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<dc:title>113 HR 3954 IH: Concussion Awareness and Education Act of 2014</dc:title>
<dc:publisher>U.S. House of Representatives</dc:publisher>
<dc:date>2014-01-28</dc:date>
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<dc:language>EN</dc:language>
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<distribution-code display="yes">I</distribution-code><congress>113th CONGRESS</congress><session>2d Session</session><legis-num>H. R. 3954</legis-num><current-chamber>IN THE HOUSE OF REPRESENTATIVES</current-chamber><action><action-date date="20140128">January 28, 2014</action-date><action-desc><sponsor name-id="B001281">Mrs. Beatty</sponsor> (for herself, <cosponsor name-id="W000812">Mrs. Wagner</cosponsor>, <cosponsor name-id="R000053">Mr. Rangel</cosponsor>, <cosponsor name-id="C000714">Mr. Conyers</cosponsor>, <cosponsor name-id="K000385">Ms. Kelly of Illinois</cosponsor>, and <cosponsor name-id="W000808">Ms. Wilson of Florida</cosponsor>) introduced the following bill; which was referred to the <committee-name committee-id="HIF00">Committee on Energy and Commerce</committee-name>, and in addition to the Committees on <committee-name committee-id="HAS00">Armed Services</committee-name> and <committee-name committee-id="HED00">Education and the Workforce</committee-name>, 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</action-desc></action><legis-type>A BILL</legis-type><official-title>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.</official-title></form><legis-body id="H829D01035D594BC7AED83C49592EBBE8" style="OLC"><section id="H663A4AA77B0C427BB642641F75AA3B56" section-type="section-one"><enum>1.</enum><header>Short title</header><text display-inline="no-display-inline">This Act may be cited as the <quote><short-title>Concussion Awareness and Education Act of 2014</short-title></quote>.</text></section><section id="H652911C0EDBC4A4EA44738348E016FC1"><enum>2.</enum><header>Table of contents</header><text display-inline="no-display-inline">The table of contents of this Act is as follows:</text><toc container-level="legis-body-container" lowest-bolded-level="division-lowest-bolded" lowest-level="section" quoted-block="no-quoted-block" regeneration="yes-regeneration"><toc-entry idref="H663A4AA77B0C427BB642641F75AA3B56" level="section">Sec. 1. Short title.</toc-entry><toc-entry idref="H652911C0EDBC4A4EA44738348E016FC1" level="section">Sec. 2. Table of contents.</toc-entry><toc-entry idref="H6DBE6D0C0EBB4EC180D1FEA8A106E145" level="section">Sec. 3. Findings; purposes.</toc-entry><toc-entry idref="H11ACA453CDE94666B37AEF84D3ED18E9" level="section">Sec. 4. Surveillance of sports-related concussions.</toc-entry><toc-entry idref="HC5B3C079A8C64C108276698D38322941" level="section">Sec. 5. Research.</toc-entry><toc-entry idref="H98268DA21B914C8C94BC4418E2D24463" level="section">Sec. 6. Biological sample repository.</toc-entry><toc-entry idref="HC4D97ACA801345069180A7F990932B82" level="section">Sec. 7. Rules of play.</toc-entry><toc-entry idref="H16F2B9E53D2D48C48E3CED0BB3030371" level="section">Sec. 8. Dissemination of information.</toc-entry><toc-entry idref="H259F8AFF78DA40D2BDA720FF7415746A" level="section">Sec. 9. Concussion Research Commission.</toc-entry></toc></section><section id="H6DBE6D0C0EBB4EC180D1FEA8A106E145"><enum>3.</enum><header>Findings; purposes</header><subsection id="HB33AF06B38BB495498E95C684D5248CB"><enum>(a)</enum><header>Findings</header><text display-inline="yes-display-inline">The Congress finds as follows:</text><paragraph id="H8A27F1691D964859AD7EB78DD742C6DA"><enum>(1)</enum><text display-inline="yes-display-inline">There is currently no comprehensive system for acquiring accurate data on the incidence of sports- and recreation-related concussions across all youth age groups and sports.