[Congressional Record Volume 161, Number 55 (Thursday, April 16, 2015)]
[Senate]
[Pages S2249-S2251]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DURBIN:
  S. 988. A bill to promote minimum State requirements for the 
prevention and treatment of concussions caused by participation in 
school sports, and for other purposes; to the Committee on Health, 
Education, Labor, and Pensions.
  Mr. DURBIN. Mr. President, in Illinois and all over the country 
thousands of high school students are participating in spring sports, 
including the national pastime: baseball and softball.
  As with any sports team, these students are training their growing 
bodies to compete in a worthy endeavor, but with that comes some risk. 
They put on helmets, they put on pads, but unfortunately some of them 
will still get hurt.
  Injuries are a part of all sports, but as we learn more about the 
long term effects of concussions and how frequently they are ignored, 
it is clear we have to step up our game to confront this health risk.
  The National Federation of State High School Associations estimates 
about 140,000 students who play high school sports have concussions 
every year. Sports are second only to motor

[[Page S2250]]

vehicle crashes as the leading cause of traumatic brain injury among 
people aged 15 to 24 years.
  According to the Centers for Disease Control, the number of children 
age 19 and younger being treated in ERs for traumatic brain injuries 
went from 153,373 in 2001 to 248,418 in 2009--a 60 percent increase.
  Some students stay in the game not recognizing the risks of playing 
hurt--especially when they have had a concussion. Many athletes do not 
know the signs and symptoms of concussion, which may cause many 
concussions to go undetected.
  A 2010 Government Accountability Office study found many sports-
related concussions go unreported. Athletes who continue to play while 
concussed are at risk for catastrophic injury if they sustain another 
concussion before recovering from the first one. This second injury can 
cause symptoms that can last for months and can even be fatal. Youth 
athletes are at the greatest risk from sports-related concussions 
because their brains are still developing and are more susceptible to 
injury.
  According to the American Academy of Neurology, athletes of high 
school age and younger with a concussion should be managed more 
conservatively when it comes to returning to play because they take 
longer to recover than college athletes.
  Since 2009, states have started implementing legislation guiding 
return to play procedures for student athletes who have sustained a 
concussion.
  With a push from the National Football League, NFL, all 50 States and 
the District of Columbia have successfully passed some form of 
legislation with varying concussion safety measures.
  Illinois has been a leader on this issue and passed legislation in 
2011, recognizing the dangers associated with concussion. In Illinois, 
a student athlete who is suspected of sustaining a concussion or head 
injury in a practice or game is immediately removed from the game until 
he or she is cleared by a health care professional.
  This is a great step forward for Illinois, and I commend the Illinois 
High School Association and its support of this legislation for its 
work protecting student athletes.
  I would like to introduce the Protecting Student Athletes from 
Concussions Act, which would support the progress made by states like 
Illinois. The bill would, for the first time, set minimum State 
requirements for the prevention and treatment of concussions.
  The legislation requires schools to post information about 
concussions on school grounds and on school websites and adopt a ``when 
in doubt, sit it out'' policy.
  This policy requires that a student suspected of sustaining a 
concussion be removed from participation in the activity and prohibited 
from returning to play that day. They can return to play in future 
events after being evaluated and cleared by a qualified health care 
professional.
  The ``when in doubt, sit it out'' policy is recommended by the 
American College of Sports Medicine and the American Academy of 
Neurology, which recommends that an athlete suspected of a concussion 
should not return to play the day of their injury--under any 
circumstance.
  According to the Center for Injury Research and Policy in Columbus, 
Ohio, more than 40 percent of young athletes return to play before they 
are fully recovered.
  Concussions are not always easily diagnosed, and symptoms that might 
indicate concussion don't always manifest themselves immediately. 
Athletes don't want to let down the team or the coach and are often 
eager to return to the game.
  So helping athletes, school officials, coaches and parents recognize 
the signs and symptoms of concussion can make all the difference in 
putting a player's safety above winning.
  This legislation will ensure that school districts have concussion 
management plans that educate students, parents, and school personnel 
about how to recognize and respond to concussions.
  It asks schools to adopt the ``when in doubt, sit it out'' policy to 
be sure athletes are not put back in the game before they have 
recovered from an initial concussion.
  I am pleased that a variety of organizations are supporting this 
bill, including the NFL, NCAA, NHL, NBA, American College of Sports 
Medicine, American Academy of Neurology, among others.
  I look forward to working with the schools, athletic programs and 
others to build on the progress already made in protecting student 
athletes from concussions.
  Mr. President, I ask unanimous consent that the text of the bill be 
printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:

