House File 2442 - Reprinted HOUSE FILE 2442 BY COMMITTEE ON EDUCATION (SUCCESSOR TO HF 2006) (As Amended and Passed by the House March 7, 2018 ) A BILL FOR An Act providing for brain injury policies for certain 1 extracurricular interscholastic activities, and including 2 applicability provisions. 3 BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF IOWA: 4 HF 2442 (5) 87 je/rj/md

H.F. 2442 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 brain 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 or expected 27 to learn at full capability, resulting in prolonged symptoms, 28 actual or potential physical injury, or death to youth athletes 29 in this state. 30 d. A concussion can impair not only the physical abilities 31 of a student athlete, but can also affect how a student athlete 32 thinks, acts, feels, and learns. A student athlete who has 33 sustained a concussion may need informal or formal adjustments, 34 accommodations, modifications of curriculum, and monitoring 35 -1- HF 2442 (5) 87 je/rj/md 1/ 6

H.F. 2442 by medical or educational staff until the student is fully 1 recovered. To that end, the department of public health, in 2 coordination with the Iowa high school athletic association 3 and the Iowa girls high school athletic union, shall establish 4 and disseminate to all schools in this state a return-to-learn 5 protocol that is based on peer-reviewed scientific evidence 6 consistent with federal guidelines. Furthermore, all schools 7 in this state shall adopt such protocols. 8 2. Definitions. For the purposes of this section: 9 a. “Contest” means an interscholastic athletic game or 10 competition. 11 b. “Contest official” means a referee, umpire, judge, or 12 other official in an athletic contest who is registered with 13 the Iowa high school athletic association or the Iowa girls 14 high school athletic union. 15 c. “Extracurricular interscholastic activity” means any 16 extracurricular interscholastic activity, contest, or practice, 17 including sports, dance, or cheerleading. 18 d. “Licensed health care provider” means a physician, 19 physician assistant, chiropractor, advanced registered nurse 20 practitioner, nurse, physical therapist, or athletic trainer 21 licensed by a board designated under section 147.13. 22 3. Training. 23 a. The department of public health, Iowa high school 24 athletic association, and the Iowa girls high school athletic 25 union shall work together to develop training materials and 26 courses regarding concussions and brain injuries, including 27 training regarding evaluation, prevention, symptoms, risks, 28 and long-term effects of concussions and brain injuries. Each 29 coach or contest official shall complete such training at least 30 every two years. 31 b. Individuals required to complete training pursuant to 32 this subsection shall submit proof of such completion to the 33 board of directors of the school district or the authorities in 34 charge of the accredited nonpublic school within thirty days 35 -2- HF 2442 (5) 87 je/rj/md 2/ 6

H.F. 2442 of such completion. 1 4. Guidelines and information sheet. 2 a. The department of public health, Iowa high school 3 athletic association, and the Iowa girls high school athletic 4 union shall work together to distribute the centers for 5 disease control and prevention guidelines and other pertinent 6 information to inform and educate coaches, students, and 7 the parents and guardians of students of the risks, signs, 8 symptoms, and behaviors consistent with a concussion or brain 9 injury, including the danger of continuing to participate in 10 extracurricular interscholastic activities after suffering a 11 concussion or brain injury and their responsibility to report 12 such signs, symptoms, and behaviors if they occur. 13 b. Annually, each school district and nonpublic school 14 shall provide to the parent or guardian of each student a 15 concussion and brain injury information sheet, as provided by 16 the department of public health, the Iowa high school athletic 17 association, and the Iowa girls high school athletic union. 18 The student and the student’s parent or guardian shall sign and 19 return a copy of the concussion and brain injury information 20 sheet to the student’s school prior to the student’s 21 participation in any extracurricular interscholastic activity. 22 5. Removal from participation. 23 a. If a student’s coach, contest official, or licensed 24 health care provider observes signs, symptoms, or behaviors 25 consistent with a concussion or brain injury in an 26 extracurricular interscholastic activity, the student shall be 27 immediately removed from participation. 28 b. A student who has been removed from participation shall 29 not recommence such participation until the student has been 30 evaluated by a licensed health care provider trained in the 31 evaluation and management of concussions and other brain 32 injuries and the student has received written clearance to 33 return to participation from the licensed health care provider. 34 6. Return-to-play and return-to-learn protocols. The 35 -3- HF 2442 (5) 87 je/rj/md 3/ 6