</text></paragraph><paragraph id="H99B7A0CB01FC4EBE9766E906F3A107CA"><enum>(2)</enum><text display-inline="yes-display-inline">Overall, according to a report entitled <quote>Sports-Related Concussions in Youth: Improving the Science, Changing the Culture</quote>, issued by the National Academies in 2013, each year in the United States, there are approximately 1.6 to 3.8 million sports- and recreation-related traumatic brain injuries, including concussions and other head injuries. These figures are based on conservative estimates.</text></paragraph><paragraph id="H1826923D165749658AC8E3D33879DFE9"><enum>(3)</enum><text>A review of National Collegiate Athletic Association data for 15 sports showed that the overall reported concussion rate doubled from 1.7 to 3.4 concussions per 1,000 athletic exposures over the past 15 years, covering the 1988–1989 and 2003–2004 academic years.</text></paragraph><paragraph id="H5DBB8C6D48B64B4A962800F9FAFB902D"><enum>(4)</enum><text>Between 2001 and 2009, the reported number of our youth ages 19 and under treated for concussion and other nonfatal, sports- and recreation-related traumatic brain injuries increased from 150,000 to 250,000.</text></paragraph><paragraph id="H94DAADC1DBFC4BF1A03F8E6530CB0B4D"><enum>(5)</enum><text>Over the same time period between 2001 and 2009, the rate of emergency room visits for concussive injuries increased by 57 percent.</text></paragraph><paragraph id="H5E3FEFCA011F4DF3852B7FB0E6984867"><enum>(6)</enum><text>Yet, according to the National Academies there currently is—</text><subparagraph id="HC96973EE1E0D41B28C170D5F7C087522"><enum>(A)</enum><text>a lack of data to accurately estimate the incidence of sports-related concussions across a variety of sports and for youth across the pediatric age spectrum; and</text></subparagraph><subparagraph id="HADB51C88B7EF4FB7B3BCE542E9DB2C39"><enum>(B)</enum><text>no comprehensive system for acquiring accurate data on the incidence of sports- and recreation-related concussions across all youth age groups and sports.</text></subparagraph></paragraph><paragraph id="H2A0C0CE493B6485494211E0BEE9B2685"><enum>(7)</enum><text>Currently, there are significant information gaps in the proper protocol for diagnosis and treatment of sports-related concussions and more research desperately is needed.</text></paragraph></subsection><subsection id="H135C2BBE7B39406CBD466E9BE6CD66DD"><enum>(b)</enum><header>Purposes</header><text display-inline="yes-display-inline">The purposes of this Act are—</text><paragraph id="H93FAA19F97ED47F8B5F3D1345160DF77"><enum>(1)</enum><text display-inline="yes-display-inline">to increase awareness and knowledge about concussions through development of, implementation of, and evaluation of the effectiveness of, large-scale collaborative efforts and research by entities including, but not limited to, national sports associations, State high school associations, trainers’ associations, appropriate Federal entities, and other stakeholders such as parents, coaches, and students; and</text></paragraph><paragraph id="H6AF68B9F5BAF40CABB2A72AB0181E8A4"><enum>(2)</enum><text>to change the culture (including social norms, attitudes, and behaviors) surrounding concussions among elementary school through college-aged youth and their parents, coaches, sports officials, educators, trainers, and health care professionals, taking into account demographic variations across population groups, where appropriate.</text></paragraph></subsection></section><section id="H11ACA453CDE94666B37AEF84D3ED18E9"><enum>4.</enum><header>Surveillance of sports-related concussions</header><text display-inline="no-display-inline">Title III of the Public Health Service Act is amended by inserting after section 317T of such Act (<external-xref legal-doc="usc" parsable-cite="usc/42/247b-22">42 U.S.C. 247b–22</external-xref>) the following:</text><quoted-block display-inline="no-display-inline" id="H16286FB22F624D629104C2C385B843F9" style="OLC"><section id="HE0110BE3E370439A8F0FCFAF1839EC08"><enum>317U.