Legislature(2011 - 2012)CAPITOL 120
04/11/2011 01:00 PM House JUDICIARY
| Audio | Topic |
|---|---|
| Start | |
| HB15 | |
| HJR16 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| + | HB 15 | TELECONFERENCED | |
| *+ | HB 224 | TELECONFERENCED | |
| + | HJR 16 | TELECONFERENCED | |
| + | TELECONFERENCED |
HB 15 - STUDENT ATHLETE TRAUMATIC BRAIN INJURIES
1:11:26 PM
CHAIR GATTO announced that the first 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." [Before the committee was CSHB 15(EDC).]
1:12:32 PM
REPRESENTATIVE MIKE DOOGAN, Alaska State Legislature, sponsor of
HB 15, in response to a request, confirmed that because some
questions were raised in the House Education Standing Committee
(HEDC) regarding one of CSHB 15(EDC)'s provisions, the bill's
referral to the House Health and Social Services Standing
Committee (HHSS) was replaced with a referral to the House
Judiciary Standing Committee (HJUD).
1:14:24 PM
FRANK AMEDURI, Staff, Representative Mike Doogan, Alaska State
Legislature, on behalf of the sponsor of HB 15, Representative
Doogan, concurred that the language of Section 2's proposed new
AS 14.30.143 - Concussions in student athletes: school district
immunity - raised concerns regarding liability. He offered his
belief that HB 15's liability language would essentially reduce
liability because currently there are no laws, regulations, or
guidelines addressing concussions, and thus liability to a
school district or one of its contractors is total. [This
proposed new AS 14.30.143] was included in the bill in order to
address the fact that almost every school in Alaska contracts
with nonprofit organizations for sport-related activities,
including activities extending beyond the regular school year.
MR. AMEDURI explained that under the bill, in order for such
organizations to receive the same immunity as would be provided
to school districts, the organizations must show proof of having
the proper amount of insurance [as outlined in proposed
AS 14.30.143(a)(3)(A), and proof of having complied with the
provisions of, and the subsequently-developed-guidelines
referenced in, Section 2's proposed AS 14.30.142 - which
addresses the prevention and reporting of concussions in student
athletes, and] which would require that coaches, parents, and
students be educated regarding [the nature and risks of]
concussions. Under proposed AS 14.30.142, [subsection (c)]
requires that a student suspected of having sustained a
concussion shall be removed from play, and [subsection (d)]
stipulates that any such student shall not be allowed to return
to play until he/she has been evaluated and cleared to do so in
writing by a qualified person.
CHAIR GATTO questioned whether the requirements outlined in the
bill would have to be followed for all sports, even those that
don't typically have an inherent risk of concussion.
MR. AMEDURI said yes, and pointed out that the bill would ensure
that once a student is suspected of suffering an initial
concussion - which can't really be protected against and could
happen in any sport - he/she is removed from play so as to
mitigate the risk that he/she will suffer a second concussion,
which can result in permanent brain damage. In response to
questions, he explained that the requirements of proposed
AS 14.30.142(b) would apply to all students - regardless of age
- and to the parents or guardians of students under the age of
18; and concurred that under proposed AS 14.30.142(c), anyone
would have standing to - and in fact would be required to -
insist that a student suspected of having sustained a concussion
be removed from play.
1:22:47 PM
MR. AMEDURI, in response to comments, explained that regardless
that the oft-times intense rivalry associated with school sports
could lead someone to try to use this legislation in an
unscrupulous manner, the primary intent of HB 15 is to protect
children from serious brain trauma, and thus part of the
training required under the bill includes how to recognize the
symptoms of a concussion - it's not just about whether a student
has sustained a blow to the head - so that in situations where a
child is exhibiting the signs of a concussion, steps can be
taken to protect him/her from further injury to the head. He
mentioned that there are training resources available on the
Internet, with various groups including the National Football
League (NFL) having contributed to the development of that
training material, which includes assessment guidelines that
would be used to determine whether a student really is
exhibiting signs of having sustained a concussion before taking
him/her out of play. In response to further comments and
questions, he indicated that because the health and safety of
the child is paramount, it would be better to err on the side of
caution.
REPRESENTATIVE HOLMES noted that proposed AS 14.30.142(a)
requires the governing body of a school district, in
consultation with the Alaska School Activities Association
(ASAA), to develop and publish guidelines and other information
regarding the nature and risks of concussions.
