HOUSE OF REPRESENTATIVES	H.B. NO.	302
TWENTY-SEVENTH LEGISLATURE, 2013
STATE OF HAWAII

A BILL FOR AN ACT

Relating to head injuries.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF HAWAII:

     SECTION 1.  The legislature finds that Act 197, Session Laws of Hawaii 2012, was enacted to require the department of education and the Hawaii High School Athletic Association to develop a concussion education program for students who are fourteen to eighteen years old.  Act 197 requires, in part: (1) the immediate removal of a student who exhibits signs, symptoms, or behaviors consistent with a concussion from a game, practice, or other activity; and (2) clearance by a licensed health care provider before the student can return to the activity.

     The legislature finds that head injuries, including but not limited to concussions and traumatic brain injuries, are sustained by children nineteen years old or younger.  According to the Centers for Disease Control and Prevention, from 2001 to 2009, the number of emergency department visits for traumatic brain injuries sustained during sports and recreational activities among children and adolescents nineteen years old or younger increased by sixty-two per cent.

The purpose of this Act is to amend Act 197, Session Laws of Hawaii 2012, to:

(1) Expand the concussion education program to include all

    head injuries under a head injury education program;

(2) Extend the head injury education program and program

    protocols to all public and private school students who

    are nineteen years old or younger, which shall include

but is not limited to student athletes, including student cheerleaders; and

(3) Implement a provision to provide immunity to public and

    private school staff and volunteers who comply with the

    head injury education program and program protocols.

     SECTION 2.  Act 197, Session Laws of Hawaii 2012, is amended by amending section 1 to read as follows:

     "SECTION 1.  The legislature finds that head injuries, including but not limited to concussions [or mild] and traumatic brain injuries sustained by children and adolescents, frequently occur in a variety of sports and recreational activities, including football, soccer, bicycling, and skateboarding.  In October 2011, the Centers for Disease Control and Prevention reported that the number of traumatic brain injury-related emergency department visits in this country by persons nineteen years old or younger that were related to sports and recreational activities increased from 153,375 in 2001 to 248,418 in 2009.  In this State, the department of education's athletic health care trainers program also noted an increase in the number of reported concussions, from two hundred thirteen in the 2007-2008 school year to four hundred forty-six in the 2010-2011 school year.

     The marked increase in national and state [concussion] statistics may be attributed, at least in part, to an increased awareness of the dangers of concussions by the people involved in sports activities.  The department of education began its concussion management program in 2011 to educate coaches, parents, and athletic trainers, and provide care for students.  The legislature finds, however, that a statewide [concussion] head injury educational program is necessary to ensure that public and private high school students, school personnel, and parents are provided with consistent and up-to-date information on [concussions] head injuries and management of symptoms [and injuries] relating to a [concussion.] head injury.

     The purpose of this Act is to require the department of education, private educational institutions, and the Hawaii High School Athletic Association to develop a [concussion] head injury educational program for students [and student athletes], which shall include but is not limited to student athletes, including student cheerleaders, who are [fourteen to eighteen years old.] nineteen years old or younger.  The program shall include:

     (1)  Education of students, student athletes, including student cheerleaders, parents, sports officials, school faculty and staff, and school administrators of the signs and symptoms of a [concussion] head injury and what to do if someone demonstrates any of these signs or symptoms;

     (2)  An annual educational session for coaches and athletic trainers about the signs and symptoms of a [concussion] head injury;

     (3)  The need for the mandatory removal of a student from the athletic or recreational activity that the student is participating in if the student demonstrates any signs or symptoms of a [concussion; and] head injury; and

     (4)  The need for a [concussed student's physician] licensed health care provider to evaluate the [student] student's head injury and determine whether the student is able to return to a particular athletic or recreational activity."

     SECTION 3.  Act 197, Session Laws of Hawaii 2012, is amended by amending section 2 to read as follows:

     "SECTION 2.  As used in this Act, the following definitions apply:

     "Coach" means a paid or volunteer coach.

     "Concussion" means [a pathophysiological process affecting the brain, caused by traumatic biomechanical forces] a transient and reversible change in mental status resulting from head trauma that can last from seconds to hours.  Symptoms may include nausea, headache, dizziness, memory loss, and loss of consciousness.

"Head injury" means any trauma that leads to injury to the scalp, skull, or brain and includes but is not limited to a concussion or traumatic brain injury.

     "Licensed health care provider" means an advanced practice registered nurse, certified or registered athletic trainer, neuropsychologist, physician assistant, physician, or osteopathic physician trained in the management of sports concussions.

