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| 5 | 5 | | 2025 -- S 0319 |
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| 7 | 7 | | LC001566 |
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| 8 | 8 | | ======== |
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| 9 | 9 | | S T A T E O F R H O D E I S L A N D |
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| 10 | 10 | | IN GENERAL ASSEMBLY |
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| 11 | 11 | | JANUARY SESSION, A.D. 2025 |
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| 12 | 12 | | ____________ |
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| 13 | 13 | | |
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| 14 | 14 | | A N A C T |
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| 15 | 15 | | RELATING TO EDUCATION -- SCHOOL AND YOUTH PROGRAMS CONCUSSION ACT |
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| 16 | 16 | | Introduced By: Senators Felag, LaMountain, Britto, and Urso |
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| 17 | 17 | | Date Introduced: February 21, 2025 |
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| 18 | 18 | | Referred To: Senate Education |
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| 19 | 19 | | |
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| 20 | 20 | | |
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| 21 | 21 | | It is enacted by the General Assembly as follows: |
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| 22 | 22 | | SECTION 1. Title 16 of the General Laws entitled "EDUCATION" is hereby amended by 1 |
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| 23 | 23 | | adding thereto the following chapter: 2 |
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| 24 | 24 | | CHAPTER 91.2 3 |
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| 25 | 25 | | SCHOOL AND YOUTH PROGRAMS CONCUSSION ACT 4 |
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| 26 | 26 | | 16-91.2-1. Definitions. 5 |
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| 27 | 27 | | For the purposes of this section, the following terms shall have the following meanings: 6 |
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| 28 | 28 | | (1) "Athletic trainer" means an athletic trainer licensed under chapter 60 of title 5, who is 7 |
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| 29 | 29 | | working under the supervision of a physician. 8 |
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| 30 | 30 | | (2) "Coach" means any volunteer or employee of a school who is responsible for organizing 9 |
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| 31 | 31 | | and supervising students to teach them or train them in the fundamental skills of an interscholastic 10 |
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| 32 | 32 | | athletic activity. "Coach" refers to both head coaches and assistant coaches. 11 |
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| 33 | 33 | | (3) "Concussion" means a complex pathophysiological process affecting the brain caused 12 |
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| 34 | 34 | | by a traumatic physical force or impact to the head or body, which may include temporary or 13 |
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| 35 | 35 | | prolonged altered brain function resulting in physical, cognitive, or emotional symptoms or altered 14 |
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| 36 | 36 | | sleep patterns and which may or may not involve a loss of consciousness. 15 |
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| 37 | 37 | | (4) "Interscholastic athletic activity" means any organized school-sponsored or school- 16 |
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| 38 | 38 | | sanctioned activity for students, generally outside of school instructional hours, under the direction 17 |
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| 39 | 39 | | of a coach, athletic director, or band leader, including, but not limited to, baseball, basketball, 18 |
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| 40 | 40 | | cheerleading, cross country track, fencing, field hockey, football, golf, gymnastics, ice hockey, 19 |
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| 41 | 41 | | |
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| 42 | 42 | | |
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| 43 | 43 | | LC001566 - Page 2 of 7 |
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| 44 | 44 | | lacrosse, marching band, rugby, soccer, skating, softball, swimming and diving, tennis, track 1 |
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| 45 | 45 | | (indoor and outdoor), ultimate Frisbee, volleyball, water polo, and wrestling. All interscholastic 2 |
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| 46 | 46 | | athletics are deemed to be interscholastic activities. 3 |
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| 47 | 47 | | (5) "Nurse" means a person who is employed by or volunteers at a school and is licensed 4 |
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| 48 | 48 | | under chapter 34 of title 5, as a registered nurse, practical nurse, or advanced practice registered 5 |
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| 49 | 49 | | nurse. 6 |
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| 50 | 50 | | (6) "Physician" means a physician licensed to practice medicine in all of its branches by 7 |
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| 51 | 51 | | the board of medical licensure and discipline. 8 |
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| 52 | 52 | | (7) "Physician assistant" means a physician assistant licensed under chapter 54 of title 5. 9 |
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| 53 | 53 | | (8) "Student" means an adolescent or child enrolled in a school. 10 |
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| 54 | 54 | | 16-91.2-2. School district guidelines to be developed and implemented. 11 |
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| 55 | 55 | | (a) The governing body of each public or charter school and the appropriate administrative 12 |
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| 56 | 56 | | officer of a private school with students enrolled who participate in an interscholastic athletic 13 |
