Rhode Island 2023 Regular Session

Rhode Island House Bill H5857 Compare Versions

Only one version of the bill is available at this time.
OldNewDifferences
11
22
33
44
55 2023 -- H 5857
66 ========
77 LC002238
88 ========
99 S TATE OF RHODE IS LAND
1010 IN GENERAL ASSEMBLY
1111 JANUARY SESSION, A.D. 2023
1212 ____________
1313
1414 A N A C T
1515 RELATING TO EDUCATION -- SCHOOL AND YOUTH PROGRAMS CONCUSSION ACT
1616 Introduced By: Representatives Baginski, Noret, Casimiro, and McNamara
1717 Date Introduced: March 01, 2023
1818 Referred To: House Education
1919
2020
2121 It is enacted by the General Assembly as follows:
2222 SECTION 1. Title 16 of the General Laws entitled "EDUCATION" is hereby amended by 1
2323 adding thereto the following chapter: 2
2424 CHAPTER 91.2 3
2525 SCHOOL AND YOUTH PROGRAMS CONCUSSION ACT 4
2626 16-91.2-1. Definitions. 5
2727 For the purpose of this section, the following terms shall have the following meanings: 6
2828 (1) "Athletic trainer" means an athletic trainer licensed under chapter 60 of title 5, who is 7
2929 working under the supervision of a physician. 8
3030 (2) "Coach" means any volunteer or employee of a school who is responsible for organizing 9
3131 and supervising students to teach them or train them in the fundamental skills of an interscholastic 10
3232 athletic activity. "Coach" refers to both head coaches and assistant coaches. 11
3333 (3) "Concussion" means a complex pathophysiological process affecting the brain caused 12
3434 by a traumatic physical force or impact to the head or body, which may include temporary or 13
3535 prolonged altered brain function resulting in physical, cognitive, or emotional symptoms or altered 14
3636 sleep patterns and which may or may not involve a loss of consciousness. 15
3737 (4) "Game official" means a person who officiates at an interscholastic athletic activity, 16
3838 such as a referee or umpire, including, but not limited to, persons enrolled or provided as game 17
3939 officials by the Rhode Island Interscholastic League. 18
4040 (5) "Interscholastic athletic activity" means any organized school-sponsored or school-19
4141
4242
4343 LC002238 - Page 2 of 10
4444 sanctioned activity for students, generally outside of school instructional hours, under the direction 1
4545 of a coach, athletic director, or band leader, including, but not limited to, baseball, basketball, 2
4646 cheerleading, cross country track, fencing, field hockey, football, golf, gymnastics, ice hockey, 3
4747 lacrosse, marching band, rugby, soccer, skating, softball, swimming and diving, tennis, track 4
4848 (indoor and outdoor), ultimate Frisbee, volleyball, water polo, and wrestling. All interscholastic 5
4949 athletics are deemed to be interscholastic activities. 6
5050 (6) "Licensed healthcare professional" means a person who has experience with concussion 7
5151 management and who is a nurse licensed under chapter 34 or title 5, a psychologist licensed under 8
5252 chapter 44 of title 5 and specializes in the practice of neuropsychology, a physical therapist licensed 9
5353 under chapter 40 of title 5, an occupational therapist licensed under chapter 40.1 of title 5, a 10
5454 physician assistant under chapter 54, of title 5, or an athletic trainer. 11
5555 (7) "Nurse" means a person who is employed by or volunteers at a school and is licensed 12
5656 under chapter 34 of title 5, as a registered nurse, practical nurse, or advanced practice registered 13
5757 nurse. 14
5858 (8) "Physician" means a physician licensed to practice medicine in all of its branches by 15
5959 the board of medical licensure and discipline. 16
6060 (9) "Physician assistant" means a physician assistant licensed under chapter 54 of title 5; 17
6161 (10) "School" means any public or private elementary or secondary school, including a 18
6262 charter school. 19
6363 (11) "Student" means an adolescent or child enrolled in a school. 20
6464 (12) "Youth sports programs" means any program organized for recreational and/or athletic 21
6565 competition purposes by any school district or by any school participating in Rhode Island 22
6666 interscholastic league competition, and whose participants are nineteen (19) years of age or 23
6767 younger. 24
6868 16-91.2-2. School district guidelines to be developed and implemented. 25
6969 (a) The governing body of each public or charter school and the appropriate administrative 26
7070 officer of a private school with students enrolled who participate in an interscholastic athletic 27
7171 activity shall appoint or approve a concussion oversight team. Each concussion oversight team shall 28
7272 establish a return-to-play protocol, based on peer-reviewed scientific evidence consistent with the 29
7373 Centers for Disease Control and Prevention guidelines, for a student's return to interscholastic 30
7474 athletics practice or competition following a force or impact believed to have caused a concussion. 31
7575 (b) Each concussion oversight team shall also establish a return-to-learn protocol, based on 32
7676 peer-reviewed scientific evidence consistent with the Centers for Disease Control and Prevention 33
