a school district, charter school or private school
with a high school interscholastic sports program to pay for,
or provide in-house, neurocognitive testing conducted by a
licensed health care professional for pupils participating in
baseball, basketball, cheerleading field hockey, football, ice
hockey, lacrosse, rugby, soccer, softball, volleyball, or
wrestling.
2)Requires a baseline test for those athletes at the beginning
of an athletic season, before any competitions have taken
place, and requires additional baseline testing at intervals
not to exceed 24 months.
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3)Requires a school district, charter school or private school
to provide post-injury neurocognitive testing within 72 hours
of an athlete sustaining any head injury. Authorizes
subsequent testing after abnormal post-injury tests to be
conducted by a licensed health care professional.
4)Requires a school district, charter school or private school
to collect and maintain data on traumatic brain injuries and
concussions sustained by athletes during athletic competition,
including baseline overviews by sport and an overview of
normal, abnormal and follow-up post-injury tests.
5)Requires reporting of data, preserving pupil confidentiality,
to county offices of education (COEs) for compilation,
retention, summarization and analysis. Specifies that
summaries include overviews of baseline results for each sport
and an overview of baseline, abnormal and follow-up tests.
6)Requires a school district, charter school or private school
to notify the parent or guardian of each athlete in writing
that the results from the baseline and post-injury
neurocognitive testing are available upon request. Authorizes
the neurocognitive testing to be shared with the student's
physician upon the request of the student's parent or
guardian.
7)Defines "neurocognitive testing" as a comprehensive evaluation
of a person's cognitive status by specified neurologic
domains, including, but not necessarily limited to, memory,
attention, problem solving, language visuospatial, processing
speed, motor and emotion.
8)Finds and declares the benefits of neurocognitive testing as
establishing a baseline of normal neurocognitive function
before injury, which can be followed by post-injury tests to
assess the degree of injury.
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EXISTING LAW:
1)Limits full-contact practices, as defined, for high school and
middle school football and urges the California
Interscholastic Federation (CIF) adoption of rules to
implement such guidelines. (Education Code 35179.5)
2)Requires an athlete suspected of sustaining a concussion or
head injury during athletic activity to be removed from that
activity and not be permitted to return until evaluated and
cleared by a licensed health care provider; urges the CIF to
develop rules and protocols to implement this; requires
athletes and parents to receive, sign and return a head injury
information sheet annually before practice or competition; and
excludes athletic activities during the regular school day or
as part of a physical education course. (Education Code
49475)
3)Requires a high school sports coach to complete education
programs developed by his or her school district and the CIF
and meeting specific guidelines. (Education Code 49032)
FISCAL EFFECT: Unknown. The Legislative Counsel has keyed this
bill as a state-mandated local program.
COMMENTS: Need for this bill. The author states that the number
of reported sports-related concussions among student athletes
has risen dramatically, including a doubling between 2002 and
2012. The author adds, "Athletes who sustain concussions are at
greater risk of chronic traumatic encephalopathy, depression,
early onset dementia, and long-term brain damage," and that,
"young athletes experiencing head injuries are at greater risk
of long-term brain damage if injured during the critical stages
of brain development." The author hopes that broader
neurocognitive testing will assist in the evaluation of
individual injuries and identify the incidence of sport-related
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concussions among young athletes.
Neurocognitive testing is used to evaluate brain processing in a
variety of neurological functions related to memory, attention,
language, emotion and other areas. Testing can be conducted with
pencil and paper, or with computerized testing. Testing can be
used as a baseline to gauge an athlete's condition post-injury
relative to performance before injury. As such, it can be a
factor in making decisions as to whether and when an athlete
should return to activity and what kinds of activity may be safe
for that athlete.
What this bill does. This bill requires testing before
participation in a season of competition for school-age athletes
and follow-up testing in the event of a concussion or head
injury. The bill also requires the collection of concussion and
head injury data for compilation, retention and analysis.
Background. The dangers of concussions and head injuries in
sport have been a growing concern, with frequent news reports of
athletes, primarily football players, sustaining traumatic and
lasting injuries.
Among the dramatic news reports in March alone:
1)A representative of the National Football League testified
that there is a connection between football and chronic
traumatic encephalopathy.
2)Women's soccer standout Brandi Chastain announced she would
donate her brain to science for research into head injuries.
3)Ivy League schools announced they would eliminate full-contact
practices for football.