</enum><header>Surveillance of sports-related concussions</header><subsection id="HDC3CF50525A547C299619E74AE59A5C8"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">The Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, and taking into account other Federal data collection efforts, shall—</text><paragraph id="HEB3480E0284341C1833E01D156ECCEC5"><enum>(1)</enum><text>establish and oversee a national system to accurately determine the incidence of sports-related concussions; and</text></paragraph><paragraph id="H7DB6AD1ACB8743F48A8D093477089277"><enum>(2)</enum><text>begin implementation of such system not later than 1 year after the date of enactment of the <short-title>Concussion Awareness and Education Act of 2014</short-title>.</text></paragraph></subsection><subsection id="H79D7ABE2EA3D466093E21EE1D5E94662"><enum>(b)</enum><header>Data To Be Collected</header><text display-inline="yes-display-inline">The data collected under subsection (a) shall, to the extent feasible, include each of the following:</text><paragraph id="HBB597F93395B4B0DBA6243ABC56DF8E0"><enum>(1)</enum><text>The incidence of sports related concussions in individuals 5 through 21 years of age.</text></paragraph><paragraph id="HA2E804C6E631436498E47FC7D4EE1DBB"><enum>(2)</enum><text>Demographic information of the injured individuals, including age, sex, race, and ethnicity.</text></paragraph><paragraph id="H2B4CDE98B1F14895A6621343F11EC034"><enum>(3)</enum><text>Pre-existing conditions of the injured individuals, such as attention deficit hyperactivity disorder and learning disabilities.</text></paragraph><paragraph id="H213AF42208824218A1F8BF235F24947B"><enum>(4)</enum><text>The concussion history of the injured individuals, such as the number and dates of prior concussions.</text></paragraph><paragraph id="H4041E73D821448C89D07473515F5EDEA"><enum>(5)</enum><text>The use of protective equipment and impact monitoring devices.</text></paragraph><paragraph id="H8DCD3F93264042A98B1AC9252A950822"><enum>(6)</enum><text>The qualifications of personnel diagnosing the concussions.</text></paragraph><paragraph id="H8F6E85FCA8CF4E44840FC4BC3051483E"><enum>(7)</enum><text>The cause, nature, and extent of the concussive injury, including—</text><subparagraph id="HC165B0B89F0C4D99B0D8C40091515F89"><enum>(A)</enum><text>the sport or activity involved;</text></subparagraph><subparagraph id="H1E461302187C498A99299480EDB5ECCD"><enum>(B)</enum><text>the recreational or competitive level of the sport or activity involved;</text></subparagraph><subparagraph id="H27FD68CA9B914C1FAEB49E8260516BF1"><enum>(C)</enum><text>the event type involved, including whether it was practice or competition;</text></subparagraph><subparagraph id="HDB83CE5A95B54FB1809B377C069DC033"><enum>(D)</enum><text>the impact location on the body;</text></subparagraph><subparagraph id="HEE6F2F1859704C1F8BCB4E0B80A50CB3"><enum>(E)</enum><text>the impact nature, such as contact with a playing surface, another player, or equipment; and</text></subparagraph><subparagraph id="HA16AA1B13E8242A0AB92AC7DA63A7838"><enum>(F)</enum><text>signs and symptoms consistent with a concussion.</text></subparagraph></paragraph></subsection></section><after-quoted-block>.</after-quoted-block></quoted-block></section><section id="HC5B3C079A8C64C108276698D38322941"><enum>5.</enum><header>Research</header><subsection id="H606ACCBC540A452B9F6EF069B329AE5C"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">Beginning not later than 1 year after the date of enactment of this Act, the Director of the National Institutes of Health and the Secretary of Defense, acting in coordination, shall conduct or support—</text><paragraph id="H2D63854E999C4ED99C842936ECE3E208"><enum>(1)</enum><text>research designed to—</text><subparagraph id="H0D9E157B46084543AF83264E9A18FE16"><enum>(A)</enum><text>establish objective, sensitive, and specific metrics and markers of concussion diagnosis, prognosis, and recovery in youth; and</text></subparagraph><subparagraph id="H5B24C671298C44CCB157427B5EDC3865"><enum>(B)</enum><text>inform the creation of age-specific, evidence-based guidelines for the management of short- and long-term sequelae of concussion in youth;</text></subparagraph></paragraph><paragraph