Committee on Children

JOINT FAVORABLE REPORT

Bill No.:

HB-5113

Title:

AN ACT CONCERNING YOUTH ATHLETICS AND CONCUSSIONS.

Vote Date:

3/11/2014

Vote Action:

Joint Favorable Substitute

PH Date:

2/27/2014

File No.:

SPONSORS OF BILL:

The Committee on Children

REASONS FOR BILL:

To better protect youth athletes against concussions and strengthen current statute.

Substitute language (as contained in LCO No. 2598): Changed “concussions and other brain injuries” to “concussions” throughout.

Added more specific language regarding implementation of coaching and instructional techniques in subdivision (3) of subsection (b) of section 1.

Changed “and” to “or” in regard to materials and training used in concussion education plan in subsection (c) of section 1 and added “in person” training to the enumerated list.

In subsection (d) of section 1, charged the governing authority for intramural and interscholastic athletics (rather than SDE) with responsibility for prohibiting student athletes from participating in athletics unless they and a parent complete the education form.

In subdivision (2) of subsection (e) of section 1, charged schools, rather than coaches, with responsibility for providing informed consent form to parents of student athletes.

In subdivision (1) of subsection (a) of section 2, tightened up removal from play requirements by allowing any qualified school employee (as opposed to only coach) to notify a parent if a student athlete exhibits signs of a concussion. Also, requires the qualified school employee to make a reasonable effort to notify the parents immediately but not later than 24 hours after student exhibits signs of concussion.

Removes requirement that student provide his or her coach with informed consent form signed by his or her parent prior to being cleared to return to play.

Removes former section 3 regarding prohibition on conducting full contact practice for more than 90 minutes in any calendar week.

Removes requirement that coaches of youth athletic activity participate in concussion training and simply requires the operator of a youth athletic league to provide a written statement to each youth, upon the youth's registration, that includes concussion education materials.

Removes any references or requirements associated with referees. (In raised bill, referees were required to participate in concussion training).

Adds a task force.

In subdivision (3) of subsection (a) of section 3, removed definition of “coach”.

Note: Testimony below is on raised bill. Substitute language addresses a number of concerns expressed regarding the raised bill. See above.

RESPONSE FROM ADMINISTRATION/AGENCY:

Dr. Jewel Mullen, Commissioner, The Department of Public Health: Supports concept of bill. Concussion is a medical condition with public health implications and that the consequences for a child's learning must also be considered. DPH makes several suggestions such as the inclusion of additional professionals in the consulting group.

Charlene Russell-Tucker, Chief Operating Officer, The State Department of Education: Expressed concern over having no way to track or enforce the prohibition of participation. CIAC, not SDE, oversees interscholastic sports. She would like clarification on the definition of 'other brain injuries'. Suggested adding school nurses to those who must be notified within 24 hours.

NATURE AND SOURCES OF SUPPORT:

Senator Toni Boucher, 26th District: This system would ensure all parties have access to the same information and be able to respond quickly and more effectively to concerns.

David Knauf, President of the Connecticut Association of Directors of Health (CADH): Childhood participation in organized athletics is at an all-time high. There is a glaring lack of data on these types of injuries and all efforts to gather additional data can be used to identify and implement additional prevention strategies.

Connecticut State Medical Society (CSMS): “Other brain injuries” is unclear from a medical standpoint. Outlines multiple language clarifications and recommends task force.

Dr. Gerard A. Gioia, Chief of Pediatric Neuropsychology, Children's National Hospital, Washington, DC: Presently, 15 of the 50 states include non-scholastic youth sports in their state laws, with others now amending their laws to include the full spectrum of youth sports. I would strongly encourage Connecticut to follow suit.

Paul Slager, Esq., The Brain Injury Alliance of Connecticut: Connecticut has fallen behind other states in requiring informed consent. The current law does not meet the current best practices for protecting our children.

Eleni Diakogeorgiou, Connecticut Athletic Trainers' Association (CATA): Concerns about the broad scope of the bill and has provided suggestions. Especially pleased that education for youth sport coaches, athletes, and parents is included.

