I 

113TH CONGRESS 

2D SESSION H. R. 3954 

To provide for systemic research, surveillance, treatment, prevention, awareness, development of rules of play, standards, and dissemination of information with respect to sports-related and other concussions. 

IN THE HOUSE OF REPRESENTATIVES 

JANUARY 28, 2014 

Mrs. BEATTY (for herself, Mrs. WAGNER, Mr. RANGEL, Mr. CONYERS, Ms. 

KELLY of Illinois, and Ms. WILSON of Florida) introduced the following 

bill; which was referred to the Committee on Energy and Commerce, and 

in addition to the Committees on Armed Services and Education and the 

Workforce, for a period to be subsequently determined by the Speaker, 

in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned 

A BILL 

To provide for systemic research, surveillance, treatment, 

prevention, awareness, development of rules of play, 

standards, and dissemination of information with respect 

to sports-related and other concussions. 

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 Awareness 

5 and Education Act of 2014’’. 


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1 SEC. 2. TABLE OF CONTENTS. 

2 The table of contents of this Act is as follows: 

Sec. 1. Short title. 

Sec. 2. Table of contents. 

Sec. 3. Findings; purposes. 

Sec. 4. Surveillance of sports-related concussions. 

Sec. 5. Research. 

Sec. 6. Biological sample repository. 

Sec. 7. Rules of play. 

Sec. 8. Dissemination of information. 

Sec. 9. Concussion Research Commission. 

3 SEC. 3. FINDINGS; PURPOSES. 

4 (a) FINDINGS.—The Congress finds as follows: 

5 (1) There is currently no comprehensive system 

6 for acquiring accurate data on the incidence of 

7 sports- and recreation-related concussions across all 

8 youth age groups and sports. 

9 (2) Overall, according to a report entitled 

10 ‘‘Sports-Related Concussions in Youth: Improving 

11 the Science, Changing the Culture’’, issued by the 

12 National Academies in 2013, each year in the 

13 United States, there are approximately 1.6 to 3.8 

14 million sports- and recreation-related traumatic 

15 brain injuries, including concussions and other head 

16 injuries. These figures are based on conservative es17 timates. 

18 (3) A review of National Collegiate Athletic As19 sociation data for 15 sports showed that the overall 

20 reported concussion rate doubled from 1.7 to 3.4 

21 concussions per 1,000 athletic exposures over the 


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1 past 15 years, covering the 1988–1989 and 2003– 

2 2004 academic years. 

3 (4) Between 2001 and 2009, the reported num4 ber of our youth ages 19 and under treated for con5 cussion and other nonfatal, sports- and recreation6 related traumatic brain injuries increased from 

7 150,000 to 250,000. 

8 (5) Over the same time period between 2001 

9 and 2009, the rate of emergency room visits for con10 cussive injuries increased by 57 percent. 

11 (6) Yet, according to the National Academies 

12 there currently is— 

13 (A) a lack of data to accurately estimate 

14 the incidence of sports-related concussions 

15 across a variety of sports and for youth across 

16 the pediatric age spectrum; and 

17 (B) no comprehensive system for acquiring 

18 accurate data on the incidence of sports- and 

19 recreation-related concussions across all youth 

20 age groups and sports. 

21 (7) Currently, there are significant information 

22 gaps in the proper protocol for diagnosis and treat23 ment of sports-related concussions and more re24 search desperately is needed. 

25 (b) PURPOSES.—The purposes of this Act are— 


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1 (1) to increase awareness and knowledge about 

2 concussions through development of, implementation 

3 of, and evaluation of the effectiveness of, large-scale 

4 collaborative efforts and research by entities includ5 ing, but not limited to, national sports associations, 

6 State high school associations, trainers’ associations, 

7 appropriate Federal entities, and other stakeholders 

8 such as parents, coaches, and students; and 

9 (2) to change the culture (including social 

10 norms, attitudes, and behaviors) surrounding con11 cussions among elementary school through college12 aged youth and their parents, coaches, sports offi13 cials, educators, trainers, and health care profes14 sionals, taking into account demographic variations 

15 across population groups, where appropriate. 

16 SEC. 4. SURVEILLANCE OF SPORTS-RELATED CONCUS17 SIONS. 

18 Title III of the Public Health Service Act is amended 

19 by inserting after section 317T of such Act (42 U.S.C. 

20 247b–22) the following: 

21 ‘‘SEC. 317U. SURVEILLANCE OF SPORTS-RELATED CONCUS22 SIONS. 

23 ‘‘(a) IN GENERAL.—The Secretary of Health and 

24 Human Services, acting through the Director of the CenVerDate Mar 15 2010 00:39 Jan 31, 2014 Jkt 039200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\H3954.IH H3954

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1 ters for Disease Control and Prevention, and taking into 

2 account other Federal data collection efforts, shall— 

3 ‘‘(1) establish and oversee a national system to 

4 accurately determine the incidence of sports-related 

5 concussions; and 

6 ‘‘(2) begin implementation of such system not 

7 later than 1 year after the date of enactment of the 

8 Concussion Awareness and Education Act of 2014. 

9 ‘‘(b) DATA TO BE COLLECTED.—The data collected 

10 under subsection (a) shall, to the extent feasible, include 

11 each of the following: 

12 ‘‘(1) The incidence of sports related concussions 

13 in individuals 5 through 21 years of age. 

