(1)Existing law requires a school district, charter school, or private school, if it offers an athletic program, to immediately remove an athlete from an athletic activity for the remainder of the day if the athlete is suspected of sustaining a concussion or head injury, and prohibits the athlete from returning to the athletic activity until the athlete is evaluated by a licensed health care provider, trained in the management of concussions and acting within the scope of his or her practice, and the athlete receives written clearance from the licensed health care provider to return to the athletic activity. Existing law also requires, on a yearly basis, a concussion and head injury information sheet to be signed and returned by the athlete and athletes parent or guardian before the athlete initiates practice or competition.

This bill would establish the Neurocognitive Testing Pilot Grant Program to provide grant funding to Title I schools for the purposes of neurocognitive testing. The bill would require the Superintendent of Public Instruction to establish an application process for school districts to apply on behalf of Title I schools interested in participating in the pilot program. The bill would require grants under the pilot program to be apportioned to a total of 3 school districts, comprising one school district in each of the following regions of the state: southern, central, and northern. A participating school district would be required to commit to participating in the pilot program for 4 school years in order to track pupils tested in grade 9 through completion of high school.

The bill would require that grant funds would be used for baseline and postinjury neurocognitive testing, as defined, for pupils attending a Title I school serving any of grades 9 to 12, inclusive, who participate in interscholastic athletics in any of 12 designated sports. The bill would require this baseline and postinjury neurocognitive testing to take place at the beginning of an athletic season before any competitions have taken place and after any head injury, and would require that baseline neurocognitive testing be repeated at intervals not exceeding 24 months for as long as the athlete is enrolled at the school and participating in one or more of the 12 sports listed in the bill. The bill would require the baseline and postinjury neurocognitive testing conducted pursuant to the bill to be administered by individuals, including, but not necessarily limited to, employees of a participating school district, who have been trained to administer these tests.

The bill would also provide that grant funds could be used for training of personnel and consultation with experts, as specified. The bill would further provide that, under the pilot program, the parent or guardian of each athlete participating in any of the 12 interscholastic sports listed in the bill would be notified, in writing, that the results of baseline and postinjury neurocognitive testing conducted on his or her child are available to the childs parent or guardian, or could be shared with the athletes physician, upon request.

The bill would also provide that grant funds could be used for reporting specified data relating to the baseline neurocognitive testing to the appropriate county office of education. The bill would require the State Department of Education to submit a report containing specified information to the appropriate policy committees of the Legislature on or before December 31, 2021.

These provisions would be contingent upon the appropriation of funds for their purposes in the annual Budget Act or another statute.

These provisions would be repealed on January 1, 2022.

(2)Existing law provides that, if a licensed health care provider determines that an athlete sustained a concussion or a head injury while engaging in an athletic activity, the athlete is required to complete a graduated return-to-play protocol of no less than 7 days in duration under the supervision of a licensed health care provider.

This bill would require a school district, charter school, or private school that offers an interscholastic athletic program to collect and maintain data on traumatic brain injuries and concussions sustained by any of its pupils during an interscholastic athletic activity. The bill would require that this data be reported periodically to the appropriate county office of education, and would require the county office of education to compile and retain the data for summary and analysis as it deems necessary. By imposing new duties on county offices of education, the bill would impose a state-mandated local program.

(3)The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.

(1)Existing law requires a school district, charter school, or private school, if it offers an athletic program, to immediately remove an athlete from an athletic activity for the remainder of the day if the athlete is suspected of sustaining a concussion or head injury, and prohibits the athlete from returning to the athletic activity until the athlete is evaluated by a licensed health care provider, trained in the management of concussions and acting within the scope of his or her practice, and the athlete receives written clearance from the licensed health care provider to return to the athletic activity. Existing law also requires, on a yearly basis, a concussion and head injury information sheet to be signed and returned by the athlete and athletes parent or guardian before the athlete initiates practice or competition.

This bill would establish the Neurocognitive Testing Pilot Grant Program to commence in the 201718 school year. provide grant funding to Title I schools for the purposes of neurocognitive testing. The bill would require the State Department of Education to develop an application for school districts interested in participating in the pilot program. Superintendent of Public Instruction to establish an application process for school districts to apply on behalf of Title I schools interested in participating in the pilot program. The bill would require grants under the pilot program to be apportioned to a total of 3 school districts, comprising one school district in each of the following regions of the state: southern, central, and northern. A participating school district would be required to commit to participating in the pilot program for 4 school years in order to track pupils tested in grade 9 through completion of high school. The

The bill would provide require that grant funds, based on an appropriation in the annual Budget Act or another statute, funds would be used for baseline and postinjury neurocognitive testing, as defined, for pupils attending a Title I school serving any of grades 9 to 12, inclusive, who participate in interscholastic athletics in any of 12 designated sports. The bill would require this baseline and postinjury neurocognitive testing to take place at the beginning of an athletic season before any competitions have taken place and after any head injury, and would require that this baseline neurocognitive testing be repeated at intervals not exceeding 24 months for as long as the athlete is enrolled at the school. school and participating in one or more of the 12 sports listed in the bill. The bill would require the baseline and postinjury neurocognitive testing conducted pursuant to the bill to be administered by individuals, including, but not necessarily limited to, employees of a participating school district, who have been trained to administer these tests.

The bill would also provide that grant funds could be used for training of personnel and consultation with experts, as specified. The bill would further provide that, under the pilot program, the parent or guardian of each athlete participating in any of the 12 interscholastic sports listed in the bill would be notified, in writing, that the results of baseline and postinjury neurocognitive testing conducted on his or her child are available to the childs parent or guardian, or could be shared with the athletes physician, upon request.

The bill would also provide that grant funds could be used for reporting specified data relating to the baseline neurocognitive testing to the appropriate county office of education. The bill would require the State Department of Education to submit a report containing specified information to the appropriate policy committees of the Legislature on or before December 31, 2021.

These provisions would be repealed on January 1, 2022.

(2)Existing law provides that, if a licensed health care provider determines that an athlete sustained a concussion or a head injury while engaging in an athletic activity, the athlete is required to complete a graduated return-to-play protocol of no less than 7 days in duration under the supervision of a licensed health care provider.

This bill would require a school district, charter school, or private school that offers an interscholastic athletic program to collect and maintain data on traumatic brain injuries and concussions sustained by any of its pupils during an interscholastic athletic activity. The bill would require that this data be reported periodically to the appropriate county office of education, and would require the county office of education to compile and retain the data for summary and analysis as it deems necessary. By imposing new duties on county offices of education, the bill would impose a state-mandated local program.

(3)The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.

(1)Existing law requires a school district, charter school, or private school, if it offers an athletic program, to immediately remove an athlete from an athletic activity for the remainder of the day if the athlete is suspected of sustaining a concussion or head injury, and prohibits the athlete from returning to the athletic activity until the athlete is evaluated by a licensed health care provider, trained in the management of concussions and acting within the scope of his or her practice, and the athlete receives written clearance from the licensed health care provider to return to the athletic activity. Existing law also requires, on a yearly basis, a concussion and head injury information sheet to be signed and returned by the athlete and athletes parent or guardian before the athlete initiates practice or competition.

This bill would express legislative findings and declarations relating to concussions or traumatic injuries sustained by pupils participating in high school interscholastic athletics and the value of neurocognitive testing.

The bill would require a school district, charter school, or private school that offers an athletic program to pay for neurocognitive testing, or provide in-house establish the Neurocognitive Testing Pilot Grant Program to commence in the 201718 school year. The bill would require the State Department of Education to develop an application for school districts interested in participating in the pilot program. A participating school district would be required to commit to participating in the pilot program for 4 school years in order to track pupils tested in grade 9 through completion of high school. The bill would provide that grant funds, based on an appropriation in the annual Budget Act or another statute, would be used for baseline neurocognitive testing, as defined, for pupils who participate in interscholastic athletics in any of 12 designated sports. The bill would require this neurocognitive testing to be conducted by a licensed health care provider, as specified. The bill would require this testing to take place at the beginning of an athletic season before any competitions have taken place and after any head injury, and would require that this baseline neurocognitive testing be repeated at intervals not exceeding 24 months for as long as the athlete is enrolled at the school.

The bill would require that also provide that grant funds could be used for training of personnel and consultation with experts, as specified. The bill would further provide that, under the pilot program, the parent or guardian of each athlete participating in any of the 12 interscholastic sports listed in the bill would be notified, in writing, that the results of baseline and postinjury neurocognitive testing conducted on his or her child is are available to the childs parent or guardian, or could be shared with the athletes physician, upon request.

This bill would require a school district, charter school, or private school that offers an interscholastic athletic program to collect and maintain data on traumatic brain injuries and concussions sustained by any of its pupils during an interscholastic athletic competition. The bill would require postinjury neurocognitive testing to be conducted within 72 hours of the occurrence of the injury. activity. The bill would require that this data be reported periodically to the appropriate county office of education, and would require the county office of education to compile and retain the data for summary and analysis as it deems necessary. By imposing new duties on county offices of education, the bill would impose a state-mandated local program.

(3)The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.

(1)Existing law requires a school district, charter school, or private school, if it offers an athletic program, to immediately remove an athlete from an athletic activity for the remainder of the day if the athlete is suspected of sustaining a concussion or head injury, and prohibits the athlete from returning to the athletic activity until the athlete is evaluated by a licensed health care provider, trained in the management of concussions and acting within the scope of his or her practice, and the athlete receives written clearance from the licensed health care provider to return to the athletic activity. Existing law also requires, on a yearly basis, a concussion and head injury information sheet to be signed and returned by the athlete and athletes parent or guardian before the athlete initiates practice or competition.

Existing law further provides that, if a licensed health care provider determines that the athlete sustained a concussion or a head injury, the athlete is required to complete a graduated return-to-play protocol of no less than 7 days in duration under the supervision of a licensed health care provider.