id="H24E4ECECEAE240578B6D6823C1A43DAD"><enum>(2)</enum><text>controlled, longitudinal, large-scale studies to assess short- and long-term cognitive, emotional, behavioral, neurobiological, and neuropathological consequences of concussions and repetitive head impacts over a life span, including—</text><subparagraph id="HA1C16D0CB67941A4A07C987D05398DA7"><enum>(A)</enum><text>an examination of the effects of concussions and repetitive head impacts on quality of life and the activities of daily living; and</text></subparagraph><subparagraph id="H2274CEAEE9064071AB9D27947F4C0819"><enum>(B)</enum><text>identification of predictors and modifiers of outcomes, including the influence of socioeconomic status, race, ethnicity, sex, and comorbidities; and</text></subparagraph></paragraph><paragraph id="HE94D8EA007B544A5BBD2DA2FA67B5461"><enum>(3)</enum><text>research on age- and sex-related biomechanical determinants of injury risk for concussion in youth, including how injury thresholds are modified by the number of and time interval between head impacts and concussions.</text></paragraph></subsection><subsection id="H018770442D2547E59638399F80080B90"><enum>(b)</enum><header>Sports and physical training at military academies and for military personnel</header><text>Beginning not later than 1 year after the date of enactment of this Act, the Secretary of Defense shall conduct a rigorous scientific evaluation of the effectiveness of techniques, rules, and playing, practice, and training standards in reducing concussions and sequelae for sports and physical training, including combatives, at military service academies and for military personnel.</text></subsection><subsection id="HF7707D6F120841D0B926A815C1B9BF27"><enum>(c)</enum><header>Sense of Congress</header><text>It is the sense of the Congress that the National Collegiate Athletic Association, in conjunction with the National Federation of State High School Associations, national governing bodies for youth sports, and youth sports organizations, should undertake a rigorous scientific evaluation of the effectiveness of age-appropriate techniques, rules, and playing and practice standards in reducing sports-related concussions and sequelae.</text></subsection></section><section id="H98268DA21B914C8C94BC4418E2D24463"><enum>6.</enum><header>Biological sample repository</header><subsection id="H92128B0FA07E4315B80DD8BD4FE5FE10"><enum>(a)</enum><header>In general</header><text display-inline="yes-display-inline">To aid research under this Act and any other similar research, the Secretary of Health and Human Services, acting through the Director of the National Institutes of Health, shall maintain a national brain tissue and biological sample repository to collect, archive, and distribute material for research on concussions.</text></subsection><subsection id="H7FFD3B19E4C44CC2B23FE6145616BD7A"><enum>(b)</enum><header>Timing</header><text>The Secretary shall begin implementation of the repository not later than 1 year after the date of enactment of this Act.</text></subsection></section><section id="HC4D97ACA801345069180A7F990932B82"><enum>7.</enum><header>Rules of play</header><subsection id="H40F5607827AF43DBAD3D8F8E32EFB692"><enum>(a)</enum><header>Development</header><text display-inline="yes-display-inline">The Director of the National Institutes of Health and the Secretary of Defense, taking into consideration the results of research, shall develop standards, best practices, and guidelines for the rules of play and training, respectively, for sports, athletic, and military training and engagement that—</text><paragraph id="H7F79BE40DF134DD9B13CD57CDDC84196"><enum>(1)</enum><text>are designed to prevent or reduce the incidence of concussions; and</text></paragraph><paragraph id="H1F66F839BA0E4650B75D83EEBCFE3F0F"><enum>(2)</enum><text>include—</text><subparagraph id="H9E7864428BDD494F874D4E3103FBD357"><enum>(A)</enum><text>standards for effective protective equipment; and</text></subparagraph><subparagraph id="H10F460DF1D4A49779D2B95A6C10A15E0"><enum>(B)</enum><text>recommendations on impact-monitoring systems.