2024 -- H 7870

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LC005073

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2024

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A N   A C T

RELATING TO EDUCATION -- SCHOOL PROGRAMS CONCUSSION ACT

     Introduced By: Representative Jacquelyn M. Baginski

     Date Introduced: March 04, 2024

     Referred To: House Education

     It is enacted by the General Assembly as follows:

     SECTION 1. Title 16 of the General Laws entitled "EDUCATION" is hereby amended by

adding thereto the following chapter:

CHAPTER 91.2

SCHOOL PROGRAMS CONCUSSION ACT

     16-91.2-1. Definitions.

     For the purpose of this section, the following terms shall have the following meanings:

     (1) "Athletic trainer" means an athletic trainer licensed under chapter 60 of title 5, who is

working under the supervision of a physician.

     (2) "Coach" means any volunteer or employee of a school who is responsible for organizing

and supervising students to teach them or train them in the fundamental skills of an interscholastic

athletic activity. "Coach" refers to both head coaches and assistant coaches.

     (3) "Concussion" means a complex pathophysiological process affecting the brain caused

by a traumatic physical force or impact to the head or body, which may include temporary or

prolonged altered brain function resulting in physical, cognitive, or emotional symptoms or altered

sleep patterns and which may or may not involve a loss of consciousness.

     (4) "Interscholastic athletic activity" means any organized school-sponsored or school-

sanctioned activity for students, generally outside of school instructional hours, under the direction

of a coach, athletic director, or band leader, including, but not limited to, baseball, basketball,

cheerleading, cross country track, fencing, field hockey, football, golf, gymnastics, ice hockey,

lacrosse, marching band, rugby, soccer, skating, softball, swimming and diving, tennis, track

(indoor and outdoor), ultimate Frisbee, volleyball, water polo, and wrestling. All interscholastic

athletics are deemed to be interscholastic activities.

     (5) "Nurse" means a person who is employed by or volunteers at a school and is licensed

under chapter 34 of title 5, as a registered nurse, practical nurse, or advanced practice registered

nurse.

     (6) "Physician" means a physician licensed to practice medicine in all of its branches by

the board of medical licensure and discipline.

     (7) "Physician assistant" means a physician assistant licensed under chapter 54 of title 5;

     (8) "School" means any public or private elementary or secondary school, including a 19

charter school.

     (9) "Student" means an adolescent or child enrolled in a school.

     16-91.2-2. School district guidelines to be developed and implemented.

     (a) The governing body of each public or charter school and the appropriate administrative

officer of a private school with students enrolled shall appoint or approve a concussion oversight

team. Each concussion oversight team shall establish a return-to-play protocol, based on peer-

reviewed scientific evidence consistent with the Centers for Disease Control and Prevention

guidelines, for a student's return to interscholastic athletics practice or competition following a

force or impact believed to have caused a concussion.

     (b) Each concussion oversight team shall also establish a return-to-learn protocol, based on

peer-reviewed scientific evidence consistent with the Centers for Disease Control and Prevention

guidelines, for a student's return to the classroom after that student is believed to have experienced

a concussion, whether or not the concussion took place while the student was participating in an

interscholastic athletic activity.

     (c) Each concussion oversight team shall include to the extent practicable at least one

physician. If a school employs an athletic trainer, the athletic trainer shall be a member of the school

concussion oversight team to the extent practicable. If a school employs a nurse, the nurse shall be

a member of the school concussion oversight team to the extent practicable. At a minimum, a school

shall appoint a person who is responsible for implementing and complying with the return-to-play

and return-to-learn protocols adopted by the concussion oversight team. At a minimum, a

concussion oversight team may be composed of only one person and this person need not be a

licensed healthcare professional; provided, however, the person shall not be a coach. A school may

appoint other licensed healthcare professionals to serve on the concussion oversight team.

     16-91.2-3. Student participation in interscholastic activity -- Concussion brochure.

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     (a) A student shall not participate in an interscholastic athletic activity for a school year

until the student and the student's parent or guardian or another person with legal authority to make

medical decisions for the student have signed a form for that school year that acknowledges

receiving and reading written information that explains concussion prevention, symptoms,

treatment, and oversight and that includes guidelines for safely resuming participation in an athletic

activity following a concussion. The form shall be approved by the commissioner of elementary

and secondary education.