This bill would express legislative findings and declarations relating to concussions or traumatic injuries sustained by pupils participating in high school interscholastic athletics and the value of neurocognitive testing.

The bill would require a school district, charter school, or private school that offers an athletic program to pay for neurocognitive testing, or provide in-house neurocognitive testing, as defined, for pupils who participate in interscholastic athletics. athletics in any of 12 designated sports. The bill would require this neurocognitive testing to be conducted by a licensed health care provider, as specified. The bill would require this testing to take place at the beginning of an athletic season before any competitions have taken place and after any head injury. injury, and would require that this baseline neurocognitive testing be repeated at intervals not exceeding 24 months for as long as the athlete is enrolled at the school.

The bill would require a school district, charter school, or private school that offers an athletic program to collect and maintain data on traumatic brain injuries and concussions sustained by any of its pupils during an athletic competition. The bill would require postinjury neurocognitive testing to be conducted within 72 hours of the occurrence of the injury. The bill would require that this data be reported periodically to the appropriate county office of education education, and would require the county office of education to compile and retain the data for summary and analysis. analysis as it deems necessary. By imposing new duties on county offices of education, the bill would impose a state-mandated local program.

(2)The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.

(1)Existing law requires a school district, charter school, or private school, if it offers an athletic program, to immediately remove an athlete from an athletic activity for the remainder of the day if the athlete is suspected of sustaining a concussion or head injury, and prohibits the athlete from returning to the athletic activity until the athlete is evaluated by a licensed health care provider, trained in the management of concussions and acting within the scope of his or her practice, and the athlete receives written clearance from the licensed health care provider to return to the athletic activity. Existing law also requires, on a yearly basis, a concussion and head injury information sheet to be signed and returned by the athlete and athletes parent or guardian before the athlete initiates practice or competition.

Existing law further provides that, if a licensed health care provider determines that the athlete sustained a concussion or a head injury, the athlete is required to complete a graduated return-to-play protocol of no less than 7 days in duration under the supervision of a licensed health care provider.

This bill would express legislative findings and declarations relating to concussions or traumatic injuries sustained by pupils participating in high school interscholastic athletics and the value of neurocognitive testing.

The bill would require a school district, charter school, or private school that offers an athletic program to provide neurocognitive testing, as defined, for pupils who participate in interscholastic athletics. The bill would require this testing to take place at the beginning of an athletic season before any competitions have taken place and after any head injury.

The bill would require a school district, charter school, or private school that offers an athletic program to collect and maintain data on traumatic brain injuries and concussions sustained by any of its pupils during an athletic competition. The bill would require that this data be reported periodically to the appropriate county office of education and would require the county office of education to compile and retain the data for summary and analysis. By imposing new duties on county offices of education, the bill would impose a state-mandated local program.

(2)The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that, if the Commission on State Mandates determines that the bill contains costs mandated by the state, reimbursement for those costs shall be made pursuant to these statutory provisions.

GOVERNOR'S VETO

GV Bill Id:AB 2182

Author:(Mullin)

As Enrolled Ver:August 25, 2016

2/3 vote

SUMMARY: Establishes the Neurocognitive Testing Pilot Grant Program to provide grant funding to Title I schools for the purposes of neurocognitive testing. Specifically, this bill:

1. Requires the California Department of Education (CDE) to develop an application process for school districts to apply on behalf of Title I schools interested in participating in the pilot program. Requires the grants to be apportioned under the pilot program to a total of three school districts, which shall comprise one school district in each of the following regions of the state: southern, central, and northern. Requires each school district to commit to participating in the pilot program for four school years in order to track pupils tested in grade 9 through completion of high school.
2. Requires the grant funds to be used for the following:
   1. Baseline and postinjury neurocognitive testing of pupils attending a Title I school serving any of grades 9 to 12, inclusive, participating in interscholastic athletics in any of the following sports: baseball, basketball, cheerleading, field hockey, football, ice hockey, lacrosse, rugby, soccer, softball, volleyball, and wrestling. The baseline neurocognitive testing shall take place at the beginning of an athletic season before any competitions have taken place and after any head injury, and shall be repeated at intervals not exceeding 24 months for as long as the athlete is enrolled at the school, provided that the athlete is still participating in one or more of the 12 specified sports. The baseline and postinjury neurocognitive testing shall be administered by individuals who have been trained to administer these tests. These individuals may include, but are not necessarily limited to, employees of a participating school district.
   2. Postinjury neurocognitive testing of an athlete who is suspected of sustaining a concussion or head injury in an interscholastic athletic activity. Postinjury neurocognitive tests shall be conducted within 72 hours of the occurrence of the injury.
   3. Training of personnel or to consult with experts on the interpretation of postinjury test results. The parent or guardian of each athlete participating in any of the sports shall also be notified, in writing, that the results of baseline and postinjury neurocognitive testing conducted on his or her child are available to the child's parent or guardian upon request. These neurocognitive testing results may also be shared with the athlete's physician upon the request of the athlete's parent or guardian.
   4. Reporting to the county office of education (COE) data that includes an overview of the baseline neurocognitive testing conducted for each of the sports specified in the bill and an overview of normal, abnormal, and followup postinjury neurocognitive tests. The data shall also include the number of athletes who discontinue participation in the sport following a concussion and postinjury testing.
3. Defines "neurocognitive testing" as a comprehensive evaluation of a person's cognitive status by specific neurologic domains, including, but not necessarily limited to, memory, attention, problem solving, language, visuospatial, processing speed, motor, and emotion.
4. Requires the CDE to, based on the data collected by the COE located in the area of participating school districts, prepare a report including, but not necessarily limited to, all of the following information:
   1. The number of athletes who received the baseline tests.
   2. The number of athletes who received the postinjury tests.
   3. The number of athletes who had taken the tests and discontinued participation in any of the specified sports due to concussion injuries.
5. Specifies that the operation of this bill is contingent upon the appropriation of funds in the annual Budget Act or another statute.
6. Requires the report to be submitted to the appropriate policy committees of the Legislature on or before December 31, 2021, and to comply with Section 9795 of the Government Code.
7. Specifies that the pilot program sunsets and repeals on January 1, 2022, unless a later enacted statute, that is enacted before January 1, 2022, deletes or extends that date.
8. Requires a school district, charter school, or private school that elects to offer an interscholastic athletic program to collect and maintain data on traumatic brain injuries and concussions sustained by any of its pupils during an interscholastic athletic activity. Requires this data to be reported periodically to the appropriate COE, but requires the names of the injured pupils to be kept confidential. Requires the COE to compile and retain the data for summary and analysis as it deems necessary.

FISCAL: According to the Assembly Appropriations Committee:

1. Proposition 98/General Fund cost pressures, potentially in the tens of thousands to fund the pilot program. The program is contingent upon an appropriation in the budget act.
2. General Fund costs to the CDE of approximately $264,000 to administer the grant program for four years. The CDE would be required to develop, implement, monitor, collect and analyze data, and prepare reports to the Legislature on the findings for each grant awarded.
3. Unknown, potentially reimbursable Proposition 98/General Fund state mandated costs, likely in the thousands of dollars, for county offices of education to compile and retain data for summary and analysis.

COMMENTS: The author states that the number of reported sports-related concussions among student athletes has risen dramatically, including a doubling between 2002 and 2012. The author adds, "Athletes who sustain concussions are at greater risk of chronic traumatic encephalopathy, depression, early onset dementia, and long-term brain damage," and that, "young athletes experiencing head injuries are at greater risk of long-term brain damage if injured during the critical stages of brain development." The author hopes that broader neurocognitive testing will assist in the evaluation of individual injuries and identify the incidence of sport-related concussions among young athletes.

Neurocognitive testing is used to evaluate brain processing in a variety of neurological functions related to memory, attention, language, emotion and other areas. Testing can be conducted with pencil and paper, or with computerized testing. Testing can be used as a baseline to gauge an athlete's condition post-injury relative to performance before injury. As such, it can be a factor in making decisions as to whether and when an athlete should return to activity and what kinds of activity may be safe for that athlete.

The dangers of concussions and head injuries in sport have been a growing concern, with frequent news reports of athletes, primarily football players, sustaining traumatic and lasting injuries.

Among the dramatic news reports in March alone:

1. A representative of the National Football League testified that there is a connection between football and chronic traumatic encephalopathy.
2. Women's soccer standout Brandi Chastain announced she would donate her brain to science for research into head injuries.
3. Ivy League schools announced they would eliminate full-contact practices for football.

A Purdue University study in 2015 indicated lasting brain changes among high school football players, even without concussions, and that changes were not completely healed at the end of an off-season. The study used brain scans and changes in brain chemistry to track players more extensively than neurocognitive testing.

The growing awareness of concussion dangers has led California to enact a series of bills to protect students by limiting full-contact practices; requiring education and information for coaches, pupils and their parents; and protocols for removing students from activity after injury and for returning them to play.

A few school districts in San Mateo County have sought stronger protections for student athletes and have, in some cases, paid for neurocognitive testing. Following on this, the San Mateo County Civil Grand Jury studied the issue and recommended, among other things, that all districts in the county serving high school students provide neurocognitive testing for all student athletes, and recommended that the districts seek funding and collect data. The grand jury report noted that a leading purveyor of the tests charges school districts $1,200 for 800 baseline tests. These tests are computerized, with results received automatically by the testing company.

This bill establishes a pilot program for schools in three districts (northern, central and southern) to test athletes in specified sports, track the pupils for four years, and collect data to evaluate the effectiveness of neurocognitive testing. Amendments adopted in the Assembly Appropriations Committee limit participation to schools that receive federal Title I funds. Title I provides supplemental funding to schools with the highest percentage of low-income children. According to the CDE, in 2014-15, there were 3.9 million students in 6,457 schools that received Title 1 funds. This bill also requires school districts, charter schools and private schools that elect to offer interscholastic sports to collect and report data on traumatic brain injuries and concussions.