[Members then discussed various ways in which one could sustain
a head injury while playing soccer.]
REPRESENTATIVE DOOGAN explained that the bill isn't intended to
eliminate the occurrence of head injuries in sports activities
altogether; instead, the goal is to ensure that a student who
has sustained a concussion has recovered completely before being
allowed to play again.
MR. AMEDURI mentioned that members' packets include a handout
from the Centers for Disease Control and Prevention (CDC)
entitled, "Heads Up: Concussion in Youth Sports"; this handout
includes information about the signs observed by
parents/guardians, and the symptoms reported by the student
athletes themselves. Before a student is removed from play, he
assured the committee, the signs and symptoms outlined must be
present.
CHAIR GATTO, mentioning that he's served as a first responder,
noted that with some brain injuries, slow bleeding can occur
after the fact and therefore remain undetected.
1:33:43 PM
STANLEY A. HERRING, M.D., Professor, University of Washington;
Member, NFL Head, Neck and Spine Committee, characterizing the
work being done on HB 15 as important and critical in terms of
keep sports safe, explained that the state of Washington adopted
the Zackery Lystedt Law - concussion legislation he'd been
working on - and became the first state in the nation to adopt
such legislation. Since then, similar legislation has been
adopted in 15 other states. In response to a comment, he
indicated that the protocols followed for suspected brain
injuries are also followed for suspected spinal injuries. It
has been observed, he went on to say, that coaches, parents, and
students, once educated, become good advocates of efforts
towards keeping sports safe. Since passage of the Zackery
Lystedt Law, there haven't been any subdural hematomas occurring
during the last five [scholastic] football seasons.
Furthermore, there have not been any problems with coaches of
opposing teams demanding that a particular player be removed
from the game, and such problems are unlikely to occur at all
because coaches must account for their actions to their
governing/licensing organizations. Instead, coaches are
relieved that they no longer have the burden of returning an
injured student to play, and education efforts have resulted in
increased awareness by everybody involved regarding the dangers
of continuing to play with a head injury.
DR. HERRING, in conclusion, said that the experience in the
state of Washington and the other states that have passed
similar legislation has been an increased awareness that paying
proper attention to an injury can prevent significant and
serious trauma, even death, and yet without any decrease in
contact-sport participation/interest. In response to a
question, he clarified that since passage of the Zackery Lystedt
Law, [schools] have been able to stop athletes from continuing
to participate in a role that could result a subdural hematoma;
in other words, the early reporting of a suspected concussion
removes the athlete before he/she can sustain a subsequent blow,
which is often the blow that causes the internal bleeding.
Every year prior to the enactment of the Zackery Lystedt Law,
there was at least one subdural hematoma occurring during the
[scholastic] football season, but, again, there have been none
occurring since passage of that law. Such legislation has
contributed to the prevention of these types of preventable
brain injuries.
1:38:55 PM
DR. HERRING, in response to another question, relayed that aside
from sometimes providing a description of how a concussion can
occur - as Section 1 of HB 15 does - no state has thus far felt
it necessary to further statutorily define the term,
"concussion" in its legislation, the idea being that if there is
even a suspicion that a student has sustained a concussion, the
safest thing to do is to remove him/her from play. In response
to another question, he reiterated that there have not been any
problems with coaches of opposing teams using the pretext that a
particular player might have sustained a concussion in order to
demand that that player be removed from the game. This issue
was discussed during the debate on the Zackery Lystedt Law, but
experience has shown instead that coaches are very interested in
understanding the nature and risks of concussion because none of
them want to hurt their own athletes - none of the coaches have
misused this law.
REPRESENTATIVE GRUENBERG asked whether the language of proposed
AS 14.30.142(e) is sufficient in terms of providing immunity to
the person conducting the evaluation of the student; proposed
subsection (e) reads:
(e) A person who conducts an evaluation under (d) of
this section and who is not paid for conducting the
evaluation may not be held liable for civil damages
resulting from an act or omission during the
evaluation, except that the person may be held liable
for reckless or intentional misconduct and for gross
negligence.
DR. HERRING said he has seen similar language used without any
problems in the legislation adopted elsewhere.
REPRESENTATIVE GRUENBERG questioned whether cheerleaders would
be covered under the bill.
MR. AMEDURI said that HB 15 only covers student athletes.
