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Traumatic Brain Injury Legislation

Traumatic Brain Injury Legislation

7/28/2014

Traumatic Brain Injury (TBI) is a disruption in the normal functioning of the brain due to a bump, blow, jolt or penetrating head injury. Approximately 1.7 million people suffer a traumatic brain injury annually with 52,000 dying. The leading causes of TBI are falls, motor vehicle crashes, being struck by or against objects and assault. While most of these injuries are mild, resulting in a short-term disruption, such as a concussion, many are severe, resulting in prolonged unconsciousness or amnesia and occasionally leading to permanent disability or death.  Every year in the United States, TBI is estimated to have direct and indirect costs of $60 billion on top of the emotional burden faced by family and friends of someone who suffers a TBI.

Programs and services for TBI patients are funded through various federal and state sources. At least 22 states and the District of Columbia currently operate a Medicaid Home- and Community-Based Services (HCBS) waiver targeting patients with TBI. HCBS waivers are active in 48 states and the District of, providing funding for cost-effective services to those at risk of being institutionalized due to a medical condition. 

Many states aim to effectively prevent and diagnose cases of TBI, and to respond and rehabilitate TBI patients. Between 2009 and 2014, 50 states and the District of Columbia passed laws to address traumatic brain injury. The majority of these states enacted legislation targeting youth sports-related concussions. Other introduced legislation addresses traumatic brain injury in veterans, appropriates funds to traumatic brain injury prevention or treatment programs, and would require insurers, hospitals and health maintenance organizations to provide insurance coverage for survivors of traumatic brain injury. Below is a list of enacted legislation between 2009 and 2014 to address traumatic brain injury. 

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State Laws on Traumatic Brain Injury: 2009-2014

State

Description of Law

Alabama

Ala. Code §22-11E (2012 HB 308)

Makes changes to current law by requiring each local board of education to develop guidelines and other pertinent information regarding medical evaluation of concussions or head injuries. This law also requires a youth athlete who has been removed from a practice or an athletic game because of a concussion be withheld from practice for or participation in athletic games and may not return to play the day of the injury.

Ala. Code §22-11E (2011 HB 108)

Requires the governing body of each sport or recreational organization to develop guidelines and other information to educate youth athletes and their parents or guardians of the nature and risk of concussion and brain injury. Also requires coaches to be trained in recognizing the symptoms of a concussion and how to seek proper medical treatment. This law requires immediate removal of a youth athlete who is suspected of sustaining a concussion or brain injury from a practice or game.

Alaska

Alaska Stat. §14.30.142-143 (2011 HB 15)

This bill requires the governing body of a school district and the Alaska school activities association to develop and publish guidelines and other information to educate coaches, student athletes and parents of student athletes regarding the nature and risks of concussions. Schools are required to provide a student and the parent or guardian written information on the nature and risks of concussions. This bill also requires that a student who is suspected of having sustained a concussion during a practice or game to be immediately removed from play and may not return to play until the student has been evaluated and cleared for participation in writing by a qualified person who has received training and is currently certified in the evaluation and management of concussions.

Alaska Stat. §18.15.360; 47.07.030; 47.07.046; 47.80.500 (2010 SB 219)

Establishes a traumatic or acquired brain injury program and registry within the Department of Health and Social Services. Also allows for a Medicaid waiver for traumatic brain injury services, upon federal approval. Along with other mandatory services, the program will offer case management services for those with traumatic or acquired brain injury residing in a community setting or those transitioning into a community setting.

Arizona

Ariz. Rev. Stat. Ann. §15.341.A.24 (2011 Senate Bill 1521)

Amends current law to require school boards to develop and enforce concussion and head injury policies for all pupils participating in school district sponsored practices, games or other interscholastic activities. These guidelines must inform and educate coaches, parents and pupils of the dangers of concussions and head injuries, and requires the immediate removal from athletic activity if a pupil is suspected of sustaining a concussion. The pupil may return to play when evaluated and cleared by a health care provider.

Arkansas

2013 Ark. Acts, Act 1435 (2013 SB 1158)

Creates the Arkansas Concussion Protocol Act; requires the Department of Health to develop concussion protocols to protect youth athletes engaged in youth athletic activities.

California

Cal. Education Code §49475 (2011 AB 25)

Requires a school district that elects to offer athletic programs to remove from an activity an athlete who is suspected of sustaining a concussion or head injury. Also prohibits the return of the athlete until he or she is evaluated, and receives written clearance from a licensed health care provider. Requires an annual related information sheet to be signed and returned by the athlete and his or her parent or guardian before practice or participation.