GOVERNOR'S VETO MESSAGE:

To Members of the California State Assembly:

I am returning the following four bills without my signature:

Assembly Bill 1198

Assembly Bill 1783

Assembly Bill 2182

Senate Bill 1113

Each of these bills creates unfunded new programs.

Despite significant funding increases for local educational agencies over the past few years, the Local Control Funding Formula remains only 96 percent funded. Given the precarious balance of the state budget, establishing new programs with the expectation of funding in the future is counterproductive to the Administration's efforts to sustain a balanced budget and to fully fund the Local Control Funding Formula.

Additional spending to support new programs must be considered in the annual budget process.

Analysis Prepared by: Sophia Kwong Kim / ED. / (916) 319-2087 FN: 0005114

 THIRD READING  

Bill No: AB 2182

Author:

:

Vote:

SENATE EDUCATION COMMITTEE: 9-0, 6/22/16

AYES: Liu, Block, Hancock, Huff, Leyva, Mendoza, Monning, Pan, Vidak

SENATE APPROPRIATIONS COMMITTEE: 7-0, 8/11/16

AYES: Lara, Bates, Beall, Hill, McGuire, Mendoza, Nielsen

ASSEMBLY FLOOR: 80-0, 6/2/16 - See last page for vote

SUBJECT:

SOURCE: Author

DIGEST: This bill, contingent upon an appropriation, establishes the Neurocognitive Testing Pilot Grant Program to provide funds to Title I schools for the purpose of neurocognitive testing. As part of the pilot program, this bill requires school districts, charter schools, and private schools that elect to offer sports programs to collect and maintain data on traumatic brain injuries and concussions sustained during these activities.

ANALYSIS:

Existing law:

1. Requires a school district, charter school, or private school that elects to offer an athletic program to immediately remove from athletic activity for the remainder of the day an athlete who is suspected of sustaining a concussion or head injury. Prohibits the athlete from returning to the activity until he or she has been evaluated by a licensed health care provider and receives a written clearance from the health care provider.
2. Provides that if the licensed health care provider determines that the athlete sustained a concussion or a head injury, the athlete shall complete a graduated return-to-play protocol of no less than seven days in duration under the supervision of a licensed health care provider.
3. Requires, annually, a concussion and head injury information sheet to be signed by the athlete’s parent prior to participation in athletic activity. (Education Code § 49475)
4. Requires each high school sports coach to complete a coaching education program developed by the employing school district or the California Interscholastic Federation that meets specified guidelines. (Education Code § 49032)
5. Requires high school athletic coaches to complete training regarding the identification of concussions. (Education Code § 35179.1)

This bill:

1. Establishes the Neurocognitive Testing Pilot Grant Program to provide grant funding to Title I schools for the purposes of neurocognitive testing.
2. Requires the California Department of Education (CDE) to establish an application process for school districts to apply on behalf of Title I schools interested in participating in the pilot program. Requires the grants to be apportioned under the pilot program to a total of three school districts, which shall comprise one school district in each of the following regions of the state: southern, central, and northern. Requires each school district to commit to participating in the pilot program for four school years in order to track pupils tested in grade 9 through completion of high school.
3. Requires the grant funds to be used for the following:
   1. Baseline and postinjury neurocognitive testing of pupils attending a Title I school serving any of grades nine to 12, inclusive, participating in interscholastic athletics in any of the following sports: baseball, basketball, cheerleading, field hockey, football, ice hockey, lacrosse, rugby, soccer, softball, volleyball, and wrestling. The baseline neurocognitive testing shall take place at the beginning of an athletic season before any competitions have taken place and after any head injury, and shall be repeated at intervals not exceeding 24 months for as long as the athlete is enrolled at the school, provided that the athlete is still participating in one or more of the 12 specified sports. The baseline and postinjury neurocognitive testing shall be administered by individuals who have been trained to administer these tests. These individuals may include, but are not necessarily limited to, employees of a participating school district.
   2. Postinjury neurocognitive testing of an athlete who is suspected of sustaining a concussion or head injury in an interscholastic athletic activity. Postinjury neurocognitive tests shall be conducted within 72 hours of the occurrence of the injury.
   3. Training of personnel or to consult with experts on the interpretation of postinjury test results. The parent or guardian of each athlete participating in any of the sports shall also be notified, in writing, that the results of baseline and postinjury neurocognitive testing conducted on his or her child are available to the child's parent or guardian upon request. These neurocognitive testing results may also be shared with the athlete's physician upon the request of the athlete's parent or guardian.
   4. Reporting to the county office of education data that includes an overview of the baseline neurocognitive testing conducted for each of the sports specified in the bill and an overview of normal, abnormal, and follow-up postinjury neurocognitive tests. The data shall also include the number of athletes who discontinue participation in the sport following a concussion and postinjury testing.
4. Defines "neurocognitive testing" as a comprehensive evaluation of a person's cognitive status by specific neurologic domains, including, but not necessarily limited to, memory, attention, problem solving, language, visuospatial, processing speed, motor, and emotion.
5. Requires the CDE to, based on the data collected by the county office of education located in the area of participating school districts, prepare a report including, but not necessarily limited to, all of the following information:
   1. The number of athletes who received the baseline tests.
   2. The number of athletes who received the postinjury tests.
   3. The number of athletes who had taken the tests and discontinued participation in any of the specified sports due to concussion injuries.
6. Requires the report to be submitted to the appropriate policy committees of the Legislature on or before December 31, 2021, and to comply with Government Code Section 9795.
7. Specifies that the operation of this bill is contingent upon the appropriation of funds in the annual Budget Act or another statute.
8. Specifies that the program shall remain in effect until January 1, 2022, unless a later enacted statute, that is enacted before January 1, 2022, deletes or extends that date.
9. Requires a school district, charter school, or private school that elects to offer an interscholastic athletic program to collect and maintain data on traumatic brain injuries and concussions sustained by any of its pupils during an interscholastic athletic activity. Requires this data to be reported periodically to the appropriate county office of education, but provides that the names of the injured pupils be kept confidential. Requires the county office of education to compile and retain the data for summary and analysis as it deems necessary.

Comments

Need for the bill. The author indicates that the number of reported sports-related concussions among student athletes has risen dramatically, including a doubling between 2002 and 2012. Further, "athletes who sustain concussions are at greater risk of chronic traumatic encephalopathy, depression, early onset dementia, and long-term brain damage. Research shows that the human brain does not fully develop until a person’s mid-20’s and therefore, young athletes experiencing head injuries are at greater risk of long-term brain damage if injured during the critical stages of brain development." This bill is intended to generate data to provide a better understanding of the frequency of sports-related head injuries among athletes.

Neurocognitive testing. The bill defines neurocognitive testing as a comprehensive evaluation of a person's cognitive status by specific neurologic domains, including, but not necessarily limited to, memory, attention, problem solving, language, visuospatial, processing speed, motor, and emotion. It is used to evaluate brain processing and can be conducted with pencil and paper, or with computerized testing. Testing can be used as a baseline to gauge an athlete's condition post-injury relative to performance before injury. As such, it can be a factor in making decisions as to whether and when an athlete should return to activity and what kinds of activity may be safe for that athlete.

Concussions in sports. The dangers of concussions and head injuries in sports have been a growing concern, with frequent news reports of athletes, primarily football players, sustaining traumatic and lasting injuries. A Purdue University study in 2015 indicated lasting brain changes among high school football players, even without concussions, and that changes were not completely healed at the end of an off-season. The study used brain scans and changes in brain chemistry to track players more extensively than neurocognitive testing.

The growing awareness of concussion dangers has led California to enact a series of bills to protect students by limiting full-contact practices; requiring education and information for coaches, pupils and their parents; and protocols for removing students from activity after injury and for returning them to play.

A few school districts in San Mateo County have sought stronger protections for student athletes and have, in some cases, paid for neurocognitive testing. The San Mateo County Civil Grand Jury studied the issue and recommended, among other things, that all districts in the county serving high school students provide neurocognitive testing for all student athletes, and recommended that the districts seek funding and collect data. The grand jury report noted that a leading purveyor of the tests charges school districts $1,200 for 800 baseline tests. These tests are computerized, with results received automatically by the testing company.

Limits on practice and full-contact. The California Interscholastic Federation (CIF) governs competitive athletics in grades 9-12. The CIF is comprised of 10 Sections across the State; each Section has a governing body that, among other things, adopts rules and regulations in addition to those promulgated by the State CIF. Each Section establishes its own rules governing the scope of team practice. It appears that five of the Sections allow football teams to conduct full-contact practice during the off-season while five do not allow full-contact practice during the off-season. For example, the Sac-Joaquin Section allows full-contact football camp during the summer and the Southern Section prohibits full-contact practice or camps during the summer.

The CIF recently adopted Bylaw 506 which, effective August 1, 2014, limits all athletic teams to no more than 18 hours of practice time per week and no more than four hours in any single day.