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| 57 | 57 | | activity shall appoint or approve a concussion oversight team. Each concussion oversight team shall 14 |
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| 58 | 58 | | establish a return-to-play protocol, based on peer-reviewed scientific evidence consistent with the 15 |
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| 59 | 59 | | Centers for Disease Control and Prevention guidelines, for a student's return to interscholastic 16 |
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| 60 | 60 | | athletics practice or competition following a force or impact believed to have caused a concussion. 17 |
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| 61 | 61 | | (b) Each concussion oversight team shall also establish a return-to-learn protocol, based on 18 |
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| 62 | 62 | | peer-reviewed scientific evidence consistent with the Centers for Disease Control and Prevention 19 |
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| 63 | 63 | | guidelines, for a student's return to the classroom after that student is believed to have experienced 20 |
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| 64 | 64 | | a concussion, whether or not the concussion took place while the student was participating in an 21 |
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| 65 | 65 | | interscholastic athletic activity. 22 |
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| 66 | 66 | | (c) Each concussion oversight team shall include, to the extent practicable, at least one 23 |
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| 67 | 67 | | physician. If a school employs an athletic trainer, the athletic trainer shall be a member of the school 24 |
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| 68 | 68 | | concussion oversight team to the extent practicable. If a school employs a nurse, the nurse shall be 25 |
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| 69 | 69 | | a member of the school concussion oversight team to the extent practicable. At a minimum, a school 26 |
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| 70 | 70 | | shall appoint a person who is responsible for implementing and complying with the return-to-play 27 |
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| 71 | 71 | | and return-to-learn protocols adopted by the concussion oversight team. At a minimum, a 28 |
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| 72 | 72 | | concussion oversight team may be composed of only one person and this person need not be a 29 |
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| 73 | 73 | | licensed healthcare professional; provided, however, the person shall not be a coach. A school may 30 |
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| 74 | 74 | | appoint other licensed healthcare professionals to serve on the concussion oversight team. 31 |
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| 75 | 75 | | 16-91.2-3. Student participation in interscholastic activity -- Concussion brochure. 32 |
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| 76 | 76 | | A student shall not participate in an interscholastic athletic activity for a school year until 33 |
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| 77 | 77 | | the student and the student's parent or guardian or another person with legal authority to make 34 |
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| 78 | 78 | | |
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| 79 | 79 | | |
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| 80 | 80 | | LC001566 - Page 3 of 7 |
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| 81 | 81 | | medical decisions for the student have signed a form for that school year that acknowledges 1 |
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| 82 | 82 | | receiving and reading written information that explains concussion prevention, symptoms, 2 |
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| 83 | 83 | | treatment, and oversight and that includes guidelines for safely resuming participation in an athletic 3 |
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| 84 | 84 | | activity following a concussion. The form shall be approved by the commissioner of elementary 4 |
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| 85 | 85 | | and secondary education. 5 |
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| 86 | 86 | | 16-91.2-4. Removal of student from practice or competition upon suspicion of 6 |
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| 87 | 87 | | sustaining a concussion. 7 |
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| 88 | 88 | | (a) A student shall be removed from an interscholastic athletic practice or competition 8 |
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| 89 | 89 | | immediately if one of the following persons believes the student might have sustained a concussion 9 |
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| 90 | 90 | | during the practice or competition: 10 |
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| 91 | 91 | | (1) A coach; 11 |
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| 92 | 92 | | (2) A physician; 12 |
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| 93 | 93 | | (3) A game official; 13 |
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| 94 | 94 | | (4) An athletic trainer; 14 |
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| 95 | 95 | | (5) The student's parent or guardian or another person with legal authority to make medical 15 |
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| 96 | 96 | | decisions for the student; 16 |
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| 97 | 97 | | (6) The student; or 17 |
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| 98 | 98 | | (7) Any other person deemed appropriate under the school's return-to-play protocol. 18 |
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| 99 | 99 | | (b) This section shall also apply to youth sports programs. 19 |
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| 100 | 100 | | 16-91.2-5. Requirements for return to practice or competition. 20 |
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| 101 | 101 | | (a) A student removed from an interscholastic athletic practice or competition under § 16- 21 |