Dr. Robert Cantu, Boston University School of Medicine Center for the Study of Traumatic Encephalopathy: Children's brains are still developing and more sensitive to the excitotoxic shock of concussion (Second Impact Syndrome). Children have weaker necks, lighter brains, and poor language skills to alert coaches to symptoms. The data are now compelling that all head trauma, even at the sub-concussive level, can result in brain damage.

Hosea H. Harvey, Assistant Professor of Law and Political Science, Temple University: Connecticut was among the first states to think broadly about the issue of youth athlete TBI, but has now fallen behind the evidence-based norm set by other states. This bill would make Connecticut a leader again, the data reporting component is a public health innovation.

Sharon McCloskey, The Connecticut Occupational Therapy Association: Symptomatic students may require active supports and accommodations in school, other students may require hospitalization and intensive rehabilitation. Occupational therapists can support a student's return to school, in collaboration with the educational and medical team.

Katherine Price Snedaker, Pink Concussions: Concussion education should be expanded from high school to elementary school students and athletes, communication must be improved between coaches, school nurses, athletic trainers, parents, and medical providers.

Arlene Doherty, a parent: Children don't have a voice and it's time that we demand basic safety measures for them.

Dr. Candito Carroccia, CT Chiropractic Association: Asks that Chiropractors be included in those who can approve return to play.

Karen Laugel, CT American Academy of Pediatrics: Children with history of concussion miss a median of 37 days of school per year, have difficulty with attention and experience decline in their GPA.

Deb Shulansky, Director of Outreach, Brain Injury Alliance of Connecticut: Limiting contact during practice is an easy and feasible way to reduce risk of concussion.

Kerri McGowan Lowrey, Network for Public Health Law: Passing this Bill, Connecticut would join 16 other states that extend protections to recreational athletics.

James Whitehead, Exec. Vice President, American College of Sports Medicine:Feels further deliberation is needed on the limiting full contact practice and data collection components, based on research now being conducted.

Sarah A. Raskin, PhD, Trinity College: Only real answer is prevention. Education component will help parents make informed decisions.

Terry O'Neil, Greenwich, CT: Injuries are occurring at the high school level due to a lack of safety precautions that would never be seen in NFL. Worked with Mike Ditka and others to form Practice Like Pros – movement for less contact in high school practice.

Marie Billye Simmers, The Connecticut Traumatic Brain Injury (TBI) Advisory Board: Current incidents of brain injuries are grossly under-reported.

Arleigha Cook, Trinity College Student: Players and families need this support at the youth, high school, and colligate level.

Dr. Michael A. Lee, Connecticut Children's Medical Center: Work should be done with medical organizations to help draft clearer language on this topic.

Charlie Wund, Agency for Student Health Research: Statewide adoption of a centralized injury reporting platform would set an example for other states.

Patricia McDonough Ryan, The Concussion Center: Younger children have proportionately bigger heads than adults so a blow to the head or whip-lash jolts exerts greater acceleration forces to a child than to an older athlete.

Catherine Skarzynski: This bill will prevent other parents from experiencing what she went through with her child's concussion recovery.

Natalie Intemann, Trumbull High School Student, Trumbull, CT: It is my generation and the generations that come after me that need to be protected. You invest in the brainpower of our country when you support this bill.

Kevin Krug: Young athletes be trained the same as coaches, so they can see signs of concussions on the field among teammates.

Joseph Bonitatebus, Ridgefield, CT: How can we expect athletes or families to know about concussions without proper education?

Victoria Bonitatebus, Ridgefield, CT: If education begins at the youth level there will be a reduction in Second Impact Syndrome.

Susan Zachary Maher: Son suffered concussion. If I had known the warning signs I could have stopped my son playing again too soon.

Tucker Callanan, Trinity College Student: Knowledge of concussions has saved my career and possibly my life.

Lisa and Bob Gfeller, The Matthew Gfeller Foundation of North Carolina: This is a landmark bill to address head injury prevention.