Cal. Penal Code §13515.36 (2010 SB 1296)

Requires the Commission on Peace Officer Standards and Training to assess the training needed by peace officers on the topic of returning veterans or other persons suffering from traumatic brain injury (TBI) or post-traumatic stress disorder (PTSD). Among other provisions, the law also requires the commission to distribute a training bulletin via the internet to the specified law enforcement agencies on the topics of TBI and PTSD and to report to the legislature by June 30, 2012 to the extent to which peace officers are receiving adequate training on how to interact with persons suffering from TBI or PTSD.

Cal. Welfare and Institutions Code § 4354; 4354.5; 4355; 4356; 4357; 4357.1; 4358.5; 4359; 14132.992 (2009 AB 398)

Removes the State Department of Mental Health as the agency responsible for administering the program of services for persons with traumatic brain injury and establishes the Department of Rehabilitation as the responsible agency. Once secured funding, requires Department of Rehabilitation to fund an array of services for adults 18 years of age and older with acquired traumatic brain injury and requires the department to determine the requirements for service delivery, uniform data collection and other aspects of program administration. Service providers participating in the program must meet and to monitor and evaluate the performance of those service providers.

Colorado

2011 Colo., Sess. Laws, Chap. 67 (2011 SB 40)

Creates the Jake Snakenberg Youth Concussion Act.  This law requires each coach of a youth athletic interscholastic activity in public and private middle, junior and high schools to compete an annual concussion recognition course. Also requires a student athlete to be removed from game, competition or practice if the athlete has sustained or is suspected of sustaining a concussion. The athlete may not participate in any team activities involving physical exertion until he/she is evaluated and receives written clearance from a health care provider.

Connecticut

2014 Conn. Acts, P.A. 14-66 (Reg. Sess.) (2014 HB 5113)

Amends current law to require the Board of Education and the Commissioner of Public Health to develop:  concussion education plans, informed consent forms, and current best practices for concussion prevention.

2010 Conn. Acts, P.A. 10-62 (Reg. Sess.) (2010 SB 456)

Requires student athletic coaches to complete annual training and review regarding concussions and head injuries. To be reissued a coaching permit, coaches are also required to complete refresher courses once every five years. These training and refresher courses must be approved by the State Board of Education. This law also requires a student athlete to be removed from play or other kinds of physical exertion when showing signs of a concussion, and are not permitted to resume participation without written clearance from a licensed medical professional.

Delaware

Vol. 78 Del. Laws, Chap. 192 (2011 SB 111)

Requires the Delaware interscholastic athletic association to adopt regulations to address the appropriate recognition and management of student athletes exhibiting signs and symptoms consistent with a concussion during practices, scrimmages and interscholastic contests. This law also requires the signing of an informational sheet by students and their parents or guardians.  

District of Columbia

2011 D.C. Stat., Chap. 22 (2011 B 7)

Requires an athlete under 18 years old who is suspected of sustaining a concussion in an athletic activity shall be removed from physical participation. Provides that an athlete who has been removed from an athletic activity may not return to physical participation in the athletic activity until he or she has been evaluated by a health-care provider and receives written clearance to return, and establishes a training program.

Florida

2012 Fla. Laws, Chap. 167

Requires an independent sanctioning authority for youth athletic teams and the Florida High School Athletic Association to adopt guidelines relating to the nature and risk of concussion and head injury in youth athletes. This law also requires the removal from practice or competition under certain circumstances and written medical clearance to return.

Georgia

2013 Ga. Laws, p. 25 (2013 HB 284)

Enacts the Return to Play Act and requires public and private schools youth athletic activities and public recreation facilities to provide information to parents on the nature and risk of concussion and head injury and to establish concussion management and return to play policies. Provides for the endorsement of concussion recognition education courses.

Hawaii

2012 Hawaii Sess. Laws Act. 197 (2012 HB 2273)

Requires the department of education and the state high school athletic association to develop a concussion awareness program to provide guidelines for public and private schools.

Idaho

2012 Idaho Sess. Laws, Chap. 299 (2012 HB 632)

Requires coaches, referees, game officials, game judges and athletic trainers shall review youth concussion guidelines and information upon employment and biannually. Also requires every Idaho middle school, junior high school and high school that participates in or offers an organized athletic league to develop protocol to be followed for removing athletes from play in the event of a concussion. Athletes may not return to play until athlete is evaluated and authorized to return by a qualified health care professional who is trained in the evaluation and management of concussions.

2010 Idaho Sess. Laws, Chap. 294 (2010 HB 676)

Requires sports related concussion and head injury guidelines to be developed by the Department of Education and the Idaho High School Activities Association to inform and educate coaches, parents/guardians, and youth athletes. These guidelines, information, and forms may be used by all organized youth sport organizations and associations that sponsor, promote or otherwise administer youth sport organizations or activities.

 

Illinois

2011 Ill. Laws, P.A. 204 (2011 HB 200)

Requires each school board to adopt a policy regarding student athlete concussions and head injuries to be included with any participation agreement. Also requires school districts to use educational materials to educate specified people regarding concussions and authorizes park districts to make available to residents and users of park district facilities educational materials that describe the nature and risk of concussion and head injuries.

