Are California Schools and Medical Providers Prepared for New Concussion Law?

By Chris Koutures, MD, FAAP

California Assembly Bill 2127 authored by Assembly Member Ken Cooley (D-Rancho Cordova) will take formal effect on January 1, 2015 and will provide that, if a licensed health care provider determines that the athlete sustained a concussion or a head injury, the athlete is required to complete a graduated return-to-play protocol of no less than 7 days in duration under the supervision of a licensed health care provider. This stipulation is an extension of previous California legislative mandates passed in 2011 and 2012 that require:

  • Immediate removal for the remainder of the day of any high school athlete suspected of having a concussion
  • Prohibit the return of the athlete to that activity until he or she is evaluated by, and receives written clearance from a licensed health care provider
  • Each year, a concussion and head injury information sheet must be signed and returned by athletes and parent/guardian
  • Concussion education must now be part of required first aid training of every high school coach

In discussions with coaches, administrators, and fellow sports medicine providers, I’ll throw out a few questions that have arose regarding several nuances of the law:

  • When is the earliest that the 7-day return protocol begins?
  • Is it potentially at the time of formal diagnosis of a concussion by a licensed provider?
  • Is it when the athlete is fully cleared of post-concussion symptoms?
  • Can the period begin before a formal diagnosis is made?
  • What is the formal definition of supervision?
  • Can an athletic trainer assume the role of supervision under the guidance of a physician?
  • Given that the bill also limits contact football practices to two 90 minute periods per week, if the timing of those two practices is perhaps a day before a player’s progression is ready for contact, can he have alternate contact to possibly play in a game if otherwise having an appropriate recovery?
  • Are school and medical providers aware and sufficiently prepared for these new edicts?
  • Is there agreement or clarification on the above terms and concerns?
  • Have concussion management plans, if already in place, been modified or reviewed to address the new mandates?

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