H.F. 2006 Section 1. Section 280.13C, Code 2018, is amended by 1 striking the section and inserting in lieu thereof the 2 following: 3 280.13C Concussion and brain injury policies. 4 1. Legislative findings. The general assembly finds and 5 declares all of the following: 6 a. Concussions are one of the most commonly reported 7 injuries in children and adolescents who participate in sports 8 and recreational activities. A concussion is caused by a blow 9 or motion to the head or body that causes the brain to move 10 rapidly inside the skull. The risk of catastrophic injuries or 11 death is significant when a concussion or head injury is not 12 properly evaluated and managed. 13 b. Concussions are a type of brain injury that can range 14 from mild to severe and can disrupt the way the brain normally 15 works. Concussions can occur in any organized or unorganized 16 sport or recreational activity and can result from a fall or 17 from players colliding with each other, the ground, or with 18 obstacles. Concussions can occur with or without loss of 19 consciousness, but the vast majority of concussions occur 20 without loss of consciousness. 21 c. Continuing to play with a concussion or symptoms of a 22 head injury leaves a young athlete especially vulnerable to 23 greater injury and even death. The general assembly recognizes 24 that, despite having generally recognized return-to-play 25 standards for concussions and head injuries, some affected 26 youth athletes are prematurely returned to play, resulting in 27 actual or potential physical injury or death to youth athletes 28 in this state. 29 d. A student athlete who has sustained a concussion may 30 need informal or formal accommodations, modifications of 31 curriculum, and monitoring by medical or educational staff 32 until the student is fully recovered. To that end, the 33 department of public health, in coordination with the Iowa high 34 school athletic association and the Iowa girls high school 35 -1- LSB 5331YH (6) 87 je/rj 1/ 7

H.F. 2006 athletic union, shall establish and disseminate to all schools 1 in this state a return-to-school protocol that is based on 2 peer-reviewed scientific evidence consistent with federal 3 guidelines. Furthermore, all schools in this state shall adopt 4 such protocols. 5 2. Definitions. For the purposes of this section: 6 a. “Contest” means an interscholastic athletic game. 7 b. “Contest official” means a referee, umpire, judge, or 8 other official in an athletic contest. 9 c. “Extracurricular interscholastic activity” means any 10 extracurricular interscholastic activity, contest, or practice, 11 including sports, dance, or cheerleading. 12 d. “Licensed health care provider” means a physician, 13 physician assistant, chiropractor, advanced registered nurse 14 practitioner, nurse, physical therapist, or athletic trainer 15 licensed by a board designated under section 147.13. 16 3. Training. 17 a. The department of public health, Iowa high school 18 athletic association, and the Iowa girls high school athletic 19 union shall work together to develop training materials and 20 courses regarding concussions and brain injuries, including 21 training regarding evaluation, prevention, symptoms, risks, 22 and long-term effects of concussions and brain injuries. Each 23 coach or contest official shall complete such training at least 24 every two years. 25 b. Individuals required to complete training pursuant to 26 this subsection shall submit proof of such completion to the 27 board of directors of the school district or the authorities in 28 charge of the accredited nonpublic school within thirty days 29 of such completion. 30 4. Guidelines and information sheet. 31 a. The department of public health, Iowa high school 32 athletic association, and the Iowa girls high school athletic 33 union shall work together to distribute the centers for 34 disease control and prevention guidelines and other pertinent 35 -2- LSB 5331YH (6) 87 je/rj 2/ 7

