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. MCCAR-
THY of New York, Ms. WOOLSEY, Mr. POLIS, Ms. HIRONO, and Mr. 
GRIJALVA) introduced the following bill; which was referred to the Com-
mittee 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. 
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Protecting Student 
Athletes from Concussions Act of 2011’’. 
SEC. 2. FINDINGS. 
The Congress finds the following: 
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(1) Involvement in sports can have tremendous 
benefits for the physical, social, emotional, and cog-
nitive development of students. 
(2) All students have the right to know the 
risks of concussions because concussions, though a 
mild traumatic brain injury, present such a signifi-
cant risk to not only the physical well-being of a de-
veloping student, but also the academic performance 
of the student. 
(3) Mild traumatic brain injuries, including 
concussions, represent 80 to 90 percent of all trau-
matic brain injuries. 
(4) Children and adolescents are more vulner-
able to brain injury than adults because their brains 
are still developing. 
(5) Surveys suggest that the prevalence of 
sport-related concussions is much higher than re-
ported and the occurrence of concussions is higher 
at the high school level than at the collegiate level. 
According to recent research, 400,000 students sus-
tained a concussion while participating in five dif-
ferent sports in a high school athletics program dur-
ing the 2005–2008 school years. Few statistics are 
available for the 41 million children participating in 
non-scholastic youth sports, but schools report that 
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concussions are occurring on the playground and 
during physical education classes. 
(6) A recent study estimated that more than 40 
percent of high school athletes return to participate 
in school athletics before they have fully recovered 
from concussions, which increases the susceptibility 
of the student athlete to greater injury or death. 
(7) The failure to recognize brain injuries and 
the mismanagement of such injuries increases the 
vulnerability of a student athlete to successive in-
jury, cumulative negative health consequences, or 
chronic impairment. 
(8) Timely recognition and response to concus-
sions aids recovery and helps prevent successive in-
jury, chronic impairment, or death. Only 42 percent 
of schools have access to an athletic trainer and only 
53 percent of schools meet the nurse-to-student ratio 
recommended by the Federal Government. 
(9) Concussion treatment and management is 
sporadic in schools and often neglects the athlete’s 
role as a student. 
(10) Medical care from hospitalization and 
emergency room visits due to a concussion is costly, 
and treatment is often arbitrary. 
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(11) Students should gradually return to phys-
ical activity and academic activities only as the 
symptoms of a concussion permit because research 
suggests that overexertion from physical activity and 
academic activities exacerbates symptoms and pro-
tracts recovery time for student athletes. 
(12) Instituting best practices offers a reason-
able means for protecting student athletes from the 
risks and consequences of concussions. 
SEC. 3. MINIMUM STATE REQUIREMENTS. 
Beginning with fiscal year 2013, in order to be eligi-
ble to receive funds for such year or a subsequent fiscal 
year under the Elementary and Secondary Education Act 
of 1965 (20 U.S.C. 6301 et seq.) each State educational 
agency shall issue regulations establishing the following 
minimum requirements: 
(1) LOCAL EDUCATIONAL AGENCY CONCUSSION 
SAFETY AND MANAGEMENT PLAN.—Each local edu-
cational agency in the State, in consultation with 
members of the community in which such agency is 
located, shall develop and implement a standard plan 
for concussion safety and management that in-
cludes— 
(A) the education of students, parents, and 
school personnel about concussions, such as— 
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(i) the training and certification of 
school personnel, including coaches, ath-
letic trainers, and school nurses, on con-
cussion safety and management; and 
(ii) using and maintaining standard-
ized release forms, treatment plans, obser-
vation, monitoring and reporting forms, 
recordkeeping forms, and post-injury fact 
sheets; 
(B) supports for students recovering from 
a concussion, such as— 
(i) guiding such student in resuming 
participation in athletic activity and aca-
demic activities with the help of a multi- 
disciplinary team, which may include— 
(I) a health care professional, the 
parents of such student, a school 
nurse, or other relevant school per-
sonnel; and 
(II) an individual who is assigned 
by a public school to oversee and 
manage the recovery of such student; 
(ii) providing appropriate academic 
accommodations; and 
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(iii) referring students whose symp-
toms of concussion reemerge or persist 
upon the reintroduction of cognitive and 
physical demands for evaluation of the eli-
gibility of such students for services under 
the Individual with Disabilities Education 
Act (20 U.S.C. 1400 et seq.) and the Re-
habilitation Act of 1973 (29 U.S.C. 701 
note et seq.); and 
(C) best practices designed to ensure, with 
respect to concussions, the uniformity of safety 
standards, treatment, and management, such 
as— 
(i) disseminating information on con-
cussion management safety and manage-
ment to the public; and 
(ii) applying uniform standards for 
concussion safety and management to all 
students enrolled in public schools. 
(2) POSTING
OF
INFORMATION
ON
CONCUS-
SIONS.—Each public elementary school and each 
secondary school shall post on school grounds, in a 
manner that is visible to students and school per-
sonnel, and make publicly available on the school 
website, information on concussions that— 
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(A) is based on peer-reviewed scientific evi-
dence (such as information made available by 
the Centers for Disease Control and Preven-
tion); 
(B) shall include— 
(i) the risks posed by sustaining a 
concussion; 
(ii) the actions a student should take 
in response to sustaining a concussion, in-
cluding the notification of school personnel; 
and 
(iii) the signs and symptoms of a con-
cussion; and 
(C) may include— 
(i) the definition of a concussion; 
(ii) the means available to the student 
to reduce the incidence or recurrence of a 
concussion; and 
(iii) the effects of a concussion on 
academic learning and performance. 
