Concussion Legislation: Best Practices Vicky Graham, M.S., ATC

1. Concussion Legislation: Best Practices Vicky Graham, M.S., ATC 2011 BOC Athletic Trainer Regulatory Conference

2. 2011 BOC Athletic Trainer Regulatory Conference Trending Now:

3. MEDIA BLITZ

5. 2011 BOC Athletic Trainer Regulatory Conference CONCUSSION POLICIES • NFHSA • NCAA • NFL • MLB • NHL, etc

6. 2011 BOC Athletic Trainer Regulatory Conference jump on the bandwagon…

7. 2011 BOC Athletic Trainer Regulatory Conference Concussion Legislation • Opportunity to promote & advance the profession • Educate legislators about the profession in the context of an important public health issue

8. 2011 BOC Athletic Trainer Regulatory Conference Concussion Legislation • Identifies ATs as experts on sports-related concussion • Athlete safety is a white hat issue • Brings the issue of ATs in secondary schools to the table

9. 2011 BOC Athletic Trainer Regulatory Conference Concussion Laws • 28 states have concussion laws • CA, OH, others- bills pending • 2009: Zachery Lystedt Law (WA) • Oregon 2009 • Connecticut; MA, NJ, OK, RI 2010 • 15 passed in 2011; NC, TX

10. 2011 BOC Athletic Trainer Regulatory Conference Other related legislation • AR - Addressed in legislation not specific to concussion • VA – Board of Education is required to develop guidelines re: concussion mgmt.

11. 2011 BOC Athletic Trainer Regulatory Conference Zachery Lystedt Law: WA • Applies to school districts and athletic leagues who utilize publicly owned fields/facilities (youth sports) • Requires any athlete (under age 18) suspected of having a concussion be removed from activity

12. 2011 BOC Athletic Trainer Regulatory Conference Lystedt cont’d • RTP requires written clearance from a licensed HCP trained in the evaluation and management of concussion • Must educate athletes, coaches, parents/guardians • Requires parental consent yearly (concussion information form)

13. 2011 BOC Athletic Trainer Regulatory Conference A note about state legislation… • Every state is different • Lots of legislative quirks • Best practices vs. “model” language

14. 2011 BOC Athletic Trainer Regulatory Conference Best Practices: Concussion Legislation Youth & school-based sports Education for coaches Education for athletes & parents Remove athlete from activity Clearance by HCP prior to RTP

15. 2011 BOC Athletic Trainer Regulatory Conference Best Practices:Applies to youth & school sports • Youth sport leagues • Pay for play or sponsored by non-profit or business entity • Interscholastic & intramural sports • Public vs. private schools? • WA (Lystedt), Nebraska language

16. 2011 BOC Athletic Trainer Regulatory Conference Best Practices:ConcussionEducation for Coaches • Mandatory training for all coaches • CE requirement • Mechanism for oversight of education process

17. 2011 BOC Athletic Trainer Regulatory Conference Best Practices:Education for athletes & parents • Educate yearly • Informed consent signed yearly by parents (re: concussion) • Mechanism for insuring that education takes place

18. 2011 BOC Athletic Trainer Regulatory Conference Best Practices:Removal from activity • REMOVE any athlete exhibiting S & S of a possible concussion from activity immediately • NO SAME DAY RTP • Refer to AT or other HCP

19. 2011 BOC Athletic Trainer Regulatory Conference Best Practices:Medical Clearance • Athlete must be cleared by a licensed health care professional prior to RTP • HCPs able to clear should include athletic trainers • Written clearance

20. 2011 BOC Athletic Trainer Regulatory Conference Problem: • Who is a “licensed health care professional”for the purposes of the bill? • Which HCPs can make a RTP determination?

21. 2011 BOC Athletic Trainer Regulatory Conference Solution: Define “HCP” • CT Public Act 10-62 • HCP is defined by statute and includes MD/DO, PA, APRN, AT • Provides statutory recognition

22. 2011 BOC Athletic Trainer Regulatory Conference ATs & RTP • CT, IA, MA, NE, NM, NV – ATs have the ability to make RTP decisions • AZ; CO: ATs involved w/graduated RTP after clearance by MD, DO, PA, APRN, or neuropsychologist

23. 2011 BOC Athletic Trainer Regulatory Conference RTP • AK, MD, MN, OK, OR, SD, WA, UT – allow RTP to be made by “licensed HCP” or “licensed HCP trained in the evaluation and management of concussion” • ND, NJ, RI – Require MD clearance

24. 2011 BOC Athletic Trainer Regulatory Conference Problem phrase? • “…licensed health care professional trained in the evaluation and management of concussion…”

25. 2011 BOC Athletic Trainer Regulatory Conference Best Practices:How to be successful • Be prepared • Lobbyist in place • Position AT assoc. as the authority • Lead the way & drive the process • Work w/ strategic partners • Develop coalition of supporters

26. 2011 BOC Athletic Trainer Regulatory Conference CATA Strategic Partners • Brain Injury Assoc. of CT • CT Interscholastic Athletic Conf. • CT Assoc. of ADs • CT Coaches Assoc. • CT State Medical Society • CT Concussion Task Force

27. 2011 BOC Athletic Trainer Regulatory Conference Coalition of Supporters(Paper Tigers) • Brain Injury Association of America • CT Chapter of the American Academy of Pediatrics • CT Traumatic Brain Injury Advisory Board

28. 2011 BOC Athletic Trainer Regulatory Conference More tigers… • Connecticut Children’s Medical Center • Connecticut Concussion Task Force • CT Disability Advocacy Collaborative • CT Speech-Language-Hearing Assoc. • National Athletic Trainers’ Association

29. 2011 BOC Athletic Trainer Regulatory Conference a few more… • Parent Heart Watch • Safe Kids Connecticut • Sarah Jane Brain Foundation • Sports Legacy Institute

30. 2011 BOC Athletic Trainer Regulatory Conference Proof that politics is a contact sport?

31. Thank You! vgraham7atc@yahoo.com 2011 BOC Athletic Trainer Regulatory Conference

32. 2011 BOC Athletic Trainer Regulatory Conference Additional Resources • Information about Connecticut Public Act 10-62 (concussion law) • Fact sheet for Connecticut concussion bill • Talking Points on ATs & RTP • Oregon language