H.F. 2006 information to inform and educate coaches, students, and 1 the parents and guardians of students of the risks, signs, 2 symptoms, and behaviors consistent with a concussion or brain 3 injury, including the danger of continuing to participate in 4 extracurricular interscholastic activities after suffering a 5 concussion or brain injury and their responsibility to report 6 such signs, symptoms, and behaviors if they occur. 7 b. Annually, each school district and nonpublic school shall 8 provide to the parent or guardian of each student a concussion 9 and brain injury information sheet, as provided by the Iowa 10 high school athletic association and the Iowa girls high 11 school athletic union. The student and the student’s parent 12 or guardian shall sign and return a copy of the concussion 13 and brain injury information sheet to the student’s school 14 prior to the student’s participation in any extracurricular 15 interscholastic activity. 16 5. Removal from participation. If a student’s coach, 17 contest official, or licensed health care provider observes 18 signs, symptoms, or behaviors consistent with a concussion or 19 brain injury in an extracurricular interscholastic activity, 20 the student shall be immediately removed from participation. 21 6. Return-to-play protocols. The department of public 22 health, Iowa high school athletic association, and the Iowa 23 girls high school athletic union shall work together to 24 develop a return-to-play protocol, based on peer-reviewed 25 scientific evidence consistent with the guidelines of the 26 centers for disease control and prevention of the United States 27 department of health and human services, for a student’s 28 return to participation in an extracurricular interscholastic 29 activity after showing signs, symptoms, or behaviors consistent 30 with a concussion or brain injury. The board of directors 31 of each school district and the authorities in charge of 32 each accredited nonpublic school with enrolled students who 33 participate in an extracurricular interscholastic activity 34 which is a contest in grades seven through twelve shall adopt 35 -3- LSB 5331YH (6) 87 je/rj 3/ 7

H.F. 2006 such protocols. 1 7. Protective gear. For school budget years beginning on 2 or after July 1, 2018, the board of directors of each school 3 district and the authorities in charge of each accredited 4 nonpublic school with enrolled students who participate 5 in an extracurricular interscholastic activity which is a 6 contest in grades seven through twelve shall provide students 7 participating in such contests with any protective gear, 8 including but not limited to helmets and pads required for the 9 activity by law, by the rules for such contests, or by Iowa 10 high school athletic association or Iowa girls high school 11 athletic union guidelines. However, an individual student 12 is responsible for other protective gear that the individual 13 student needs but that is not required for participation in the 14 contest as provided in this subsection. 15 8. Liability. 16 a. A school district or accredited nonpublic school that 17 fully implements the protocols required by this section and 18 provides a licensed health care provider at an extracurricular 19 interscholastic activity shall not be liable for any claim for 20 injuries or damages based upon the actions or inactions of the 21 licensed health care provider present at the extracurricular 22 interscholastic activity at the request of the school district 23 or accredited nonpublic school. 24 b. A licensed health care provider providing care without 25 compensation for a school district or accredited nonpublic 26 school under this section shall not be liable for any claim for 27 injuries or damages arising out of such care except for acts 28 or omissions which involve intentional misconduct or knowing 29 violation of the law. 30 Sec. 2. APPLICABILITY. A person required to complete 31 training pursuant to section 280.13C, subsection 3, as enacted 32 by this Act, has until July 1, 2019, to initially complete such 33 training. 34 Sec. 3. STATE MANDATE FUNDING SPECIFIED. In accordance 35 -4- LSB 5331YH (6) 87 je/rj 4/ 7

