(Senate - November 29, 2018)

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[Pages S7243-S7245]
From the Congressional Record Online through the Government Publishing Office []


      By Mr. DURBIN:
  S. 3686. A bill to promote minimum State requirements for the 
prevention and treatment of concussions caused by participation in 
school sports, and for other purposes; to the Committee on Health, 
Education, Labor, and Pensions.
  Mr. DURBIN. Mr. President, I ask unanimous consent that the text of 
the bill be printed in the Record.
  There being no objection, the text of the bill was ordered to be 
printed in the Record, as follows:
  Mr. DURBIN. Mr. President, when we encourage our students to be 
active and play school sports, it's because we want to promote healthy 
habits and team-building skills. Yet every year, more than 140,000 
student athletes sustain a concussion--and that's just the reported 
count. We can be sure that many more go unreported and untreated.
  The benefits of competing in school sports are undermined if students 
are staying out on the field after an injury--especially concussions. 
And there is more evidence than ever about the detrimental long term 
effects of concussions.
  That's why I'm reintroducing the Protecting Student Athletes from 
Concussions Act. My bill would direct States to develop concussion 
safety plans for public schools that include a concussion safety 
awareness component. Certain States like Illinois already have such 
procedures in place, but it's high time we make this true for all 
States. By equipping our schools and communities with evidence-based 
guidance for responding to concussions; we can keep our students, and 
their futures safe.
  The bill would also require States to adopt a ``when in doubt, sit it 
out'' policy. If there is even the possibility that a student athlete 
has suffered a concussion, their health and safety ought to be the 
number one priority. That means, if an athlete is suspected of having 
sustained a concussion, they should sit out and not be allowed to 
return to play the same day and, after that, only once evaluated and 
cleared by a qualified health care professional.
  Unfortunately, many student athletes return to play prematurely--to 
the detriment of both their health and academic performance.
  Let's be clear: a concussion is a traumatic brain injury that affects 
brain function. It is, by no means, something we can simply shake or 
walk off. The still-developing brains of students make them more 
susceptible to injury, making concussions all the more dangerous.
  A ``when in doubt, sit it out'' policy, endorsed by the American 
College of Sports Medicine and the American Academy of Neurology, will 
take the decision to return to the game out of the hands of a coach or 
an injured athlete who may not want to look ``weak''

[[Page S7244]]

to their teammates. It will prevent students from experiencing 
successive injuries by staying in the game when they are not fit. It 
will give injured athletes the time to heal to help ensure that short 
term symptoms do not become long term effects.
  For school sports to be a safe option, we have to put the necessary, 
common-sense procedures for preventing, detecting, responding to, and 
treating concussions in place. This bill would help do that.
  It's why my bill is endorsed by the American College of Sports 
Medicine, the American Academy of Neurology, the National Collegiate 
Athletic Association, the National Football League, the National 
Basketball Association, Major League Baseball, the National Hockey 
League, the National Parent Teacher Association, the National 
Association of Secondary School Principals, the Sports & Fitness 
Industry Association, the Korey Stringer Institute, and Safe Kids World 
  I hope my colleagues will join me in this common-sense, evidence-
based approach to protecting student athletes. Thank you.

                                S. 3686

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,


       This Act may be cited as the ``Protecting Student Athletes 
     from Concussions Act of 2018''.


       (a) Minimum Requirements.--Each State that receives funds 
     under the Elementary and Secondary Education Act of 1965 (20 
     U.S.C. 6301 et seq.) and does not meet the requirements 
     described in this section, as of the date of enactment of 
     this Act, shall, not later than the last day of the fifth 
     full fiscal year after the date of enactment of this Act 
     (referred to in this Act as the ``compliance deadline''), 
     enact legislation or issue regulations establishing the 
     following minimum requirements:
       (1) Local educational agency concussion safety and 
     management plan.--Each local educational agency in the State, 
     in consultation with members of the community in which such 
     agency is located, shall develop and implement a standard 
     plan for concussion safety and management that--
       (A) educates students, parents, and school personnel about 
     concussions, through activities such as--
       (i) training school personnel, including coaches, teachers, 
     athletic trainers, related services personnel, and school 
     nurses, on concussion safety and management, including 
     training on the prevention, recognition, and academic 
     consequences of concussions and response to concussions; and
       (ii) using, maintaining, and disseminating to students and 

       (I) release forms and other appropriate forms for reporting 
     and record keeping;
       (II) treatment plans; and
       (III) prevention and post-injury observation and monitoring 
     fact sheets about concussion;

       (B) encourages supports, where feasible, for a student 
     recovering from a concussion (regardless of whether or not 
     the concussion occurred during school-sponsored activities, 
     during school hours, on school property, or during an 
     athletic activity), such as--
       (i) guiding the student in resuming participation in 
     athletic activity and academic activities with the help of a 
     multi-disciplinary concussion management team, which may 

       (I) a health care professional, the parents of such 
     student, a school nurse, relevant related services personnel, 
     and other relevant school personnel; and
       (II) an individual who is assigned by a public school to 
     oversee and manage the recovery of such student; and