FISCAL EFFECT: Appropriation: Fiscal Com.: Local:

According to the Senate Appropriations Committee, this bill would result in the following:

• Unknown cost pressure to implement this pilot as costs would depend on the size of the school districts awarded. Costs likely in the tens of thousands to low hundreds of thousands annually, unless the Los Angeles Unified School District is awarded, which would increase costs to about $2 million.
• The CDE estimates costs of about $252,000 spanning across several positions over the life of the pilot for start-up activities, administering the program, and the reporting requirement if the program were to be funded. (General Fund)
• Cost pressure, potentially in the hundreds of thousands, for all school districts and charter schools that offer an interscholastic athletic program to collect, maintain, and report data on traumatic brain injuries and concussions. Potential minor reimbursable state mandate costs for county offices of education to compile and retain the data. (Proposition 98)
• Significant cost pressure to the extent the pilot is funded, to subsequently expand it statewide. (Proposition 98)

SUPPORT: (Verified 8/12/16)

California Athletics Trainers’ Association

California Concussion Institute

California Optometric Association

California Psychological Association

Consumer Attorneys of California

San Mateo Union High School District

OPPOSITION: (Verified 8/12/16)

None received

ASSEMBLY FLOOR: 80-0, 6/2/16

AYES: Achadjian, Alejo, Travis Allen, Arambula, Atkins, Baker, Bigelow, Bloom, Bonilla, Bonta, Brough, Brown, Burke, Calderon, Campos, Chang, Chau, Chávez, Chiu, Chu, Cooley, Cooper, Dababneh, Dahle, Daly, Dodd, Eggman, Frazier, Beth Gaines, Gallagher, Cristina Garcia, Eduardo Garcia, Gatto, Gipson, Gomez, Gonzalez, Gordon, Gray, Grove, Hadley, Harper, Roger Hernández, Holden, Irwin, Jones, Jones-Sawyer, Kim, Lackey, Levine, Linder, Lopez, Low, Maienschein, Mathis, Mayes, McCarty, Medina, Melendez, Mullin, Nazarian, Obernolte, O'Donnell, Olsen, Patterson, Quirk, Ridley-Thomas, Rodriguez, Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting, Wagner, Waldron, Weber, Wilk, Williams, Wood, Rendon

Prepared by:

8/15/16 19:39:46

**** END ****

SENATE COMMITTEE ON APPROPRIATIONS

Senator Ricardo Lara, Chair

2015 - 2016 Regular Session

AB 2182 (Mullin) - School athletics: neurocognitive testing

This bill meets the criteria for referral to the Suspense File.

Bill Summary:

This bill, contingent upon an appropriation, establishes the Neurocognitive Testing Pilot Grant Program to provide funds to Title I schools for neurocognitive testing. As part of the pilot program, this bill requires school districts, charter schools, and private schools that elect to offer sports programs to collect and maintain data on traumatic brain injuries and concussions sustained during these activities.

Fiscal Impact:

• Unknown cost pressure to implement this pilot as costs would depend on the size of the school districts awarded. Costs likely in the tens of thousands to low hundreds of thousands annually, unless the Los Angeles Unified School District is awarded, which would increase costs to about $2 million.
• The California Department of Education (CDE) estimates costs of about $252,000 spanning across several positions over the life of the pilot for start-up activities, administering the program, and the reporting requirement if the program were to be funded. (General Fund)
• Cost pressure, potentially in the hundreds of thousands, for all school districts and charter schools that offer an interscholastic athletic program to collect, maintain, and report data on traumatic brain injuries and concussions. Potential minor reimbursable state mandate costs for county offices of education to compile and retain the data. (Proposition 98)
• Significant cost pressure to the extent the pilot is funded, to subsequently expand it statewide. See staff comments. (Proposition 98)

Background:

The growing awareness of concussion dangers has led the state to enact a series of bills to protect students. Existing law requires a school that offers an athletic program to immediately remove an athlete from athletic activity for the remainder of the day if he or she is suspected of sustaining a concussion or head injury and prohibits the athlete’s return until written clearance is provided by a licensed health care provider. If the athlete sustained a concussion, the athlete is required to complete a graduated return-to play protocol of no less than seven days under the supervision of a health care provider. Existing law also requires a concussion and head injury information sheet to be signed by the athlete’s parent before participation in athletic activity. Some California Interscholastic Federation (CIF) sections have limits on full-contact practice. Finally, state law requires each high school sports coach to complete training regarding the identification of concussions.

Neurocognitive testing is used to evaluate brain processing and can be conducted with pencil and paper, or with computerized testing. Testing can be used as a baseline to gauge an athlete's condition post-injury relative to performance before injury. As such, it can be a factor in making decisions as to whether and when an athlete should return to activity and what kinds of activity may be safe for that athlete.

A few school districts in San Mateo County have sought stronger protections for student athletes and have, in some cases, paid for computerized neurocognitive testing. The San Mateo County Civil Grand Jury studied the issue and recommended, among other things, that all districts in the county serving high school students provide neurocognitive testing for all student athletes, and recommended that the districts seek funding and collect data.

According to the author’s office, this bill is intended to generate data to better understand the frequency and consequences of head injuries among young athletes.

Proposed Law:

This bill, contingent upon funding provided in the annual budget act or other statute, establishes the Neurocognitive Testing Pilot Grant Program to provide grant funding to Title I schools (schools with high numbers or high percentages of children from low-income families) for neurocognitive testing. This program is scheduled to sunset on January 1, 2022.

This bill requires the CDE to establish an application process for school districts to apply on behalf of Title I schools interested in participating in the pilot program. If funded, grant awards would go to three school districts, one in each of the northern, central, and southern areas of the state. Each school district is required to participate in the pilot program for four years in order to track students in grade 9 through the completion of high school.

Grant funding is required to be used for the following activities:

• Baseline and post injury neurocognitive testing of students participating in specified sports. The baseline testing is required to take place at the beginning of an athletic season and must be repeated at intervals not exceeding 24 months. The testing is required to be administered by individuals who have been trained to administer the tests.
• Post injury neurocognitive testing of an athlete who is suspected of sustaining a concussion or head injury in an interscholastic athletic activity and must be conducted within 72 hours of the injury.
• Training of personnel or to consult with experts on the interpretation of post injury test results. Parents of the students participating in the specified sports are required to be notified that the results of the baseline and post injury neurocognitive testing conducted on their children are available upon request.
• Reporting to the county office of education data that includes an overview of the baseline neurocognitive testing conducted for each of the specified sports and an overview of normal, abnormal, and follow up post injury neurocognitive tests. The data are also required to include the number of students who discontinue participation in the sport following a concussion and post injury testing.

Based on information collected from county offices of education, the CDE is required to prepare a report including, but not limited to: (1) the number of athletes who received the baseline and the post injury tests, and (2) the number of students that have taken the tests and discontinued participation in sports due to concussion injuries. The report is required to be submitted to the Legislature by December 31, 2021.

Outside of the pilot program, this bill provides that a school district, charter school, or private school that elects to offer an interscholastic athletic program is required to collect and maintain data on traumatic brain injuries and concussions sustained by any of its students during an athletic activity. The data are required to be reported periodically to the appropriate county office of education. The county office of education is required to compile and retain the data for summary and analysis as it deems necessary.

Staff Comments:

Costs of this pilot program will depend on the size of the school districts awarded since the numbers of schools within a school district vary significantly. Most schools will qualify for grant funding as about 88 percent of schools in the state are Title I schools. Neurocognitive testing can be provided through companies through a variety of payment schemes. Charges can range from $1 to $7.50 per test or can be offered on a flat rate. Assuming a school district would contract with a company to conduct testing and a flat rate per school of $1,800 most school districts operating grades 9 through 12 would incur costs in the tens of thousands to hundreds of thousands depending on the number of schools in the school district. However, for Los Angeles Unified School District, with about 800 high schools and over 200 charter schools, costs would be about $1.8 million to perform required neurocognitive testing.

If this pilot were to be expanded statewide, to include about 2,000 high schools (including charter schools) in the state, costs would be about $3.6 million to conduct testing annually.

-- END --

SENATE COMMITTEE ON EDUCATION

Senator Carol Liu, Chair

2015 - 2016 Regular

Bill No:

Subject:

SUMMARY

This bill, contingent upon an appropriation, establishes the Neurocognitive Testing Pilot Grant Program to provide funds to Title I schools for the purpose of neurocognitive testing. As part of the pilot program, this bill requires school districts, charter schools, and private schools that elect to offer sports programs to collect and maintain data on traumatic brain injuries and concussions sustained during these activities.

BACKGROUND

Existing law:

1. Requires a school district, charter school, or private school that elects to offer an athletic program to immediately remove from athletic activity for the remainder of the day an athlete who is suspected of sustaining a concussion or head injury. Prohibits the athlete from returning to the activity until he or she has been evaluated by a licensed health care provider and receives a written clearance from the health care provider.
2. Provides that if the licensed health care provider determines that the athlete sustained a concussion or a head injury, the athlete shall complete a graduated return-to-play protocol of no less than seven days in duration under the supervision of a licensed health care provider.
3. Annually requires a concussion and head injury information sheet to be signed by the athlete’s parent prior to participation in athletic activity.

(Education Code § 49475)

1. Requires each high school sports coach to complete a coaching education program developed by the employing school district or the California Interscholastic Federation that meets specified guidelines.

