BILL ANALYSIS                                                                                                                                                                                                    �




                                                                  AB 2127
                                                                  PageA
          Date of Hearing:   April 9, 2014

                           ASSEMBLY COMMITTEE ON EDUCATION
                                Joan Buchanan, Chair
                     AB 2127 (Cooley) - As Amended: April 1, 2014
           
          SUBJECT  :   Interscholastic sports: full-contact practices:  
          concussions and head injuries

           SUMMARY  :   Makes legislative findings and declarations relating  
          to head injuries sustained by high school pupil-athletes,  
          particularly those who play football; prohibits high school and  
          middle school football teams from conducting more than two  
          full-contact practices, as defined, per week during the  
          preseason and regular season, as defined; completely prohibits  
          full-contact practice during the off-season, as defined; and  
          prohibits an athlete suspected of having sustained a concussion  
          from returning to the athletic activity until the athlete has  
          completed a return-to-play protocol, as specified.   
          Specifically,  this bill  :  

             1)   Makes legislative findings and declarations related to  
               the significance of concussions and other mild traumatic  
               brain injuries, the symptoms of such brain injuries, the  
               additional risks children and adolescents face when it  
               comes to such brain injuries, and the long term effects of  
               cumulative sub-concussive blows to the brain.


             2)   Requires school districts, charter schools, or privates  
               schools that elect to offer and athletic program to comply  
               with all of the following:


                  a)        Prohibits high school and middle school  
                    football teams from conducting more than two  
                    full-contact practices per week during the preseason  
                    and regular season.


                  b)        Limits the full-contact portion of a practice  
                    to 90 minutes in any single day.


                  c)        Prohibits high school and middle school  









                                                                  AB 2127
                                                                  PageB
                    football teams from conducting full-contact practices  
                    during the off-season.


                  d)        Deems team camp sessions a practice for the  
                    purposes of this section.


             3)   Urges the California Interscholastic Federation (CIF) to  
               develop and adopt rules to implement these prohibitions.


             4)   Defines "full-contact practice" to mean a practice where  
               drills or live action is conducted that involves collisions  
               at game speed, where players execute tackles, and other  
               activity that is typical of an actual tackle football game.


             5)   Defines "off-season" to mean the period of time  
               extending from the end of the regular season until 30 days  
               before the commencement of the next regular season.


             6)   Defines "preseason" to mean the period of 30 days before  
               the commencement of the regular season.


             7)   Defines "regular season" to mean the period of time from  
               the first interscholastic football game or scrimmage until  
               the completion of the final interscholastic football game  
               of that season.


             8)   Makes clear that this section does not prohibit the CIF,  
               an athletic league, a school, a school district, or any  
               other appropriate entity, from adopting and enforcing rules  
               intended to provide a higher standard of safety for  
               athletes than the standard established under this section.


             9)   Requires an athlete who has sustained a concussion or  
               head injury, as diagnosed by the licensed health care  
               provider, to also complete a graduated return-to-play  
               protocol of no less than 7 days in duration and supervised  
               by a licensed health care provider.









                                                                  AB 2127
                                                                  PageC


             10)  Urges the CIF 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 the return-to-play protocol requirement.


           EXISTING LAW  
          1)Requires the governing school board of each school district to  
            have control of and be responsible for all aspects of the  
            interscholastic athletic policies, programs, and activities in  
            its district.


          2)Permits governing boards of school districts to enter into  
            associations or consortia with other governing boards for the  
            purpose of governing regional or statewide interscholastic  
            athletic programs by permitting the schools under their  
            jurisdictions to enter into a voluntary association with other  
            schools for the purpose of enacting and enforcing rules  
            relating to eligibility for, and participation in,  
            interscholastic athletic programs among and between schools.


          3) Defines interscholastic athletics as those policies,  
            programs, and activities that are formulated or executed in  
            conjunction with, or in contemplation of, athletic contests  
            between two or more schools, either public or private.


          4)Requires each high school sports coach to complete a coaching  
            education program developed by his or her school district, or  
            the CIF, that meets the guidelines set forth by the High  
            School Coaching Education and Training Program (HSCETP).  

          5)Requires a school district that elects to offer an athletic  
            program to comply with all of the following:
             a)   Remove an athlete who is suspected of sustaining a  
               concussion or head injury in an athletic activity from the  
               activity for the remainder of the day.


             b)   Prohibit an athlete who is suspected of sustaining a  
               concussion or head injury in an athletic activity from  









                                                                  AB 2127
                                                                  PageD
               returning to the activity until he or she is evaluated by a  
               licensed health care provider, trained in the management of  
               concussions, acting within the scope of his or her  
               practice.


             c)   Prohibit the return of the athlete to the activity until  
               he or she receives written clearance to return to the  
               activity from that licensed health care provider.  


             d)   Require, annually, a concussion and head injury  
               information sheet be signed and returned by the athlete and  
               the athlete's parent or guardian prior to the start of the  
               athlete's season of practice or competition.  



          6)Exempts an athlete engaging in an athletic activity during the  
            regular school day, or as part of a physical education course,  
            from these requirements. 

           FISCAL EFFECT  :   This measure has been keyed non-fiscal by  
          Legislative Counsel

           COMMENTS  :   In 2011, the National Football League (NFL) limited  
          the total number of full-contact practices to 14 for the year  
          with 11 of those practices conducted during the first 11 weeks  
          of the season (a maximum of one per week), with no full-contact  
          practices during the off season.  Similarly, 19 states have  
          banned off-season full-contact high school football practices,  
          including Texas, which is widely seen as the mecca of high  
          school football.  In instituting such limitations, the NFL and  
          state Legislatures have cited an effort to reduce exposure to  
          possible brain trauma from hits to the head.  

