BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 25
                                                                  Page  1

          Date of Hearing:   April 6, 2011

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                Felipe Fuentes, Chair

                    AB 25 (Hayashi) - As Amended:  March 25, 2011 

          Policy Committee:                              Education 
          Vote:9-0

          Urgency:     No                   State Mandated Local Program: 
          No     Reimbursable:              No

           SUMMARY  

          This bill requires a school district that elects to offer an 
          athletic program to implement a concussion/head injury 
          identification process and requires compliance with this process 
          by all organizations the district authorizes to use their school 
          facilities under the Civic Center Act (CCA), as specified.  
          Specifically, this bill:  

          1)Requires an athlete who is suspected of sustaining a 
            concussion or head injury in an athletic activity to be 
            immediately removed from the activity for the remainder of the 
            day and prohibited from returning until he or she is evaluated 
            by a licensed health care provider, as specified.  This 
            measure also prohibits an athlete from returning to the 
            activity until he or she receives written clearance from the 
            same licensed health care provider.  

          2)Requires, on an annual basis, an athlete and his or her 
            parent/guardian to sign and return a concussion/head injury 
            information sheet prior to the athlete's initiating practice 
            or competition.  

          3)Requires organizations providing supervised recreational 
            activities on school facility grounds pursuant to the CCA to 
            provide a statement of compliance with the policies for the 
            management of concussion/head injuries, as referenced above.  

           FISCAL EFFECT  

          1)GF/98 costs, of at least $150,000, to school districts to 
            develop a concussion/head injury policy for grades K-12, as 








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            specified.  The majority of these costs would be on-time time, 
            but there would be on-going costs for record keeping duties.  
            Currently, school districts with grades 9-12 that participate 
            in California Interscholastic Federation (CIF) sports are 
            required to adhere to a similar CIF policy.  This bill, 
            however, applies to all school districts.  

            Even though school districts participating in CIF sports 
            adhere to a similar policy, there is a potential for them to 
            file a state mandate claim for the development of the policy 
            and on-going record keeping associated with the requirements 
            of this bill.  These GF/98 costs would be in the range of 
            $150,000 to $200,000 and in addition to the costs referenced 
            above.       

          2)GF administrative costs to the State Department of Education 
            (SDE), of approximately $50,000, to ensure school districts 
            are complying with requirements of this bill, as specified.  
            If this measure applies to a student participating in an 
            athletic activity during the school day, such as physical 
            education or recess, the SDE's costs would likely increase.  

          3)Potential increased liability costs in the tens to hundreds of 
            thousands of dollars to school districts regarding compliance 
            with the CCA requirements in this bill.  Current law requires 
            school districts to be liable for any injuries resulting from 
            the negligence in the ownership and maintenance of their 
            facilities or grounds.  This bill requires school districts to 
            ensure any organization using their facilities under the CCA 
            provide a statement of compliance regarding a concussion/head 
            injury policy for athletes.  This requirement expands the 
            liability issues for school districts to potentially include 
            the injury of an athlete if the organization does not comply 
            with the concussion/head injury policy, as proposed in this 
            measure.   

           COMMENTS  

           1)Purpose  .  There are an estimated 136,000 sports-related 
            concussions that occur among high school athletes in the 
            United States each school year.  In December 2010, the 
            American Journal of Sports Medicine published a study 
            revealing the most common symptom reported by concussed 
            athletes was a headache (94%), followed by dizziness or 
            unsteadiness (75%), difficulty concentrating (57%), and 








                                                                  AB 25
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            confusion or disorientation (46%).  The data concluded these 
            symptoms were resolved within one week for most athletes 
            (83%).  The study also reported that computerized 
            neuropsychological testing was used to evaluate 26% of the 
            athletes after they were injured and these athletes were less 
            likely to return to play within a week of their injury in 
            comparison to untested athletes.  According to William Meehan 
            II, MD, director of the Sports Concussion Clinic at Children's 
            Hospital, Boston, co-author of the study, "computerized 
            neuropsychological testing can be an important resource in the 
            management of sports-related concussion.  However, it is 
            important to remember that it should never be used alone to 
            determine if an athlete is ready to return to play.  The 
            results of neuropsychological testing should be used in 
            conjunction with a trained medical care professional's 
            analysis of concussion signs and symptoms to determine when 
            the athlete is ready to return to activity."  

