I 

112TH CONGRESS 

1ST SESSION H. R. 469 

To promote minimum State requirements for the prevention and treatment 

of concussions caused by participation in school sports, and for other 

purposes. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 26, 2011 

Mr. BISHOP of New York (for himself, Mr. GEORGE MILLER of California, 

Mr. KUCINICH, Mr. ANDREWS, Mr. HOLT, Mr. LOEBSACK, Mrs. MCCARTHY of New York, Ms. WOOLSEY, Mr. POLIS, Ms. HIRONO, and Mr. 

GRIJALVA) introduced the following bill; which was referred to the Committee on Education and the Workforce 

A BILL 

To promote minimum State requirements for the prevention 

and treatment of concussions caused by participation 

in school sports, 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 ‘‘Protecting Student 

5 Athletes from Concussions Act of 2011’’. 

6 SEC. 2. FINDINGS. 

7 The Congress finds the following: 


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1 (1) Involvement in sports can have tremendous 

2 benefits for the physical, social, emotional, and cog3 nitive development of students. 

4 (2) All students have the right to know the 

5 risks of concussions because concussions, though a 

6 mild traumatic brain injury, present such a signifi7 cant risk to not only the physical well-being of a de8 veloping student, but also the academic performance 

9 of the student. 

10 (3) Mild traumatic brain injuries, including 

11 concussions, represent 80 to 90 percent of all trau12 matic brain injuries. 

13 (4) Children and adolescents are more vulner14 able to brain injury than adults because their brains 

15 are still developing. 

16 (5) Surveys suggest that the prevalence of 

17 sport-related concussions is much higher than re18 ported and the occurrence of concussions is higher 

19 at the high school level than at the collegiate level. 

20 According to recent research, 400,000 students sus21 tained a concussion while participating in five dif22 ferent sports in a high school athletics program dur23 ing the 2005–2008 school years. Few statistics are 

24 available for the 41 million children participating in 

25 non-scholastic youth sports, but schools report that 


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1 concussions are occurring on the playground and 

2 during physical education classes. 

3 (6) A recent study estimated that more than 40 

4 percent of high school athletes return to participate 

5 in school athletics before they have fully recovered 

6 from concussions, which increases the susceptibility 

7 of the student athlete to greater injury or death. 

8 (7) The failure to recognize brain injuries and 

9 the mismanagement of such injuries increases the 

10 vulnerability of a student athlete to successive in11 jury, cumulative negative health consequences, or 

12 chronic impairment. 

13 (8) Timely recognition and response to concus14 sions aids recovery and helps prevent successive in15 jury, chronic impairment, or death. Only 42 percent 

16 of schools have access to an athletic trainer and only 

17 53 percent of schools meet the nurse-to-student ratio 

18 recommended by the Federal Government. 

19 (9) Concussion treatment and management is 

20 sporadic in schools and often neglects the athlete’s 

21 role as a student. 

22 (10) Medical care from hospitalization and 

23 emergency room visits due to a concussion is costly, 

24 and treatment is often arbitrary. 


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1 (11) Students should gradually return to phys2 ical activity and academic activities only as the 

3 symptoms of a concussion permit because research 

4 suggests that overexertion from physical activity and 

5 academic activities exacerbates symptoms and pro6 tracts recovery time for student athletes. 

7 (12) Instituting best practices offers a reason8 able means for protecting student athletes from the 

9 risks and consequences of concussions. 

10 SEC. 3. MINIMUM STATE REQUIREMENTS. 

11 Beginning with fiscal year 2013, in order to be eligi12 ble to receive funds for such year or a subsequent fiscal 

13 year under the Elementary and Secondary Education Act 

14 of 1965 (20 U.S.C. 6301 et seq.) each State educational 

15 agency shall issue regulations establishing the following 

16 minimum requirements: 

17 (1) LOCAL EDUCATIONAL AGENCY CONCUSSION

18 SAFETY AND MANAGEMENT PLAN.—Each local edu19 cational agency in the State, in consultation with 

20 members of the community in which such agency is 

21 located, shall develop and implement a standard plan 

22 for concussion safety and management that in23 cludes— 

24 (A) the education of students, parents, and 

25 school personnel about concussions, such as— 


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1 (i) the training and certification of 

