Legislature(2011 - 2012)CAPITOL 106
03/16/2011 08:00 AM House EDUCATION
| Audio | Topic |
|---|---|
| Start | |
| Presentation(s): Haines Borough School District Superintendent | |
| HB15 | |
| HB104 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | TELECONFERENCED | ||
| *+ | HB 15 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
| = | HB 104 | ||
HB 15-STUDENT ATHLETE TRAUMATIC BRAIN INJURIES
8:27:11 AM
CHAIR DICK announced that the next order of business would be
HOUSE BILL NO. 15, "An Act relating to prevention and evaluation
of and liability for traumatic brain injuries in student
athletes."
8:27:25 AM
REPRESENTATIVE PRUITT moved to adopt the proposed committee
substitute (CS) for HB 15, Version 27-LS0130\M, Mischel,
2/17/11, as the working draft.
REPRESENTATIVE SEATON objected for discussion.
8:27:51 AM
REPRESENTATIVE MIKE DOOGAN, Alaska State Legislature,
paraphrasing from the sponsor statement, which read [original
punctuation provided]:
More than 60,000 high school student athletes sustain
concussions each year. The number is much greater when
you include middle school and younger children. The
National Football League has recently begun focusing
on concussions and brain trauma, raising public
awareness of this serious problem, and many states are
now moving to add protections for students who
participate in sports or other potentially dangerous
activities. While concussions and brain trauma are
more prevalent in football, many other sports and
activities are also dangerous, with girls' soccer
resulting in the second-most concussions.
A concussion results from the brain striking the
inside of the skull, and can be caused by a blow to
the head, or by violent motion of the head. Though the
risk can be somewhat reduced with a helmet, it cannot
be prevented with external equipment. While it is
nearly impossible to completely prevent an initial
concussion or brain trauma, this legislation seeks to
minimize complications and more permanent conditions
that can be caused when athletes continue to practice
or play after receiving a concussion.
HB 15 is modeled after legislation that recently
passed in Washington State, known as the Zackery
Lystedt Law. Zackery was a middle-school football
player who was returned to a game after suffering a
concussion. He sat out for about 15 minutes, and then
returned to the game, forcing a game-saving fumble,
but suffering a further head injury on the play. The
second injury caused a brain hemorrhage that
ultimately lead to the removal of both sides of
Zackery's cranium, leaving him drifting in and out of
a coma for three months. He has battled his way back
to some sense of normalcy, but will never fully
recover from this avoidable injury.
HB 15 simply requires school districts, in
consultation with the Alaska School Activities
Association, to develop and publish guidelines and
information to educate coaches, student athletes and
parents about the nature and risks of concussions and
traumatic brain injuries. The bill will require that
a student athlete suspected of suffering a concussion
or brain trauma be removed from practice or play, and
not be allowed to return until cleared by a licensed
health care professional.
While there is no way to completely prevent
concussions or traumatic brain injuries, we can strive
to prevent the serious complications and potentially
life-altering or life-threatening ramifications that
can occur from continuing to practice or compete once
a brain injury has occurred. This is a critical
public health issue, and a responsibility to our
children we should take seriously.
8:31:22 AM
FRANK AMEDURI, Staff, Representative Mike Doogan, Alaska State
Legislature, explained that the two major changes for the
committee substitute (CS) were (1) documentation requirements
from the Alaska School Activities Association (ASAA) that the
training for parents, students, and coaches all be documented in
writing that it had been received, and (2) that "a person who is
acting at the direction and under the supervision of a licensed
physician" was now also defined as a "qualified person" to allow
a student to return to play. He added that certified athletic
trainers, although not licensed in Alaska, were licensed in 47
other states, and were often the people who would make the
decision for a student to return to play.
8:34:34 AM
REPRESENTATIVE P. WILSON asked if village health aides, who were
not nurses but were supervised by a physician's assistant or an
advanced nurse practitioner, were qualified to make this
decision.
MR. AMEDURI replied that, as long as the supervisor was
licensed, the village health aide would be qualified.
8:35:09 AM
REPRESENTATIVE P. WILSON asked to have that confirmed.
8:36:39 AM
REPRESENTATIVE SEATON withdrew his objection. There being no
further objection, Version M was adopted as the working draft.
8:36:48 AM
MR. AMEDURI suggested that on page 3, line 3, it be amended to
read "licensed health care provider."
8:37:23 AM
REPRESENTATIVE SEATON reported that the House Health and Social
Services Standing Committee (HSS) had considered that Indian
Health Service health professionals were to be exempt from state
license.
8:38:27 AM
REPRESENTATIVE SEATON moved to adopt Conceptual Amendment 1, as
follows:
Page 3, line 1, after "licensed health care provider,
or"
Insert "a health care professional exempt from
occupational licensing"
There being no objection, it was so ordered.