(Education Code § 49032)

1. Requires high school athletic coaches to complete training regarding the identification of concussions. (Education Code § 35179.1)

ANALYSIS

This bill:

1. Establishes the Neurocognitive Testing Pilot Grant Program to provide grant funding to Title I schools for the purposes of neurocognitive testing.
2. Requires the California Department of Education (CDE) to establish an application process for school districts to apply on behalf of Title I schools interested in participating in the pilot program. Requires the grants to be apportioned under the pilot program to a total of three school districts, which shall comprise one school district in each of the following regions of the state: southern, central, and northern. Requires each school district to commit to participating in the pilot program for four school years in order to track pupils tested in grade 9 through completion of high school.
3. Requires the grant funds to be used for the following:
   1. Baseline and postinjury neurocognitive testing of pupils attending a Title I school serving any of grades nine to 12, inclusive, participating in interscholastic athletics in any of the following sports: baseball, basketball, cheerleading, field hockey, football, ice hockey, lacrosse, rugby, soccer, softball, volleyball, and wrestling. The baseline neurocognitive testing shall take place at the beginning of an athletic season before any competitions have taken place and after any head injury, and shall be repeated at intervals not exceeding 24 months for as long as the athlete is enrolled at the school, provided that the athlete is still participating in one or more of the 12 specified sports. The baseline and postinjury neurocognitive testing shall be administered by individuals who have been trained to administer these tests. These individuals may include, but are not necessarily limited to, employees of a participating school district.
   2. Postinjury neurocognitive testing of an athlete who is suspected of sustaining a concussion or head injury in an interscholastic athletic activity. Postinjury neurocognitive tests shall be conducted within 72 hours of the occurrence of the injury.
   3. Training of personnel or to consult with experts on the interpretation of postinjury test results. The parent or guardian of each athlete participating in any of the sports shall also be notified, in writing, that the results of baseline and postinjury neurocognitive testing conducted on his or her child are available to the child's parent or guardian upon request. These neurocognitive testing results may also be shared with the athlete's physician upon the request of the athlete's parent or guardian.
   4. Reporting to the county office of education data that includes an overview of the baseline neurocognitive testing conducted for each of the sports specified in the bill and an overview of normal, abnormal, and follow-up postinjury neurocognitive tests. The data shall also include the number of athletes who discontinue participation in the sport following a concussion and postinjury testing.
4. Defines "neurocognitive testing" as a comprehensive evaluation of a person's cognitive status by specific neurologic domains, including, but not necessarily limited to, memory, attention, problem solving, language, visuospatial, processing speed, motor, and emotion.
5. Requires the California Department of Education (CDE) to, based on the data collected by the county office of education located in the area of participating school districts, prepare a report including, but not necessarily limited to, all of the following information:
   1. The number of athletes who received the baseline tests.
   2. The number of athletes who received the postinjury tests.
   3. The number of athletes who had taken the tests and discontinued participation in any of the specified sports due to concussion injuries.
6. Requires the report to be submitted to the appropriate policy committees of the Legislature on or before December 31, 2021, and to comply with Government Code Section 9795.
7. Specifies that the operation of this bill is contingent upon the appropriation of funds in the annual Budget Act or another statute.
8. Specifies that the program shall remain in effect until January 1, 2022, unless a later enacted statute, that is enacted before January 1, 2022, deletes or extends that date.
9. Requires a school district, charter school, or private school that elects to offer an interscholastic athletic program to collect and maintain data on traumatic brain injuries and concussions sustained by any of its pupils during an interscholastic athletic activity. Requires this data to be reported periodically to the appropriate county office of education, but provides that the names of the injured pupils be kept confidential. Requires the county office of education to compile and retain the data for summary and analysis as it deems necessary.

STAFF COMMENTS

1. Need for the bill. The author indicates that the number of reported sports-related concussions among student athletes has risen dramatically, including a doubling between 2002 and 2012. Further, "athletes who sustain concussions are at greater risk of chronic traumatic encephalopathy, depression, early onset dementia, and long-term brain damage. Research shows that the human brain does not fully develop until a person’s mid-20’s and therefore, young athletes experiencing head injuries are at greater risk of long-term brain damage if injured during the critical stages of brain development." This bill is intended to generate data to provide a better understanding of the frequency of sports-related head injuries among athletes.
2. What is neurocognitive testing? The bill defines neurocognitive testing as a comprehensive evaluation of a person's cognitive status by specific neurologic domains, including, but not necessarily limited to, memory, attention, problem solving, language, visuospatial, processing speed, motor, and emotion. It is used to evaluate brain processing and can be conducted with pencil and paper, or with computerized testing. Testing can be used as a baseline to gauge an athlete's condition post-injury relative to performance before injury. As such, it can be a factor in making decisions as to whether and when an athlete should return to activity and what kinds of activity may be safe for that athlete.
3. Concussions in sports. The dangers of concussions and head injuries in sports have been a growing concern, with frequent news reports of athletes, primarily football players, sustaining traumatic and lasting injuries. A Purdue University study in 2015 indicated lasting brain changes among high school football players, even without concussions, and that changes were not completely healed at the end of an off-season. The study used brain scans and changes in brain chemistry to track players more extensively than neurocognitive testing.

The growing awareness of concussion dangers has led California to enact a series of bills to protect students by limiting full-contact practices; requiring education and information for coaches, pupils and their parents; and protocols for removing students from activity after injury and for returning them to play.

A few school districts in San Mateo County have sought stronger protections for student athletes and have, in some cases, paid for neurocognitive testing. The San Mateo County Civil Grand Jury studied the issue and recommended, among other things, that all districts in the county serving high school students provide neurocognitive testing for all student athletes, and recommended that the districts seek funding and collect data. The grand jury report noted that a leading purveyor of the tests charges school districts $1,200 for 800 baseline tests. These tests are computerized, with results received automatically by the testing company.

1. Limits on practice and full-contact. The California Interscholastic Federation (CIF) governs competitive athletics in grades 9-12. The CIF is comprised of 10 Sections across the State; each Section has a governing body that, among other things, adopts rules and regulations in addition to those promulgated by the State CIF. Each Section establishes its own rules governing the scope of team practice. It appears that five of the Sections allow football teams to conduct full-contact practice during the off-season while five do not allow full-contact practice during the off-season. For example, the Sac-Joaquin Section allows full-contact football camp during the summer and the Southern Section prohibits full-contact practice or camps during the summer.
   

The CIF recently adopted Bylaw 506 which, effective August 1, 2014, limits all athletic teams to no more than 18 hours of practice time per week and no more than four hours in any single day.

1. Fiscal impact. According to the Assembly Appropriations Committee, this bill would result in the following:
   1. Proposition 98/General Fund cost pressures, potentially in the tens of thousands to fund the pilot program. The program is contingent upon an appropriation in the budget act.
   2. General Fund costs to the California Department of Education (CDE) of approximately $264,000 to administer the grant program for four years. The CDE would be required to develop, implement, monitor, collect and analyze data, and prepare reports to the Legislature on the findings for each grant awarded.
   3. Unknown, potentially reimbursable Proposition 98/General Fund state mandated costs, likely in the thousands of dollars, for county offices of education to compile and retain data for summary and analysis.

SUPPORT

California Concussion Institute

California Optometric Association

California Psychological Association

Consumer Attorneys of California

San Mateo Union High School District

OPPOSITION

None received.

-- END --

ASSEMBLY THIRD READING

ATR Bill Id:AB 2182

Author:(Mullin)

As Amended Ver:May 31, 2016

Majority vote

SUMMARY: Establishes the Neurocognitive Testing Pilot Grant Program to provide grant funding to Title I schools for the purposes of neurocognitive testing. Specifically, this bill:

1. Requires the California Department of Education (CDE) to develop an application process for school districts to apply on behalf of Title I schools interested in participating in the pilot program. Requires the grants to be apportioned under the pilot program to a total of three school districts, which shall comprise one school district in each of the following regions of the state: southern, central, and northern. Requires each school district to commit to participating in the pilot program for four school years in order to track pupils tested in grade 9 through completion of high school.
2. Requires the grant funds to be used for the following:
   1. Baseline and postinjury neurocognitive testing of pupils attending a Title I school serving any of grades nine to 12, inclusive, participating in interscholastic athletics in any of the following sports: baseball, basketball, cheerleading, field hockey, football, ice hockey, lacrosse, rugby, soccer, softball, volleyball, and wrestling. The baseline neurocognitive testing shall take place at the beginning of an athletic season before any competitions have taken place and after any head injury, and shall be repeated at intervals not exceeding 24 months for as long as the athlete is enrolled at the school, provided that the athlete is still participating in one or more of the 12 specified sports. The baseline and postinjury neurocognitive testing shall be administered by individuals who have been trained to administer these tests. These individuals may include, but are not necessarily limited to, employees of a participating school district.
   2. Postinjury neurocognitive testing of an athlete who is suspected of sustaining a concussion or head injury in an interscholastic athletic activity. Postinjury neurocognitive tests shall be conducted within 72 hours of the occurrence of the injury.
   3. Training of personnel or to consult with experts on the interpretation of postinjury test results. The parent or guardian of each athlete participating in any of the sports shall also be notified, in writing, that the results of baseline and postinjury neurocognitive testing conducted on his or her child are available to the child's parent or guardian upon request. These neurocognitive testing results may also be shared with the athlete's physician upon the request of the athlete's parent or guardian.
   4. Reporting to the county office of education (COE) data that includes an overview of the baseline neurocognitive testing conducted for each of the sports specified in the bill and an overview of normal, abnormal, and follow-up postinjury neurocognitive tests. The data shall also include the number of athletes who discontinue participation in the sport following a concussion and postinjury testing.
3. Defines "neurocognitive testing" as a comprehensive evaluation of a person's cognitive status by specific neurologic domains, including, but not necessarily limited to, memory, attention, problem solving, language, visuospatial, processing speed, motor, and emotion.
4. Requires the CDE to, based on the data collected by the COE located in the area of participating school districts, prepare a report including, but not necessarily limited to, all of the following information:
   1. The number of athletes who received the baseline tests.
   2. The number of athletes who received the postinjury tests.
   3.  The number of athletes who had taken the tests and discontinued participation in any of the specified sports due to concussion injuries.
5. Specifies that the operation of this bill is contingent upon the appropriation of funds in the annual Budget Act or another statute.
6. Requires the report to be submitted to the appropriate policy committees of the Legislature on or before December 31, 2021, and to comply with Government Code Section 9795.
7. Specifies that the pilot program sunsets and repeals on January 1, 2022, unless a later enacted statute, that is enacted before January 1, 2022, deletes or extends that date.
8. Requires a school district, charter school, or private school that elects to offer an interscholastic athletic program to collect and maintain data on traumatic brain injuries and concussions sustained by any of its pupils during an interscholastic athletic activity. Requires this data to be reported periodically to the appropriate COE, but requires the names of the injured pupils to be kept confidential. Requires the COE to compile and retain the data for summary and analysis as it deems necessary.