                                 S. 988

       Be it enacted by the Senate and House of Representatives 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 2015''.

     SEC. 2. MINIMUM STATE REQUIREMENTS.

       (a) Minimum Requirements.--Each State that receives funds 
     under the Elementary and Secondary Education Act of 1965 (20 
     U.S.C. 6301 et seq.) and does not meet the requirements 
     described in this section, as of the date of enactment of 
     this Act, shall, not later than the last day of the fifth 
     full fiscal year after the date of enactment of this Act 
     (referred to in this Act as the ``compliance deadline''), 
     enact legislation or issue regulations establishing the 
     following minimum requirements:
       (1) Local educational agency concussion safety and 
     management plan.--Each local educational 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--
       (A) educates students, parents, and school personnel about 
     concussions, through activities such as--
       (i) training school personnel, including coaches, teachers, 
     athletic trainers, related services personnel, and school 
     nurses, on concussion safety and management, including 
     training on the prevention, recognition, and academic 
     consequences of concussions and response to concussions; and
       (ii) using, maintaining, and disseminating to students and 
     parents--

       (I) release forms and other appropriate forms for reporting 
     and record keeping;
       (II) treatment plans; and
       (III) prevention and post-injury observation and monitoring 
     fact sheets about concussion;

       (B) encourages supports, where feasible, for a student 
     recovering from a concussion (regardless of whether or not 
     the concussion occurred during school-sponsored activities, 
     during school hours, on school property, or during an 
     athletic activity), such as--
       (i) guiding the student in resuming participation in 
     athletic activity and academic activities with the help of a 
     multi-disciplinary concussion management team, which may 
     include--

       (I) a health care professional, the parents of such 
     student, a school nurse, relevant related services personnel, 
     and other relevant school personnel; and
       (II) an individual who is assigned by a public school to 
     oversee and manage the recovery of such student; and

       (ii) providing appropriate academic accommodations aimed at 
     progressively reintroducing cognitive demands on the student; 
     and
       (C) encourages the use of best practices designed to 
     ensure, with respect to concussions, the uniformity of safety 
     standards, treatment, and management, such as--
       (i) disseminating information on concussion safety and 
     management to the public; and
       (ii) applying uniform best practice standards for 
     concussion safety and management to all students enrolled in 
     public schools.
       (2) Posting of information on concussions.--Each public 
     elementary school and each public secondary school shall post 
     on school grounds, in a manner that is visible to students 
     and school personnel, and make publicly available on the 
     school website, information on concussions that--
       (A) is based on peer-reviewed scientific evidence (such as 
     information made available by the Centers for Disease Control 
     and Prevention);
       (B) shall include information on--
       (i) the risks posed by sustaining a concussion;
       (ii) the actions a student should take in response to 
     sustaining a concussion, including the notification of school 
     personnel; and
       (iii) the signs and symptoms of a concussion; and
       (C) may include information on--
       (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 an individual designated 
     from among school personnel for purposes of this Act suspects 
     that a student has sustained a concussion (regardless of 
     whether or not the concussion occurred during school-
     sponsored activities, during school hours, on school 
     property, or during an athletic activity)--

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       (A) the student shall be--
       (i) immediately removed from participation in a school-
     sponsored athletic activity; and
       (ii) prohibited from returning to participate in a school-
     sponsored athletic activity--

