03/30/2011 01:30 PM Senate HEALTH & SOCIAL SERVICES

        SB  22-STUDENT ATHLETE TRAUMATIC BRAIN INJURIES                                                                     
                                                                                                                                
1:45:58 PM                                                                                                                    
CHAIR DAVIS announced the next order  of business would be SB 22,                                                               
relating to student athlete traumatic brain injuries.                                                                           
                                                                                                                                
ESTHER TEMPEL, staff to Senator  Lesil McGuire, sponsor of SB 22,                                                               
said  the  bill seeks  to  minimize  the complications  and  more                                                               
permanent  conditions that  can be  caused when  student athletes                                                               
continue to practice  or play after receiving  a concussion. More                                                               
than  60,000 high  school  student  athletes sustain  concussions                                                               
each  year. The  risk  can be  reduced with  a  helmet but  these                                                               
injuries cannot always be prevented.                                                                                            
                                                                                                                                
SB 22 is modeled after  legislation passed in Washington State. A                                                               
middle  school  football player  was  returned  to a  game  after                                                               
receiving a  concussion. When he  returned to play he  suffered a                                                               
second  injury from  which he  will  never fully  recover. SB  22                                                               
seeks to  require school districts  and Alaska  School Activities                                                               
Association  (ASAA)   to  develop  and  publish   guidelines  and                                                               
information  about the  nature and  risks. It  will also  require                                                               
athletes  suspected of  sustaining a  concussion be  removed from                                                               
play and cleared by a licensed  health care provider. There is no                                                               
way  to  completely prevent  concussions  but  we can  strive  to                                                               
prevent serious complications.                                                                                                  
                                                                                                                                
1:49:35 PM                                                                                                                    
SENATOR  EGAN moved  to adopt  the proposed  committee substitute                                                               
(CS) for SB 22, labeled 27-LS0250\B, as the working document.                                                                   
                                                                                                                                
CHAIR DAVIS objected for discussion purposes.                                                                                   
                                                                                                                                
MS. TEMPEL said  the CS was prepared after  consultation with the                                                               
Alaska Brain Injury  Network and the ASAA. It  replaces the words                                                               
"traumatic brain injuries" with  "concussions." A concussion is a                                                               
form  of traumatic  brain injury.  The change  occurs on  page 1,                                                               
line 6; page 2, line 13; and page 3, lines 18 and 21.                                                                           
                                                                                                                                
Section 2  adds a  new section,  AS 14.30.142(b),  which requires                                                               
that  schools provide  students  and their  parents with  written                                                               
information on the  nature and risks of  concussions. Parents are                                                               
also  required  to   sign  off  that  they   have  received  this                                                               
information.                                                                                                                    
                                                                                                                                
There  is  also a  language  change  with  reference to  who  can                                                               
evaluate a student suspected of  sustaining a concussion. This is                                                               
because in rural  Alaska a licensed health care  provider may not                                                               
always  be present.  A qualified  person could  be a  health care                                                               
provider  or a  person  acting  at the  direction  and under  the                                                               
supervision  of  a  licensed  physician.  This  would  include  a                                                               
village  health  aide.  Subsection 14.30.142(e)  adds  additional                                                               
language saying, " .  . . and who is not  paid for conducting the                                                               
evaluation."                                                                                                                    
                                                                                                                                
1:53:50 PM                                                                                                                    
GARY  MATTHEWS,  Executive  Director,  Alaska  School  Activities                                                               
Association (ASAA), said that their  responsibility is to provide                                                               
guidance  and regulation  and promote  interscholastic activities                                                               
in the high schools in Alaska.  This is an entity which will work                                                               
with member school  districts. They have worked  closely with the                                                               
Alaska   Association  of   School  Boards   (AASB),  the   Alaska                                                               
Association of  School Administrators  (AASA), and the  office of                                                               
Representative  Doogan,  who  sponsored  a similar  bill  in  the                                                               
House.                                                                                                                          
                                                                                                                                
About 12 states  have adopted similar legislation.  The intent is                                                               
to protect  students. It  is also to  educate and  train parents,                                                               
coaches,  school   nurses,  and  others  in   the  management  of                                                               
concussions  and  return  to  play. They  work  with  a  national                                                               
affiliate  to   reduce  injuries  in  sports.   Their  sphere  of                                                               
influence is  high school  interscholastic activities.  The rules                                                               
should  include proper  safety  equipment,  training of  coaches,                                                               
etc.                                                                                                                            
                                                                                                                                
ASAA is pleased  with the CS but they do  have one small concern.                                                               
On page 2, section (d), starting  on line 27, the state of Alaska                                                               
has  no  registry which  lists  health  care providers  who  have                                                               
received training in the management  of concussions. The provider                                                               
is the  only one who  knows if he or  she is a  qualified person.                                                               
The  last  step  should  be   to  place  a  slight  amendment  to                                                               
subsection (d), as follows: "A  student who has been removed from                                                               
participation in a  practice or game for  suspicion of concussion                                                               
may not return  to play until the student has  been evaluated and                                                               
cleared for participation by a  qualified person who has received                                                               
training  and  is  currently  certified  in  the  evaluation  and                                                               
management of  concussions."   At the end  of that  sentence they                                                               
would like  to add, ",  as verified  in writing by  the qualified                                                               
person."                                                                                                                        
                                                                                                                                
1:59:01 PM                                                                                                                    
There is no way for the school  to know if a person is qualified.                                                               
So  the person  needs to  self-certify they  are qualified.  That                                                               
way, any liability  falls onto the health care  provider, not the                                                               
school district.                                                                                                                
                                                                                                                                
