Report Title:

Concussion Evaluation Tool; High School Football



Requires department of education to implement a concussion evaluation tool for each high school student athlete participating in the sport of football statewide. Appropriation.



H.B. NO.














relating to SCHOOL SPORTS concussions.





SECTION 1. The legislature finds that many student athletes suffer concussions while engaged in a various sports each year. A concussion is any change in mental status that results when the brain is violently rocked back and forth inside of the skull due to a blow to the head, neck, or upper body. Symptoms may include amnesia, confusion, disorientation, "not feeling right," fogginess, headache, nausea, uncoordinated hand-eye movements, and in some cases, loss of consciousness. Symptoms are not always definite and vary in severity and longevity.

However, student athletes, coaches, and parents generally do not know how serious the effects of even a seemingly mild concussion can be. That lack of awareness may result in allowing a student athlete to return to play too soon following the initial injury, placing the student athlete in danger of further, more serious injury.

According to the University of Pittsburgh Medical Center, about one in ten local high school athletes in contact sports will sustain a concussion during the sports season. Recent clinical research shows that even seemingly mild concussions can have long-term serious effects on some of the brain's neurocognitive functions and that the effects of multiple concussions can be cumulative. According to Dr. Mark Lovell of the University of Pittsburgh Medical Center, a student athlete who sustains an initial concussion can fully recover as long that student athlete does not sustain a second concussion before the brain has had time to heal from the first one. Problems occur when the student athlete plays through the symptoms and is not taken out of the game. Research has shown that returning a mildly concussed student athlete to play too soon before the brain has healed puts the student athlete at greater risk for a second concussion and more severe, longer-lasting neurocognitive damage.

A student athlete with a suspected concussion should always be evaluated by an athletic trainer, team or family physician, or neuropsychologist before returning to play or practice. Athletes, coaches, and parents should never self-diagnose or self-evaluate a concussion, regardless of how mild the injury or symptoms appeared to be or to have been.

The legislature finds that the University of Pittsburgh Medical Center Sports Medicine Concussion Program is an ongoing clinical service and research program that focuses on the diagnosis, evaluation, and management of sports-related concussions in student athletes of all levels. Because of the uncertainty surrounding the diagnosis and evaluation of sports-related concussions, University of Pittsburgh Medical Center doctors over the past decade have developed the first computerized concussion evaluation tool called ImPACT (Immediate Post-concussion Assessment and Cognitive Testing). ImPACT, the most widely-used concussion evaluation system in the world today, objectively measures actual neurocognitive brain function along with reported symptoms to help determine injury severity, recovery, and when it is safe to return to play. ImPACT is used by more than four hundred high schools, one hundred eighty colleges and universities, eighteen National Football League teams, several major league baseball teams, and numerous other organizations.

In general, ImPACT is used by doctors to conduct twenty-minute preseason computer evaluations to establish baseline data about each student athlete. If a student athlete experiences a concussion during the season, the student athlete is retested and the postconcussion data are compared to the baseline data. The student athlete is allowed to resume sports activity when brain functions return to normal.

The purpose of this Act is to require the department of education to conduct systematic concussion evaluations for all public school student football athletes with a tool similar to the Immediate Post-concussion Assessment and Cognitive Testing tool developed by the University of Pittsburgh Medical Center.

SECTION 2. Chapter 302A, Hawaii Revised Statutes, is amended by adding a new section to be appropriately designated and to read as follows:

"302A-    High school football; concussion evaluation tool. The department shall implement use of a concussion evaluation tool and apply the tool to evaluate each student athlete participating in the sport of football in public high schools throughout the State. The department shall adopt rules pursuant to chapter 91 to implement this section; provided that the department shall require use of the tool developed by the University of Pittsburgh Medical Center known as the "immediate post-concussion assessment and cognitive testing" ("ImPact") or a similar evaluation tool."

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $       or so much thereof as may be necessary for fiscal year 2008-2009 to implement use of a concussion evaluation tool to evaluate each student athlete participating in football at a public high school.

The sum appropriated shall be expended by the department of education for the purposes of this Act.

SECTION 4. New statutory material is underscored.

SECTION 5. This Act shall take effect upon its approval, except that section 3 shall take effect on July 1, 2008.