8:39:05 AM
REPRESENTATIVE FEIGE directed attention to page 3, line 12, and
asked about the liability if the accident did not occur on
school property.
8:39:46 AM
MR. AMEDURI replied that he would research an inclusion for
events off the school property.
8:40:23 AM
REPRESENTATIVE FEIGE, directing attention to page 3, line 12,
suggested amending this to include "on, in search, or off school
property."
8:40:49 AM
REPRESENTATIVE PRUITT offered his belief that line 11 clarified
that this addressed a nonprofit youth organization.
8:41:37 AM
MR. AMEDURI agreed that the intent was to extend the immunity to
contractors who worked for the school district. He offered an
example of the baseball season which continued after the end of
the high school baseball season. He offered his belief for the
intent to be coverage for any school event.
8:42:36 AM
REPRESENTATIVE FEIGE asked if it was necessary to mention school
property.
8:42:45 AM
MR. AMEDURI replied that he would seek clarification.
8:42:57 AM
REPRESENTATIVE FEIGE stated the importance for protecting the
school districts from liability.
8:43:08 AM
REPRESENTATIVE PRUITT offered his belief that page 3, lines 12
and 13, released the school district from liability.
8:43:49 AM
MR. AMEDURI noted that these were school related events which
were often contracted with outside groups, and that the bill
intended to include protection of the contractor from liability.
8:44:39 AM
REPRESENTATIVE P. WILSON, reflecting on track students who run
through town while training, asked about coverage and liability
if one of them were hurt.
8:45:54 AM
REPRESENTATIVE SEATON expressed concern that this offered a
broad waiver of liability which did not currently exist in law.
He suggested that this was beyond the purview of the House
Education Standing Committee and that HB 15 should be forwarded
to the House Judiciary Standing Committee.
8:47:18 AM
MR. AMEDURI, in response to Representative Seaton, said that the
liability language was intended to ensure that children were
protected through recognition of an injury and through
precautions from continued play until they were released by a
medical professional. The bill did not release anyone from
responsibility if negligence had occurred.
8:49:17 AM
CHAIR DICK opened public testimony.
8:49:28 AM
KENNETH EDMONDS, Director, National Football League (NFL),
reading from a prepared statement, [Included in members'
packets] stated that the NFL supported HB 15, and that this will
help to "prevent preventable brain injuries and make sports and
recreational activities safer for Alaska's youth athletes." He
stated that the NFL wanted to put player safety first in all
sports, at all levels. He pointed out that the NFL had strict
"return to play" guidelines, and that a similar approach was
necessary for youth players. He reported that more than 40
percent of high school athletes returned to participation before
they were fully recovered. He shared that the NFL promoted
state initiatives similar to the Washington State law named
after Zackery Lystedt, as previously mentioned. He listed the
three core principles: concussion education for parents,
coaches, and youth athletes; immediate removal from play or
practice of a youth athlete who appeared to have suffered a
concussion; mandatory clearance of the youth athlete by a
licensed health care provider trained in evaluation and
management of concussions. He declared that HB 15 would make
youth athletics safer, would ensure the necessary time for
healing, and would reinforce that medical decisions by health
care professionals would take precedence over the playing
decisions of coaches and players. He pointed out that these
laws had now been passed in nine states, and were being actively
considered in 15-20 other states.
8:53:53 AM
REPRESENTATIVE SEATON asked if other states had statutes that
required appropriate protective equipment. He asked if
prevention of the first concussion was often written in statute.
8:55:01 AM
MR. EDMONDS said that it was difficult to prevent the first
concussion from occurring, even with proper equipment. He said
that HB 15 intended to raise the awareness among school
officials, youth athletes, and parents for the dangers of brain
injuries, and the heightened risk of a second concussion when
there was not adequate time for recovery.
8:57:32 AM
The committee took a brief at-ease.
8:58:47 AM
CHRISTOPHER DEAN, Certified Athletic Trainer, Alaska Athletic
Trainers Association, testified in support of HB 15. He
reported that concussions were under reported and considered a
non-injury as there were no visible signs of injury. He
estimated that 300,000 high schoolers suffered concussions each
year, with 25 percent occurring in football. He stated that HB
15 put the responsibility on everyone to intervene on a child's
behalf.
9:00:20 AM
BRENDA SHELDEN, President, Alaska Athletic Trainers Association,
stated the necessity for knowing the signs and symptoms of
concussions. She reported that standards already existed to
apply to protect student athletes, and she offered support for
HB 15.
9:01:42 AM
REPRESENTATIVE FEIGE asked what other sports involved a higher
risk for concussions.
9:01:55 AM
MR. DEAN, in response to Representative Feige, stated that
hockey and football had the highest risk, but that basketball,
cheerleading, and wrestling also had a high risk for concussion.