14 ‘‘(2) Demographic information of the injured 

15 individuals, including age, sex, race, and ethnicity. 

16 ‘‘(3) Pre-existing conditions of the injured indi17 viduals, such as attention deficit hyperactivity dis18 order and learning disabilities. 

19 ‘‘(4) The concussion history of the injured indi20 viduals, such as the number and dates of prior con21 cussions. 

22 ‘‘(5) The use of protective equipment and im23 pact monitoring devices. 

24 ‘‘(6) The qualifications of personnel diagnosing 

25 the concussions. 


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1 ‘‘(7) The cause, nature, and extent of the con2 cussive injury, including— 

3 ‘‘(A) the sport or activity involved; 

4 ‘‘(B) the recreational or competitive level 

5 of the sport or activity involved; 

6 ‘‘(C) the event type involved, including 

7 whether it was practice or competition; 

8 ‘‘(D) the impact location on the body; 

9 ‘‘(E) the impact nature, such as contact 

10 with a playing surface, another player, or equip11 ment; and 

12 ‘‘(F) signs and symptoms consistent with a 

13 concussion.’’. 

14 SEC. 5. RESEARCH. 

15 (a) IN GENERAL.—Beginning not later than 1 year 

16 after the date of enactment of this Act, the Director of 

17 the National Institutes of Health and the Secretary of De18 fense, acting in coordination, shall conduct or support— 

19 (1) research designed to— 

20 (A) establish objective, sensitive, and spe21 cific metrics and markers of concussion diag22 nosis, prognosis, and recovery in youth; and 

23 (B) inform the creation of age-specific, evi24 dence-based guidelines for the management of 


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1 short- and long-term sequelae of concussion in 

2 youth; 

3 (2) controlled, longitudinal, large-scale studies 

4 to assess short- and long-term cognitive, emotional, 

5 behavioral, neurobiological, and neuropathological 

6 consequences of concussions and repetitive head im7 pacts over a life span, including— 

8 (A) an examination of the effects of con9 cussions and repetitive head impacts on quality 

10 of life and the activities of daily living; and 

11 (B) identification of predictors and modi12 fiers of outcomes, including the influence of so13 cioeconomic status, race, ethnicity, sex, and 

14 comorbidities; and 

15 (3) research on age- and sex-related biomechan16 ical determinants of injury risk for concussion in 

17 youth, including how injury thresholds are modified 

18 by the number of and time interval between head 

19 impacts and concussions. 

20 (b) SPORTS AND PHYSICAL TRAINING AT MILITARY

21 ACADEMIES AND FOR MILITARY PERSONNEL.—Beginning 

22 not later than 1 year after the date of enactment of this 

23 Act, the Secretary of Defense shall conduct a rigorous sci24 entific evaluation of the effectiveness of techniques, rules, 

25 and playing, practice, and training standards in reducing 


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1 concussions and sequelae for sports and physical training, 

2 including combatives, at military service academies and 

3 for military personnel. 

4 (c) SENSE OF CONGRESS.—It is the sense of the Con5 gress that the National Collegiate Athletic Association, in 

6 conjunction with the National Federation of State High 

7 School Associations, national governing bodies for youth 

8 sports, and youth sports organizations, should undertake 

9 a rigorous scientific evaluation of the effectiveness of age10 appropriate techniques, rules, and playing and practice 

11 standards in reducing sports-related concussions and 

12 sequelae. 

13 SEC. 6. BIOLOGICAL SAMPLE REPOSITORY. 

14 (a) IN GENERAL.—To aid research under this Act 

15 and any other similar research, the Secretary of Health 

16 and Human Services, acting through the Director of the 

17 National Institutes of Health, shall maintain a national 

18 brain tissue and biological sample repository to collect, ar19 chive, and distribute material for research on concussions. 

20 (b) TIMING.—The Secretary shall begin implementa21 tion of the repository not later than 1 year after the date 

22 of enactment of this Act. 

23 SEC. 7. RULES OF PLAY. 

24 (a) DEVELOPMENT.—The Director of the National 

25 Institutes of Health and the Secretary of Defense, taking 


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1 into consideration the results of research, shall develop 

2 standards, best practices, and guidelines for the rules of 

3 play and training, respectively, for sports, athletic, and 

4 military training and engagement that— 

5 (1) are designed to prevent or reduce the inci6 dence of concussions; and 

7 (2) include— 

8 (A) standards for effective protective 

9 equipment; and 

10 (B) recommendations on impact-moni11 toring systems. 

