BILL ANALYSIS
AB 1647
Page 1
Date of Hearing: April 6, 2010
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Mary Hayashi, Chair
AB 1647 (Hayashi) - As Amended: April 5, 2010
SUBJECT : Athletics
SUMMARY : Sets return to play guidelines for athletes who have
a concussion, requires the State Department of Education
(department) to adopt a heat-acclimatization program,
establishes automated external defibrillator (AED) requirements
for schools offering sports programs, requires a school
governing board (board) to adopt an emergency plan, and
establishes a title act for athletic trainers (ATs).
Specifically, this bill :
1)Requires a school district, if it elects to offer any
interscholastic athletic programs to require a high school
athlete suspected of sustaining a concussion or head injury in
a school-sponsored athletic activity to be immediately removed
from the activity and not be permitted to return to the
activity until he or she is evaluated by a licensed physician
and surgeon, osteopathic physician and surgeon, or AT trained
in the management of concussions, commencing July 1, 2014. If
the athlete is evaluated by a licensed physician and surgeon
or an osteopathic physician and surgeon, that athlete shall
not be permitted to return to the activity until he or she
receives written clearance to return to the activity from that
licensed physician and surgeon or osteopathic physician and
surgeon; and,
2)Requires the department to adopt a heat-acclimatization
program established by the National Athletic Trainers'
Association or other similarly recognized organization, and
make this program available to school districts through its
Internet Web site or other means.
3)Requires a school district, if it elects to offer any
interscholastic athletic programs to comply with all of the
following commencing July 1, 2014:
a) The board shall acquire an AED for pupils, instructors,
spectators, and other individuals in attendance at
extracurricular athletic competitions under the
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jurisdiction of, or sponsored or controlled by, the
district or the authorities of any school of the district.
Requires the board to ensure its availability to trained
personnel during all athletic activities under the
jurisdiction of, or sponsored or controlled by, the
district or the authorities of any school of the district:
i) An employee of a school district who renders
emergency care or treatment is not liable for civil
damages resulting from the use, attempted use, or nonuse
of an AED, except as specified;
ii) When an employee of a school district uses, attempts
to use, or does not use an AED to render emergency care
or treatment as specified, the employee, school district,
or both are not liable for civil damages resulting from
any act or omission in rendering the emergency care or
treatment, including the use or nonuse of an AED, except
as specified;
iii) Prohibits civil indemnification in the case of
personal injury or wrongful death that results from gross
negligence or willful or wanton misconduct on the part of
the person who uses, attempts to use, or maliciously
fails to use an AED to render emergency care or
treatment; and,
iv) Requires a school district to ensure all of the
following:
(1) That the AED is maintained and regularly
tested according to the operation and maintenance
guidelines set forth by the manufacturer;
(2) That the AED is checked for readiness after
each use and at least once every 30 days if the AED
has not been used in the preceding 30 days. Records
of these checks shall be maintained;
(3) That any person who renders emergency care or
treatment to a person in cardiac arrest by using an
AED activates the emergency medical services system as
soon as possible;
(4) That for every AED acquired, up to five units,
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not less than one employee per AED shall complete a
training course in cardiopulmonary resuscitation and
AED use that complies with the regulations adopted by
the Emergency Medical Services Authority and the
standards of the American Heart Association (AHA) or
the American Red Cross. After the first five AEDs are
acquired, for each additional five AED acquired, a
minimum of one employee shall be trained beginning
with the first additional AED acquired. Acquirers of
AEDs shall have trained employees who should be
available to respond to an emergency that may involve
the use of an AED unit; and,
(5) That there is a written plan available that
describes the procedures to be followed in the event
of an emergency that may involve the use of an AED, to
ensure compliance with the requirements of this
section. The written plan shall include, but shall
not be limited to, immediate notification of 911 and
trained office personnel at the start of AED
procedures;
b) Requires the board to ensure that there is a written
emergency action plan available that describes the
procedures to be followed in the event of any emergency
that occurs in connection with an athletic activity.
4)Prohibits anyone from holding himself or herself out to be an
AT unless he or she has done any of the following:
a) Graduated from a college or university after completing
an athletic training education program accredited by the
Commission on Accreditation of Athletic Training Education,
or its predecessors or successors;
b) Completed requirements for certification by the Board of
Certification, Inc., (BOC) prior to January 1, 2004; or,
c) Been certified by the BOC.
5)Restricts an AT's athletic training activities to those
activities authorized pursuant to protocols developed for that
AT by a physician and surgeon licensed by the Medical Board of
California or an osteopathic physician and surgeon licensed by
the Osteopathic Medical Board of California.
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6)Declares an unfair business practice, as specified, for any
person to use the title of "AT" or "certified athletic
trainer" or any other term, such as "licensed," "registered,"
or "ATC," that implies or suggests that the person is
certified as an AT, if the person does not meet the
requirements above and engages in AT activities, as specified.
7)Makes legislative findings and declarations.
EXISTING LAW:
1)Authorizes school districts to provide specified medical
services in connection with athletic events that are under the
jurisdiction of, or sponsored or controlled by, school
districts. These services include medical or hospital
insurance for pupils injured while participating in athletic
activities, and ambulance service for pupils, instructors,
spectators, and other individuals in attendance at athletic
activities.