FISCAL: According to the Assembly Appropriations Committee:

1. Proposition 98/General Fund cost pressures, potentially in the tens of thousands to fund the pilot program. The program is contingent upon an appropriation in the budget act.
2. General Fund costs to the CDE of approximately $264,000 to administer the grant program for four years. The CDE would be required to develop, implement, monitor, collect and analyze data, and prepare reports to the Legislature on the findings for each grant awarded.
3. Unknown, potentially reimbursable Proposition 98/General Fund state mandated costs, likely in the thousands of dollars, for county offices of education to compile and retain data for summary and analysis.

COMMENTS: The author states that the number of reported sports-related concussions among student athletes has risen dramatically, including a doubling between 2002 and 2012. The author adds, "Athletes who sustain concussions are at greater risk of chronic traumatic encephalopathy, depression, early onset dementia, and long-term brain damage," and that, "young athletes experiencing head injuries are at greater risk of long-term brain damage if injured during the critical stages of brain development." The author hopes that broader neurocognitive testing will assist in the evaluation of individual injuries and identify the incidence of sport-related concussions among young athletes.

Neurocognitive testing is used to evaluate brain processing in a variety of neurological functions related to memory, attention, language, emotion and other areas. Testing can be conducted with pencil and paper, or with computerized testing. Testing can be used as a baseline to gauge an athlete's condition post-injury relative to performance before injury. As such, it can be a factor in making decisions as to whether and when an athlete should return to activity and what kinds of activity may be safe for that athlete.

The dangers of concussions and head injuries in sport have been a growing concern, with frequent news reports of athletes, primarily football players, sustaining traumatic and lasting injuries.

Among the dramatic news reports in March alone:

1. A representative of the National Football League testified that there is a connection between football and chronic traumatic encephalopathy.
2. Women's soccer standout Brandi Chastain announced she would donate her brain to science for research into head injuries.
3. Ivy League schools announced they would eliminate full-contact practices for football.

A Purdue University study in 2015 indicated lasting brain changes among high school football players, even without concussions, and that changes were not completely healed at the end of an off-season. The study used brain scans and changes in brain chemistry to track players more extensively than neurocognitive testing.

The growing awareness of concussion dangers has led California to enact a series of bills to protect students by limiting full-contact practices; requiring education and information for coaches, pupils and their parents; and protocols for removing students from activity after injury and for returning them to play.

A few school districts in San Mateo County have sought stronger protections for student athletes and have, in some cases, paid for neurocognitive testing. Following on this, the San Mateo County Civil Grand Jury studied the issue and recommended, among other things, that all districts in the county serving high school students provide neurocognitive testing for all student athletes, and recommended that the districts seek funding and collect data. The grand jury report noted that a leading purveyor of the tests charges school districts $1,200 for 800 baseline tests. These tests are computerized, with results received automatically by the testing company.

This bill establishes a pilot program for schools in three districts (northern, central, and southern) to test athletes in specified sports, track the pupils for four years, and collect data to evaluate the effectiveness of neurocognitive testing. Amendments adopted in the Assembly Appropriations Committee limit participation to schools that receive federal Title I funds. Title I provides supplemental funding to schools with the highest percentage of low-income children. According to the CDE, in 2014-15, there were 3.9 million students in 6,457 schools that received Title 1 funds. This bill also requires school districts, charter schools and private schools that elect to offer interscholastic sports to collect and report data on traumatic brain injuries and concussions.

Analysis Prepared by: Sophia Kwong Kim / ED. / (916) 319-2087 FN: 0003350

Date of Hearing: April 27, 2016

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Lorena Gonzalez, Chair

ABPCA Bill Id:AB 2182

Author:(Mullin) – As Amended Ver:April 13, 2016

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

SUMMARY:

This bill establishes a four-year Neurocognitive Testing Pilot Grant Program (pilot program), starting in the 2017-18 school year, for school districts to conduct testing of students in grades 9-12 that participate in interscholastic sports. Separate from the pilot program, this bill also requires a school district, charter school or private school that elects to offer an interscholastic athletic program, to collect and maintain data on traumatic brain injuries and concussions sustained during activity. Specifically, this bill:

1. Requires the California Department of Education (CDE) to develop pilot program applications for school districts willing to commit to participate in the program for four school years in order to track pupils tested in grade 9 through completion of high school.
2. Requires grant funds, contingent upon an appropriation in the annual Budget Act, to be used to conduct baseline neurocognitive testing and post injury testing of pupils attending grades 9 to 12, inclusive, participating in the following interscholastic sports: baseball; basketball; cheerleading; field hockey; football; ice hockey; lacrosse; rugby; soccer; softball; volleyball; and wrestling. Grant funding can also be used to train personnel, notify parents of testing, and report data to the county office of education (COE), as specified.
3. Requires the CDE, using data collected by the COEs, to report on the number of athletes who received baseline tests and post-injury tests, and the number of athletes who discontinued participation in sports due to concussion injuries. Requires this report to be submitted to the Legislature on or before December 31, 2021.
4. Repeals the program on January 1, 2022.
5. Requires a school district, charter school, or private school that elects to offer an interscholastic athletic program, to collect and maintain data on traumatic brain injuries and concussions sustained by any of its pupils during an interscholastic athletic activity. Requires this data to be reported periodically to the appropriate COE, keeping the names of the injured confidential. Requires the COE to compile and retain the data for summary and analysis as it deems necessary.
6. Defines “neurocognitive testing” as a comprehensive evaluation of a person’s cognitive status by specific neurologic domains, including, but not necessarily limited to, memory, attention, problem solving, language, visuospatial, processing speed, motor, and emotion.

FISCAL EFFECT 

1. Unknown Proposition 98/GF cost pressures, potentially in the hundreds of thousands of dollars, to fund the pilot program. The program is contingent upon an appropriation in the budget act. The Governor's January budget does not contain funding for this program and the legislative budget subcommittees have not considered this proposal.
2. General Fund costs to the CDE of approximately $264,000 to administer the grant program for four years. The CDE would be required to develop, implement, monitor, collect and analyze data, and prepare reports to the Legislature on the findings for each grant awarded.
3. Unknown, potentially reimbursable Proposition 98/GF state mandated costs, likely in the thousands of dollars, for COEs to compile and retain data for summary and analysis, as the COE deems necessary.

COMMENTS:

1. Purpose. According to the author, from 2002 to 2012, the number of reported sports-related concussions among student athletes doubled. This increase in reported concussions is attributed to various factors, including greater awareness and recognition of TBIs. However, research shows that it is likely that self-reported concussion symptoms are under diagnosed, which may lead athletes to return to play prematurely. The author hopes that broader neurocognitive testing will assist in the evaluation of individual injuries and identify the incidence of sport-related concussions among young athletes.
2. Background. Neurocognitive testing is used to evaluate brain processing in a variety of neurological functions related to memory, attention, language, emotion and other areas. Testing can be conducted with pencil and paper, or with computerized testing. Testing can be used as a baseline to gauge an athlete’s condition post-injury relative to performance before injury. As such, it can be a factor in making decisions as to whether and when an athlete should return to activity and what kinds of activity may be safe for that athlete.

This bill stems in part from events in the author's district, where some school districts in San Mateo County have sought stronger protections for student athletes and have, in some cases, paid for neurocognitive testing. The San Mateo County Civil Grand Jury studied the issue and recommended, among other things, that all districts in the county serving high school students provide neurocognitive testing for all student athletes, and recommended that the districts seek funding and collect data.

The Legislature has taken action in recent years to address the issue of sports related concussions. Current law requires a school district, charter school, or private school, if it offers an athletic program, to immediately remove an athlete from an athletic activity for the remainder of the day if the student athlete is suspected of sustaining a concussion or head injury. Current law also prohibits the student athlete from returning to the athletic activity until the athlete is evaluated by a licensed health care provider, trained in the management of concussions, and the student athlete receives written clearance from the licensed health care provider to return to the activity. Existing law also requires that a concussion and head injury information sheet be signed and returned by the athlete and the athlete’s parent or guardian before the athlete begins practice or competition. This sheet must be signed and turned in annually. Additionally, existing law provides that, if a licensed health care provider determines that an athlete sustained a concussion or head injury while engaging in athletic activity, the athlete is required to complete a graduated return-to-play protocol under the supervision of a licensed health care provider. This protocol is to last no less than seven days.

Analysis Prepared by: Misty Feusahrens / APPR. / (916) 319-2081

Date of Hearing: April 12, 2016

ASSEMBLY COMMITTEE ON ARTS, ENTERTAINMENT, SPORTS, TOURISM, AND INTERNET MEDIA

Kansen Chu, Chair

ABPCA Bill Id:AB 2182 (

Author:Mullin) – As Amended Ver:March 29, 2016

AS PROPOSED TO BE AMENDED IN COMMITTEE

SUBJECT: School athletics: neurocognitive testing.

SUMMARY: Creates a baseline neurocognitive testing pilot program for concussion and head injury, as defined, applying to students playing interscholastic sports, as provided, and requires specified schools to collect, maintain and report on traumatic brain injuries sustained by any pupil during athletic competition.

Specifically, this bill:

1. Creates a Neurocognitive Testing Pilot Grant Program, which would provide grants to schools, subject to appropriation, in order to do the following:
   1. Establish baseline neurocognitive testing of pupils attending grades 9 through 12, as specified.

Further requires that this testing must take place at the beginning of an athletic season before any competitions have taken place and after any head injury, and shall be repeated at intervals not exceeding 24 months for as long as the athlete is enrolled at the school.