H.F. 2006 with section 25B.2, subsection 3, the state cost of requiring 1 compliance with any state mandate included in this division 2 of this Act shall be paid by a school district from state 3 school foundation aid received by the school district under 4 section 257.16. This specification of the payment of the state 5 cost shall be deemed to meet all of the state funding-related 6 requirements of section 25B.2, subsection 3, and no additional 7 state funding shall be necessary for the full implementation of 8 this Act by and enforcement of this Act against all affected 9 school districts. 10 EXPLANATION 11 The inclusion of this explanation does not constitute agreement with 12 the explanation’s substance by the members of the general assembly. 13 This bill strikes current Code section 280.13C relating 14 to concussion and brain injury policies and creates new Code 15 section 280.13C relating to the same subject. 16 The bill requires the department of public health, the Iowa 17 high school athletic association (IHSAA), and the Iowa girls 18 high school athletic union (IGHSAU) to work together to develop 19 training materials and courses regarding concussions and brain 20 injuries. The bill requires each coach or contest official 21 to complete such training at least every two years. The bill 22 requires individuals required to complete training to submit 23 proof of such completion to the school board or authorities in 24 charge of the accredited nonpublic school within 30 days of 25 such completion. The bill provides that a person required to 26 complete such training has until July 1, 2019, to initially 27 complete the training. 28 The bill requires the department of public health, the 29 IHSAA, and the IGHSAU to work together to distribute the 30 centers for disease control and prevention guidelines and other 31 pertinent information to inform and educate coaches, students, 32 and the parents and guardians of students of the risks, signs, 33 symptoms, and behaviors consistent with a concussion or brain 34 injury. The bill requires each school district and nonpublic 35 -5- LSB 5331YH (6) 87 je/rj 5/ 7

H.F. 2006 school to annually provide to the parent or guardian of each 1 student a concussion and brain injury information sheet, as 2 provided by the department of public health, the IHSAA, and the 3 IGHSAU. The bill requires the student and the student’s parent 4 or guardian to sign and return the information sheet to the 5 student’s school prior to the student’s participation in any 6 extracurricular interscholastic activity. 7 The bill requires that a student be immediately removed from 8 participation in an extracurricular interscholastic activity if 9 the student’s coach, contest official, or licensed health care 10 provider observes signs, symptoms, or behaviors consistent with 11 a concussion or brain injury. 12 The bill requires the department of public health, 13 the IHSAA, and the IGHSAU to work together to develop a 14 return-to-play protocol for a student’s return to participation 15 in an extracurricular interscholastic activity after showing 16 signs, symptoms, or behaviors consistent with a concussion 17 or brain injury. The bill requires the school board and the 18 authorities in charge of each accredited nonpublic school 19 with enrolled students who participate in an extracurricular 20 interscholastic activity which is a contest in grades 7 through 21 12 to adopt such protocols. 22 The bill requires the school board and the authorities 23 in charge of each accredited nonpublic school with enrolled 24 students who participate in an extracurricular interscholastic 25 activity which is a contest in grades 7 through 12, for school 26 budget years beginning July 1, 2018, to provide students 27 participating in such contests with any protective gear 28 required for the activity by law, by the rules for such 29 contests, or by IHSAA or IGHSAU guidelines. The bill provides 30 that an individual student is responsible for other protective 31 gear that the individual student needs but that is not required 32 for participation in the contest as provided in the bill. 33 The bill provides that a school district or nonpublic school 34 that fully implements the protocols required by the bill and 35 -6- LSB 5331YH (6) 87 je/rj 6/ 7

H.F. 2006 provides a licensed health care provider at an extracurricular 1 interscholastic activity shall not be liable for any claim for 2 injuries or damages based upon the actions or inactions of 3 the provider present at the extracurricular interscholastic 4 activity at the request of the school district or nonpublic 5 school. 6 The bill provides that a licensed health care provider 7 providing care without compensation for a school district or 8 accredited nonpublic school under the bill shall not be liable 9 for any claim for injuries or damages arising out of such 10 care except for acts or omissions which involve intentional 11 misconduct or knowing violation of the law. 12 The bill provides legislative findings. 13 The bill may include a state mandate as defined in Code 14 section 25B.3. The bill requires that the state cost of 15 any state mandate included in the bill be paid by a school 16 district from state school foundation aid received by the 17 school district under Code section 257.16. The specification 18 is deemed to constitute state compliance with any state mandate 19 funding-related requirements of Code section 25B.2. The 20 inclusion of this specification is intended to reinstate the 21 requirement of political subdivisions to comply with any state 22 mandates included in the bill. 23 -7- LSB 5331YH (6) 87 je/rj 7/ 7