"Student" means any child who is nineteen years old or younger enrolled in grades twelve or under at a public or private school."

     SECTION 4.  Act 197, Session Laws of Hawaii 2012, is amended by amending section 3 to read as follows:

     "SECTION 3.  The department of education, private educational institutions, and the Hawaii High School Athletic Association shall develop a [concussion] head injury educational program that shall include:

     (1)  Educating students, parents, sports officials, school faculty, coaches, staff, and school administrators about the signs and symptoms of a [concussion] head injury and the procedures to follow if a person displays any of the signs or symptoms of a [concussion;] head injury;

     (2)  Annual educational sessions about the signs and symptoms of a [concussion] head injury for coaches and athletic trainers;

     (3)  The need for the mandatory removal of a student from the athletic or recreational activity that the student is participating in, if the student demonstrates any signs and symptoms of a [concussion;] head injury;

     (4)  The need for a [concussed student's] licensed health care provider to evaluate the [student] student's head injury and determine whether the student is able to return to a particular athletic or recreational activity; and

     (5)  The monitoring of a student's return to physical activity by the school or the school's certified athletic trainer, if an athletic trainer is employed by the school.  This return to activity plan is to be based upon peer-review scientific evidence, such as that from the National Athletic Trainer Association or Centers for Disease Control and Prevention."

     SECTION 5.  Act 197, Session Laws of Hawaii 2012, is amended by amending section 4 to read as follows:

     "SECTION 4.  Educational guidelines for development of a [high] school [concussion] head injury awareness program.  There shall be an educational program developed for every public and private school [that is a member of the Hawaii High School Athletic Association] on how to develop a school's [concussion] head injury awareness plan.  Every program shall require:

     (1)  Annual [concussion] head injury awareness training for coaches, administrators, faculty, staff, and sports officials, including:

         (A)  The signs and symptoms of a [concussion;] head injury;

         (B)  The need to obtain proper medical attention for a person suspected of having a [concussion; and] head injury; and

         (C)  Information on the nature and risk of [concussions,] head injuries, including the danger of continuing to play after sustaining a [concussion] head injury and the proper method of allowing a student who has sustained a [concussion] head injury to return to activity;

     (2)  Annual [concussion] head injury awareness education for parents and students who participate in a school's athletic team [or], athletic program, recreational programs, or [both.] any combination thereof.  The parents and students shall sign a [concussion] head injury information sheet documenting that they have attended and received this [concussion] head injury awareness education;

     (3)  Immediate removal from a game, practice, or other activity of any student who exhibits signs, symptoms, or behaviors consistent with a [concussion,] head injury, such as excessive irritability, fatigue, nausea, bruising behind the ear or around the eyes, loss of consciousness, headache, lightheadedness, dizziness, confusion, or balance problems.  The student shall not return to the activity until cleared to do so by a licensed health care provider; and

     (4)  The student to obtain written clearance from a licensed health care provider prior to returning to academics and athletics, which:

         (A)  States that the student is capable of resuming participation in a particular sport[;] or recreational activity;

         (B)  May require the student to follow a plan designed to aid the student to recover and resume participation in school and athletic or recreational activities that:

              (i)  [Includes,] Include, as appropriate, periods of cognitive and physical rest while symptoms of a [concussion] head injury persist; and

             (ii)  [Reintroduces] Reintroduce cognitive and physical demands on the student on a progressive basis to prevent the reemergence or worsening of symptoms of a [concussion; and] head injury; and

         (C)  [Requires] Require that the student's return to physical activity be monitored by the school or school's certified athletic trainer, if an athletic trainer is employed by the school.

Any public or private school coach, administrator, faculty, staff, sports official, or volunteer acting in accordance with Section 4 of this Act shall not be liable for the injury or death of a student who sustains or is suspected of having sustained a head injury while engaged in a sport or recreational activity."

     SECTION 6.  Session law material to be repealed is bracketed and stricken.  New session law material is underscored.

     SECTION 7.  This Act shall take effect upon its approval.

INTRODUCED BY:	_____________________________
	_____________________________

Report Title:

Head Injury; Head Injury Awareness Program; Students

Description:

Amends Act 197, Session Laws of Hawaii 2012, to expand the concussion education program to include all head injuries, extend the head injury education program to certain public and private school students, and provide immunity to those who comply with program protocols.  

The summary description of legislation appearing on this page is for informational purposes only and is not legislation or evidence of legislative intent.