2011 Ill. Laws, P.A. 97-0078 (2011 HB 3275)

Amends current law to creates the Veterans Traumatic Brain Injury and Post-Traumatic Stress Disorder Public Service Announcement Fund.

Indiana

2014 Ind. Acts, P.L. 89 (2014 SB 180)

Requires the state department of health to study and report findings and recommendations to the legislative council concerning implementation of a program for the treatment of veterans who have traumatic brain injury or posttraumatic stress disorder.

2014 Ind. Acts, P.L. 34 (2014 SB 222)

Amends current law to require high school students who were removed from practice or a game because of a suspected concussion or head injury, to return to play no less than 24 hours after the concussion. Also requires coaches to complete a certified coaching education course which includes concussion awareness.

2012 Ind. Acts, P.L. 110 (2012 SB 15)

Requires the department of health and the office of the secretary of family and social services to study how to implement brain injury services and rehabilitation programs. The department and office are required to report the study's findings to the health finance commission.

2011 Ind. Acts, P.L. 144 (2011 SB 93)

Requires the Department of Education to develop and disseminate guidelines, information sheets and forms to inform and educate coaches, student athletes and parents of the nature and risk of concussions and head injuries. Also requires the removal from practice of a game of a high school student suspected of sustaining a concussion or head injury. The high school student may return to play until they are evaluated and cleared by a licensed health care provider trained in the evaluation and management of concussions and head injuries.

Iowa

2013 Iowa Acts, Chap. 98 (2013 HF 545)

Allows the Commission of Veterans Affairs to expend moneys on expenses related to screening or treatment for any medical need related to a military service-connected traumatic brain injury for which payment or reimbursement is not otherwise available through any other federal or state program or, if applicable, through a veteran's private insurance or managed care organization.

2011 Iowa Acts, 32 (2011 SF 367) 

Requires the Iowa high school athletic association and the Iowa girls high school athletic union to distribute guidelines and information to coaches, students and parents/guardians about the risks, signs and symptoms of concussions/brain injuries. Also requires a student’s immediate removal from athletic participation upon exhibiting signs, symptoms or behaviors consistent with a concussion. The student may not recommence participation until they have been evaluated and cleared by a licensed health care provider.

Kansas

2011 Kan. Sess. Laws, Chap. 45 (2011 HB 2182)

Creates the School Sports Head Injury Prevention Act and requires the school activities association to compile information about the nature and risk of concussions and head injuries from sports and other activities. Coaches, parents and athletes will receive information about concussions prior to any student’s participation in athletics. Also requires the immediate removal from play of any athlete that suffers or is suspected of sustaining a concussion during competition or practice. The student may return to competition or practice after being evaluated and receiving written clearance from a health care professional.

Kentucky

2012 Ky. Acts, Chap. 72 (2012 HB 281)

Requires coaches to complete training on recognizing and treating concussions and head injuries. Also requires a medical evaluation before an athlete with a suspected concussion or head injury may return to play.

Louisiana

La. Acts 2011, 314 (2011 SB 189)

Creates the Louisiana Youth Concussion Act which requires youth athlete concussion education requirements for coaches, officials, volunteers, athletes and parents or guardians. Also requires the removal of youth athletes from competition or practice upon sustaining a concussion. A youth athlete suspected of sustaining a concussion or head injury may only return to competition or practice after being evaluated and receiving written clearance from a health care provider for a full or graduated return to play.

Maine

2012 Me. Acts, Chap. 688 (2012 SB 654)

Directs the commissioner of education to propose a model policy for public and private schools on the management of concussive and other head injuries in school activities and athletics and specifies requirements for the model policy. This law also requires schools to adopt a policy on the management of head injuries and  provides that the commissioner and school officials may share the model policy with statewide and local organizations that sponsor sports and athletics.

2011 Me. Acts, Chap. 293 (2011 HB 887)

Requires the department of health and human services to develop a comprehensive neurorehabilitation service system to assist, educate and rehabilitate persons with an acquired brain injury, which must include care management and coordination, crisis stabilization services, physical therapy, occupational therapy, speech therapy, neuropsychology, neurocognitive retraining, positive neurobehavioral supports and teaching, social skills retraining, counseling, vocational rehabilitation, and independent living skills and supports.

2009 Me. Acts, Chap. 79 (2009 HP 903)

Establishes a working group to make recommendations on the prevention, diagnosis, and treatment of head injuries in student athletes, including baseline and post-concussion testing and diagnosis of student athletes, return to play guidelines, training for school coaches, athletic directors and trainers, delivery of post-concussive management services, and ways to integrate education, training, and diagnostic programs into school athletic programs. This workgroup will include related state organizations and stakeholder groups.