However, members of the Alaska School Nurses Association (ASNA)
have relayed that if the bill passes, they would be interested
in approaching school districts with the concept of having the
same rules/guidelines contained in the bill apply to students in
general. Furthermore, in states which have passed similar
legislation, the rules/guidelines therein tend to be adopted by
various scholastic-sports groups/organizations and applied to
all students, regardless of whether they are on school property,
simply because those rules/guidelines make sense, particularly
in terms of preventing additional concussions and [resultant]
serious brain injuries.
1:46:01 PM
KEN EDMONDS, Director, Government Relations and Public Policy,
National Football League (NFL), referring to Dr. Herring as the
leading expert, relayed that his organization has been active in
other states on this issue, with the main objective being to
help those states pass laws like the Zackery Lystedt Law, which
Alaska's proposed law is very similar to, containing the same
three core principles: requiring education regarding the risks
and signs of concussion, requiring immediate removal from play
upon suspicion of having sustained a concussion, and requiring
medical evaluation and clearance before returning to play. His
organization therefore supports HB 15 and would like to see it
pass as soon as possible, particularly given the impact such
legislation has had in other states. In response to a question,
he provided a list of some of the states that have passed such a
law, and noted that should Alaska do so as well, it would be
among the first 20 states to do so, and thereby be in the
forefront of protecting its student athletes.
MR. AMEDURI, in response to a question, explained that in order
to address the issue of scholastic sports played in rural and
oft-times remote areas of the state, changes were made to the
bill such that proposed AS 14.30.142(d)(1)-(2) of CSHB 15(EDC)
now defines the term, "qualified person" - as used in subsection
(d) - as meaning either a healthcare provider licensed in the
state or one who by law is exempt from such licensure - such as
a visiting doctor on rotation - or a person acting at the
direction and under the supervision of a physician licensed in
the state or one who by law is exempt from such licensure - such
as a village nurse or a village health aide or a certified
athletic trainer. This language should ensure that only
qualified people are conducting the required evaluations. In
response to another question, he reiterated that the bill itself
only addresses student athletes, and that many
communities/organizations in the other states that have passed
similar legislation tend to adopt/apply the same
rules/guidelines contained in their state's legislation.
1:56:40 PM
JEAN MISCHEL, Attorney, Legislative Legal Counsel, Legislative
Legal and Research Services, Legislative Affairs Agency (LAA),
as the drafter of HB 15, in response to questions and comments,
indicated that language could be added to proposed AS 14.30.143
in order to clarify that the immunity provided therein only
pertains to concussions.
REPRESENTATIVE GRUENBERG expressed interest in doing so.
1:57:46 PM
JILL HODGES, Executive Director, Alaska Brain Injury Network,
Inc. (ABIN), after providing some information about the ABIN,
expressed appreciation for the work being done on HB 15, and
relayed that there is a need for this bill and that it makes
complete sense, particularly if one has met someone who has been
impacted by a concussion in which the second impact was
devastating. She reported that she's heard testimony from young
adults across the country who, as student athletes in high
school, sustained traumatic brain injuries, and all say that
they wished that they'd had more information back when they'd
suffered the [initial injury], and all have spent years
attempting to restore their brain function to what it was before
their head trauma occurred. Although it is hard right now to
track just how many student athletes have sustained a
concussion, it is estimated that every year, 3,000 Alaskans go
to the emergency room due to a concussion or a traumatic brain
injury, with approximately 800 of those Alaskans having to be
hospitalized for more than 24 hours because the injury was
severe.
MS. HODGES said that once one learns to recognize the signs of
concussion, it becomes very easy to tell that a child has
sustained a concussion: for example, he/she may be
disorientated, may be unable to remember the plays called, may
look dazed, or may be unable to see normally. These are huge
signs that the child is indeed concussed. She relayed that as a
former student athlete herself, she wishes that she and her team
and school had had the knowledge and resources to recognize that
there were times when maybe sitting out of the game/practice for
a few days/weeks/months would have been best, particularly given
how short a period of time that is compared to losing one's life
or [suffering permanent brain damage/loss].
MS. HODGES, noting that the ABIN encourages the committee to
support HB 15, relayed that the ABIN has worked very closely
with some of the states that have already adopted similar
legislation. In those other states, as mentioned earlier,
[groups/organizations] are going above and beyond what's
required by law, resulting in more and more people - both kids
and adults - becoming educated about the vulnerability of the
brain and about the seriousness of concussion, whether occurring
on the field or off. House Bill 15 would be a good bill for
Alaska, helping it get control over traumatic brain injury,
which is viewed as a silent epidemic and a public-health crisis.