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| 102 | 102 | | 91.2-4 shall not be permitted to practice or compete again following the force or impact believed 22 |
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| 103 | 103 | | to have caused the concussion until: 23 |
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| 104 | 104 | | (1) The student has been evaluated, using established medical protocols based on peer-24 |
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| 105 | 105 | | reviewed scientific evidence consistent with Centers for Disease Control and Prevention guidelines, 25 |
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| 106 | 106 | | by a treating physician chosen by the student or the student's parent or guardian or another person 26 |
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| 107 | 107 | | with legal authority to make medical decisions for the student, an athletic trainer, an advanced 27 |
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| 108 | 108 | | practice registered nurse, or a physician assistant; 28 |
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| 109 | 109 | | (2) The student has successfully completed each requirement of the return-to-play protocol 29 |
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| 110 | 110 | | established under this section necessary for the student to return to play or practice; 30 |
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| 111 | 111 | | (3) The student has successfully completed each requirement of the return-to-learn protocol 31 |
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| 112 | 112 | | established under this section necessary for the student to return to learn; 32 |
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| 113 | 113 | | (4) The treating physician, the athletic trainer, or the physician assistant has provided a 33 |
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| 114 | 114 | | written statement indicating that, in that person’s professional judgment, it is safe for the student to 34 |
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| 115 | 115 | | |
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| 116 | 116 | | |
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| 117 | 117 | | LC001566 - Page 4 of 7 |
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| 118 | 118 | | return to play or practice and return to learn; and 1 |
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| 119 | 119 | | (5) The student and the student's parent or guardian or another person with legal authority 2 |
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| 120 | 120 | | to make medical decisions for the student: 3 |
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| 121 | 121 | | (i) Have acknowledged that the student has completed the requirements of the return-to 4 |
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| 122 | 122 | | play and return-to-learn protocols necessary for the student to return to play or practice; 5 |
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| 123 | 123 | | (ii) Have provided the treating physician's, athletic trainer's, advanced practice registered 6 |
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| 124 | 124 | | nurse's, or physician assistant's written statement under subsection (a)(4) of this section to the 7 |
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| 125 | 125 | | person responsible for compliance with the return-to-play and return-to-learn protocols under § 16-8 |
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| 126 | 126 | | 91.2-2(c) and the person who has supervisory responsibilities under subsection (b) of this section; 9 |
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| 127 | 127 | | and 10 |
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| 128 | 128 | | (iii) Have signed a consent form indicating that the person signing: 11 |
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| 129 | 129 | | (A) Has been informed concerning and consent to the student participating in returning to 12 |
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| 130 | 130 | | play or practice in accordance with the return-to-play and return-to-learn protocols; 13 |
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| 131 | 131 | | (B) Understands the risks associated with the student returning to play or practice and 14 |
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| 132 | 132 | | returning to learn and will comply with any ongoing requirements in the return-to-play and return 15 |
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| 133 | 133 | | to-learn protocols; and 16 |
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| 134 | 134 | | (C) Consents to the disclosure to appropriate persons, consistent with the federal Health 17 |
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| 135 | 135 | | Insurance Portability and Accountability Act of 1996 (Pub. L. 104-191), of the treating physician's, 18 |
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| 136 | 136 | | athletic trainer's, physician assistant's, or advanced practice registered nurse's written statement 19 |
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| 137 | 137 | | under subsection (a)(4) of this section and, if any, the return-to-play and return-to-learn 20 |
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| 138 | 138 | | recommendations of the treating physician, the athletic trainer, the physician assistant, or the 21 |
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| 139 | 139 | | advanced practice registered nurse, as the case may be. 22 |
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| 140 | 140 | | (b) A coach of an interscholastic athletics team may not authorize a student's return to play 23 |
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| 141 | 141 | | or practice or return to learn. The district superintendent, or designee, in the case of a public 24 |
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| 142 | 142 | | elementary or secondary school, the chief school administrator, or designee, in the case of a charter 25 |
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| 143 | 143 | | school, or the appropriate administrative officer, or designee, in the case of a private school shall 26 |