Maryland

2011 Md. Laws, Chap. 549 (2011 HB 858)

Requires the department of education to develop policies and to implement programs to provide awareness of the risks of concussions/head injuries to coaches, school personnel, students, and parents/guardians. Also requires the removal from play of a student suspected of sustaining a concussion or other head injury in a practice or game. The student may not return to play until evaluated and cleared by a licensed health care provider trained in the evaluation and management of concussions.

Massachusetts

2010 Mass. Acts, Chap. 166 (2010 SB 2469)

Requires the department of health to direct the division of violence and injury prevention to develop an interscholastic athletic head injury safety training program in which all public schools and any school subject to the Massachusetts Interscholastic Athletic Association rules shall participate. Participation in the program shall be required annually of coaches, trainers, parent volunteers for any extracurricular athletic activity, physicians and nurses who are employed by a school or school district or who volunteer to assist with an extracurricular athletic activity, school athletic directors, school marching band directors, and a parent or legal guardian of a child who participates in an extracurricular athletic activity. Students’ parents/guardians are also required to complete and sign a form releasing them to participate in an extracurricular activity. Students who become unconscious during practice or competition may not return to practice or competition until receiving a written authorization from a doctor, licensed neuropsychologist, certified athletic trainer, or another appropriately trained licensed health care professional.

Michigan

2012 Mich. Pub. Acts, Act 342 (2012 SB 1122)

Requires the development of a concussion awareness training program that includes the criteria for the removal of a youth athlete from physical participation in an athletic activity and the risks to an athlete of not reporting a suspected concussion. Also makes the training program available to all individuals required to participate in the program and interested individuals, including school personnel, coaches, parents, students and athletes.

Minnesota

2011 Minn. Laws, Chap. 90 (2011 SB 612)

Requires an organization that charges a fee for a youth athletic activity to inform all participating coaches, officials, youth athletes and parents of the nature and risks of concussions. Also would require a coach or official to remove a youth athlete from the athletic activity if the youth athlete exhibits signs, symptoms, or behaviors consistent with a concussion or  is suspected of sustaining a concussion. The athlete may not return to the activity until they no longer exhibit signs, symptoms, or behaviors consistent with a concussion or are evaluated and cleared by a trained provider. This provider needs to develop a recovery plan for the youth athlete.

Mississippi

2014 House Bill 48

Requires public, charter and private schools that provide youth athletic activities to adopt and implement a concussion management and return to play policy that includes certain components and to provide parents with the concussion policy before the start of the regular school athletic season. Requires the State Department of Health shall endorse a concussion recognition education course to provide public information regarding the nature and risk of concussions in youth athletics. 

2010 Miss. Laws, Chap. 476 (2010 SB 3004)

Requires the state department of education to include traumatic brain injury as an intellectual disability that qualifies individuals between the ages of three and 20, for special education and other state services. Among other provisions, this law allows the Department of Rehabilitation Services to match state funds with the Division of Medicaid federal funds for care and rehabilitation for individuals with traumatic brain injury.

Missouri

Mo. Rev. Stat. §167.765 (2011 HB 300)

Provides for the establishment of the interscholastic youth sports brain injury prevention act; which requires rules to educate coaches, student athletes, and their parents or guardians on the nature and risk of concussion and brain injury. Also requires an athlete to be removed from the field/practice for a minimum period if suspected of sustaining a brain injury.

Montana

2013 Mont. Laws, Chap. 260 (2013 SB 112)

Requires each school district to adopt a policy addressing the dangers of concussions and provides minimum requirements for the contents of a district policy. Requires that a youth athlete who exhibits signs, symptoms, or behaviors consistent with a concussion be removed from participation under medical clearance is obtained.

Nebraska

2014 Neb. Laws, L.B. 923

Creates the position of State School Security Director in the State Department of Education and requires schools to establish a return to learn protocol for students who have sustained a concussion.

2011 Neb. Laws, L.B. 260 (2011 LB 260)

Creates the Concussion Awareness Act and requires each school to make available training on concussions and brain injuries to all coaches of school athletic teams. Requires a student suspected of having sustained a concussion or brain injury to be removed from a practice or game and may not return to play until the student has been evaluated and received written clearance from a licensed health care professional.

Neb. Rev. Stat. § 71-8248 (2009 LB 195)

Establishes and maintains the statewide trauma registry, which tracks incidence, severity and causes of trauma, including traumatic brain injury. All hospitals involved in the care of a trauma patient will have unrestricted access to all prehospital reports for the trauma registry for that specific trauma occurrence.