• 1. Provide post injury neurocognitive testing of an athlete who is suspected of sustaining a concussion or head injury in an athletic activity.

Mandates post injury neurocognitive tests be conducted within 72 hours of the occurrence of the injury.

• 1. Train personnel or to consult with experts on the interpretation of post injury test results.
  2. Report to the county office of education data that includes an overview of the baseline neurocognitive testing conducted for each of the sports covered under the program, and an overview of normal, abnormal, and follow-up post injury neurocognitive tests. The data shall also include the number of athletes who discontinue participation in the sport following a concussion and post injury testing.

1. States that the grant funds shall be used for testing of pupils participating in interscholastic athletics in any of the following sports:
   1. Baseball.
   2. Basketball.
   3. Cheerleading.
   4. Field hockey.
   5. Football.
   6. Ice hockey.
   7. Lacrosse.
   8. Rugby.
   9. Soccer.
   10. Softball.
   11. Volleyball.
   12. Wrestling.
2. Declares that the department shall develop an application for school districts interested in participating in the pilot program.
3. Requires that school districts interested in participation must commit to participating in the pilot for four years in order to track students tested in grade 9 through high school.
4. Defines “Neurocognitive testing” to mean: a comprehensive evaluation of a person’s cognitive status by specific neurologic domains, including, but not necessarily limited to, memory, attention, problem solving, language, visuospatial, processing speed, motor, and emotion.
5. Requires the department to submit a report, as specified, within six months after the conclusion of the grant program to the appropriate policy committees of the Legislature with the following information:
   1. The number of athletes who received the baseline tests.
   2. The number of athletes who received the post injury tests.
   3. The number of athletes who had taken the tests and discontinued participation in any of the sports covered under the program due to concussion injuries.
6. Requires school districts, charter schools, or private schools to collect and maintain data on traumatic brain injuries and concussions sustained by any of its pupils during an athletic competition.
7. Provides that this data shall be reported periodically to the appropriate county office of education, but the names of the injured pupils shall be kept confidential. The county office of education shall compile and retain the data for summary and analysis as it deems necessary.
8. Declares the bill's provisions will sunset January 1, 2022.
9. Makes related findings and declarations.

EXISTING LAW:

1. Limits full-contact practices, as defined, for high school and middle school football and urges the California Interscholastic Federation (CIF) adoption of rules to implement such guidelines. (Education Code 35179.5)
2. Requires an athlete suspected of sustaining a concussion or head injury during athletic activity to be removed from that activity and not be permitted to return until evaluated and cleared by a licensed health care provider; urges the CIF to develop rules and protocols to implement this; requires athletes and parents to receive, sign and return a head injury information sheet annually before practice or competition; and excludes athletic activities during the regular school day or as part of a physical education course. (Education Code 49475)
3. Requires a high school sports coach to complete education programs developed by his or her school district and the CIF and meeting specific guidelines. (Education Code 49032)

FISCAL EFFECT: Unknown

COMMENTS:

1. Author's statement in support and need for legislation. According to the author, "A concussion is a traumatic brain injury (TBI) caused by a bump, blow, or jolt to the head. Although concussions are generally considered mild TBIs, they can have serious consequences if not properly diagnosed and managed. Athletes who sustain concussions are at greater risk of chronic traumatic encephalopathy, depression, early onset dementia, and long-term brain damage.

"Research shows that the human brain does not fully develop until a person’s mid-20s. Therefore, young athletes experiencing head injuries are at greater risk of long-term brain damage if injured during the critical stages of brain development. From 2002 to 2012 the number of reported sports-related concussions among student athletes doubled. This increase in reported concussions is attributed to various factors, including greater awareness and recognition of TBIs. However, research shows that it is likely that self-reported concussion symptoms are under diagnosed, which may lead athletes to return to play prematurely."

This bill stems in part from events in the author's district, where some school districts in San Mateo County have sought stronger protections for student athletes and have, in some cases, paid for neurocognitive testing. Following on this, the San Mateo County Civil Grand Jury studied the issue and recommended, among other things, that all districts in the county serving high school students provide neurocognitive testing for all student athletes, and recommended that the districts seek funding and collect data. The grand jury report noted that a leading purveyor of the tests charges school districts $1,200 for 800 baseline tests. These tests are computerized, with results received automatically by the testing company.

1. Background: Concussions and Chronic Traumatic Encephalopathy (CTE) making recent news. The dangers of concussions and head injuries in sport have been a growing concern, with frequent news reports of athletes, primarily football players, sustaining traumatic and lasting injuries. On March 1, 2016, this committee participated in a screening of the movie "Concussion" featuring Dr. Bennett Omalu who discussed his ground breaking research into CTE which was the focus of the film, in conjunction with a discussion of the topic of sports safety and concussion prevention by the California Athletic Trainers’ Association (CATA). In addition to a major motion picture on the issue, other dramatic news reports in March alone include:
   1. A representative of the National Football League testified that there is a connection between football and chronic traumatic encephalopathy.
   2. Women’s soccer standout Brandi Chastain announced she would donate her brain to science for research into head injuries.
   3. Ivy League schools announced they would eliminate full-contact practices for football.

A Purdue University study in 2015 indicated lasting brain changes among high school football players, even without concussions, and that changes were not completely healed at the end of an off-season. The study used brain scans and changes in brain chemistry to track players more extensively than neurocognitive testing.

The growing awareness of concussion dangers has led California to enact a series of bills to protect students by limiting full-contact practices; requiring education and information for coaches, pupils and their parents; and protocols for removing students from activity after injury and for returning them to play (See comment 5 below).

1. What is CTE and how is it related to concussions? According to information on the website of the Bennett Omalu Foundation, "Chronic Traumatic Encephalopathy (CTE) is a progressive degenerative disease that afflicts the brain of people who have suffered repeated concussions and traumatic brain injuries (TBI). Though Bennet Omalu first discovered CTE in the brain of NFL Hall of Famer Mike Webster in 2002, it was previously thought to have existed in boxers, and was referred to as dementia pugilistica. It has since been found in the brains of more than ninety NFL players, and other athletes, including wrestlers and hockey players. It has also been identified in the brains of deceased military veterans, domestic abuse victims, and others.

"The brain of an individual who suffers from CTE gradually deteriorates and begins to lose mass. Brain trauma can also cause the accumulation of a type of protein called tau, which significantly interferes with brain function. As CTE progresses, it can cause memory loss, impulsive and erratic behavior, difficulty with balance, impaired judgment, and behavioral disturbances including aggression, depression, and increased suicidality. Ultimately, CTE progresses to the onset of dementia. A similar accumulation of tau protein is also seen in the brains of Alzheimer’s patients. CTE symptoms can manifest months or years after brain trauma, and a definitive diagnosis of CTE can only be made after death by analyzing brain tissue at autopsy.

"The CDC estimates that up to 3.8 million concussions occur each year, with up to ten percent of high school athletes suffering from post-concussion syndrome. Trauma is also often repeated: an athlete who sustains a concussion is four to six times more likely to sustain a second concussion. It’s not well understood how these incidents of trauma progress to CTE and currently there is no cure."

1. Education Committee amendments will be taken in this committee. This measure was heard in the Committee on Education April 6, 2016, and in that hearing the author accepted substantial amendments. Due to the approaching deadline for hearing of fiscal bills and committee schedules these amendments could not be put in print within the time allowed by the Joint Rules, and therefore they will be adopted and put into the measure in this committee. The following describes the amendments:
   1. The bill now creates a pilot project. Committee staff expressed concern that requiring all school districts to implement neurocognitive testing of all athletes participating in the specified sports will create a significant mandate, noting that there are 1.8 million students participating in California Interscholastic Federation sports alone. The amendments strike that requirement and establish a four-year grant program in three districts (one in northern, one in central and one in southern California) based on the parameters of the bill.

According to the Education Committee analysis, operating the pilot for four years would allow districts to track first year high school students through potentially four years of sports activities. Districts interested in participating in the pilot shall receive funds for administering baseline and post-injury neurocognitive tests to high school students participating in the specified sports identified in the bill and to pay for training of personnel or to consult with experts on the interpretation of post-injury test results.

Selection shall be based on a district's commitment to participate in the pilot for four years, a commitment to submit specified data to the county office of education (COE) and other criteria established by the California Department of Education (CDE). Within six months after the conclusion of the pilot, the CDE shall, based on data provided by COEs located in the districts participating in the pilot program, submit a report to the appropriate policy committees of the Legislature on the number of athletes that received the baseline tests and the post-injury tests, and the number of athletes who had taken the tests and stopped playing a sport due to concussion injuries.

• 1. Other amendments:
     1. Amend the findings and declarations section to replace "physicians" with “licensed health care providers."
     2. Revise various parameters of the bill for implementation through a pilot program, such as deleting charter schools and private schools from the bill, deleting the requirement that school districts pay for the tests, and deleting specific requirements as to who administers and interprets the tests.
     3. Revise the provision requiring submission of neurocognitive testing data to the COE to instead require all school districts and charter schools to submit data on the number of athletes sustaining brain injuries and concussions to the COE.

1. Committee conforming language amendment suggested.

The pilot program language and reporting requirements contained in Section 1 of the bill refer to injuries sustained during "athletic activities," which would include injuries which were suffered during both competition and practices. However, the injury report language contained in section 2 of the bill refers only to injuries sustained during "athletic competition." The author has agreed to amend the bill in order to conform the language of these two sections, and will amend page 5, line 6, to strike the word "competition" and replace it with "activity."