2)Grants the department certain authority over interscholastic
athletics, including the authority to state that the policies
of school districts, of associations or consortia of school
districts, and of the California Interscholastic Federation,
concerning interscholastic athletics, are in compliance with
both state and federal law.
FISCAL EFFECT : Unknown
COMMENTS :
Purpose of this bill . According to the author's office,
"Recognizing the need for additional safety standards in school
sports is an important first step in helping to prevent future
sports-related illness, injury and death.
"Our kids believe that they need to be tough and play through
the pain when injuries occur, so they're unlikely to tell anyone
when they think they have a concussion. It's also hard for
parents to say no to their kids when they want to go back and
play. We need to help the adults around student athletes become
more aware of the problem, and empower them with laws that put
the health of the player first. 2010 should be the year that
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California resolved to take concrete steps to protect its
student athletes. Through this bill, we can better protect our
kids, allowing them to be the athletes they want to be, without
sacrificing their safety."
Background . It has been estimated that more than 6 million high
school students participate in sports nationwide. Over 715,000
sports related injuries occur annually and in just the last two
years, over 125 middle and high school athletes died as a result
of an injury. California alone suffered 18 fatalities.
Scientific studies have raised concerns about the long-term
impacts of head injuries in sports. Their lasting effects are
unknown and have recently been highlighted by reports of
professional football players who sustained concussions during
their playing years and are now feeling the effects of memory
loss and other memory related diseases. For females, the
leading cause of high school sports concussion is soccer, and a
2009 American Journal of Sports Medicine article showed that
female athletes are suffering more significant effects from
multiple concussions than male athletes. The San Jose Mercury
News reported on a 2009 study that showed that 41% of high
school athletes who suffered a concussion return to play
prematurely. This bill would require authorization prior to an
athlete who has suffered a concussion from returning to play.
Heat related illness in sports is a problem for young athletes
as well. Many high school sports begin practice during the
summer months when high temperatures are extreme. A recent USA
Today article reported four heatstroke related deaths at the
high school level in 2008. This bill would require the
department to adopt a heat-acclimatization program, and boards
to develop written emergency plans.
A number of states in addition to California are considering
legislation to better protect their high school students. Three
states, Washington, Oregon, and Texas, have already done so:
Oregon's "Max's Law," passed in 2009, requires annual training
for coaches to recognize concussion symptoms and assign
appropriate medical treatment.
Texas enacted "Will's Bill" in 2007, which requires every high
school coach to be trained in basic safety and emergency
procedures, with special emphasis on concussions and
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second-impact syndrome.
Washington's "Zackery Lystedt Law" requires all athletes under
the age of 18 who are suspected of having a concussion to get
written consent from a licensed medical provider trained in
evaluating concussions before returning to play.
According to the United States Bureau of Labor Statistics, ATs
are recognized by the American Medical Association as allied
health professionals and specialize in the prevention,
assessment, treatment, and rehabilitation of muscle and bone
injuries and illnesses. A bachelor's degree is usually the
minimum requirement to become an AT, but many hold a master's or
doctoral degree. As of 2009, 47 states (not including
California) required ATs to be licensed or hold some form of
registration.
An AED is a computerized medical device that can check a
person's heart rhythm, recognize a rhythm that requires a shock,
and advise a rescuer when a shock is needed. An AED uses voice
prompts, lights and text messages to tell the rescuer the steps
to take. According to AHA, as of 2009, 15 states have laws
governing the use of AEDs in elementary and/or high school
settings.
Each year in the U.S., there are approximately 295,000 sudden
cardiac arrests (SCA) treated outside of a hospital setting.
SCA affects people of all ages, and on average just 8% of
out-of-hospital SCA victims in the U.S. survive.
However, cardiopulmonary resuscitation (CPR) and early
defibrillation with an AED more than double a victim's chance of
survival. According to the AHA, early defibrillation with CPR
is the only way to restore the SCA victim's heart rhythm to
normal. For every minute that passes without CPR and
defibrillation, the chances of survival decrease by 7-10%.
Related legislation . AB 1646 (Hayashi), 2010, expands existing
coaching requirements to include training that includes a basic
understanding of the signs, symptoms, and appropriate emergency
action steps regarding potentially catastrophic injuries,
including, but not limited to, head and neck injuries,
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concussions, second impact syndrome, asthma attacks, heatstroke,
and cardiac arrest. This bill is in Assembly Appropriations
Committee.
Technical amendments .
Page 4, line 34, and 5, line 2, and replace "(e)" with "(4)"
Page 5, line 32, replace "Subparagraphs (B) and (C)" with
"Subparagraphs (1) and (2)"
Double referred . This bill is double-referred to Assembly
Judiciary Committee.
REGISTERED SUPPORT / OPPOSITION :
Support
California Athletic Trainers' Association (sponsor)
American Red Cross, California Chapters
California Association for Health, Physical Education,
Recreation and Dance
California Brain Injury Association
California Medical Association
The Sport Foundation
Numerous individuals
Opposition
None on file.
Analysis Prepared by : Sarah Weaver / B. & P. / (916) 319-3301