Nevada

2011 Nev. Stats., Chap. 170 (2011 AB 455)

Requires the Nevada Interscholastic Activities Association and the board of trustees of each school district to adopt policies concerning the prevention and treatment of injuries to the head sustained by students while participating in sports and other athletic activities. This bill also requires school districts and sports organizations that are not governed by the Association to adopt a similar policy. These policies must require the immediate removal of a student from activity or event if the student sustains or is suspected of sustaining a head injury. The student may return to the activity or event after providing a signed medical clearance from a health care provider.

 

New Hampshire

2014 N.H. Laws, Chap. 19 (2014 HB 1113)

Requires school districts to distribute a concussion and head injury information sheet to student-athletes and establishes a definition for head injury.

2014 N.H. Laws, Chap. 135 (2014 SB 298)

Establishes the permanent commission on post-traumatic stress disorder and traumatic brain injury to develop, coordinate, and oversee the recommendations study the effects of service-connected post-traumatic stress disorder and traumatic brain injury suffered in the line of duty by members of the armed forces and veterans.

2013 N.H. Laws, Chap. 19 (2013 HB 180)

Changes the definitions of “student athlete” and “student sports” for purposes of management of head injury and concussion.

2013 N.H. Laws, Chap. 229 (2013 SB 90)

Establishes a committee to study developing a policy for giving preference to veterans in government hiring. Extends the commission on the effects of service-connected post-traumatic stress disorder and traumatic brain injury.

2012 N.H. Laws, Chap. 234 (2012 SB 402)

Requires school districts to develop policies for the management of concussion and head injury in youth sports and limits a school district's liability for injuries occurring on school district property resulting from the action or inaction of a person employed by, or under contract with, a youth program, provided such program furnishes proof of insurance.

2011 N.H. Laws, Chap. 84 (2011 SB 102)

Creates a commission to study the effects of service-related post-traumatic stress disorder and traumatic brain injury suffered in the line of duty by members of the armed forces and veterans.

2010 N.H. Laws, Chap. 225 (2010 SB 517)

Establishes a veteran’s legal aid advocacy project to address the legal needs of veterans including those with traumatic brain injury, based on a 2009 committee study.

New Jersey

2010 N.J. Laws, Chap. 168 (2010 AB 4008)

Requires department of education to include cheerleaders in the student-athlete head injury safety program.

2010 N.J. Laws, Chap. 94 (2010 AB 2743)

Requires the department of education to develop and implement an interscholastic athletic head injury safety training program to be completed by a school physician, a person who coaches a public school district or nonpublic school interscholastic sport, and an athletic trainer involved in a public or nonpublic school interscholastic sports program. This law requires the department of education to develop an educational fact sheet about sports-related concussions and other head injuries, and requires each school district to develop a written policy concerning the prevention and treatment of sports-related concussions and other head injuries among student-athletes. This law also specifies that a student who is suspected of having sustained a concussion or other head injury while engaged in a sports competition or practice must be immediately removed from play and may not participate in further sports activity until she/he is evaluated by a physician or other licensed healthcare provider trained in the evaluation and management of concussions and receives written clearance.

New Mexico

2014 N.M. Laws, Chap. 36 (2014 HB 58)

Creates the brain injury services fund to institute and maintain a statewide brain injury services program designed to increase the independence of persons with brain injuries.

2010 N.M. Laws, Chap. 96 (2010 SB 1)

Requires that safety protocols for brain injury during school athletic activity be provided to coaches and parents of student athletes and that athletes exhibiting signs of head injury be held out of activity until the student athlete no longer exhibits any associated symptoms and is cleared by a medical professional or one week after the student athlete received the brain injury.

New York

N.Y. Education Law § 305.42 (2011 SB 3953)

Enacts the "concussion management and awareness act" and directs the commissioners of education and health to adopt and implement rules and regulations for the treatment and monitoring of students with mild traumatic brain injuries and requires school personnel to receive training in mild traumatic brain injuries. This law also requires an information pamphlet on mild traumatic brain injuries to be distributed to parents of pupils participating in interscholastic sports or who have suffered a mild traumatic brain injury and provides for the establishment of concussion management teams to implement the provisions established in this law.

North Carolina

2011 N.C. Sess. Laws, Chap 147 (2011 HB 792)

Creates the Gfeller-Waller Concussion Awareness Act and requires development of an athletic concussion safety training program for the use of coaches, school nurses, athletic directors, volunteers, student athletes and their parents. Requires students who exhibit signs of concussion to be removed from the activity and not permitted to practice that day or any subsequent day until the student is evaluated by and receives written clearance for such participation from  a qualified health professional. Also requires schools to develop related emergency plans and maintain related records.

2009 N.C. Sess. Laws, Chap. 361 (2009  HB 1309)

The commission for mental health, developmental disabilities, and substance abuse services adopts rules for the licensure and accreditation of residential treatment facilities for individuals with traumatic brain injury. The law also makes changes to the North Carolina Traumatic Brain Injury Advisory Council.

