Concussion Legislation Proposed in Iowa
 

There's a piece of legislation that's cleared committee in the Iowa legislature that's on our local association's radar. It could -- I think probably would -- make officials legally responsible for observing the symptoms of a concussion and removing a player from a game. Does anyone else out there have this?

I've pasted the summary and a link to the full bill below.

We've sent notes/letters to the bill sponsors and our own representatives outlining what guidance and training are already available (Iowa HS associations, NFHS, NASO, etc.) and in place, but this is something that's tough for them to vote against. Any thoughts or experience dealing with anything like this elsewhere would be appreciated.

(Iowa) House File 385
HOUSE FILE 385 BY KOESTER and LOFGREN
An Act concerning the protection of student athletes from concussions and other brain injuries.

EXPLANATION
This bill directs the board of directors of each public school district and the authorities in charge of each nonpublic school to work in concert with the Iowa high school athletic association and the Iowa girls high school athletic union to distribute guidelines and other pertinent information and forms to inform and educate coaches, student athletes, and parents and guardians of student athletes of the risks, signs, symptoms, and behaviors consistent with a sports-related concussion or brain injury, including the danger of continuing to participate in athletic activities after a concussion or brain injury.

The bill requires school districts and nonpublic schools to annually provide the parent or guardian of a student athlete with a concussion and brain injury information sheet which must be signed and returned before the student athlete may participate in an extracurricular interscholastic athletic activity for grades seven through 12.

The bill provides that if a student athlete’s coach or contest official observes signs, symptoms, or behaviors consistent with a concussion or brain injury in an interscholastic athletic practice or game, the student athlete must be removed from participation.

The bill provides that a student athlete removed from participation shall not recommence participation until the student athlete has been evaluated by a licensed health care provider, defined as a physician, physician assistant, chiropractor, advanced registered nurse practitioner, nurse, or athletic trainer licensed by a board designated under Code section 147.13, trained in the evaluation and management of concussions and other head injuries and received written clearance to return to play.

The bill directs the board of directors of each school district and the authorities in charge of each nonpublic school to adopt rules and procedures necessary to carry out the requirements of the bill.

http://coolice.legis.state.ia.us/lin...Introduced.pdf

I have no problem sending a kid off who appears injured. Many times this year I have even told a coach, "Hey, watch #32, he just landed pretty hard."

The part that we, as officials will have no control over, that the school will have to deal with is the "written clearance to return to play." There's no way we'll know about individual players unless informed.

I don't have a problem sending them off, I have a problem with some sue-happy parent who (two weeks later) thinks I didn't send them off quick enough...

As I read this, it's exactly the NFHS policy. Officials must remove players who exhibit symptoms consistent with concussion, and the player may not return until cleared in writing by a suitable health care professional. I don't see any additional liability imposed on officials beyond what's already in NFHS rules.

The clearance clause fails to specify who is to receive the written clearance. That's an oversight.

Anybody Old Enough To Remember Iowa Tests ???
 

In Connecticut, which is, obviously, not Iowa, we have been told that if the possibly concussed player reports back into the game, that we are to assume that he has been cleared by a health care professional. No written clearance necessary. Not even any oral clearance needed.

That is the way it is in FL. You guys should know that there is free course on the NFHS website on recognizing concussion signs. Online. Takes about 25 minutes.

So Let it Be Written, So Let it Be Done.....
 

This is also the way it's written in the NFHS Preseason Guide.

It further states, "the responsibility for obtaining that clearance rests with the coach/school, and need not be verified by the officials (less state procedures require verification). If A2 appears at the scorers table to reenter the game, the official shall assume the coach/school followed the appropriate return to play procedures and A2 is eligible to participate."

VT needs a designated HCP BEFORE the game for EACH team who must provide written okay for re-entry. What I hope any legislation does NOT do, is lead to hesitation to send someone off because he might be a star and it would mean no re-entry. Could be headed that way. Take the course at NFHS | National Federation of State High School Associations It is free. Even if it looks like you are buying it.

Unfortunately it has in TN. TSSAA in it's instructions at the State rules meetings and information passed through the State supervisors has "recommended" that referees not utter the word "concussion" or any variant thereof. I will not be complying if I see a player who exhibits "signs or symptoms" as described in the NFHS online training referenced above.

sounds like the state is ripe for a lawsuit here.

The Iowa law, as explained in the article, seems to be a codification of the NFHS policy. I personally find that to be a silly use of legislative time, but unless there's something in there that's not being reported here, I don't see anything that makes it more likely for an official to get sued.

And it seems to me pretty obvious that my NASO atty could get the case thrown out on the grounds that I'm not a doctor and thus not trained to recognize concussion symptoms.

The C Word ???
 

We got the same advice here in the Land of Steady Habits from our interpreter.

No, it's not (imo). It's providing flexibility to allow (require) the states to determine who can provide it -- some states might require an MD or MO. SOme might allow trainers. Some might allow any "licensed medical professional."

Georgia brought in the "concussed" language this year. If a player shows any signs of concussion, they must leave the game and cannot return without a written doctor note. Good rule.

I'm talking about the clause in the Iowa law, not the clause in the NFHS policy.

I'm fairly confident that your attorney would NOT bring that up, given the wide availability of training in such recognition, including most obviously the NFHS online training. A plaintiff's attorney would feast on an admission that you were officiating without proper training.

The crucial distinction here, it seems to me, is "recognizing symptoms" vs. "diagnosing." We are now expected to do the former.

I recommend that all officials take the course. I also recommend that all legislators take the course. Saying the words "Exhibiting the signs of a possible concussion" is a protection for the official. And beckoning on the coach in those instances will ensure that the player will be replaced.

I had one near the end of the season. I blew the whistle because the kid was shaking his head after having gone to the floor and possibly hitting his head. The play was at the other end with no attempt to go for the basket by the other team. The kid returned later that quarter, but in FL, that is on the coach. We are to assume clearance has been given. Watching the video, it seems prudent that anyone leaving should not play anymore that game. I saw the video after the incident.

Massachusetts passed a "concussion law" last year. All the responsibility is with schools and parents; officials are not mentioned at all.

The state law...and corresponding direction from the MIAA, however...calls for stronger action than the NFHS rules. If a player is sent out of a game (or practice) with symptoms of a concussion, he may not return that day at all...and may not return without written permission from a health-care professional to the school athletic director.

Details here: Concussion Update Issues

It should be noted that that 99.99% of all legislative time used is silly.

And the rest is squandered.

When In The Constitution State, Do As ...
 

As I have already stated, we have been advised not to use the "C Word" here. Instead we have been advised to just tell the coach what symptoms we have observed. i.e., beckon the coach and say, "Hey coach, this kid hit his head and seems a little shaky on his feet". After that we just treat it as any other injury.

I haven't been nutmegged, so I am fine with my language.

Take It Over To The Soccer Forum ...
 

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I can almost see it now...

Star player H1 fast break drives through and hits wall on endline. Bumps his a head a bit. Shakes it off and wants to continue.

HC for Visitor will come in with "Hey Ref, I think H1 is showing sings of concussion, you better do something." :rolleyes:

He'd better be in his box when he says it. :cool:

Coach: "So what does the rule book say about "shaky on his feet? You can't send him to the bench for that."

Exactly. And diction is no defense against legal liability: I can be sued for failing to enforce the policy just as easily as enforcing it using the word 'concussion'.

When In The Constitution State ...
 

Plus, once he's beckoned, then he either has to request, and be granted, a timeout, or let the player sit a tick. After that it's up to him, and his health care professional, to let the kid continue to play, or not. The rest is none of my business. In Connecticut, I've done my job.