The Concussion Blog

HB200 of the Illinois State Legislature has moved forward and is poised to be voted in very soon.  (Full bill in .pdf HERE)

Amends the School Code. Requires a school board to work in concert with the Illinois High School Association to develop guidelines and other pertinent information and forms to inform and educate coaches, student athletes, and these athletes’ parents and guardians of the nature and risk of concussions and head injuries, including continuing to play after a concussion or head injury. Requires the concussion and head injury information sheet to be signed and returned by a student athlete and the athlete’s parent or guardian prior to the student athlete’s initiating practice or competition. Provides that a school board shall adopt a policy requiring a student athlete who is suspected of sustaining a concussion or head injury in a practice or game to be removed from competition at that time. Requires the policy to provide that a student athlete who has been removed from play may not return to play until the student athlete is evaluated by a licensed health care provider trained in the evaluation and management of concussions and head injuries and the student athlete receives written clearance to return to play from that health care provider.

This is a good start-that is all it is-in my opinion, because this bill does not include other sanctioned sports except those that fall under the Illinois High School Association (IHSA) umbrella.  What this does not address; are the youth leagues and JFL (Junior Football Leagues) for example, where the brains of those kids are even more susceptible to injury and Second Impact Syndrome, or the ever popular club sports.

The other issue is that this bill uses vague terminology for those responsible for clearance –  “licensed health care provider”.  This would include doctors and athletic trainers, but a whole host of other professions (by the way this list does not have athletic training on it, an omission as AT’s in Illinois are licensed health care providers) as well, such as; nurses, podiatric physician, social workers, dietitian, surgical technician, etc.  Sure they use the qualifier “trained in the evaluation and management of concussions” but that is a ginormous loophole that some could exploit.

Before being too critical it must be noted that the Illinois legislature is doing good by installing the process of having both kids and parents read/sign an information sheet about concussions; an example of informed consent.

I am hopeful that Tom Cross is truthful (SOURCE);

House Minority Leader Tom Cross, R-Oswego, sponsored the bill and said it is a “work in progress” because it could be expanded to include sports leagues not affiliated with school athletics, such as teams sponsored by parks.

This bill, to this author, seems like a hastily put together bill to “get it out there”, I question who was involved in the deliberation and if they even looked at other state bills.  And they could have, but I just want to put it out there.  Perhaps the legislature did not want to become to encompassing and restrictive, allowing for the schools to create their own policies.  Again this is a good start for Illinois and I have it on good authority that this is not the only bill that was debated, and there are indeed others behind the scene looking for further direction.

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On the other hand there is a bill coming to the floor in Texas, S.B. No. 835, that is MUCH more comprehensive and thought out.  This bill includes SPECIFIC language about who should be in charge of clearing the individual, as well as creating a novel approach of a “Concussion Management Team”;

(b) Each concussion management team must include a physician and, to the greatest extent practicable, an athletic trainer and a neuropsychologist. If it is not practicable to include on the team an athletic trainer or a neuropsychologist, the team must include a physician assistant or advanced practice nurse.  Each member of the team must have training in the evaluation, treatment, and management of concussions.

Furthermore the bill explains what needs to be done for the “training”;

Sec. 38.156.  TRAINING COURSE. (a) The agency shall establish the Training and Education Advisory Council to develop a training course in concussion management, including evaluation of a student following an impact sustained by the student during an athletic activity and diagnosis of, prevention of, symptoms of, appropriate medical treatment for, risks associated with, and long-term effects of a concussion. The training course must be designed to be presented for at least three hours.

And after getting further clarification on the above statement the athletic trainers would need to show continuing education in the area to satisfy this requirement.  Add to that the required vigilance of the school district itself by wording it this way;

(e)  Before a person described by Subsection (d) may serve or continue to serve on a concussion management team, the person must submit to the school district superintendent or the superintendent ’s designee or, in the case of an open-enrollment charter school or private school, a person who serves the function of a superintendent or that person’s designee, proof of timely completion of an approved training course.

The next, novel approach that Texas is taking is a concussion surveillance system to be created, that is on the schools to do.  This report must include;

• Age, grade level, activity and position of those concussed
• Number of students that were concussed more than once
• The names and role of those on the concussion management team
• Amount of time the individual was out
• Number of individuals that were not able to return to activity

If they don’t submit the report the schools will be suspended from by the governing body.

The next aspect of the Texas bill, that follows Colorado somewhat, is the wording of “immunity” from liability.  Basically if the school follows all the rules in place and have proper documentation the schools and their representatives are immune from litigation pertaining to liability with the injury.

The final and most poignant sub-section of the bill is opening up the authority to league commissioners to establish rules for “employment” of athletic trainers, specifically.  This, in my mind will give more wide-ranging “power” to make athletic trainers not only available but REQUIRED for schools.

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We can see to VASTLY different offerings from law makers.  Both have the short fall of not including sports outside the “schools”, but the Texas bill goes much further and gets more specific in handling the issue.  As it stands now both do not add any more cost to the schools, rather added responsibility.  The Texas offering is, in my opinion, the best bill that has been brought forth.  All other bills across the nation have merit too, because at least they are doing something.

I happen to know of one profession capable of helping ease the responsibility, ATHLETIC TRAINERS.