He said that every sport had the possibility for concussions,
and that they were generally under reported, as coaches
encouraged students to continue to play. He stressed that
concussions were serious injuries.
9:03:02 AM
REPRESENTATIVE FEIGE asked to clarify that a concussion was a
bruising of the brain.
MR. DEAN explained that it was an interruption in the normal
function of the brain, and that medicine was not aware of all
the mechanism of the injury. He established that most
concussions would show no indications on a CT scan or an MRI.
9:03:55 AM
REPRESENTATIVE P. WILSON asked about ways to educate for this.
9:04:17 AM
MS. SHELDEN reported that an educational program, Heads Up, was
available at a nominal cost, and was geared toward the athlete.
She said that this program showed incidences, signs and
symptoms, and follow up procedures. She stated that athletic
directors had to also be educated for the expectations of
coaches, and the ramifications for not reporting concussions.
9:05:36 AM
MR. DEAN reported that often an athlete would only exhibit
visible concussion symptoms for a short period, and that coaches
and staff needed to understand that the healing process was not
immediate.
9:06:28 AM
REPRESENTATIVE SEATON directed attention to page 2, lines 25-26,
and asked who would determine that a student be immediately
removed from the practice or game.
MR. DEAN replied that the onus to remove the student from
competition or practice would fall on any adults involved.
9:07:13 AM
REPRESENTATIVE P. WILSON asked for a further explanation to the
dangers from early participation after a concussion.
9:07:39 AM
MR. DEAN explained that research indicated that "a second strike
syndrome" occurred if the first concussion had not been fully
healed. He stated that this created "an exponentially higher
rate of injury," though the exact reasons were not yet
understood. He declared the necessity for full recovery of a
concussion before play was resumed.
9:08:37 AM
MS. SHELDEN added that medical professionals can often recognize
symptoms which are not readily discernible.
9:09:16 AM
JILL HODGES, Executive Director, Alaska Brain Injury Network,
testified in support of HB 15. She reported that the
seriousness of concussion and brain injury had been a focus in
the last few years and that new information was being brought
forward regularly as research continued. She pointed to studies
from the NFL and the Centers for Disease Control and Prevention
(CDC) which were now available to the public. She pointed out
that many state legislatures were also passing bills emphasizing
brain health and reducing the risk of serious injuries. She
noted that, in Alaska, there were 800 people hospitalized each
year with severe brain injuries. She reported that, since 2003,
brain injury rates from car accidents had been reduced by 40
percent, possibly due to the passage of the seat belt law. She
declared HB 15 to be a prevention and educational tool, and, as
there was not a fiscal note, it was a very cost-effective means.
It would educate student athletes, coaches, athletic directors,
parents, and teachers. She stated that physical and mental
efforts could slow the recovery rate, as there were metabolic
changes occurring in the brain during recovery. She shared that
many states had passed similar legislation and that communities
were voluntarily going above and beyond the requirements of the
bill. She described baselining as an examination for each
individual, so that should a concussion occur, there was
specific personal data for comparison. She encouraged support
for HB 15, so student athletes could maximize their potential.
9:14:39 AM
GARY MATTHEWS, Executive Director, Alaska School Activities
Association (ASAA), stated that ASAA, with membership of more
than 200 high schools, supported HB 15. He said that ASAA had
worked on this legislation and he assured the committee that the
membership was prepared to implement the bill. He pointed out
that ASAA had a sports medicine advisory committee which was
ready to implement concussion management, training, and
regulation. He agreed with the necessity for the bill to be
workable in all parts of Alaska. He expressed the importance
for return to play only to be permitted by an authorized
individual. He explained that the rules for high school sports
were generated on the national level by the National Federation
of State High School Associations (NFHS) with the express
purpose to protect students from injury and to maintain
standards for the games. The football regulations required the
officials to be aware of impaired play or suspected head injury.
He spoke about a better national awareness for cognitive
impairment. He expressed support for the proposed committee
substitute, Version M. He reported that Impact, or baseline,
testing had been offered experimentally with some athletes in
Alaska, but that it was very costly and had limited availability
for rural schools. He stated that the ASAA was ready to
implement the bill.
9:20:57 AM
REPRESENTATIVE SEATON, pointing to page 3, lines 21-22, and
noting that this referred to post concussion, asked about
prevention of concussions. He asked if there was adequate
protocol for the use of protective gear.
9:22:08 AM
MR. MATTHEWS said that protective gear was specified in the
national rule books for every sport, except soccer. He
discussed the difficulty of developing gear that would not alter
the fundamental nature of a sport. He cited that many youth
organizations also followed the national federation rules. He
directed attention to page 2, lines 16-17, which stated "the
nature and risks of concussions." He opined that the risks
could be reduced. He referred to the aforementioned Heads Up
program, which taught safer ways to compete, and would hopefully
eliminate some of the concussions.