       (ii) providing appropriate academic accommodations aimed at 
     progressively reintroducing cognitive demands on the student; 
       (C) encourages the use of best practices designed to 
     ensure, with respect to concussions, the uniformity of safety 
     standards, treatment, and management, such as--
       (i) disseminating information on concussion safety and 
     management to the public; and
       (ii) applying uniform best practice standards for 
     concussion safety and management to all students enrolled in 
     public schools.
       (2) Posting of information on concussions.--Each public 
     elementary school and each public secondary school shall post 
     on school grounds, in a manner that is visible to students 
     and school personnel, and make publicly available on the 
     school website, information on concussions that--
       (A) is based on peer-reviewed scientific evidence (such as 
     information made available by the Centers for Disease Control 
     and Prevention);
       (B) shall include information on--
       (i) the risks posed by sustaining a concussion;
       (ii) the actions a student should take in response to 
     sustaining a concussion, including the notification of school 
     personnel; and
       (iii) the signs and symptoms of a concussion; and
       (C) may include information on--
       (i) the definition of a concussion;
       (ii) the means available to the student to reduce the 
     incidence or recurrence of a concussion; and
       (iii) the effects of a concussion on academic learning and 
       (3) Response to concussion.--If an individual designated 
     from among school personnel for purposes of this Act, one of 
     whom must be in attendance at every school-sponsored 
     activity, suspects that a student has sustained a concussion 
     (regardless of whether or not the concussion occurred during 
     school-sponsored activities, during school hours, on school 
     property, or during an athletic activity)--
       (A) the student shall be--
       (i) immediately removed from participation in a school-
     sponsored athletic activity; and
       (ii) prohibited from returning to participate in a school-
     sponsored athletic activity on the day that student is 
     removed from such participation; and
       (B) the designated individual shall report to the parent or 
     guardian of such student--
       (i) any information that the designated school employee is 
     aware of regarding the date, time, and type of the injury 
     suffered by such student (regardless of where, when, or how a 
     concussion may have occurred); and
       (ii) any actions taken to treat such student.
       (4) Return to athletics.--If a student has sustained a 
     concussion (regardless of whether or not the concussion 
     occurred during school-sponsored activities, during school 
     hours, on school property, or during an athletic activity), 
     before such student resumes participation in school-sponsored 
     athletic activities, the school shall receive a written 
     release from a health care professional, that--
       (A) states that the student is capable of resuming 
     participation in such activities; and
       (B) may require the student to follow a plan designed to 
     aid the student in recovering and resuming participation in 
     such activities in a manner that--
       (i) is coordinated, as appropriate, with periods of 
     cognitive and physical rest while symptoms of a concussion 
     persist; and
       (ii) reintroduces cognitive and physical demands on such 
     student on a progressive basis only as such increases in 
     exertion do not cause the reemergence or worsening of 
     symptoms of a concussion.
       (b) Noncompliance.--
       (1) First year.--If a State described in subsection (a) 
     fails to comply with subsection (a) by the compliance 
     deadline, the Secretary of Education shall reduce by 5 
     percent the amount of funds the State receives under the 
     Elementary and Secondary Education Act of 1965 (20 U.S.C. 
     6301 et seq.) for the first fiscal year following the 
     compliance deadline.
       (2) Succeeding years.--If the State fails to so comply by 
     the last day of any fiscal year following the compliance 
     deadline, the Secretary of Education shall reduce by 10 
     percent the amount of funds the State receives under that Act 
     for the following fiscal year.
       (3) Notification of noncompliance.--Prior to reducing any 
     funds that a State receives under the Elementary and 
     Secondary Education Act of 1965 (20 U.S.C. 6301 et seq.) in 
     accordance with this subsection, the Secretary of Education 
     shall provide a written notification of the intended 
     reduction of funds to the State and to the appropriate 
     committees of Congress.


       Nothing in this Act shall be construed to affect civil or 
     criminal liability under Federal or State law.


       In this Act:
       (1) Concussion.--The term ``concussion'' means a type of 
     mild traumatic brain injury that--
       (A) is caused by a blow, jolt, or motion to the head or 
     body that causes the brain to move rapidly in the skull;
       (B) disrupts normal brain functioning and alters the mental 
     state of the individual, causing the individual to 
       (i) any period of observed or self-reported--

       (I) transient confusion, disorientation, or impaired 
       (II) dysfunction of memory around the time of injury; or
       (III) loss of consciousness lasting less than 30 minutes; 

       (ii) any 1 of 4 types of symptoms, including--

       (I) physical symptoms, such as headache, fatigue, or 
       (II) cognitive symptoms, such as memory disturbance or 
     slowed thinking;
       (III) emotional symptoms, such as irritability or sadness; 
       (IV) difficulty sleeping; and

       (C) can occur--
       (i) with or without the loss of consciousness; and
       (ii) during participation in any organized sport or 
     recreational activity.
       (2) Health care professional.--The term ``health care 
       (A) means an individual who has been trained in diagnosis 
     and management of traumatic brain injury in a pediatric 
     population; and
       (B) includes a physician (M.D. or D.O.) or certified 
     athletic trainer who is registered, licensed, certified, or 
     otherwise statutorily recognized by the State to provide such 
     diagnosis and management.
       (3) Local educational agency; state.--The terms ``local 
     educational agency'' and

[[Page S7245]]

     ``State'' have the meanings given such terms in section 8101 
     of the Elementary and Secondary Education Act of 1965 (20 
     U.S.C. 7801).
       (4) Related services personnel.--The term ``related 
     services personnel'' means individuals who provide related 
     services, as defined under section 602 of the Individuals 
     with Disabilities Education Act (20 U.S.C. 1401).
       (5) School-sponsored athletic activity.--The term ``school-
     sponsored athletic activity'' means--
       (A) any physical education class or program of a school;
       (B) any athletic activity authorized during the school day 
     on school grounds that is not an instructional activity;
       (C) any extra-curricular sports team, club, or league 
     organized by a school on or off school grounds; and
       (D) any recess activity.