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| 144 | 144 | | supervise an athletic trainer or other person responsible for compliance with the return-to-play 27 |
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| 145 | 145 | | protocol and shall supervise the person responsible for compliance with the return-to-learn 28 |
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| 146 | 146 | | protocol. The person who has supervisory responsibilities under this subsection may not be a coach 29 |
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| 147 | 147 | | of an interscholastic athletics team. 30 |
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| 148 | 148 | | SECTION 2. Chapter 16-91 of the General Laws entitled "School and Youth Programs 31 |
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| 149 | 149 | | Concussion Act" is hereby repealed in its entirety. 32 |
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| 150 | 150 | | CHAPTER 16-91 33 |
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| 151 | 151 | | School and Youth Programs Concussion Act 34 |
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| 152 | 152 | | |
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| 153 | 153 | | |
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| 154 | 154 | | LC001566 - Page 5 of 7 |
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| 155 | 155 | | 16-91-1. Findings of fact. 1 |
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| 156 | 156 | | The general assembly hereby finds and declares: (1) Concussions are one of the most 2 |
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| 157 | 157 | | commonly reported injuries in children and adolescents who participate in sports and recreational 3 |
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| 158 | 158 | | activities. A concussion is caused by a blow or motion to the head or body that causes the brain to 4 |
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| 159 | 159 | | move rapidly inside the skull. The risk of catastrophic injuries or death is significant when a 5 |
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| 160 | 160 | | concussion or head injury is not properly evaluated and managed. 6 |
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| 161 | 161 | | (2) Concussions are a type of brain injury that can range from mild to severe and can disrupt 7 |
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| 162 | 162 | | the way the brain normally works. Concussions can occur in any organized or unorganized sport 8 |
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| 163 | 163 | | or recreational activity and can result from a fall or from players colliding with each other, the 9 |
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| 164 | 164 | | ground, or with obstacles. Concussions occur with or without loss of consciousness, but the vast 10 |
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| 165 | 165 | | majority occurs without loss of consciousness. 11 |
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| 166 | 166 | | (3) Continuing to play with a concussion or symptoms of a head injury leaves the young 12 |
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| 167 | 167 | | athlete especially vulnerable to greater injury and even death. The general assembly also recognizes 13 |
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| 168 | 168 | | that, despite having generally recognized return-to-play standards for concussion and head injury, 14 |
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| 169 | 169 | | some affected youth athletes are prematurely returned to play resulting in actual or potential 15 |
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| 170 | 170 | | physical injury or death to youth athletes in the state of Rhode Island. 16 |
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| 171 | 171 | | (4) Concussions can occur in any sport or recreational activity, furthermore, symptoms of 17 |
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| 172 | 172 | | concussions may manifest themselves after the injury during school hours and in the classroom 18 |
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| 173 | 173 | | setting. All school nurses, coaches, parents, and athletes shall be advised of the signs and symptoms 19 |
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| 174 | 174 | | of concussions as well as the protocol for treatment. 20 |
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| 175 | 175 | | 16-91-2. Definitions. 21 |
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| 176 | 176 | | For the purpose of this section, the term “youth sports programs” means any program 22 |
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| 177 | 177 | | organized for recreational and/or athletic competition purposes by any school district or by any 23 |
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| 178 | 178 | | school participating in Rhode Island Interscholastic League Competition, and whose participants 24 |
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| 179 | 179 | | are nineteen (19) years of age or younger. 25 |
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| 180 | 180 | | 16-91-3. School district’s guidelines to be developed and implemented. 26 |
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| 181 | 181 | | (a) The department of education and the department of health shall work in concert with 27 |
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| 182 | 182 | | the Rhode Island Interscholastic League to develop and promulgate guidelines to inform and 28 |
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| 183 | 183 | | educate coaches, teachers, school nurses, youth athletes, and their parents and/or guardians of the 29 |
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| 184 | 184 | | nature and risk of concussion and head injury, including continuing to play after concussion or head 30 |
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| 185 | 185 | | injury. A concussion and head injury information sheet shall be signed and returned by the youth 31 |
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| 186 | 186 | | athlete and the athlete’s parent and/or guardian prior to the youth athlete’s return to practice or 32 |
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| 187 | 187 | | competition. 33 |