DR. HERRING, in response to a question, concurred that until
fully recovered from an initial injury, the brain is
particularly vulnerable to re-injury, and that the brains of
children take longer to recover. During this period of
vulnerability, certain and unique things can happen to the child
that can be devastating - if not deadly. This is particularly
relevant, both for this type of injury and for youth athletes.
It's not the first blow to the head - it's the second or third
blow [that can cause terrible damage] - and thus there's a
chance of being able to prevent these types of head injuries,
which, again, are preventable.
2:04:57 PM
BRUCE JOHNSON, Executive Director, Alaska Council of School
Administrators (ACSA), relayed that the ACSA and the Association
of Alaska School Boards (AASB) have been working closely with
the sponsor of HB 15 to ensure that it will work well for
student athletes, and provide for adequate protections and
protocols. The ACSA would like to lend its support, he relayed.
In response to a question, he relayed that legal counsel has
recommended that the language of proposed AS 14.30.142(d) that
reads, "is currently certified in the evaluation and management
of concussions" be amended by adding the phrase, "as verified in
writing by the qualified person". This additional language
should ensure that the person evaluating a concussed student
really is properly trained in performing such evaluations.
DR. HERRING indicated that he was amenable to such a change,
surmising that it could be helpful in ensuring that the person
doing the evaluations has the proper knowledge. He offered his
understanding that such trained personnel are readily available
through various organizations.
MR. JOHNSON, in response to a question, indicated that a form
for such verification could be developed and used.
MS. MISCHEL, in response to a question, relayed that if the
committee wished to allow for such verification to be provided
in an electronic format, then that should be specified in the
proposed additional language. She pointed out, however, that
having the person who is claiming to be qualified merely state
in writing that he/she is qualified doesn't provide any
reassurance that such is actually the case. She suggested
instead that requiring the person to provide proof of current
certification to the school district would be the better
approach.
REPRESENTATIVE GRUENBERG indicated a desire to add language that
would allow for electronic delivery of the necessary paperwork.
CHAIR GATTO, after ascertaining that no one else wished to
testify, closed public testimony on HB 15.
MR. AMEDURI, noting that Mr. Johnson's suggested language has
already been incorporated into the Senate companion bill,
cautioned against changing HB 15 to the point where a school
district no longer has the flexibility it needs to develop
guidelines appropriate to its own circumstances, or can no
longer obtain the services of a qualified person due to
liability issues.
2:16:19 PM
REPRESENTATIVE GRUENBERG made a motion to adopt Conceptual
Amendment 1, to amend proposed AS 14.30.143(a) - specifically
the words, "an injury to or the death of a person" located on
page 3, line 11 - [such that the immunity provided for would
pertain only to concussive injuries or deaths caused by
concussion]. There being no objection, Conceptual Amendment 1
was adopted.
2:20:50 PM
REPRESENTATIVE HOLMES [made a motion to adopt] Conceptual
Amendment 2, to amend proposed 14.30.142(d) such that the words,
"as verified in writing by the qualified person" would be added
to page 2, line 30, after the word, "certified".
REPRESENTATIVE GRUENBERG objected.
REPRESENTATIVE GRUENBERG then made a motion to amend Conceptual
Amendment 2 such that the words, "or electronically" would be
added after the word, "writing". There being no objection,
Conceptual Amendment 2 was so amended.
REPRESENTATIVE GRUENBERG removed his objection to the motion to
adopt Conceptual Amendment 2, as amended.
REPRESENTATIVE KELLER objected, and sought clarification
regarding who would be providing the verification.
REPRESENTATIVE HOLMES offered her understanding that it would be
provided by the qualified person himself/herself.
REPRESENTATIVE KELLER removed his objection.
2:23:51 PM
CHAIR GATTO, after ascertaining that there were no further
objections, announced that Conceptual Amendment 2, as amended,
was adopted.
REPRESENTATIVE GRUENBERG questioned whether the bill should be
amended such that a definition of concussion would get added to
the statutes themselves.
REPRESENTATIVE HOLMES expressed a preference for not doing so,
predicting that it could create problems.
2:27:04 PM
REPRESENTATIVE THOMPSON moved to report CSHB 15(EDC), as
amended, out of committee with individual recommendations and
the accompanying fiscal notes. There being no objection,
CSHB 15(JUD) was reported from the House Judiciary Standing
Committee.