A Purdue University study in 2015 indicated lasting brain
changes among high school football players, even without
concussions, and that changes were not completely healed at the
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end of an off-season. The study used brain scans and changes in
brain chemistry to track players more extensively than
neurocognitive testing.
The growing awareness of concussion dangers has led California
to enact a series of bills to protect students by limiting
full-contact practices; requiring education and information for
coaches, pupils and their parents; and protocols for removing
students from activity after injury and for returning them to
play.
This bill stems in part from actions in the author's district.
A few school districts in San Mateo County have sought stronger
protections for student athletes and have, in some cases, paid
for neurocognitive testing. Following on this, the San Mateo
County Civil Grand Jury studied the issue and recommended, among
other things, that all districts in the county serving high
school students provide neurocognitive testing for all student
athletes, and recommended that the districts seek funding and
collect data. The grand jury report noted that a leading
purveyor of the tests charges school districts $1,200 for 800
baseline tests. These tests are computerized, with results
received automatically by the testing company.
The California Psychological Association has a "support if
amended" position and states that it is seeking a technical
amendment in the Findings and Declarations section of the bill.
The Association notes that references to existing law, Education
Code Section 49475, are incorrectly paraphrased, and requests
that the term "physician" be replaced with "licensed health care
provider" to accurately reflect the referenced statute.
Pilot project? Requiring all school districts to implement
neurocognitive testing of all athletes participating in the
specified sports will create a significant mandate. There are
1.8 million students alone participating in California
Interscholastic Federation sports. Staff recommends striking
the requirement and establishing a four-year grant program in
three districts (one in northern, one in central and one in
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southern California) based on the parameters of the bill.
Operating the pilot for four years would allow districts to
track first year high school students through potentially four
years of sports activities. Districts interested in
participating in the pilot shall receive funds for administering
baseline and post-injury neurocognitive tests to high school
students participating in the specified sports identified in the
bill and to pay for training of personnel or to consult with
experts on the interpretation of post-injury test results.
Selection shall be based on a district's commitment to
participate in the pilot for four years, a commitment to submit
specified data to the COE and other criteria established by the
California Department of Education (CDE). Within six months
after the conclusion of the pilot, the CDE shall, based on data
provided by COEs located in the districts participating in the
pilot program, submit a report to the appropriate policy
committees of the Legislature on the number of athletes that
received the baseline tests and the post-injury tests, and the
number of athletes who had taken the tests and stopped playing a
sport due to concussion injuries.
Other amendments:
1)Staff recommends amending the findings and declarations
section to replace "physicians" with "licensed health care
providers."
2)Staff recommends revising various parameters of the bill for
implementation through a pilot program, such as deleting
charter schools and private schools from the bill, deleting
the requirement that school districts pay for the tests, and
deleting specific requirements as to who administers and
interprets the tests.
3)Staff recommends revising the provision requiring submission
of neurocognitive testing data to the COE to instead require
all school districts and charter schools to submit data on the
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number of athletes sustaining brain injuries and concussions
to the COE.
Related legislation: AB 1639 (Maienschein), passed by this
Committee and pending in the Assembly Judiciary Committee,
requires the CDE to make available specified guidelines and
materials on sudden cardiac arrest, requires pupils and parents
to sign informational materials before athletic participation,
requires training of coaches, and sets requirements for action
in the event a pupil experiences specified symptoms.
Previous related legislation. AB 2127 (Cooley), Chapter 165,
Statutes of 2014, among other things, limits full-contact
practices for high school and middle school football teams for
concussion and head injury prevention, and requires that a
return-to-play protocol after concussion or head injury be no
less than seven days in duration.
AB 588 (Fox), Chapter 423, Statutes of 2013, extends
requirements relating to students who sustain, or are suspecting
of sustaining, a concussion during a school-sponsored athletic
activity to charter schools and private schools.
AB 25 (Hayashi), Chapter 456, Statues of 2011, among other
things, requires an athlete suspected of sustaining a concussion
or head injury to be removed from activity immediately, requires
written clearance from a medical health care provider for the
athlete's return and requires a yearly information sheet be
signed by an athlete and the athlete's parent or guardian.
REGISTERED SUPPORT / OPPOSITION:
Support
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California Psychological Association (if amended)
Consumer Attorneys of California
Opposition
None on file
Analysis Prepared by:Carlos Alcala and Sophia Kwong Kim / ED. /
(916) 319-2087