(3) RESPONSE TO CONCUSSION.—If any school 
personnel, including coaches and athletic trainers, of 
a public school suspects that a student has sustained 
a concussion during a school-sponsored athletic ac-
tivity— 
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(A) the student shall be— 
(i) immediately removed from partici-
pation in such activity; and 
(ii) prohibited from returning to par-
ticipate in school-sponsored athletic activi-
ties— 
(I) on the day such student sus-
tained a concussion; and 
(II) until such student submits a 
written release from a health care 
professional stating that the student 
is capable of resuming participation in 
school-sponsored 
athletic 
activities; 
and 
(B) such personnel shall report to the par-
ent or guardian of such student— 
(i) the date, time, and extent of the 
injury suffered by such student; and 
(ii) any actions taken to treat such 
student. 
(4) RETURN TO ATHLETICS AND ACADEMICS.— 
Before a student who has sustained a concussion in 
a school-sponsored athletic activity resumes partici-
pation in school-sponsored athletic activities or aca-
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demic activities, the school shall receive a written re-
lease from a health care professional, that— 
(A) states that the student is capable of 
resuming participation in such activities; and 
(B) may require the student to follow a 
plan designed to aid the student in recovering 
and resuming participation in such activities in 
a manner that— 
(i) is coordinated, as appropriate, with 
periods of cognitive and physical rest while 
symptoms of a concussion persist; and 
(ii) reintroduces cognitive and phys-
ical demands on such student on a pro-
gressive basis only as such increases in ex-
ertion do not cause the reemergence or 
worsening of symptoms of a concussion. 
SEC. 4. REPORT TO SECRETARY OF EDUCATION. 
Not later than 6 months after promulgating regula-
tions pursuant to section 3 in order to be eligible to receive 
funds under the Elementary and Secondary Education Act 
of 1965 (20 U.S.C. 6301 et seq.), each State educational 
agency shall submit to the Secretary of Education a report 
that contains— 
(1) a description of the State regulations pro-
mulgated pursuant to section 3; and 
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(2) an assurance that the State has imple-
mented such regulations. 
SEC. 5. RULE OF CONSTRUCTION. 
Nothing in this Act shall be construed to alter or su-
persede State law with respect to education standards or 
procedures or civil liability. 
SEC. 6. DEFINITIONS. 
In this Act: 
(1) 
CONCUSSION.—The 
term 
‘‘concussion’’ 
means a type of traumatic brain injury that— 
(A) is caused by a blow, jolt, or motion to 
the head or body that causes the brain to move 
rapidly in the skull; 
(B) disrupts normal brain functioning and 
alters the mental state of the individual, caus-
ing the individual to experience— 
(i) any period of observed or self-re-
ported — 
(I) 
transient 
confusion, 
dis-
orientation, or impaired consciousness; 
(II) 
dysfunction 
of 
memory 
around the time of injury; and 
(III) loss of consciousness lasting 
less than 30 minutes; 
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(ii) any one of four types of symptoms 
of a headache, including— 
(I) physical symptoms, such as 
headache, fatigue, or dizziness; 
(II) cognitive symptoms, such as 
memory disturbance or slowed think-
ing; 
(III) emotional symptoms, such 
as irritability or sadness; and 
(IV) difficulty sleeping; and 
(C) can occur— 
(i) with or without the loss of con-
sciousness; and 
(ii) during participation in any orga-
nized sport or recreational activity. 
(2) HEALTH CARE PROFESSIONAL.—The term 
‘‘health care professional’’ means a physician, nurse, 
certified 
athletic 
trainer, 
physical 
therapist, 
neuropsychologist or other qualified individual 
who— 
(A) is a registered, licensed, certified, or 
otherwise statutorily recognized by the State to 
provide medical treatment; 
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(B) is experienced in the diagnosis and 
management of traumatic brain injury among a 
pediatric population; and 
(C) may be a volunteer. 
(3) LOCAL EDUCATIONAL AGENCY; STATE EDU-
CATIONAL AGENCY.—The terms ‘‘local educational 
agency’’ and ‘‘State educational agency’’ have the 
meanings given such terms in section 9101 of the 
Elementary and Secondary Education Act of 1965 
(20 U.S.C. 7801). 
(4) SCHOOL
PERSONNEL.—The term ‘‘school 
personnel’’ has the meaning given such term in sec-
tion 4151 of the Elementary and Secondary Edu-
cation Act of 1965 (20 U.S.C. 7161). 
(5) SCHOOL-SPONSORED ATHLETIC ACTIVITY.— 
The 
term 
‘‘school-sponsored 
athletic 
activity’’ 
means— 
(A) any physical education class or pro-
gram of a school; 
(B) any athletic activity authorized during 
the school day on school grounds that is not an 
instructional activity; and 
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(C) any extracurricular sports team, club, 
or league organized by a school on or off school 
grounds. 
Æ 
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