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| 188 | 188 | | (b) School districts are required to use training materials made available by the United 34 |
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| 189 | 189 | | |
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| 190 | 190 | | |
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| 191 | 191 | | LC001566 - Page 6 of 7 |
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| 192 | 192 | | States Center for Disease Control and Prevention entitled “Heads Up: Concussion in the High 1 |
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| 193 | 193 | | School Sports/Concussion in Youth Sports” and any updates or amendments thereto, or training 2 |
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| 194 | 194 | | materials substantively and substantially similar thereto. The department of education shall post 3 |
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| 195 | 195 | | training materials made available by the Center for Disease Control and Prevention and the Rhode 4 |
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| 196 | 196 | | Island Interscholastic League on its website. All coaches and volunteers involved in a youth sport 5 |
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| 197 | 197 | | or activity covered by this chapter must complete a training course and a refresher course annually 6 |
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| 198 | 198 | | thereafter in concussions and traumatic brain injuries. All school nurses must complete a training 7 |
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| 199 | 199 | | course and an annual refresher course in concussions and traumatic brain injuries. Teachers and 8 |
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| 200 | 200 | | teachers’ aides are strongly encouraged to complete the training course in concussions and 9 |
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| 201 | 201 | | traumatic brain injuries. Training may consist of videos, classes, and any other generally accepted 10 |
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| 202 | 202 | | mode and medium of providing information. 11 |
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| 203 | 203 | | (c) School districts are encouraged to have all student athletes perform baseline 12 |
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| 204 | 204 | | neuropsychological testing, computerized or otherwise. Parents and/or guardians shall be provided 13 |
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| 205 | 205 | | with information as to the risk of concussion and/or traumatic brain injuries prior to the start of 14 |
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| 206 | 206 | | every sport season and they shall sign an acknowledgement as to their receipt of such information. 15 |
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| 207 | 207 | | (d) A youth athlete, who is suspected of sustaining a concussion or head injury in a practice 16 |
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| 208 | 208 | | or game, shall be removed from competition at that time. 17 |
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| 209 | 209 | | (e) A youth athlete, who has been removed from play, may not return to play until the 18 |
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| 210 | 210 | | athlete is evaluated by a licensed physician who may consult with an athletic trainer, all of whom 19 |
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| 211 | 211 | | shall be trained in the evaluation and management of concussions. The athlete must receive written 20 |
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| 212 | 212 | | clearance to return to play from that licensed physician. 21 |
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| 213 | 213 | | (f) All school districts are encouraged to have an athletic trainer, or similarly trained 22 |
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| 214 | 214 | | person, at all recreational and athletic events addressed by this statute. 23 |
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| 215 | 215 | | 16-91-4. All other youth sports program. 24 |
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| 216 | 216 | | All other youth sports programs not specifically addressed by this statute are encouraged 25 |
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| 217 | 217 | | to follow the guidance set forth in this statute for all program participants who are age nineteen 26 |
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| 218 | 218 | | (19) and younger. 27 |
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| 219 | 219 | | SECTION 3. This act shall take effect on July 1, 2025. 28 |
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| 221 | 221 | | LC001566 |
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| 224 | 224 | | |
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| 225 | 225 | | LC001566 - Page 7 of 7 |
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| 226 | 226 | | EXPLANATION |
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| 227 | 227 | | BY THE LEGISLATIVE COUNCIL |
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| 228 | 228 | | OF |
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| 229 | 229 | | A N A C T |
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| 230 | 230 | | RELATING TO EDUCATION -- SCHOOL AND YOUTH PROGRAMS CO NCUSSION ACT |
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| 231 | 231 | | *** |
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| 232 | 232 | | This act would replace the existing chapter on this subject by requiring school districts to 1 |
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| 233 | 233 | | organize concussion oversight teams, develop removal-from-play, return-to-play, and return-to-2 |
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| 234 | 234 | | learn protocols, and develop a concussion brochure. This act would repeal chapter 16-91, the 3 |
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| 235 | 235 | | "school and youth programs concussion act." 4 |
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| 236 | 236 | | This act would take effect on July 1, 2025. 5 |
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| 238 | 238 | | LC001566 |
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