            This bill requires a school district that elects to offer an 
            athletic program, to implement a concussion/head injury 
            identification process and requires compliance with this 
            process by all organizations the district authorizes to use 
            their school facilities under the CCA.  

          2)Does this bill apply to athletes participating in an athletic 
            activity during the school day  ?  The bill requires an athlete 
            who is suspected of sustaining a concussion or head injury in 
            an athletic activity to be immediately removed from the 
            activity for the remainder of the day.  Does a school district 
            need to enforce this policy in a situation where a student 
            athlete is participating in a basketball game as part of a 
            physical education class or on the playground during recess?  
            Under this measure, it is conceivable that a district would 
            need to adhere to the proposed concussion policy in this 
            situation.  The author may wish to clarify this issue.   
           
           3)Existing law  establishes the CCA, which governs the use of 
            school facilities by outside organizations, including the Boy 
            Scouts, Girl Scouts, parent-teacher organizations, and 
            religious organizations.  Specifically, the CCA authorizes the 
            governing board of a school district to grant the use of 
            school facilities for supervised recreational activities 
            including, but not limited to, sports league activities for 
            youth.  This bill requires organizations providing these 
            activities to provide a statement of compliance with the 








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            policies for the management of concussion/head injuries, as 
            specified in this measure.  

            Under the CCA, school districts are liable for any injuries 
            resulting from the negligence of the district in the ownership 
            and maintenance of their facilities or grounds.  Likewise, 
            existing law states any group using the school facilities or 
            grounds is liable for any injuries resulting from the 
            negligence of that group during the use of the facilities or 
            grounds.  School districts and groups are required to bear the 
            cost of insuring against its respective risks and any costs 
            associated with defending itself against claims arising from 
            those risks.  

           4)California Interscholastic Federation (CIF) policy  .  The CIF, 
            established in 1914, is a voluntary organization consisting of 
            school and school-related personnel with responsibility for 
            administering interscholastic athletic activities in grades 
            9-12. It is accountable to the governing boards of school 
            districts and other local agencies. In 2010, approximately 
            1,508 public, private, and charter schools were members of 
            CIF.  Of this number, 1,096 schools are public, including 
            charter schools.  In 2009, a total of 736,727 students 
            (438,561 boys and 298,166 girls) participated in athletics 
            through this organization. 

            On May 7, 2010, the State CIF Federated Council passed Bylaw 
            313, which requires a signed medical release before a 
            student-athlete who is suspected to have sustained a 
            concussion can return to play.   Specifically, Bylaw 313 
            states: "a student-athlete who is suspected of sustaining a 
            concussion or head injury in a practice or game shall be 
            removed from competition at that time for the remainder of the 
            day.  A student-athlete who has been removed from play may not 
            return to play until the athlete is evaluated by a licensed 
            health care provider trained in the evaluation and management 
            of concussion and receives written clearance to return to play 
            from that health care provider."  

            The concussion policy requirements in this measure are the 
            same as CIF's bylaw, with the exception that this bill applies 
            to grades K-12 and the bylaw only applies to grades 9-12.  
            Likewise, CIF also offers a free-online twenty minute class 
            entitled Concussion in Sports: What You Need to Know.  
            According to CIF, of the 67,929 coaches in California, 1,714 








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            (3%) have taken this class.  

          5)Non-fiscal bill  .  This bill is keyed non-fiscal, however, the 
            committee requested this measure because of the potential 
            costs incurred by the majority of school districts in the 
            state to develop a concussion policy and the potential state 
            costs to enforce district compliance with this measure.  


           Analysis Prepared by  :    Kimberly Rodriguez / APPR. / (916) 
          319-2081