North Dakota

2013 N.D. Sess. Laws, Chap. 418 (HB 1424)

Provides for a legislative management study the feasibility and desirability of participating in the provision of nontraditional healing therapies for posttraumatic stress, traumatic brain injury, and other neurological conditions for state veterans and their families.

2011 N.D. Sess. Laws, Chap. 126 (2011 SB 2281)

Requires the development of a concussion management program for student athletes participating in school district and nonpublic school sponsored athletic activity. This program requires the removal of a student athlete from competition, practice or training, if the student exhibits signs or symptoms of sustaining a concussion. The student may return to play when evaluated and cleared by a certified health provider whose scope of practice includes the diagnosis and treatment of concussions. This law also requires a legislative management study on youth athlete concussion management to be completed during 2011 and 2012.

Ohio

Vol. 118, 2014 Ohio Laws (2014 HB 487)

Requires a physicians and licensed health care professionals who conduct concussion or head injury assessments to meet a minimum educational requirement.

Vol. 192, 2012 Ohio Laws H. 143

Prohibits school chartered or nonchartered nonpublic school districts from allowing a student to practice for or compete in interscholastic athletics until the student has submitted a form signed by parent, guardian, or other person having care or charge of student, stating that the student has received a concussion and head injury information sheet. The law also prohibits an individual to referee interscholastic athletics unless the individual holds a public activity program permit, and presents evidence that the individual has successfully completed a training program in recognizing the symptoms of concussions and head injuries. This law prohibits a student practicing for or competing in an interscholastic athletic event when they exhibits signs, symptoms, or behaviors consistent with having sustained a concussion or head injury while participating in the practice or competition. The coach or referee shall not allow the student to return to that practice or competition or to participate in any other practice or competition for which the coach or referee is responsible until the student's condition is assessed by either a physician or any other licensed health care provider the school district board of education or governing authority of the chartered or nonchartered nonpublic school. The student may return when they receive written clearance that it is safe for the student to return to practice or competition.

Oklahoma

2010 Okla. Sess. Laws, Chap. 264 (2010 SB 1700)

Requires each school district’s board of education to develop information and guidelines, in cooperation with the Oklahoma Secondary School Activities Association, to inform young athletes, parents or guardians, and coaches about the risks and consequences of sustaining a head injury during a practice or game. This law also requires the removal of a young athlete from participation in a practice or game following a suspected concussion or head injury. The youth athlete may not return to participation without clearance from a licensed health care provider.

Oregon

2009 Or. Laws, Chap. 661 (2009 SB 348)

Requires each school district to ensure that coaches receive annual training to learn to recognize the symptoms of a concussion and how to seek proper medical treatment for a person suspected of having a concussion. A student athlete showing signs, symptoms or behaviors consistent with a concussion or diagnosed with a concussion may not return to play until receiving medical release form from a medical professional or when the athlete no longer exhibits the signs of a concussion.

Pennsylvania

P.A. Laws, Act. 101 (2011 SB 200)

Establishes standards for managing concussions and traumatic brain injuries for student athletes. Requires the department of health and education to develop guidelines to educate students participating in or desiring to participate in athletic activity, their parents and coaches about the nature and risk of concussion and traumatic brain injury. A student how is determined by a game official, coach from the student's team, certified athletic trainer, licensed physician, licensed physical therapist or other official designated by the student’s school entity exhibits signs or symptoms of a concussion or traumatic brain injury while participating in an athletic activity is required to be removed from participation at that time. The student may not return to play until the student is evaluated an cleared for participation by an appropriate medical professional.

Rhode Island

2014 R.I. Pub. Laws, Chap. 237 (2014 HB 7367)

Amends the School and Youth Programs Concussion Act to direct the Department of Education to promulgate guidelines for teachers and teachers' aides to complete a training course in concussions and traumatic brain injuries. Also requires all school nurses to complete a training course and an annual refresher course in concussions and traumatic brain injuries.

2011 R.I. Pub. Laws, Chap. 237 (2011 HB 5540)

Amends current law to require coaches and volunteers to complete an annual refresher course in addition to the already mandated training course. This law also encourages school districts to have school nurses complete a training course and authorizes physicians to consult with an athletic trainer when determining whether to return a youth athlete to a practice or game.

2010 R.I. Pub. Laws, Chap. 22 (2010 HB 7036)

Requires the department of education and the state department of health with the Rhode Island Interscholastic League to develop guidelines for informing and educating coaches, youth athletes and their parents or guardians about the risks associated with concussions, including the risk of continuing to play after sustaining a head injury. Among other provisions, this law requires all coaches, volunteers and trainers to complete a training course in concussions and traumatic brain injuries. This law also requires youth athletes suspected of sustaining a head injury to be removed from play and not return until cleared by a medical professional.