</text></subparagraph></paragraph></subsection><subsection id="H93A9BE90741349D2AFB9D2958B74EFAF"><enum>(b)</enum><header>Timing</header><text display-inline="yes-display-inline">The Director of the National Institutes of Health and the Secretary of Defense shall—</text><paragraph id="H1AB24AF487284A24B6179B3F1CB71DAA"><enum>(1)</enum><text>begin development of the rules of play under this section not later than 1 year after the date of enactment of this Act; and</text></paragraph><paragraph id="H1C1E9AEB59DB488F9C6F04F4365F1A00"><enum>(2)</enum><text>after such rules of play are finalized, periodically review and update such rules of play as appropriate.</text></paragraph></subsection></section><section id="H16F2B9E53D2D48C48E3CED0BB3030371"><enum>8.</enum><header>Dissemination of information</header><subsection id="H934B0192660346C0980F9473BDD62AFF"><enum>(a)</enum><header>In general</header><text>The Secretary of Health and Human Services, acting through the Director of the Centers for Disease Control and Prevention, shall develop and disseminate to the public information regarding concussions.</text></subsection><subsection id="H081B5F85D30F4DA4866EBBD916B0B205"><enum>(b)</enum><header>Arrangements with other entities</header><text>In carrying out paragraph (1), the Secretary may disseminate information through arrangements with nonprofit organizations, consumer groups, institutions of higher education, Federal, State, or local agencies, or the media.</text></subsection></section><section id="H259F8AFF78DA40D2BDA720FF7415746A"><enum>9.</enum><header>Concussion Research Commission</header><subsection id="H9A6D75188B3E40BA8D050CFC2B900D68"><enum>(a)</enum><header>Establishment</header><text>There is established a Concussion Research Commission (referred to in this section as the <quote>Commission</quote>).</text></subsection><subsection id="HF29105A5A3BF436897A3097A50BB8191"><enum>(b)</enum><header>Membership</header><paragraph id="H879A25B86B024C10AA5170D322ECD4FD"><enum>(1)</enum><header>Appointment</header><text>The Commission shall be composed of the following nine members:</text><subparagraph id="HE27944C64BC0429E8ACCF673B05D4C3D"><enum>(A)</enum><text>Five shall be appointed by the President.</text></subparagraph><subparagraph id="H163413732FC0419B8003CC9F9264C3C9"><enum>(B)</enum><text>One shall be appointed by the Speaker of the House of Representatives.</text></subparagraph><subparagraph id="H2C7654428C91435F952DB46BBF66B3C8"><enum>(C)</enum><text>One shall be appointed by the minority leader of the House of Representatives.</text></subparagraph><subparagraph id="HF80228AFDD75443B99D8771E0C947B47"><enum>(D)</enum><text>One shall be appointed by the majority leader of the Senate.</text></subparagraph><subparagraph id="HA2009F52EDDF4EC68350B45CFA720FFB"><enum>(E)</enum><text>One shall be appointed by the minority leader of the Senate.</text></subparagraph></paragraph><paragraph id="H07C4175E6B8C4F0CB734393E3EB93433"><enum>(2)</enum><header>Qualifications</header><text display-inline="yes-display-inline">To be eligible for appointment under paragraph (1), an individual shall—</text><subparagraph id="H81DF60610366443981B20869FEC0197A"><enum>(A)</enum><text>have experience with research, treatment, and prevention with respect to all types of concussive injuries; and</text></subparagraph><subparagraph id="H50216A5B37A44098A3430F418CF9A2F1"><enum>(B)</enum><text>be a leading medical or scientific expert, or an otherwise authoritatively qualified expert, in one or more relevant fields.</text></subparagraph></paragraph><paragraph id="HE650CC1B15AB44378342197BEC724D59"><enum>(3)</enum><header>Terms</header><text>Each member of the Commission shall be appointed for the life of the Commission.