9:25:06 AM
REPRESENTATIVE KAWASAKI asked if all schools currently had a
qualified person present during competitions.
9:25:13 AM
MR. MATTHEWS replied that although many areas did not have the
personnel on site, they could be standing by. He opined that it
was more likely for onsite personnel to be at the highest risk
sports of football, hockey, and wrestling. He stated that
anyone had the opportunity to recognize concussion, and a check
list could be used to determine whether a player needed further
evaluation. Currently, if an Alaskan student indicated for a
concussion, they were not allowed to return to play until the
following day. He said that it would be very difficult to have
a licensed provider at every contest.
9:27:34 AM
REPRESENTATIVE P. WILSON asked whether baselines could be set
during the required pre-season physical examination.
9:28:42 AM
MR. MATTHEWS replied that every student was required to have an
annual sports physical exam prior to participation in sports.
He noted that it was more difficult in rural areas, but it was
the rule and it did occur. He opined that there were very few
people in Alaska to administer or evaluate the impact tests.
9:30:27 AM
JIM NYGAARD, Superintendent, Cordova School District, stated
support for HB 15, paraphrasing from a prepared statement, which
read [original punctuation provided]:
Thank you for the opportunity to testify in support of
HB 15. It's a great time of year in Alaska. After a
long season of basketball games, the state playoffs
are just around the corner. Sports, especially
basketball, are the glue that helps keep many of our
smaller communities together during the long winters.
And what a celebration each weekend is, when we can
gather with friends and neighbors to enjoy a friendly
rivalry on the court. Truly a great time for the
superintendent of schools, at that point I know where
all my kids are. Can you imagine the pain felt among
the crowd when our athletes struggled for the ball,
and one is no longer capable to regain his composure
and come to his feet. We've all seen this, and we've
all gasped in disbelief and denial that it could
happen on our court in front of all of us. Now,
imagine the coach, the players, and the parents. The
many things that race through our brains at the time
when a student athlete is sprawled on the floor trying
to recover from a collision, there will never be a
time when we are all more vulnerable and in need of
(indisc.) coach to ensure that that student athlete
will successfully recover. From this point, the final
score means nothing, as long as the student athlete is
capable of recovering. We're not doctors, nor can we
guarantee that a doctor will always be present. I
appreciate the sponsor's efforts to see the necessary
language in the amendments reflect a qualified person,
as in many communities, a licensed physician is not
always available. Getting this language clarified has
been monumental for all the schools involved in these
conversations. As with all human nature, education is
key. Getting the information out to the public will
benefit all parties. Necessary sign-offs of the
nature of risk of concussions by parents and student
athletes will complement the need for all parties to
be better prepared to deal with potential concussions.
Legislative influence will add consistency to the
adherence of this bill, as well. At a time when
information is readily available via internet, we have
limited reasons not to be better informed, nor to be
more pro-active, especially when it has to do with the
wellbeing of our young populations. I support this
bill as it moves forward, and appreciate the
committee's time as you listen to similar testimony
throughout the morning.
CHAIR DICK stated that public testimony would remain open.
[HB 15 was held over.]
| Document Name | Date/Time | Subjects |
|---|---|---|
| HB 15 NPR Story.pdf |
HEDC 3/16/2011 8:00:00 AM |
HB 15 |
| HB 15 Sectional Analysis.docx |
HEDC 3/16/2011 8:00:00 AM |
HB 15 |
| HB 15 Sponsor Statement.pdf |
HEDC 3/16/2011 8:00:00 AM |
HB 15 |
| HB 15 State Legislatures Article.pdf |
HEDC 3/16/2011 8:00:00 AM |
HB 15 |
| HB 15 Time Magazine.pdf |
HEDC 3/16/2011 8:00:00 AM |
HB 15 |
| HB 15 Youth Concussion Ed Pack.pdf |
HEDC 3/16/2011 8:00:00 AM |
HB 15 |
| HB 15.PDF |
HEDC 3/16/2011 8:00:00 AM |
HB 15 |
| HB 15 ASAA questions.docx |
HEDC 3/16/2011 8:00:00 AM |
HB 15 |
| HB 15 Boston Univ Article.pdf |
HEDC 3/16/2011 8:00:00 AM |
HB 15 |
| HB 15 Brain Injury Associaiton of WA.pdf |
HEDC 3/16/2011 8:00:00 AM |
HB 15 |
| HB 15 Committee Substitute.pdf |
HEDC 3/16/2011 8:00:00 AM |
HB 15 |
| HB 15 Fiscal Note.pdf |
HEDC 3/16/2011 8:00:00 AM |
HB 15 |