South Carolina

2013 S.C. Acts, Act 33 (2013 HB 3061)

Requires the Department of Education to develop and distribute model policies concerning the nature and risk of concussions sustained by student athletes. Also requires the removal from play and medical evaluation of a student athlete believed to have sustained a concussion during play, and allows for the evaluation to be undertaken by a volunteer health care provider.

2013 S.C. Acts, Act 63 (2013 SB 127)

Creates the State Brain Injury Leadership Council and requires the council to provide statewide coordination in promoting support services to persons with brain injuries, their families, and caregivers, and to identify emerging issues and innovations, foster education and advocacy, and build consensus to support necessary police and programs.

South Dakota

2011 S.D. Sess. Laws, Chap. 97 (2011 Senate Bill 149)

Requires the South Dakota High School Activities Association and the department of education to develop guidelines that educate schools, coaches, athletes, and the parents/guardians of the nature and risk of concussion. Coaches must complete an annual training program about the nature, risks, signs, symptoms and behaviors consistent with a concussion and how to follow proper medical direction and protocols for treatment and return to play after an athlete sustains a concussion. This law also requires athletes to be removed from participation in any athletic activity when they exhibits signs, symptoms or behaviors consistent with a concussion or are suspected of sustaining a concussion. An athlete may return to play when they no longer exhibit signs of a concussion and are evaluated by a licensed health care provider trained in the evaluation and management of concussions.

Tennessee

2013 Tenn. Pub. Acts, Chap. 148 (2013 SB 882)

Relates to youth sports-related injuries and includes a community-based youth athletic activity and school youth athletic activities. Provides for guidelines, other pertinent information and forms approved by the department of health to educate coaches, school administrators, youth athletes and their parents or guardians of the nature, risk and symptoms of concussion and head injury, including continuing to play after a concussion or head injury.

2012 Tenn. Pub. Acts, Chap. 937 (2012 SB 3535)

Requires that certain adult care home providers with residents with traumatic brain injuries must hold a certification or a current professional license or employ a resident manager who holds a current license as a specified medical professional.

2010 Tenn. Pub. Acts, Chap. 642 (2010 SB 3853)

Revises the list of licenses a Level 2 adult health care home provider serving residents with traumatic brain injury or a resident manager employed by the provider must hold to include a licensed rehabilitation professional or licensed mental health professional instead of a respiratory therapist.

Texas

Tex. Education Code Ann. § 38.151 (2011 HB 2038)

Requires the governing body of each school district and open-enrollment charter school with students enrolled who participate in an interscholastic athletic activity shall appoint or approve a concussion oversight team. Also requires parents or guardians of student athletes to sign a form for that acknowledges receiving and reading written information that explains concussion prevention, symptoms, treatment, and oversight and that includes guidelines for safely resuming participation in an athletic activity following a concussion. The law includes provisions for student athletes to be removed from interscholastic athletics practice or competition immediately if they are believed to have sustained a concussion during the practice or competition. That student may not be permitted to practice or compete again following the force or impact believed to have caused the concussion until evaluated by a physician.

Utah

2013 Utah laws, Chap. 18 (2013 HB 58)

Modifies the Protection of Athletes with Head Injuries Act. Redefines sporting event as applied to a government entity to provide that it does not include merely making available a field, facility, or other location owned, leased, or controlled by the government entity to an amateur sports organization or a child, regardless of whether the government entity charges a fee for the use or free play or recess taking place during school hours.

2013 Utah Laws, Chap. 289 (2013 HB 269)

Clarifies the requirements of a school nurse engaged in treating a student who sustains a concussion or traumatic head injury.

Utah Code Ann. § 26-54 (2012 HB 400)

Creates the Traumatic Spinal Cord and Brain Injury Rehabilitation Trust Fund and an advisory committee to administer the fund and to disburse funds received through appropriations, gifts and a portion of impound fees to assist charitable clinics providing rehabilitation services for the post-acute-care of people with such injuries.

Utah Code Ann. § 26-53 (2011 HB 204)

Creates the Protection of Athletes with Head Injuries Act and requires amateur sports organizations to adopt and enforce a concussion and head injury policy. These policies must include a written notice of policy to the youth athlete's parent or guardian. This law also requires children participating in a sporting event who are suspected of sustaining a concussion or traumatic brain injury to be removed from play. Medical clearance is required before returning to play.

 
Vermont

2013 Vt. Acts, Act 68 (2013 SB 4)

Requires that school athletic coaches and referees receive training on how to prevent concussions during athletic activities, and prohibits a coach or trainer from allowing an athlete to participate in an event if the athlete has sustained a concussion or head injury. Also requires that a health care provider be consulted in certain cases, and requires the home team to ensure that a licensed athletic trainer or health care provider is present at any athletic event involving a contact sport.

