II 

113TH CONGRESS 

1ST SESSION S. 1516 

To amend title III of the Public Health Service Act to provide for the 

establishment and implementation of guidelines on best practices for 

diagnosis, treatment, and management of mild traumatic brain injuries 

(MTBIs) in school-aged children, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 18, 2013 

Mr. MENENDEZ introduced the following bill; which was read twice and 

referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To amend title III of the Public Health Service Act to 

provide for the establishment and implementation of 

guidelines on best practices for diagnosis, treatment, and 

management of mild traumatic brain injuries (MTBIs) 

in school-aged children, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Concussion Treatment 

5 and Care Tools Act of 2013’’ or the ‘‘ConTACT Act of 

6 2013’’. 


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1 SEC. 2. FINDINGS. 

2 Congress finds the following: 

3 (1) Concussions are mild traumatic brain inju4 ries, the long-term effects of which are not well un5 derstood. 

6 (2) According to the Centers for Disease Con7 trol and Prevention (CDC), each year United States 

8 emergency departments treat an estimated 173,285 

9 sports- and recreation-related mild traumatic brain 

10 injuries (MTBIs), including concussions, among chil11 dren and adolescents, from birth to 19 years of age. 

12 However, this number does not capture the total 

13 number, as many MTBIs go undiagnosed. 

14 (3) There is an increased risk for subsequent 

15 brain injuries among persons who have had at least 

16 one previous brain injury. 

17 (4) A repeat concussion, one that occurs before 

18 the brain recovers from a previous concussion, can 

19 slow recovery or increase the likelihood of having 

20 long-term problems. 

21 (5) In rare cases, repeat concussions can result 

22 in second impact syndrome, which can be marked by 

23 brain swelling, permanent brain damage, and death. 

24 (6) Recurrent brain injuries and second impact 

25 syndrome are highly preventable. 


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1 (7) Many States have adopted concussion man2 agement rules and regulations, but many schools 

3 lack the resources to implement best practices in 

4 concussion diagnosis and management. 

5 SEC. 3. GUIDELINES ON BEST PRACTICES FOR DIAGNOSIS, 

6 TREATMENT, AND MANAGEMENT OF MILD 

7 TRAUMATIC BRAIN INJURIES IN SCHOOL8 AGED CHILDREN. 

9 Part B of title III of the Public Health Service Act 

10 6 (42 U.S.C. 243 et seq.) is amended by inserting after 

11 section 317T the following: 

12 ‘‘SEC. 317U. GUIDELINES ON BEST PRACTICES FOR DIAG13 NOSIS, TREATMENT, AND MANAGEMENT OF 

14 MILD TRAUMATIC BRAIN INJURIES IN 

15 SCHOOL-AGED CHILDREN. 

16 ‘‘(a) GUIDELINES.— 

17 ‘‘(1) BY SECRETARY.—Not later than 90 days 

18 after issuance of the final report under paragraph 

19 (2), the Secretary shall establish guidelines for 

20 States on the implementation of best practices for 

21 diagnosis, treatment, and management of MTBIs in 

22 school-aged children. 

23 ‘‘(2) BY PANEL.—Not later than March 15, 

24 2015, the Pediatric MTBI Guideline Expert Panel 

25 of the Centers for Disease Control and Prevention 


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1 shall issue a final report on best practices for diag2 nosis, treatment, and management of MTBIs in 

3 school-aged children. 

4 ‘‘(3) STUDENT ATHLETES RETURNING TO

5 PLAY.—The guidelines under paragraph (1) and the 

6 report under paragraph (2) shall address best prac7 tices for diagnosis, treatment, and management of 

8 MTBIs in student athletes returning to play after an 

9 MTBI. 

10 ‘‘(b) GRANTS TO STATES.— 

11 ‘‘(1) IN GENERAL.—After establishing the 

12 guidelines under subsection (a)(1), the Secretary 

13 may make grants to States for purposes of— 

14 ‘‘(A) adopting such guidelines, and dis15 seminating such guidelines to elementary and 

16 secondary schools; and 

17 ‘‘(B) ensuring that elementary and sec18 ondary schools— 

19 ‘‘(i) implement such guidelines; 

20 ‘‘(ii) are adequately staffed with ath21 letic trainers and other medical profes22 sionals necessary to implement such guide23 lines; and 


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1 ‘‘(iii) implement computerized pre-sea2 son baseline and post-injury neuro3 psychological testing for student athletes. 