       (I) on the day such student is removed from such 
     participation; 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) the designated individual shall report to the parent or 
     guardian of such student--
       (i) any information that the designated school employee is 
     aware of regarding the date, time, and type of the injury 
     suffered by such student (regardless of where, when, or how a 
     concussion may have occurred); and
       (ii) any actions taken to treat such student.
       (4) Return to athletics.--If a student has sustained a 
     concussion (regardless of whether or not the concussion 
     occurred during school-sponsored activities, during school 
     hours, on school property, or during an athletic activity), 
     before such student resumes participation in school-sponsored 
     athletic activities, the school shall receive a written 
     release 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 physical demands on such 
     student on a progressive basis only as such increases in 
     exertion do not cause the reemergence or worsening of 
     symptoms of a concussion.
       (b) Noncompliance.--
       (1) First year.--If a State described in subsection (a) 
     fails to comply with subsection (a) by the compliance 
     deadline, the Secretary of Education shall reduce by 5 
     percent the amount of funds the State receives under the 
     Elementary and Secondary Education Act of 1965 (20 U.S.C. 
     6301 et seq.) for the first fiscal year following the 
     compliance deadline.
       (2) Succeeding years.--If the State fails to so comply by 
     the last day of any fiscal year following the compliance 
     deadline, the Secretary of Education shall reduce by 10 
     percent the amount of funds the State receives under that Act 
     for the following fiscal year.
       (3) Notification of noncompliance.--Prior to reducing any 
     funds that a State receives under the Elementary and 
     Secondary Education Act of 1965 (20 U.S.C. 6301 et seq.) in 
     accordance with this subsection, the Secretary of Education 
     shall provide a written notification of the intended 
     reduction of funds to the State and to the appropriate 
     committees of Congress.

     SEC. 3. RULE OF CONSTRUCTION.

       Nothing in this Act shall be construed to affect civil or 
     criminal liability under Federal or State law.

     SEC. 4. DEFINITIONS.

       In this Act:
       (1) Concussion.--The term ``concussion'' means a type of 
     mild 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, causing the individual to 
     experience--
       (i) any period of observed or self-reported--

       (I) transient confusion, disorientation, or impaired 
     consciousness;
       (II) dysfunction of memory around the time of injury; or
       (III) loss of consciousness lasting less than 30 minutes; 
     or

       (ii) any 1 of 4 types of symptoms, including--

       (I) physical symptoms, such as headache, fatigue, or 
     dizziness;
       (II) cognitive symptoms, such as memory disturbance or 
     slowed thinking;
       (III) emotional symptoms, such as irritability or sadness; 
     or
       (IV) difficulty sleeping; and

       (C) can occur--
       (i) with or without the loss of consciousness; and
       (ii) during participation in any organized sport or 
     recreational activity.
       (2) Health care professional.--The term ``health care 
     professional''--
       (A) means an individual who has been trained in diagnosis 
     and management of traumatic brain injury in a pediatric 
     population; and
       (B) includes a physician (M.D. or D.O.) or certified 
     athletic trainer who is registered, licensed, certified, or 
     otherwise statutorily recognized by the State to provide such 
     diagnosis and management.
       (3) Local educational agency; state.--The terms ``local 
     educational agency'' and ``State'' have the meanings given 
     such terms in section 9101 of the Elementary and Secondary 
     Education Act of 1965 (20 U.S.C. 7801).
       (4) Related services personnel.--The term ``related 
     services personnel'' means individuals who provide related 
     services, as defined under section 602 of the Individuals 
     with Disabilities Education Act (20 U.S.C. 1401).
       (5) School-sponsored athletic activity.--The term ``school-
     sponsored athletic activity'' means--
       (A) any physical education class or program of a school;
       (B) any athletic activity authorized during the school day 
     on school grounds that is not an instructional activity;
       (C) any extra-curricular sports team, club, or league 
     organized by a school on or off school grounds; and
       (D) any recess activity.
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