2:00:03 PM                                                                                                                    
CHAIR DAVIS  said that everything was  in the new CS,  except "as                                                               
verified  in writing  by the  qualified person."  She noted  that                                                               
language could be added today by the committee.                                                                                 
                                                                                                                                
2:00:53 PM                                                                                                                    
JILL  HODGES, Executive  Director, Alaska  Brain Injury  Network,                                                               
said  she was  calling  in  support of  SB  22.  The network  has                                                               
testified in support of many  bills and resolutions. SB 22 brings                                                               
attention to concussions among student  athletes. She said it was                                                               
exciting to  be testifying in support  of a bill that  would help                                                               
to  keep student  athletes safe  and  prevent serious,  traumatic                                                               
brain injury.                                                                                                                   
                                                                                                                                
2:03:52 PM                                                                                                                    
There  is  no fiscal  note,  so  this  is  an affordable  way  to                                                               
increase  awareness.  SB  22  will  help  keep  brains  safe  and                                                               
increase  awareness of  traumatic  brain injuries.  It will  help                                                               
schools and  coaches better understand  how to reduce  the number                                                               
of injuries  and the risk  of injuries. The Brain  Injury Network                                                               
believes SB 22 will help  student athletes to continue to succeed                                                               
in sports and school.                                                                                                           
                                                                                                                                
2:06:17 PM                                                                                                                    
PETER HOEFFNER,  Board Member, Cordova  School District,  said he                                                               
supports SB  22. It focuses  on concussions  and is good  for the                                                               
health and well being of students.                                                                                              
                                                                                                                                
2:07:33 PM                                                                                                                    
CHRISTOPHER DEAN,  Alaska Athletic  Trainers Association  said SB
 creates  a right and a  duty for all people  involved in youth                                                               
athletics to  protect the child.  The Center for  Disease Control                                                               
(CDC) has  defined concussions as  being at epidemic level.  As a                                                               
trainer  he sees  this first  hand. Post  season reporting  shows                                                               
that close to 50 percent of  athletes in contact sports receive a                                                               
concussion during  the season, yet  only 15 percent of  these are                                                               
reported to  the athletic trainer during  the season. Concussions                                                               
are  severely underreported.  Many  schools do  not have  trained                                                               
personnel on site, which makes  it important to train and educate                                                               
our coaches, administrators, and parents.                                                                                       
                                                                                                                                
2:09:58 PM                                                                                                                    
BRENDA SHELTON,  President, Alaska Athletic  Trainers Association                                                               
(AATA), said  the organization  is committed  to the  support and                                                               
implementation  of this  legislation.  An athletic  trainer is  a                                                               
health  care  professional  who specializes  in  the  prevention,                                                               
diagnosis,   treatment,  and   rehabilitation  of   sport-related                                                               
injuries.  SB   22  is  revenue   neutral;  free   and  reputable                                                               
educational  tools are  available.  An athlete  who exhibits  the                                                               
signs,  symptoms,  or  behaviors  consistent  with  a  concussion                                                               
should be  removed immediately from  practice or  competition and                                                               
should not be returned to play  until cleared by a trained health                                                               
care professional. AATA stands in support of SB 22.                                                                             
                                                                                                                                
2:11:43 PM                                                                                                                    
BRUCE  JOHNSON,  Executive  Director, Alaska  Council  of  School                                                               
Administrators  (ACSA), said  they  have  worked collectively  to                                                               
bring this legislation to the  committee. They feel strongly that                                                               
the  time is  right to  pass this  bill. Education  is available,                                                               
particularly  for those  involved  in contact  sports. They  have                                                               
worked  hard  to  get  the  protocols  in  place  for  evaluating                                                               
possible concussions.                                                                                                           
                                                                                                                                
2:13:05 PM                                                                                                                    
CHAIR DAVIS  closed public  testimony on SB  22. She  noted there                                                               
was one recommendation for a small change.                                                                                      
                                                                                                                                
SENATOR MEYER asked  Ms. Lelake if she thought  the sponsor would                                                               
agree to the suggested change.                                                                                                  
                                                                                                                                
MS. LELAKE said she thought he would.                                                                                           
                                                                                                                                
SENATOR DYSON said we can pass  the bill out with the change, and                                                               
the sponsor can undo it if he wants to.                                                                                         
                                                                                                                                
SENATOR EGAN asked where the new words would be inserted.                                                                       
                                                                                                                                
MS. LELAKE answered on page 2, line 30.                                                                                         
                                                                                                                                
2:15:41 PM                                                                                                                    
CHAIR DAVIS  said it  was just  a matter  of adding  "as verified                                                               
by."                                                                                                                            
                                                                                                                                
SENATOR MEYER  said it was  a good bill  and would work  in urban                                                               
areas, but what  about in rural areas if no  health care provider                                                               
was available.                                                                                                                  
                                                                                                                                
MS. LELAKE responded  she believes the CS  addresses the problem,                                                               
because village health aids would qualify.                                                                                      
                                                                                                                                
SENATOR MEYER said that should work.                                                                                            
                                                                                                                                
CHAIR DAVIS asked for a motion to move the bill.                                                                                
                                                                                                                                
SENATOR EGAN moved to report CS  for SB 22, version B as amended,                                                               
and  adding  on  line  30, after  concussions,  "as  verified  in                                                               
writing by the qualified person,"  from committee with individual                                                               
recommendations   and   accompanying    fiscal   notes.   Without                                                               
objection, CSSB 22(HSS)  moved from the Senate  Health and Social                                                               
Services Standing Committee.