4 ‘‘(2) GRANT APPLICATIONS.— 

5 ‘‘(A) IN GENERAL.—To be eligible to re6 ceive a grant under this section, a State shall 

7 submit an application to the Secretary at such 

8 time, in such manner, and containing such in9 formation as the Secretary may require. 

10 ‘‘(B) MINIMUM CONTENTS.—The Secretary 

11 shall require that an application of a State 

12 under subparagraph (A) contain at a min13 imum— 

14 ‘‘(i) a description of the strategies the 

15 State will use to disseminate the guidelines 

16 under subsection (a)(1) to elementary and 

17 secondary schools, and to ensure imple18 mentation of such guidelines by such 

19 schools, including any strategic partner20 ships that the State will form; and 

21 ‘‘(ii) an agreement by the State to pe22 riodically provide data with respect to the 

23 incidence of MTBIs and second impact 

24 syndrome among student athletes in the 

25 State. 


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1 ‘‘(3) UTILIZATION OF HIGH SCHOOL SPORTS

2 ASSOCIATIONS AND LOCAL CHAPTERS OF NATIONAL

3 BRAIN INJURY ORGANIZATIONS.—The Secretary 

4 shall require States receiving grants under this sec5 tion to utilize, to the extent practicable, applicable 

6 expertise and services offered by high school sports 

7 associations and local chapters of national brain in8 jury organizations in such States. 

9 ‘‘(c) COORDINATION OF ACTIVITIES.—In carrying 

10 out this section, the Secretary shall coordinate in an ap11 propriate manner with the heads of other Federal depart12 ments and agencies that carry out activities related to 

13 MTBIs. 

14 ‘‘(d) REPORT TO CONGRESS.—Not later than 4 years 

15 after the date of the enactment of this section, the Sec16 retary shall submit to Congress a report on the implemen17 tation of subsection (b) and shall include in such report— 

18 ‘‘(1) the number of States that have adopted 

19 the guidelines under subsection (a)(1); 

20 ‘‘(2) the number of elementary and secondary 

21 schools that have implemented computerized pre-sea22 son baseline and post-injury neuro-psychological 

23 testing for student athletes; and 


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1 ‘‘(3) the data collected with respect to the inci2 dence of MTBIs and second impact syndrome among 

3 student athletes. 

4 ‘‘(e) DEFINITIONS.—In this section, the following 

5 definitions apply: 

6 ‘‘(1) The term ‘MTBI’ means a mild traumatic 

7 brain injury. 

8 ‘‘(2) The term ‘school-aged child’ means an in9 dividual in the range of 5 through 18 years of age. 

10 ‘‘(3) The term ‘second impact syndrome’ means 

11 catastrophic or fatal events that occur when an indi12 vidual suffers an MTBI while symptomatic and heal13 ing from a previous MTBI. 

14 ‘‘(4) The term ‘Secretary’ means the Secretary 

15 of Health and Human Services, acting through the 

16 Director of the Centers for Disease Control and Pre17 vention. 

18 ‘‘(5) The term ‘State’ means each of the 50 

19 States and the District of Columbia. 

20 ‘‘(6) The term ‘student athlete’ means a school21 aged child in any of the grades 6th through 12th 

22 who participates in a sport through such child’s ele23 mentary or secondary school. 

24 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—To 

25 carry out this section, there are authorized to be approVerDate Mar 15 2010 23:11 Sep 18, 2013 Jkt 029200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1516.IS S1516

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1 priated $5,000,000 for fiscal year 2016 and such sums 

2 as may be necessary for each of fiscal years 2017 through 

3 2020.’’. 

Æ 


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