7777 guidelines, for a student's return to the classroom after that student is believed to have experienced 34
7878
7979
8080 LC002238 - Page 3 of 10
8181 a concussion, whether or not the concussion took place while the student was participating in an 1
8282 interscholastic athletic activity. 2
8383 (c) Each concussion oversight team shall include to the extent practicable at least one 3
8484 physician. If a school employs an athletic trainer, the athletic trainer shall be a member of the school 4
8585 concussion oversight team to the extent practicable. If a school employs a nurse, the nurse shall be 5
8686 a member of the school concussion oversight team to the extent practicable. At a minimum, a school 6
8787 shall appoint a person who is responsible for implementing and complying with the return-to-play 7
8888 and return-to-learn protocols adopted by the concussion oversight team. At a minimum, a 8
8989 concussion oversight team may be composed of only one person and this person need not be a 9
9090 licensed healthcare professional; provided, however, the person shall not be a coach. A school may 10
9191 appoint other licensed healthcare professionals to serve on the concussion oversight team. 11
9292 16-91.2-3. Student participation in interscholastic activity -- Concussion brochure. 12
9393 (a) A student shall not participate in an interscholastic athletic activity for a school year 13
9494 until the student and the student's parent or guardian or another person with legal authority to make 14
9595 medical decisions for the student have signed a form for that school year that acknowledges 15
9696 receiving and reading written information that explains concussion prevention, symptoms, 16
9797 treatment, and oversight and that includes guidelines for safely resuming participation in an athletic 17
9898 activity following a concussion. The form shall be approved by the commissioner of elementary 18
9999 and secondary education. 19
100100 (b) The commissioner shall develop, publish, and disseminate a brochure to educate the 20
101101 parents and the general public on the effects of concussions in children and discuss how to look for 21
102102 concussion warning signs in children, including, but not limited to, delays in the learning 22
103103 development of children. The brochure shall be distributed free of charge by schools to any child 23
104104 or the parent or guardian of a child who may have sustained a concussion, regardless of whether or 24
105105 not the concussion occurred while the child was participating in an interscholastic athletic activity. 25
106106 This brochure shall satisfy the written information required in subsection (a) of this section. 26
107107 (c) This section shall also apply to youth sports programs. 27
108108 16-91.2-4. Removal of student from practice or competition upon suspicion of 28
109109 sustaining a concussion. 29
110110 (a) A student shall be removed from an interscholastic athletics practice or competition 30
111111 immediately if one of the following persons believes the student might have sustained a concussion 31
112112 during the practice or competition: 32
113113 (1) A coach; 33
114114 (2) A physician; 34
115115
116116
117117 LC002238 - Page 4 of 10
118118 (3) A game official; 1
119119 (4) An athletic trainer; 2
120120 (5) The student's parent or guardian or another person with legal authority to make medical 3
121121 decisions for the student; 4
122122 (6) The student; or 5
123123 (7) Any other person deemed appropriate under the school's return-to-play protocol. 6
124124 (b) This section shall also apply to youth sports programs. 7
125125 16-91.2-5. Requirements for return to practice or competition. 8
126126 (a) A student removed from an interscholastic athletics practice or competition under § 16-9
127127 91.2-4 shall not be permitted to practice or compete again following the force or impact believed 10
128128 to have caused the concussion until: 11
129129 (1) The student has been evaluated, using established medical protocols based on peer-12
130130 reviewed scientific evidence consistent with Centers for Disease Control and Prevention guidelines, 13
131131 by a treating physician (chosen by the student or the student's parent or guardian or another person 14
132132 with legal authority to make medical decisions for the student), an athletic trainer, an advanced 15
133133 practice registered nurse, or a physician assistant; 16
134134 (2) The student has successfully completed each requirement of the return-to-play protocol 17
135135 established under this section necessary for the student to return to play or practice; 18
136136 (3) The student has successfully completed each requirement of the return-to-learn protocol 19
137137 established under this section necessary for the student to return to learn; 20
138138 (4) The treating physician, the athletic trainer, or the physician assistant has provided a 21
139139 written statement indicating that, in the physician's professional judgment, it is safe for the student 22
140140 to return to play or practice and return to learn or the treating advanced practice registered nurse, 23