2011 Vt. Acts, Act 58 (2011 SB 100)

Requires the commissioner of education to develop statewide guidelines, forms, and other materials, that are designed to educate coaches, youth athletes, and the parents and guardians of youth athletes regarding the nature and risks of concussions and other head injuries. Each youth athlete and a parent or guardian of the athlete annually must sign a form acknowledging receipt of this information. Also requires that a coach cannot permit a youth athlete to train or compete with a school athletic team if the athlete has been removed from play due to symptoms of a concussion or other head injury until the athlete has been examined by and received written permission to participate in athletic activities from a health care provider licensed and trained in the evaluation and management of concussions and other head injuries.

Vt. Stat. Ann. tit. 28, §906 (2009 SB 2)

Includes traumatic brain injury as a functional impairment relevant to guidelines for prisoner classification, treatment, and segregation. Each diagnosis needs to be made by a qualified mental health professional.

Virginia

2014 Va. Acts, Chap. 760 (2014 HB 410/SB 172)

Requires each non-interscholastic youth sports program utilizing public school property to establish policies and procedures regarding the identification and handling of suspected concussions in student-athletes, based on either the local school division's policies and procedures or the Board's Guidelines for Policies on Concussions in Student-Athletes, or follow certain local school division's policies and procedures.

2011 Va. Acts, Chap. 847 (2011 SB 1063/HB 1691)

Requires the mental health and rehabilitative services program within the department of veterans affairs to cooperate with localities that establish special treatment procedures for veterans and active military service members which who are offenders or defendants in the criminal justice system and who need access to proper treatment for mental illness including major depression, alcohol or drug abuse, post traumatic stress disorder or traumatic brain injury.

2010 Va. Acts, Chap. 483 (2010 SB 652)

Requires the State Board of Education to develop policies to educate coaches, youth athletes, and parents or guardians of the risk of concussions, removal and return to play guidelines and risks of not reporting the injury and continuing to play. Each local school district shall develop policies for identifying and handling student athletes suspected of sustaining a concussion or head injury during a practice or game. A student athlete suspected to have an injury will be removed from play and may not return until cleared by a licensed health care provider.

2010 Va. Acts, Chap. 58 (2010 HB 174)

Eliminates a requirement that the Wounded Warrior program only cover combat injuries sustained by military service personnel in combat areas. The program facilitates support for covered individuals to provide timely assessment and treatment for stress-related injuries and traumatic brain injuries resulting from military service, and subject to the availability of public and private funds appropriated for them, case management services, outpatient, family support, and other appropriate behavioral health and brain injury services necessary to provide individual services and support.

Washington

Wash. Rev. Code §74.31.020 (2011 HB 1614)

Amends the Washington traumatic brain injury strategic partnership advisory council to: require the partnership to develop and submit a report to the legislature every year that makes recommendations for revisions to the statewide plan and makes revisions to the council’s activities, among other things.

Wash. Rev. Code §28A.600.190 (2009 HB 1824)

Requires each school district’s board of directors to work with the Washington Interscholastic Activities Association to develop guidelines and other information to educate coaches, athletes, and parents or guardians about concussion and head injury, including continuing to play after injury is sustained. A youth athlete suspected of sustaining a concussion or head injury must be removed from play until cleared by a licensed health care provider.

2009 Wash. Laws, Chap. 447 (2009 HB 2078)

Creates a workgroup to be chaired by the Developmental Disabilities Council, the Washington Association of Sheriffs, and Police Chiefs to address issues relating to persons with developmental disabilities who are in correctional facilities. This workgroup has to include, among other recommendations, advice on the feasibility of screening and accommodating prisoners with traumatic brain injury. The work group shall develop a simple screening tool for jails to use as part of intake of offenders who may have developmental disabilities, a model policy for the use of the screening tool, a cost-effective way to provide training to the jail staff on the use of the tool, and information on best practices and training for accommodating persons with developmental disabilities during their confinement.

West Virginia

2013 W. Va. Acts, Chap. 58 (2013 SB 336)

Establishes protocols and protections to limit and treat injury to youth athletes and students.

Wisconsin

2012 Wis. Laws, Act 172 (2012 HB 400)

Requires an athletic coach or official to remove a person from a youth athletic activity if the person exhibits signs, symptoms, or behavior consistent with a concussion or head injury or the coach or official suspects the person has sustained a concussion or head injury.

Wyoming

2011 Wyo. Sess. Laws, Chap. 190 (2011 SB 38)

Requires the State Superintendent of Public Instruction to develop a model protocol and to assist school districts in developing protocols for addressing risks associated with concussions and other head injuries from school athletics. This law also requires school districts to adopt protocols to address risks associated with concussions and other head injuries, to include training of coaches and trainers, restrictions on a student's participation in athletics after suffering a concussion or head injury, and provision of related information to students and parents.

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