     (b) The commissioner shall develop, publish, and disseminate a brochure to educate the

parents and the general public on the effects of concussions in children and discuss how to look for

concussion warning signs in children, including, but not limited to, delays in the learning

development of children. The brochure shall be distributed free of charge by schools to any child

or the parent or guardian of a child who may have sustained a concussion, regardless of whether or

not the concussion occurred while the child was participating in an interscholastic athletic activity.

This brochure shall satisfy the written information required in subsection (a) of this section.

     16-91.2-4. Removal of student from practice or competition upon suspicion of

sustaining a concussion.

     (a) A student shall be removed from an interscholastic athletics practice or competition

immediately if one of the following persons believes the student might have sustained a concussion

during the practice or competition:

     (1) A coach;

     (2) A physician;

     (3) An athletic trainer;

     (4) The student's parent or guardian or another person with legal authority to make medical

decisions for the student;

     (5) The student; or

     (6) Any other person deemed appropriate under the school's return-to-play protocol.

     16-91.2-5. Requirements for return to practice or competition.

     (a) A student removed from an interscholastic athletics practice or competition under § 16-

91.2-4 shall not be permitted to practice or compete again following the force or impact believed

to have caused the concussion until:

     (1) The student has been evaluated, using established medical protocols based on peer

reviewed scientific evidence consistent with Centers for Disease Control and Prevention guidelines,

by a treating physician (chosen by the student or the student's parent or guardian or another person

with legal authority to make medical decisions for the student), an athletic trainer, an advanced

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practice registered nurse, or a physician assistant;

     (2) The student has successfully completed each requirement of the return-to-play protocol

established under this section necessary for the student to return to play or practice; The student

has successfully completed each requirement of the return-to-learn protocol established under this

section necessary for the student to return to learn;

     (3) The treating physician, the athletic trainer, or the physician assistant has provided a

written statement indicating that, in the physician's professional judgment, it is safe for the student

to return to play or practice and return to learn or the treating advanced practice registered nurse,

the athletic trainer or the physician assistant has provided a written statement indicating that it is

safe for the student to return to play or practice and return to learn; and

     (4) The student and the student's parent or guardian or another person with legal authority

to make medical decisions for the student:

     (i) Have acknowledged that the student has completed the requirements of the return-to

play and return-to-learn protocols necessary for the student to return to play or practice;

     (ii) Have provided the treating physician's, athletic trainer's, advanced practice registered

nurse's, or physician assistant's written statement under subsection (a)(4) of this section to the

person responsible for compliance with the return-to-play and return-to-learn protocols under § 16-

91.2-2(c) and the person who has supervisory responsibilities under subsection (b) of this section;

and

     (iii) Have signed a consent form indicating that the person signing:

     (A) Has been informed concerning and consents to the student participating in returning to

play or practice in accordance with the return-to-play and return-to-learn protocols;

     (B) Understands the risks associated with the student returning to play or practice and

returning to learn and will comply with any ongoing requirements in the return-to-play and return

to-learn protocols; and

     (C) Consents to the disclosure to appropriate persons, consistent with the federal Health

Insurance Portability and Accountability Act of 1996 (Pub, L. 104-191), of the treating physician's,

athletic trainer's, physician assistant's, or advanced practice registered nurse's written statement

under subsection (a)(4) of this section and, if any, the return-to-play and return-to-learn

recommendations of the treating physician, the athletic trainer, the physician assistant, or the

advanced practice registered nurse, as the case may be.

     (b) A coach of an interscholastic athletics team may not authorize a student's return to play

or practice or return to learn. The district superintendent, or designee, in the case of a public

elementary or secondary school, the chief school administrator, or designee, in the case of a charter

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school, or the appropriate administrative officer, or designee, in the case of a private school shall

supervise an athletic trainer or other person responsible for compliance with the return-to-play

protocol and shall supervise the person responsible for compliance with the return-to-learn

protocol. The person who has supervisory responsibilities under this subsection may not be a coach

of an interscholastic athletics team.

     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO EDUCATION -- SCHOOL PROGRAMS CONCUSSION ACT

***

     This act would modernize and update the prior chapter on this subject by requiring the

development of school district concussion guidelines, a brochure for the students and parents, the

procedures for removal and return of a student from or to practice or competition and mandatory

concussion training for coaches and game officials.

     This act would take effect upon passage.

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