141141 the athletic trainer or the physician assistant has provided a written statement indicating that it is 24
142142 safe for the student to return to play or practice and return to learn; and 25
143143 (5) The student and the student's parent or guardian or another person with legal authority 26
144144 to make medical decisions for the student: 27
145145 (i) Have acknowledged that the student has completed the requirements of the return-to-28
146146 play and return-to-learn protocols necessary for the student to return to play or practice; 29
147147 (ii) Have provided the treating physician's, athletic trainer's, advanced practice registered 30
148148 nurse's, or physician assistant's written statement under subsection (a)(4) of this section to the 31
149149 person responsible for compliance with the return-to-play and return-to-learn protocols under § 16-32
150150 91.2-2(c) and the person who has supervisory responsibilities under subsection (b) of this section; 33
151151 and 34
152152
153153
154154 LC002238 - Page 5 of 10
155155 (iii) Have signed a consent form indicating that the person signing: 1
156156 (A) Has been informed concerning and consents to the student participating in returning to 2
157157 play or practice in accordance with the return-to-play and return-to-learn protocols; 3
158158 (B) Understands the risks associated with the student returning to play or practice and 4
159159 returning to learn and will comply with any ongoing requirements in the return-to-play and return-5
160160 to-learn protocols; and 6
161161 (C) Consents to the disclosure to appropriate persons, consistent with the federal Health 7
162162 Insurance Portability and Accountability Act of 1996 (Pub, L. 104-191), of the treating physician's, 8
163163 athletic trainer's, physician assistant's, or advanced practice registered nurse's written statement 9
164164 under subsection (a)(4) of this section and, if any, the return-to-play and return-to-learn 10
165165 recommendations of the treating physician, the athletic trainer, the physician assistant, or the 11
166166 advanced practice registered nurse, as the case may be. 12
167167 (b) A coach of an interscholastic athletics team may not authorize a student's return to play 13
168168 or practice or return to learn. The district superintendent, or designee, in the case of a public 14
169169 elementary or secondary school, the chief school administrator, or designee, in the case of a charter 15
170170 school, or the appropriate administrative officer, or designee, in the case of a private school shall 16
171171 supervise an athletic trainer or other person responsible for compliance with the return-to-play 17
172172 protocol and shall supervise the person responsible for compliance with the return-to-learn 18
173173 protocol. The person who has supervisory responsibilities under this subsection may not be a coach 19
174174 of an interscholastic athletics team. 20
175175 16-91.2-6. Mandatory training for coaches and game officials. 21
176176 (a)(1) The Rhode Island interscholastic league shall approve, for coaches, game officials, 22
177177 and non-licensed healthcare professionals, training courses that provide for not less than two (2) 23
178178 hours of training in the subject matter of concussions, including evaluation, prevention, symptoms, 24
179179 risks, and long-term effects. The league shall maintain an updated list of individuals and 25
180180 organizations authorized by the league to provide the training. 26
181181 (2) The following persons shall take a training course in accordance with subsection (a)(4) 27
182182 of this section from an authorized training provider at least once every two (2) years: 28
183183 (i) A coach of an interscholastic athletic activity; 29
184184 (ii) A nurse, licensed healthcare professional, or non-licensed healthcare professional who 30
185185 serves as a member of a concussion oversight team either on a volunteer basis or in their capacity 31
186186 as an employee, representative, or agent of a school; and 32
187187 (iii) A game official of an interscholastic athletic activity. 33
188188 (3) A physician who serves as a member of a concussion oversight team shall, to the 34
189189
190190
191191 LC002238 - Page 6 of 10
192192 greatest extent practicable, periodically take an appropriate continuing medical education course in 1
193193 the subject matter of concussions. 2
194194 (4) For purposes of subsection (a)(2) of this section: 3
195195 (i) A coach, game official, or non-licensed healthcare professional, as the case may be, 4
196196 shall take a course described in subsection (a)(1) of this section; 5
197197 (ii) An athletic trainer shall take a concussion-related continuing education course from an 6
198198 athletic trainer continuing education sponsor approved by the commissioner; 7
199199 (iii) A nurse shall take a concussion-related continuing education course from a nurse 8
200200 continuing education sponsor approved by the commissioner; 9
201201 (iv) A physical therapist shall take a concussion-related continuing education course from 10
202202 a physical therapist continuing education sponsor approved by the commissioner; 11