2 school personnel, including coaches, ath3 letic trainers, and school nurses, on con4 cussion safety and management; and 

5 (ii) using and maintaining standard6 ized release forms, treatment plans, obser7 vation, monitoring and reporting forms, 

8 recordkeeping forms, and post-injury fact 

9 sheets; 

10 (B) supports for students recovering from 

11 a concussion, such as— 

12 (i) guiding such student in resuming 

13 participation in athletic activity and aca14 demic activities with the help of a multi15 disciplinary team, which may include— 

16 (I) a health care professional, the 

17 parents of such student, a school 

18 nurse, or other relevant school per19 sonnel; and 

20 (II) an individual who is assigned 

21 by a public school to oversee and 

22 manage the recovery of such student; 

23 (ii) providing appropriate academic 

24 accommodations; and 


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1 (iii) referring students whose symp2 toms of concussion reemerge or persist 

3 upon the reintroduction of cognitive and 

4 physical demands for evaluation of the eli5 gibility of such students for services under 

6 the Individual with Disabilities Education 

7 Act (20 U.S.C. 1400 et seq.) and the Re8 habilitation Act of 1973 (29 U.S.C. 701 

9 note et seq.); and 

10 (C) best practices designed to ensure, with 

11 respect to concussions, the uniformity of safety 

12 standards, treatment, and management, such 

13 as— 

14 (i) disseminating information on con15 cussion management safety and manage16 ment to the public; and 

17 (ii) applying uniform standards for 

18 concussion safety and management to all 

19 students enrolled in public schools. 

20 (2) POSTING OF INFORMATION ON CONCUS21 SIONS.—Each public elementary school and each 

22 secondary school shall post on school grounds, in a 

23 manner that is visible to students and school per24 sonnel, and make publicly available on the school 

25 website, information on concussions that— 


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1 (A) is based on peer-reviewed scientific evi2 dence (such as information made available by 

3 the Centers for Disease Control and Preven4 tion); 

5 (B) shall include— 

6 (i) the risks posed by sustaining a 

7 concussion; 

8 (ii) the actions a student should take 

9 in response to sustaining a concussion, in10 cluding the notification of school personnel; 

11 and 

12 (iii) the signs and symptoms of a con13 cussion; and 

14 (C) may include— 

15 (i) the definition of a concussion; 

16 (ii) the means available to the student 

17 to reduce the incidence or recurrence of a 

18 concussion; and 

19 (iii) the effects of a concussion on 

20 academic learning and performance. 

21 (3) RESPONSE TO CONCUSSION.—If any school 

22 personnel, including coaches and athletic trainers, of 

23 a public school suspects that a student has sustained 

24 a concussion during a school-sponsored athletic ac25 tivity— 


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1 (A) the student shall be— 

2 (i) immediately removed from partici3 pation in such activity; and 

4 (ii) prohibited from returning to par5 ticipate in school-sponsored athletic activi6 ties— 

7 (I) on the day such student sus8 tained a concussion; and 

9 (II) until such student submits a 

10 written release from a health care 

11 professional stating that the student 

12 is capable of resuming participation in 

13 school-sponsored athletic activities; 

14 and 

15 (B) such personnel shall report to the par16 ent or guardian of such student— 

17 (i) the date, time, and extent of the 

18 injury suffered by such student; and 

19 (ii) any actions taken to treat such 

20 student. 

21 (4) RETURN TO ATHLETICS AND ACADEMICS.— 

22 Before a student who has sustained a concussion in 

23 a school-sponsored athletic activity resumes partici24 pation in school-sponsored athletic activities or acaVerDate Mar 15 2010 01:00 Feb 03, 2011 Jkt 099200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\H469.IH H469

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1 demic activities, the school shall receive a written re2 lease from a health care professional, that— 

3 (A) states that the student is capable of 

4 resuming participation in such activities; and 

5 (B) may require the student to follow a 

6 plan designed to aid the student in recovering 

7 and resuming participation in such activities in 

8 a manner that— 

9 (i) is coordinated, as appropriate, with 

10 periods of cognitive and physical rest while 

11 symptoms of a concussion persist; and 

12 (ii) reintroduces cognitive and phys13 ical demands on such student on a pro14 gressive basis only as such increases in ex15 ertion do not cause the reemergence or 

16 worsening of symptoms of a concussion. 