H.F. 2442 department of public health, the department of education, the 1 Iowa high school athletic association, and the Iowa girls 2 high school athletic union shall work together to develop 3 a return-to-play protocol and a return-to-learn protocol, 4 based on peer-reviewed scientific evidence consistent with the 5 guidelines of the centers for disease control and prevention 6 of the United States department of health and human services, 7 for a student’s return to participation in an extracurricular 8 interscholastic activity and in the classroom after showing 9 signs, symptoms, or behaviors consistent with a concussion 10 or brain injury. The board of directors of each school 11 district and the authorities in charge of each accredited 12 nonpublic school with enrolled students who participate in an 13 extracurricular interscholastic activity which is a contest in 14 grades seven through twelve shall adopt such protocols. 15 7. Protective gear. For school budget years beginning on 16 or after July 1, 2018, the board of directors of each school 17 district and the authorities in charge of each accredited 18 nonpublic school with enrolled students who participate 19 in an extracurricular interscholastic activity which is a 20 contest in grades seven through twelve shall provide students 21 participating in such contests with any protective gear, 22 including but not limited to helmets and pads required for the 23 activity by law, by the rules for such contests, or by Iowa 24 high school athletic association or Iowa girls high school 25 athletic union guidelines. However, an individual student 26 is responsible for other protective gear that the individual 27 student needs but that is not required for participation in the 28 contest as provided in this subsection. 29 8. Liability. 30 a. A school district or accredited nonpublic school that 31 fully implements the protocols required by this section and 32 provides a licensed health care provider at a contest shall 33 not be liable for any claim for injuries or damages based upon 34 the actions or inactions of the licensed health care provider 35 -4- HF 2442 (5) 87 je/rj/md 4/ 6

H.F. 2442 present at the contest at the request of the school district 1 or accredited nonpublic school so long as the licensed health 2 care provider acts reasonably and in good faith and in the best 3 interest of the student athlete and without undue influence of 4 the school district or accredited nonpublic school or coaching 5 staff employed by the school district or accredited nonpublic 6 school. 7 b. A licensed health care provider providing care without 8 compensation for a school district or accredited nonpublic 9 school under this section shall not be liable for any claim for 10 injuries or damages arising out of such care so long as the 11 licensed health care provider acts reasonably and in good faith 12 and in the best interest of the student athlete and without 13 undue influence of the school district or accredited nonpublic 14 school or coaching staff employed by the school district or 15 accredited nonpublic school. 16 9. Recommendations. The advisory council on brain 17 injuries established pursuant to section 135.22A shall make 18 recommendations to the governor on the prevention, diagnosis, 19 and treatment of brain injuries in student athletes, including 20 baseline and post-concussion testing and diagnosis of student 21 athletes, return-to-play and return-to-learn guidelines, 22 training for school educators, coaches, athletic directors, 23 and athletic trainers, delivery of post-concussive management 24 services, and ways to integrate education, training, and 25 diagnostic programs into school programs. 26 Sec. 2. APPLICABILITY. A person required to complete 27 training pursuant to section 280.13C, subsection 3, as enacted 28 by this Act, has until July 1, 2019, to initially complete such 29 training. 30 Sec. 3. STATE MANDATE FUNDING SPECIFIED. In accordance 31 with section 25B.2, subsection 3, the state cost of requiring 32 compliance with any state mandate included in this division 33 of this Act shall be paid by a school district from state 34 school foundation aid received by the school district under 35 -5- HF 2442 (5) 87 je/rj/md 5/ 6

H.F. 2442 section 257.16. This specification of the payment of the state 1 cost shall be deemed to meet all of the state funding-related 2 requirements of section 25B.2, subsection 3, and no additional 3 state funding shall be necessary for the full implementation of 4 this Act by and enforcement of this Act against all affected 5 school districts. 6 -6- HF 2442 (5) 87 je/rj/md 6/ 6