12 (b) TIMING.—The Director of the National Institutes 

13 of Health and the Secretary of Defense shall— 

14 (1) begin development of the rules of play 

15 under this section not later than 1 year after the 

16 date of enactment of this Act; and 

17 (2) after such rules of play are finalized, peri18 odically review and update such rules of play as ap19 propriate. 

20 SEC. 8. DISSEMINATION OF INFORMATION. 

21 (a) IN GENERAL.—The Secretary of Health and 

22 Human Services, acting through the Director of the Cen23 ters for Disease Control and Prevention, shall develop and 

24 disseminate to the public information regarding concus25 sions. 


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1 (b) ARRANGEMENTS WITH OTHER ENTITIES.—In 

2 carrying out paragraph (1), the Secretary may dissemi3 nate information through arrangements with nonprofit or4 ganizations, consumer groups, institutions of higher edu5 cation, Federal, State, or local agencies, or the media. 

6 SEC. 9. CONCUSSION RESEARCH COMMISSION. 

7 (a) ESTABLISHMENT.—There is established a Con8 cussion Research Commission (referred to in this section 

9 as the ‘‘Commission’’). 

10 (b) MEMBERSHIP.— 

11 (1) APPOINTMENT.—The Commission shall be 

12 composed of the following nine members: 

13 (A) Five shall be appointed by the Presi14 dent. 

15 (B) One shall be appointed by the Speaker 

16 of the House of Representatives. 

17 (C) One shall be appointed by the minority 

18 leader of the House of Representatives. 

19 (D) One shall be appointed by the majority 

20 leader of the Senate. 

21 (E) One shall be appointed by the minority 

22 leader of the Senate. 

23 (2) QUALIFICATIONS.—To be eligible for ap24 pointment under paragraph (1), an individual 

25 shall— 


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1 (A) have experience with research, treat2 ment, and prevention with respect to all types 

3 of concussive injuries; and 

4 (B) be a leading medical or scientific ex5 pert, or an otherwise authoritatively qualified 

6 expert, in one or more relevant fields. 

7 (3) TERMS.—Each member of the Commission 

8 shall be appointed for the life of the Commission. 

9 (4) VACANCIES.—Any member appointed to fill 

10 a vacancy occurring before the expiration of the 

11 term for which the member’s predecessor was ap12 pointed shall be appointed only for the remainder of 

13 that term. A member may serve after the expiration 

14 of that member’s term until a successor has taken 

15 office. A vacancy in the Commission shall be filled 

16 in the manner in which the original appointment was 

17 made. 

18 (5) NO PAY.—The members of the Commission 

19 shall serve without pay. Members of the Commission 

20 who are full-time officers or employees of the United 

21 States or Members of Congress may not receive ad22 ditional pay, allowances, or benefits by reason of 

23 their service on the Commission. 

24 (6) TRAVEL EXPENSES.—Each member of the 

25 Commission shall receive travel expenses, including 


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1 per diem in lieu of subsistence, in accordance with 

2 applicable provisions under subchapter I of chapter 

3 57 of title 5, United States Code. 

4 (7) RESOURCES.—The Secretary shall ensure 

5 that appropriate personnel, funding, and other re6 sources are provided to the Committee to carry out 

7 its responsibilities. 

8 (c) MEETINGS.—The Commission shall meet at least 

9 4 times each year. 

10 (d) STAFF OF FEDERAL AGENCIES.—Upon request 

11 of the Commission, the head of any Federal department 

12 or agency may detail, without reimbursement, any of the 

13 personnel of that department or agency to the Commission 

14 to assist in carrying out this section. 

15 (e) STUDY.—The Commission shall— 

16 (1) study the programs and activities conducted 

17 pursuant to this Act; and 

18 (2) based on the results of such programs and 

19 activities, formulate systemic recommendations for 

20 furthering the purposes of this Act, as described in 

21 section 3(b). 

22 (f) REVIEW OF NATIONAL ACADEMIES REPORT.— 

23 The Commission shall review the report of the National 

24 Academies entitled ‘‘Sports-Related Concussions in Youth: 

25 Improving the Science, Changing the Culture’’ and recVerDate Mar 15 2010 00:39 Jan 31, 2014 Jkt 039200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6201 E:\BILLS\H3954.IH H3954

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1 ommend corrections or updates to such report, as the 

2 Commission determines appropriate. 

3 (g) REPORTING.— 

4 (1) INTERIM REPORTS.—Every 6 months, the 

5 Commission shall submit to the appropriate commit6 tees of Congress an interim report on the Commis7 sion’s activities. 

8 (2) FINAL REPORT.—Not later than 36 months 

9 after the date of enactment of this Act, the Commis10 sion shall submit to the appropriate committees of 

11 Congress, and make available to the public, a final 

12 report on the results of the Commission’s study 

13 under subsection (e) and review under subsection 

14 (f). 

15 (h) TERMINATION.—The Commission shall terminate 

16 upon the date of submission of the final report required 

17 by subsection (g)(2), unless the Secretary of Health and 

18 Human Services chooses to maintain the Commission be19 yond such date. 

Æ 


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