Johnson Couch, Jr. President, Norwalk Lacrosse Association: Approve HB 5113 but use caution in drawing up specific requirements of the measure.

Tom Renner, Bethel, CT: Coaches at youth level are frequently volunteers; they need support on concussion education. Too many times coaches keep athletes in game.

Tom Hearn: Details three amendments to improve the language of the bill.

Dorothy Bedford, Valley Force, PA: Would like to see more discussion of the social-emotional consequences of concussions.

Michael Cyr, Trinity College Student: When ignored, concussions have severe impacts on health, athletic performance, and student achievement.

Lesley W. Vandermark, Assistant Director of Research, Korey Stringer Institute, UCONN: Asks for extended coverage to athletes of all ages.

Elliot Landon, Superintendent of Schools, Westport Public Schools, Westport, CT: The proposed legislation guarantees for our children meaningful uniformity, accountability and oversight with regard to their health and welfare when engaged in athletics.

Chris Coyne, Yale University Student: When educated student athletes can look out for warning signs and make the right judgments in reporting head injuries.

Diana Coyne, Parents Concussion Coalition: Supports the bill, but not in favor of forming a task force to further study the issue.

Eve Pensak, Westport, CT: There are gaps in the current concussion laws.

Alison Thomson, Staples High School Student, Westport, CT: Education on concussions can save young lives from being destroyed by their lasting impact.

Susan Thomson, Westport, CT: This bill extends basic safety measures to youth.

Melissa Kane, Westport, CT: State legislation is essential because CIAC does not cover independent or non-school based sports.

Suzanne Levasseur, Association of School Nurses of Connecticut: As our knowledge of concussions grows, so must our actions to protect children.

Brett Aronow, Westport Board of Education, Westport, CT: Girls are more vulnerable.

Keith Stein, Westport, CT: Asks for flexibility for local communities to design their programs.

Ann Sherwood, Parents Concussion Coalition: As parent of child who had concussion, one doesn't fully realize importance of education until you've mismanaged an injury.

Luke Foreman, Staples High School Student, Westport, CT: Suffered 2 life-changing concussions. Train athletes not just coaches.

Pippa Bell Ader, Westport, CT :She became educated after son's concussion. She includes legal cases associated with CT youth concussions.

Sheila Flinn, Westport PTA Council, Westport, CT: Strongly supports the bill's informed consent component for athletes and parents.

NATURE AND SOURCES OF OPPOSITION:

Connecticut Association of Boards of Education (CABE): the bill as drafted is over prescriptive.

Dr. Karissa Niehoff, Executive Director, The Connecticut Association of Schools and the Connecticut Interscholastic Athletic Conference: Asks for flexibility and responsiveness in the actions taken to remain on the forefront of injury education.

The Eastern Board of Softball Umpires Executive Board: If the law is passed as written, the impact will be detrimental to retention of current officials and further recruitment.

Connecticut Conference of Municipalities (CCM): Concerns regarding municipalities having to comply with education plans not yet written.

Rebecca Michlin, Southington, CT: Does not want the limitations on contact practices.

Edward Kravitz, President, Athletic Trainer Solutions, LLC: There are already measures in place in CT to address concussion concerns, and the current legislation is too broad.

Don Romoser, President, The Connecticut Parent Teacher Student Alliance (CT PTA): Listed a number of concerns in bill as written, including the lack of return to school protocols.

Daniel Scavone, Athletic Director, Berlin High School, Berlin, CT: Flexibility is required at the local level. Collecting and reporting occurrences would be a tremendous burden.

Raymond Faustich, Connecticut State Board of Approved Baseball Umpires: We have already provided more than adequate concussion training for our umpires.

William Riccio, Jr., NFHS Football Officials Manual Committee Member: Concerns regarding liability of officials.

Elaine Whitney, Chair of the Westport Board of Education: Limits to contact time would impede the ability of schools and youth programs to meet the current standard.

John L. Cattelan, Exec. Director, CT Alliance of YMCAs: Concerns with requiring volunteer coaches and referees to attend a training course.