17 SEC. 4. REPORT TO SECRETARY OF EDUCATION. 

18 Not later than 6 months after promulgating regula19 tions pursuant to section 3 in order to be eligible to receive 

20 funds under the Elementary and Secondary Education Act 

21 of 1965 (20 U.S.C. 6301 et seq.), each State educational 

22 agency shall submit to the Secretary of Education a report 

23 that contains— 

24 (1) a description of the State regulations pro25 mulgated pursuant to section 3; and 


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1 (2) an assurance that the State has imple2 mented such regulations. 

3 SEC. 5. RULE OF CONSTRUCTION. 

4 Nothing in this Act shall be construed to alter or su5 persede State law with respect to education standards or 

6 procedures or civil liability. 

7 SEC. 6. DEFINITIONS. 

8 In this Act: 

9 (1) CONCUSSION.—The term ‘‘concussion’’ 

10 means a type of traumatic brain injury that— 

11 (A) is caused by a blow, jolt, or motion to 

12 the head or body that causes the brain to move 

13 rapidly in the skull; 

14 (B) disrupts normal brain functioning and 

15 alters the mental state of the individual, caus16 ing the individual to experience— 

17 (i) any period of observed or self-re18 ported — 

19 (I) transient confusion, dis20 orientation, or impaired consciousness; 

21 (II) dysfunction of memory 

22 around the time of injury; and 

23 (III) loss of consciousness lasting 

24 less than 30 minutes; 


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1 (ii) any one of four types of symptoms 

2 of a headache, including— 

3 (I) physical symptoms, such as 

4 headache, fatigue, or dizziness; 

5 (II) cognitive symptoms, such as 

6 memory disturbance or slowed think7 ing; 

8 (III) emotional symptoms, such 

9 as irritability or sadness; and 

10 (IV) difficulty sleeping; and 

11 (C) can occur— 

12 (i) with or without the loss of con13 sciousness; and 

14 (ii) during participation in any orga15 nized sport or recreational activity. 

16 (2) HEALTH CARE PROFESSIONAL.—The term 

17 ‘‘health care professional’’ means a physician, nurse, 

18 certified athletic trainer, physical therapist, 

19 neuropsychologist or other qualified individual 

20 who— 

21 (A) is a registered, licensed, certified, or 

22 otherwise statutorily recognized by the State to 

23 provide medical treatment; 


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1 (B) is experienced in the diagnosis and 

2 management of traumatic brain injury among a 

3 pediatric population; and 

4 (C) may be a volunteer. 

5 (3) LOCAL EDUCATIONAL AGENCY; STATE EDU6 CATIONAL AGENCY.—The terms ‘‘local educational 

7 agency’’ and ‘‘State educational agency’’ have the 

8 meanings given such terms in section 9101 of the 

9 Elementary and Secondary Education Act of 1965 

10 (20 U.S.C. 7801). 

11 (4) SCHOOL PERSONNEL.—The term ‘‘school 

12 personnel’’ has the meaning given such term in sec13 tion 4151 of the Elementary and Secondary Edu14 cation Act of 1965 (20 U.S.C. 7161). 

15 (5) SCHOOL-SPONSORED ATHLETIC ACTIVITY.— 

16 The term ‘‘school-sponsored athletic activity’’ 

17 means— 

18 (A) any physical education class or pro19 gram of a school; 

20 (B) any athletic activity authorized during 

21 the school day on school grounds that is not an 

22 instructional activity; and 


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1 (C) any extracurricular sports team, club, 

2 or league organized by a school on or off school 

3 grounds. 

Æ 


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