</text></paragraph><paragraph id="HC743D2DE775541FC88245AB925162260"><enum>(4)</enum><header>Vacancies</header><text>Any member appointed to fill a vacancy occurring before the expiration of the term for which the member’s predecessor was appointed shall be appointed only for the remainder of that term. A member may serve after the expiration of that member’s term until a successor has taken office. A vacancy in the Commission shall be filled in the manner in which the original appointment was made.</text></paragraph><paragraph id="H106BFC7F479B4C46B6E0205F10701047"><enum>(5)</enum><header>No pay</header><text>The members of the Commission shall serve without pay. Members of the Commission who are full-time officers or employees of the United States or Members of Congress may not receive additional pay, allowances, or benefits by reason of their service on the Commission.</text></paragraph><paragraph id="H85913BC0811A458589E86BB735FAE5D8"><enum>(6)</enum><header>Travel expenses</header><text>Each member of the Commission shall receive travel expenses, including per diem in lieu of subsistence, in accordance with applicable provisions under subchapter I of <external-xref legal-doc="usc-chapter" parsable-cite="usc-chapter/5/57">chapter 57</external-xref> of title 5, United States Code.</text></paragraph><paragraph id="H88ED0FAA9AE948DBBABFA3445A7962CA"><enum>(7)</enum><header>Resources</header><text display-inline="yes-display-inline">The Secretary shall ensure that appropriate personnel, funding, and other resources are provided to the Committee to carry out its responsibilities.</text></paragraph></subsection><subsection id="H94BB870333C8423698E7D3A6A30C7EF6"><enum>(c)</enum><header>Meetings</header><text>The Commission shall meet at least 4 times each year.</text></subsection><subsection id="H38D42319FE8A4005BE978EF7890D2866"><enum>(d)</enum><header>Staff of Federal agencies</header><text>Upon request of the Commission, the head of any Federal department or agency may detail, without reimbursement, any of the personnel of that department or agency to the Commission to assist in carrying out this section.</text></subsection><subsection id="HAF8B6B666DAC4704A5D482BAEDE286C1"><enum>(e)</enum><header>Study</header><text>The Commission shall—</text><paragraph id="HB663ED68154C4C92ADBF798F2B37AF5A"><enum>(1)</enum><text>study the programs and activities conducted pursuant to this Act; and</text></paragraph><paragraph id="HACCF391F2AFD457C8A1B3A4377315092"><enum>(2)</enum><text>based on the results of such programs and activities, formulate systemic recommendations for furthering the purposes of this Act, as described in section 3(b).</text></paragraph></subsection><subsection id="HA332221E028F450BA25E4E66770A09A9"><enum>(f)</enum><header>Review of National Academies report</header><text>The Commission shall review the report of the National Academies entitled <quote>Sports-Related Concussions in Youth: Improving the Science, Changing the Culture</quote> and recommend corrections or updates to such report, as the Commission determines appropriate.</text></subsection><subsection id="H64FDDF2471194CA0A2A33A624018FFE2"><enum>(g)</enum><header>Reporting</header><paragraph id="H8D735813922644C68E6D0D83A4A3DA0F"><enum>(1)</enum><header>Interim reports</header><text>Every 6 months, the Commission shall submit to the appropriate committees of Congress an interim report on the Commission’s activities.</text></paragraph><paragraph id="HBE79863BAD3A4F6CA769757FC942834B"><enum>(2)</enum><header>Final report</header><text>Not later than 36 months after the date of enactment of this Act, the Commission shall submit to the appropriate committees of Congress, and make available to the public, a final report on the results of the Commission’s study under subsection (e) and review under subsection (f).</text></paragraph></subsection><subsection id="H1AEE7352D548422FBC7532C9FCE48075"><enum>(h)</enum><header>Termination</header><text>The Commission shall terminate upon the date of submission of the final report required by subsection (g)(2), unless the Secretary of Health and Human Services chooses to maintain the Commission beyond such date.</text></subsection></section></legis-body></bill>