          In an October 19, 2009 New Yorker article, Malcolm Gladwell,  
          concludes that "data suggest that practice-the routine part of  
          the sport-can be as dangerous as the games themselves."  He  
          looked to the dramatic helmet-to-helmet hits as well as the more  
          innocuous falls or contact and pointed to the cumulative  
          exposure:
               This is a crucial point. Much of the attention in the  
               football world, in the past few years, has been on  
               concussions-on diagnosing, managing, and preventing  









                                                                  AB 2127
                                                                  PageE
               them-and on figuring out how many concussions a player  
               can have before he should call it quits. But a  
               football player's real issue isn't simply with  
               repetitive concussive trauma. It is, as the concussion  
               specialist Robert Cantu argues, with repetitive  
               sub-concussive trauma. It's not just the handful of  
               big hits that matter. It's lots of little hits,  
               too.<1> 

           

          This bill  addresses the repetitive concussive trauma and follows  
          the lead of the NFL, by limiting the number of full-contact  
          practices in which a high school football player can  
          participate. In so doing, this bill seeks to minimize the  
          opportunities for trauma.

           Return -To-Play Protocol  
          The Return-To-Play Protocol, as described by the United States'  
          Center for Disease Control (CDC) consists of 5 "steps" following  
          a complete physical and the absence of concussion symptoms for a  
          period of 24 hours.  The steps progress from light aerobic  
          exercise for 5-10 minutes, to moderate exercise, to non-contact  
          but more intense exercise, a reintegration into full practice,  
          and finally a return to play.  The CDC emphasizes the need for  
          each of these steps to be monitored for a return of concussion  
          symptoms.   This bill  would prohibit an athlete who is suspected  
          of sustaining a concussion from returning to the athletic  
          activity in which he or she suffered the concussion until the  
          athlete has completed a return-to-play protocol of not less than  
          7 days in duration.  This bill makes no reference to any  
          particular protocol, but instead urges the CIF to work with the  
          American Academy of Pediatrics and the American Medical Society  
          for Sports Medicine to develop and adopt rules and protocols to  
          implement the protocol.

           Previous Legislation  :  
          AB 588 (Fox), Chapter 423, Statutes of 2013, applies existing  
          law relating to students who sustain, or are suspecting of  
          sustaining, a concussion during a school-sponsored athletic  
          activity to charter schools and private schools.  This bill  
          passed out the Assembly Education Committee by a vote of 7 - 0. 

          ---------------------------
          <1>  
           http://www.newyorker.com/reporting/2009/10/19/091019fa_fact_gladw 
          ell?currentPage=all  Accessed on March 10, 2014.








                                                                  AB 2127
                                                                  PageF

          AB 1451 (Hayashi), Chapter 173, Statutes of 2012, includes a  
          basic understanding of the signs and symptoms of concussions and  
          the appropriate response to concussions within the HSCET,  
          administered by school districts. This bill passed out the  
          Assembly Education Committee by a vote of 10 - 1. 

          AB 25 (Hayashi), Chapter 465, Statutes of 2011, requires a  
          school district that elects to offer athletic programs to  
          immediately remove an athlete who is suspected of sustaining a  
          concussion or head injury during that activity; prohibits the  
          return of the athlete to that activity until he or she is  
          evaluated by, and receives written clearance from, a licensed  
          health care provider; requires, on a yearly basis, a concussion  
          and head injury information sheet to be signed and returned by  
          the athlete and the athlete's parent or guardian before the  
          athlete's initiating practice or competition. This measure was  
          passed out of this committee by a vote of 9-0.

          AB 1449 (Hayashi) (2012), held in the Assembly Education  
          Committee, requires the SPI to develop and make available a  
          sample concussion and head injury information sheet for use by  
          school districts.  

          AB 1646 (Hayashi) (2010), held in the Assembly Appropriations  
          Committee suspense file, requires training for coaches to be  
          able to identify symptoms of head and neck injury.  This measure  
          was passed out of this committee by a vote of 6-2.

          AB 1647 (Hayashi) (2010), establishes certification and training  
          requirements for athletic trainers.  The bill also prohibits  
          individuals from calling themselves athletic trainers unless  
          they met those requirements.  Governor Schwarzenegger vetoed  
          this bill with the following message:  

               This bill is similar to legislation I have vetoed twice  
               before in the past because there is no evidence that  
               regulating the use of the term "certified athletic trainer"  
               poses any threat to the public health and safety.

          AB 1893 (Hayashi) (2010), held in the Assembly Education  
          Committee, requires all high school spirit activities coaches to  
          have valid certification in CPR and first aid, including an  
          understanding of signs, symptoms, and appropriate emergency  
          action steps regarding potentially catastrophic injury,  









                                                                  AB 2127
                                                                  PageG
          including but not limited to, head and neck injury and  
          concussion.  Pupils participating in this activity who  
          experience or show signs of trauma or other injury must obtain a  
          release from the treating provider before resuming these  
          activities.  

          AB 533 (Hayashi) (2009), held in the Assembly Appropriations  
          Committee suspense file, requires training for coaches to be  
          able to identify symptoms of head and neck injury.  This measure  
          was passed out of this committee by a vote of 8-1.

           REGISTERED SUPPORT / OPPOSITION  :   

           Support 

           American Academy of Pediatrics
          Brain Injury Association
          California Psychological Association

           Opposition 
           
          None on file
           
          Analysis Prepared by  :    Jill Rice / ED. / (916) 319-2087