1. Prior and related legislation.
   1. AB 2007 (McCarty), Legislation of 2016, would protect youth sports participants from severe injury by requiring the same protocols to be in place as those in place for high school athletes. AB 2007 is currently pending before this committee.
   2. AB 2127 (Cooley), Chapter 165, Statutes of 2014, among other things, limits full-contact practices for high school and middle school football teams for concussion and head injury prevention, and requires that a return-to-play protocol after concussion or head injury be no less than seven days in duration.
   3. AB 588 (Fox), Chapter 423, Statutes of 2013, extends requirements relating to students who sustain, or are suspected of sustaining, a concussion during a school-sponsored athletic activity to charter schools and private schools.
   4. AB 25 (Hayashi), Chapter 456, Statues of 2011, among other things, requires an athlete suspected of sustaining a concussion or head injury to be removed from activity immediately, requires written clearance from a medical health care provider for the athlete’s return and requires a yearly information sheet be signed by an athlete and the athlete’s parent or guardian.

REGISTERED SUPPORT / OPPOSITION:

Support

California Psychological Association

Consumer Attorneys of California

Opposition

There is no opposition on file.

Analysis Prepared by: Dana Mitchell / A.,E.,S.,T., & I.M. / (916) 319-3450

Date of Hearing: April 6, 2016

ASSEMBLY COMMITTEE ON EDUCATION

Patrick O'Donnell, Chair

ABPCA Bill Id:AB 2182 (

Author:Mullin) – As Amended Ver:March 29, 2016

[Note: This bill is doubled referred to the Assembly Arts, Entertainment, Sports, Tourism, and Internet Media Committee and will be heard by that Committee as it relates to issues under its jurisdiction.]

SUBJECT: School athletics: neurocognitive testing

SUMMARY: Adds neurocognitive testing to concussion and head injury requirements applying to students playing interscholastic sports. Specifically, this bill:

1. Requires a school district, charter school or private school with a high school interscholastic sports program to pay for, or provide in-house, neurocognitive testing conducted by a licensed health care professional for pupils participating in baseball, basketball, cheerleading field hockey, football, ice hockey, lacrosse, rugby, soccer, softball, volleyball, or wrestling.
2. Requires a baseline test for those athletes at the beginning of an athletic season, before any competitions have taken place, and requires additional baseline testing at intervals not to exceed 24 months.
3. Requires a school district, charter school or private school to provide post-injury neurocognitive testing within 72 hours of an athlete sustaining any head injury. Authorizes subsequent testing after abnormal post-injury tests to be conducted by a licensed health care professional.
4. Requires a school district, charter school or private school to collect and maintain data on traumatic brain injuries and concussions sustained by athletes during athletic competition, including baseline overviews by sport and an overview of normal, abnormal and follow-up post-injury tests.
5. Requires reporting of data, preserving pupil confidentiality, to county offices of education (COEs) for compilation, retention, summarization and analysis. Specifies that summaries include overviews of baseline results for each sport and an overview of baseline, abnormal and follow-up tests.
6. Requires a school district, charter school or private school to notify the parent or guardian of each athlete in writing that the results from the baseline and post-injury neurocognitive testing are available upon request. Authorizes the neurocognitive testing to be shared with the student's physician upon the request of the student's parent or guardian.
7. Defines “neurocognitive testing” as a comprehensive evaluation of a person’s cognitive status by specified neurologic domains, including, but not necessarily limited to, memory, attention, problem solving, language visuospatial, processing speed, motor and emotion.
8. Finds and declares the benefits of neurocognitive testing as establishing a baseline of normal neurocognitive function before injury, which can be followed by post-injury tests to assess the degree of injury.

EXISTING LAW:

1. Limits full-contact practices, as defined, for high school and middle school football and urges the California Interscholastic Federation (CIF) adoption of rules to implement such guidelines. (Education Code 35179.5)
2. Requires an athlete suspected of sustaining a concussion or head injury during athletic activity to be removed from that activity and not be permitted to return until evaluated and cleared by a licensed health care provider; urges the CIF to develop rules and protocols to implement this; requires athletes and parents to receive, sign and return a head injury information sheet annually before practice or competition; and excludes athletic activities during the regular school day or as part of a physical education course. (Education Code 49475)
3. Requires a high school sports coach to complete education programs developed by his or her school district and the CIF and meeting specific guidelines. (Education Code 49032)

FISCAL EFFECT: Unknown. The Legislative Counsel has keyed this bill as a state-mandated local program.

COMMENTS: Need for this bill. The author states that the number of reported sports-related concussions among student athletes has risen dramatically, including a doubling between 2002 and 2012. The author adds, “Athletes who sustain concussions are at greater risk of chronic traumatic encephalopathy, depression, early onset dementia, and long-term brain damage,” and that, “young athletes experiencing head injuries are at greater risk of long-term brain damage if injured during the critical stages of brain development.” The author hopes that broader neurocognitive testing will assist in the evaluation of individual injuries and identify the incidence of sport-related concussions among young athletes.

Neurocognitive testing is used to evaluate brain processing in a variety of neurological functions related to memory, attention, language, emotion and other areas. Testing can be conducted with pencil and paper, or with computerized testing. Testing can be used as a baseline to gauge an athlete’s condition post-injury relative to performance before injury. As such, it can be a factor in making decisions as to whether and when an athlete should return to activity and what kinds of activity may be safe for that athlete.

What this bill does. This bill requires testing before participation in a season of competition for school-age athletes and follow-up testing in the event of a concussion or head injury. The bill also requires the collection of concussion and head injury data for compilation, retention and analysis.

Background. The dangers of concussions and head injuries in sport have been a growing concern, with frequent news reports of athletes, primarily football players, sustaining traumatic and lasting injuries.

Among the dramatic news reports in March alone:

1. A representative of the National Football League testified that there is a connection between football and chronic traumatic encephalopathy.
2. Women’s soccer standout Brandi Chastain announced she would donate her brain to science for research into head injuries.
3. Ivy League schools announced they would eliminate full-contact practices for football.

A Purdue University study in 2015 indicated lasting brain changes among high school football players, even without concussions, and that changes were not completely healed at the end of an off-season. The study used brain scans and changes in brain chemistry to track players more extensively than neurocognitive testing.

The growing awareness of concussion dangers has led California to enact a series of bills to protect students by limiting full-contact practices; requiring education and information for coaches, pupils and their parents; and protocols for removing students from activity after injury and for returning them to play.

This bill stems in part from actions in the author’s district. A few school districts in San Mateo County have sought stronger protections for student athletes and have, in some cases, paid for neurocognitive testing. Following on this, the San Mateo County Civil Grand Jury studied the issue and recommended, among other things, that all districts in the county serving high school students provide neurocognitive testing for all student athletes, and recommended that the districts seek funding and collect data. The grand jury report noted that a leading purveyor of the tests charges school districts $1,200 for 800 baseline tests. These tests are computerized, with results received automatically by the testing company.

The California Psychological Association has a "support if amended" position and states that it is seeking a technical amendment in the Findings and Declarations section of the bill. The Association notes that references to existing law, Education Code Section 49475, are incorrectly paraphrased, and requests that the term "physician” be replaced with “licensed health care provider” to accurately reflect the referenced statute.

Pilot project? Requiring all school districts to implement neurocognitive testing of all athletes participating in the specified sports will create a significant mandate. There are 1.8 million students alone participating in California Interscholastic Federation sports. Staff recommends striking the requirement and establishing a four-year grant program in three districts (one in northern, one in central and one in southern California) based on the parameters of the bill. Operating the pilot for four years would allow districts to track first year high school students through potentially four years of sports activities. Districts interested in participating in the pilot shall receive funds for administering baseline and post-injury neurocognitive tests to high school students participating in the specified sports identified in the bill and to pay for training of personnel or to consult with experts on the interpretation of post-injury test results. Selection shall be based on a district's commitment to participate in the pilot for four years, a commitment to submit specified data to the COE and other criteria established by the California Department of Education (CDE). Within six months after the conclusion of the pilot, the CDE shall, based on data provided by COEs located in the districts participating in the pilot program, submit a report to the appropriate policy committees of the Legislature on the number of athletes that received the baseline tests and the post-injury tests, and the number of athletes who had taken the tests and stopped playing a sport due to concussion injuries.

Other amendments:

1. Staff recommends amending the findings and declarations section to replace "physicians" with “licensed health care providers."
2. Staff recommends revising various parameters of the bill for implementation through a pilot program, such as deleting charter schools and private schools from the bill, deleting the requirement that school districts pay for the tests, and deleting specific requirements as to who administers and interprets the tests.
3. Staff recommends revising the provision requiring submission of neurocognitive testing data to the COE to instead require all school districts and charter schools to submit data on the number of athletes sustaining brain injuries and concussions to the COE.

Related legislation: AB 1639 (Maienschein), passed by this Committee and pending in the Assembly Judiciary Committee, requires the CDE to make available specified guidelines and materials on sudden cardiac arrest, requires pupils and parents to sign informational materials before athletic participation, requires training of coaches, and sets requirements for action in the event a pupil experiences specified symptoms.

Previous related legislation. AB 2127 (Cooley), Chapter 165, Statutes of 2014, among other things, limits full-contact practices for high school and middle school football teams for concussion and head injury prevention, and requires that a return-to-play protocol after concussion or head injury be no less than seven days in duration.

AB 588 (Fox), Chapter 423, Statutes of 2013, extends requirements relating to students who sustain, or are suspecting of sustaining, a concussion during a school-sponsored athletic activity to charter schools and private schools.

AB 25 (Hayashi), Chapter 456, Statues of 2011, among other things, requires an athlete suspected of sustaining a concussion or head injury to be removed from activity immediately, requires written clearance from a medical health care provider for the athlete’s return and requires a yearly information sheet be signed by an athlete and the athlete’s parent or guardian.

REGISTERED SUPPORT / OPPOSITION:

Support

California Psychological Association (if amended)

Consumer Attorneys of California

Opposition

None on file

Analysis Prepared by: Carlos Alcala and Sophia Kwong Kim / ED. / (916) 319-2087