203203 (v) A psychologist shall take a concussion-related continuing education course from a 12
204204 psychologist continuing education sponsor approved by the commissioner; 13
205205 (vi) An occupational therapist shall take a concussion-related continuing education course 14
206206 from an occupational therapist continuing education sponsor approved by the commissioner; and 15
207207 (vii) A physician assistant shall take a concussion-related continuing education course from 16
208208 a physician assistant continuing education sponsor approved by the commissioner. 17
209209 (5) Each person described in subsection (a)(2) of this section shall submit proof of timely 18
210210 completion of an approved course in compliance with subsection (a)(4) of this section to the district 19
211211 superintendent, or designee, in the case of a public elementary or secondary school, the chief school 20
212212 administrator, or designee, in the case of a charter school, or the appropriate administrative officer, 21
213213 or designee, in the case of a private school. 22
214214 (6) A physician, licensed healthcare professional, or non-licensed healthcare professional 23
215215 who is not in compliance with the training requirements under this subsection shall not serve on a 24
216216 concussion oversight team in any capacity. 25
217217 (7) A person required under this subsection to take a training course in the subject of 26
218218 concussions shall complete the training prior to serving on a concussion oversight team in any 27
219219 capacity. 28
220220 (b) The governing body of each public or charter school and the appropriate administrative 29
221221 officer of a private school with students enrolled who participate in an interscholastic athletic 30
222222 activity shall develop a school-specific emergency action plan for interscholastic athletic activities 31
223223 to address the serious injuries and acute medical conditions in which the condition of the student 32
224224 may deteriorate rapidly. The plan shall include a delineation of roles, methods of communication, 33
225225 available emergency equipment, and access to and a plan for emergency transport. This emergency 34
226226
227227
228228 LC002238 - Page 7 of 10
229229 action plan shall be: 1
230230 (1) In writing; 2
231231 (2) Reviewed by the concussion oversight team; 3
232232 (3) Approved by the district superintendent, or designee, in the case of a public elementary 4
233233 or secondary school, the chief school administrator, or designee, in the case of a charter school, or 5
234234 the appropriate administrative officer, or designee, in the case of a private school; 6
235235 (4) Distributed to all appropriate personnel; 7
236236 (5) Posted conspicuously at all venues utilized by the school; and 8
237237 (6) Reviewed annually by all athletic trainers, first responders, coaches, school nurses, 9
238238 athletic directors, and volunteers for interscholastic athletic activities. 10
239239 16-91.2-7. All other youth sports programs. 11
240240 All other youth sports programs not specifically addressed by this chapter are encouraged 12
241241 to follow the guidance set forth in this chapter for all program participants who are age nineteen 13
242242 (19) and younger. 14
243243 16-91.2-8. Rules and regulations. 15
244244 The commissioner of education shall promulgate rules and regulations as necessary to 16
245245 administer this chapter, including, but not limited to, rules governing the informal or formal 17
246246 accommodation of a student who may have sustained a concussion during an interscholastic athletic 18
247247 activity or practice. 19
248248 SECTION 2. Chapter 16-91 of the General Laws entitled "School and Youth Programs 20
249249 Concussion Act" is hereby repealed in its entirety. 21
250250 CHAPTER 16-91 22
251251 School and Youth Programs Concussion Act 23
252252 16-91-1. Findings of fact. 24
253253 The general assembly hereby finds and declares: (1) Concussions are one of the most 25
254254 commonly reported injuries in children and adolescents who participate in sports and recreational 26
255255 activities. A concussion is caused by a blow or motion to the head or body that causes the brain to 27
256256 move rapidly inside the skull. The risk of catastrophic injuries or death is significant when a 28
257257 concussion or head injury is not properly evaluated and managed. 29
258258 (2) Concussions are a type of brain injury that can range from mild to severe and can disrupt 30
259259 the way the brain normally works. Concussions can occur in any organized or unorganized sport 31
260260 or recreational activity and can result from a fall or from players colliding with each other, the 32
261261 ground, or with obstacles. Concussions occur with or without loss of consciousness, but the vast 33
262262 majority occurs without loss of consciousness. 34
263263
264264
265265 LC002238 - Page 8 of 10
266266 (3) Continuing to play with a concussion or symptoms of a head injury leaves the young 1
267267 athlete especially vulnerable to greater injury and even death. The general assembly also recognizes 2
268268 that, despite having generally recognized return-to-play standards for concussion and head injury, 3