Fred Balsamo, Exec. Director, CT Association of Athletic Directors, Inc: Implies mistrust in the ability of school districts and the coaches they hire. Bill far exceeds what is being done in other states.

Paul Hoey, Assoc. Executive Director, Connecticut Interscholastic Athletic Conference (CIAC): Legislative intervention in athletics at the public school level is not needed given the requirements and changes already being imposed on member schools by CAS-CIAC.

Tom Sparks, Berlin, CT: We now have a shortage of officials and this increase liability will be a deterrent to new ones. Other states have laws that give immunity to officials to decrease their liability. 

Fred Capozziello, North Haven, CT: All officials can do is recognize symptoms and seek medical relief. Bill increases legal exposure for officials.

Trish Witkin, Athletic Director, Glastonbury High School, Glastonbury, CT: Current standards are sufficient and expressed concern over the liability placed on officials.

James E. Tebo: Concerns over lawsuits for referees.

Barry Chasen, Simsbury, CT: Recommends requiring a trainer to be on site for all home games.

Tom DeJoseph, Atlantic Coast Conference Football: Medical assessments should be made by medical staff.

Michael L. Barbaro, Wallingford, CT: It is unfair to ask sports officials to make a medical diagnosis.

Susan Orrill, Ledyard, CT: Will consider resigning as an official, if the bill passes.

Bruce Backus, Burlington, CT: As an official, the bill is vague about my responsibilities.

Robert Speziale, Madison, CT: Officials have no more capability of assessing a concussed athlete than one with a sprain vs a broken bone.

Antonio Portal, Berlin, CT: Maybe you should hire a medic to be at every game instead of expecting people who are not trained to see these symptoms

Jim Bauer, Newton, CT: Officials have no prior history with these players and many times it is cumulative effects that are devastating when concussions are concerned.

Harry Dauphinais, Winstead, CT: Coaches and athletic trainers, who are more familiar with their athletes than officials, are present at meets to evaluate their athletes if the need arises.

Grant Manning, Dan Mathieu, Ricky Narracci, Allen Tramuta, Paul Mengold, Paula Fitzgerald, Kevin Burke, Jeffrey Belanger, Dave Johnson, Jim Buonocore, Tracy Nichols, Paul Soucy, Fred Williams, Joseph M. Velardi, Newell Porch, Alan Walker,Leonard J. Corto, Mark Scozzafava, Robert Paskiewicz, John Niski, Robert Hale, Carl Charles, J. Brent Hawkins, Bill Buscetto, Stephen Baldwin, Steve Trifone, David Dennehy, Craig Knop, Anne MacNeil, VJ Sarullo, Jonathan Nadeau, Leon Johnson, Mark Ney, Michael Rothman, David DeMartino, John Christos, Anthony Suppa, Ralph Gutierrez, Daniel Goyzueta, Frank Pallone, Brian Zimmerman, Anthony Calabrese, Robert Meyers, Mike Giannelli, Ryan Mahoney, Robert Bjork, Dean DiMauro, Jim Gartner, Christopher Gluz, Thomas J. Casey, Bob Bernier, Bill Peet, Chris Burns, David McDowell, Donald M. Costello, Joe Halloran, Rocco Sanzo, Joseph Miller, Kevin Albanese, Joe Tonelli, Matthew J. Jacobs, Al Harrison, David Pretlove, Robby Casey, Sal Corsino, Tom Dooley, Tony Lopes, David K. Johnson, Brian Fell, Wendy Rubin, Julie Harvey, Jason Kasprzyk, Damian Frassinelli:

Connecticut already has the most stringent coaching permit and coaching education requirements in the country. The current concussion law, the extensive coaching education requirements and the recent actions and mandates put out by the CIAC requiring concussion education for parents & students and limiting contact in football practice far exceeds what is being done in other states. Express concern regarding the impact on retention of officials because of liability.

Reported by: Michael Werner, Assistant Clerk and Alessandra Burgett, Intern

Date: March 25, 2014