BILL ANALYSIS Ó SENATE COMMITTEE ON EDUCATION Senator Carol Liu, Chair 2015 - 2016 Regular Bill No: AB 2182 ----------------------------------------------------------------- |Author: |Mullin | |-----------+-----------------------------------------------------| |Version: |May 31, 2016 Hearing | | |Date: June 22, 2016 | ----------------------------------------------------------------- ----------------------------------------------------------------- |Urgency: |No |Fiscal: |Yes | ----------------------------------------------------------------- ----------------------------------------------------------------- |Consultant:|Lenin DelCastillo | | | | ----------------------------------------------------------------- Subject: School athletics: neurocognitive testing SUMMARY This bill, contingent upon an appropriation, establishes the Neurocognitive Testing Pilot Grant Program to provide funds to Title I schools for the purpose of neurocognitive testing. As part of the pilot program, this bill requires school districts, charter schools, and private schools that elect to offer sports programs to collect and maintain data on traumatic brain injuries and concussions sustained during these activities. BACKGROUND Existing law: 1) Requires a school district, charter school, or private school that elects to offer an athletic program to immediately remove from athletic activity for the remainder of the day an athlete who is suspected of sustaining a concussion or head injury. Prohibits the athlete from returning to the activity until he or she has been evaluated by a licensed health care provider and receives a written clearance from the health care provider. 2) Provides that if the licensed health care provider determines that the athlete sustained a concussion or a head injury, the athlete shall complete a graduated return-to-play protocol of no less than seven days in AB 2182 (Mullin) Page 2 of ? duration under the supervision of a licensed health care provider. 3) Annually requires a concussion and head injury information sheet to be signed by the athlete's parent prior to participation in athletic activity. (Education Code § 49475) 4) Requires each high school sports coach to complete a coaching education program developed by the employing school district or the California Interscholastic Federation that meets specified guidelines. (Education Code § 49032) 5) Requires high school athletic coaches to complete training regarding the identification of concussions. (Education Code § 35179.1) ANALYSIS This bill: 1) Establishes the Neurocognitive Testing Pilot Grant Program to provide grant funding to Title I schools for the purposes of neurocognitive testing. 2) Requires the California Department of Education (CDE) to establish an application process for school districts to apply on behalf of Title I schools interested in participating in the pilot program. Requires the grants to be apportioned under the pilot program to a total of three school districts, which shall comprise one school district in each of the following regions of the state: southern, central, and northern. Requires each school district to 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. 3) Requires the grant funds to be used for the following: AB 2182 (Mullin) Page 3 of ? a) Baseline and postinjury neurocognitive testing of pupils attending a Title I school serving any of grades nine to 12, inclusive, participating in interscholastic athletics in any of the following sports: baseball, basketball, cheerleading, field hockey, football, ice hockey, lacrosse, rugby, soccer, softball, volleyball, and wrestling. 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, provided that the athlete is still participating in one or more of the 12 specified sports. The baseline and postinjury neurocognitive testing shall be administered by individuals who have been trained to administer these tests. These individuals may include, but are not necessarily limited to, employees of a participating school district. b) 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. c) 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 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. AB 2182 (Mullin) Page 4 of ? d) Reporting to the county office of education data that includes an overview of the baseline neurocognitive testing conducted for each of the sports specified in the bill and an overview of normal, abnormal, and follow-up postinjury neurocognitive tests. The data shall also include the number of athletes who discontinue participation in the sport following a concussion and postinjury testing. 4) Defines "neurocognitive testing" as 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. 5) Requires the California Department of Education (CDE) to, based on the data collected by the county office 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 specified sports due to concussion injuries. 6) Requires the report to be submitted to the appropriate policy committees of the Legislature on or before December 31, 2021, and to comply with Government Code Section 9795. 7) Specifies that the operation of this bill is contingent AB 2182 (Mullin) Page 5 of ? upon the appropriation of funds in the annual Budget Act or another statute. 8) Specifies that the program shall remain in effect until January 1, 2022, unless a later enacted statute, that is enacted before January 1, 2022, deletes or extends that date. 9) Requires a school district, charter school, or private school that elects to offer an interscholastic athletic program to collect and maintain data on traumatic brain injuries and concussions sustained by any of its pupils during an interscholastic athletic activity. Requires this data to be reported periodically to the appropriate county office of education, but provides that the names of the injured pupils be kept confidential. Requires the county office of education to compile and retain the data for summary and analysis as it deems necessary. STAFF COMMENTS 1) Need for the bill. The author indicates that the number of reported sports-related concussions among student athletes has risen dramatically, including a doubling between 2002 and 2012. Further, "athletes who sustain concussions are at greater risk of chronic traumatic encephalopathy, depression, early onset dementia, and long-term brain damage. Research shows that the human brain does not fully develop until a person's mid-20's and therefore, young athletes experiencing head injuries are at greater risk of long-term brain damage if injured during the critical stages of brain development." This bill is intended to generate data to provide a better understanding of the frequency of sports-related head injuries among athletes. 2) What is neurocognitive testing? The bill defines neurocognitive testing as 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. It is used to AB 2182 (Mullin) Page 6 of ? evaluate brain processing and 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. 3) Concussions in sports. The dangers of concussions and head injuries in sports have been a growing concern, with frequent news reports of athletes, primarily football players, sustaining traumatic and lasting injuries. 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 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. A few school districts in San Mateo County have sought stronger protections for student athletes and have, in some cases, paid for neurocognitive testing. 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. 4) Limits on practice and full-contact. The California Interscholastic Federation (CIF) governs competitive athletics in grades 9-12. The CIF is comprised of 10 Sections across the State; each Section has a governing AB 2182 (Mullin) Page 7 of ? body that, among other things, adopts rules and regulations in addition to those promulgated by the State CIF. Each Section establishes its own rules governing the scope of team practice. It appears that five of the Sections allow football teams to conduct full-contact practice during the off-season while five do not allow full-contact practice during the off-season. For example, the Sac-Joaquin Section allows full-contact football camp during the summer and the Southern Section prohibits full-contact practice or camps during the summer. The CIF recently adopted Bylaw 506 which, effective August 1, 2014, limits all athletic teams to no more than 18 hours of practice time per week and no more than four hours in any single day. 5) Fiscal impact. According to the Assembly Appropriations Committee, this bill would result in the following: a) Proposition 98/General Fund cost pressures, potentially in the tens of thousands to fund the pilot program. The program is contingent upon an appropriation in the budget act. b) General Fund costs to the California Department of Education (CDE) of approximately $264,000 to administer the grant program for four years. The CDE would be required to develop, implement, monitor, collect and analyze data, and prepare reports to the Legislature on the findings for each grant awarded. c) Unknown, potentially reimbursable Proposition 98/General Fund state mandated costs, likely in the thousands of dollars, for county offices of education to compile and retain data for summary and analysis. SUPPORT California Concussion Institute California Optometric Association California Psychological Association Consumer Attorneys of California San Mateo Union High School District AB 2182 (Mullin) Page 8 of ? OPPOSITION None received. -- END --