269269 some affected youth athletes are prematurely returned to play resulting in actual or potential 4
270270 physical injury or death to youth athletes in the state of Rhode Island. 5
271271 (4) Concussions can occur in any sport or recreational activity, furthermore, symptoms of 6
272272 concussions may manifest themselves after the injury during school hours and in the classroom 7
273273 setting. All school nurses, coaches, parents, and athletes shall be advised of the signs and symptoms 8
274274 of concussions as well as the protocol for treatment. 9
275275 16-91-2. Definitions. 10
276276 For the purpose of this section, the term “youth sports programs” means any program 11
277277 organized for recreational and/or athletic competition purposes by any school district or by any 12
278278 school participating in Rhode Island Interscholastic League Competition, and whose participants 13
279279 are nineteen (19) years of age or younger. 14
280280 16-91-3. School district’s guidelines to be developed and implemented. 15
281281 (a) The department of education and the department of health shall work in concert with 16
282282 the Rhode Island Interscholastic League to develop and promulgate guidelines to inform and 17
283283 educate coaches, teachers, school nurses, youth athletes, and their parents and/or guardians of the 18
284284 nature and risk of concussion and head injury, including continuing to play after concussion or head 19
285285 injury. A concussion and head injury information sheet shall be signed and returned by the youth 20
286286 athlete and the athlete’s parent and/or guardian prior to the youth athlete’s return to practice or 21
287287 competition. 22
288288 (b) School districts are required to use training materials made available by the United 23
289289 States Center for Disease Control and Prevention entitled “Heads Up: Concussion in the High 24
290290 School Sports/Concussion in Youth Sports” and any updates or amendments thereto, or training 25
291291 materials substantively and substantially similar thereto. The department of education shall post 26
292292 training materials made available by the Center for Disease Control and Prevention and the Rhode 27
293293 Island Interscholastic League on its website. All coaches and volunteers involved in a youth sport 28
294294 or activity covered by this chapter must complete a training course and a refresher course annually 29
295295 thereafter in concussions and traumatic brain injuries. All school nurses must complete a training 30
296296 course and an annual refresher course in concussions and traumatic brain injuries. Teachers and 31
297297 teachers’ aides are strongly encouraged to complete the training course in concussions and 32
298298 traumatic brain injuries. Training may consist of videos, classes, and any other generally accepted 33
299299 mode and medium of providing information. 34
300300
301301
302302 LC002238 - Page 9 of 10
303303 (c) School districts are encouraged to have all student athletes perform baseline 1
304304 neuropsychological testing, computerized or otherwise. Parents and/or guardians shall be provided 2
305305 with information as to the risk of concussion and/or traumatic brain injuries prior to the start of 3
306306 every sport season and they shall sign an acknowledgement as to their receipt of such information. 4
307307 (d) A youth athlete, who is suspected of sustaining a concussion or head injury in a practice 5
308308 or game, shall be removed from competition at that time. 6
309309 (e) A youth athlete, who has been removed from play, may not return to play until the 7
310310 athlete is evaluated by a licensed physician who may consult with an athletic trainer, all of whom 8
311311 shall be trained in the evaluation and management of concussions. The athlete must receive written 9
312312 clearance to return to play from that licensed physician. 10
313313 (f) All school districts are encouraged to have an athletic trainer, or similarly trained 11
314314 person, at all recreational and athletic events addressed by this statute. 12
315315 16-91-4. All other youth sports program. 13
316316 All other youth sports programs not specifically addressed by this statute are encouraged 14
317317 to follow the guidance set forth in this statute for all program participants who are age nineteen 15
318318 (19) and younger. 16
319319 SECTION 3. This act shall take effect on July 1, 2024. 17
320320 ========
321321 LC002238
322322 ========
323323
324324
325325 LC002238 - Page 10 of 10
326326 EXPLANATION
327327 BY THE LEGISLATIVE COUNCIL
328328 OF
329329 A N A C T
330330 RELATING TO EDUCATION -- SCHOOL AND YOUTH PRO GRAMS CONCUSSION ACT
331331 ***
332332 This act would modernize and update the prior chapter on this subject by requiring the 1
333333 development of school district concussion guidelines, a brochure for the students and parents, the 2
334334 procedures for removal and return of a student from or to practice or competition and mandatory 3
335335 concussion training for coaches and game officials. 4
336336 This act would take effect on July 1, 2024. 5
337337 ========
338338 LC002238
339339 ========