H.R. 6172, PROTECTING STUDENT ATHLETES FROM CONCUSSIONS HEARING BEFORE THE COMMITTEE ON EDUCATION AND LABOR U.S. HOUSE OF REPRESENTATIVES ONE HUNDRED ELEVENTH CONGRESS SECOND SESSION HEARING HELD IN WASHINGTON, DC, SEPTEMBER 23, 2010 Serial No. 111–75 Printed for the use of the Committee on Education and Labor ( Available on the Internet: http://www.gpoaccess.gov/congress/house/education/index.html U.S. GOVERNMENT PRINTING OFFICE 58–256 PDF WASHINGTON : 2010 For sale by the Superintendent of Documents, U.S. Government Printing Office Internet: bookstore.gpo.gov Phone: toll free (866) 512–1800; DC area (202) 512–1800 Fax: (202) 512–2104 Mail: Stop IDCC, Washington, DC 20402–0001 COMMITTEE ON EDUCATION AND LABOR GEORGE MILLER, California, Chairman Dale E. Kildee, Michigan, Vice Chairman John Kline, Minnesota, Donald M. Payne, New Jersey Senior Republican Member Robert E. Andrews, New Jersey Thomas E. Petri, Wisconsin Robert C. ‘‘Bobby’’ Scott, Virginia Howard P. ‘‘Buck’’ McKeon, California Lynn C. Woolsey, California Peter Hoekstra, Michigan Rube´n Hinojosa, Texas Michael N. Castle, Delaware Carolyn McCarthy, New York Vernon J. Ehlers, Michigan John F. Tierney, Massachusetts Judy Biggert, Illinois Dennis J. Kucinich, Ohio Todd Russell Platts, Pennsylvania David Wu, Oregon Joe Wilson, South Carolina Rush D. Holt, New Jersey Cathy McMorris Rodgers, Washington Susan A. Davis, California Tom Price, Georgia Rau´ l M. Grijalva, Arizona Rob Bishop, Utah Timothy H. Bishop, New York Brett Guthrie, Kentucky Joe Sestak, Pennsylvania Bill Cassidy, Louisiana David Loebsack, Iowa Tom McClintock, California Mazie Hirono, Hawaii Duncan Hunter, California Jason Altmire, Pennsylvania David P. Roe, Tennessee Phil Hare, Illinois Glenn Thompson, Pennsylvania Yvette D. Clarke, New York [Vacant] Joe Courtney, Connecticut Carol Shea-Porter, New Hampshire Marcia L. Fudge, Ohio Jared Polis, Colorado Paul Tonko, New York Pedro R. Pierluisi, Puerto Rico Gregorio Kilili Camacho Sablan, Northern Mariana Islands Dina Titus, Nevada Judy Chu, California Mark Zuckerman, Staff Director Barrett Karr, Minority Staff Director (II) CONTENTS Page Hearing held on September 23, 2010 ..................................................................... 1 Statement of Members: Kline, Hon. John, Senior Republican Member, Committee on Education and Labor ...................................................................................................... 4 Prepared statement of ............................................................................... 5 Miller, Hon. George, Chairman, Committee on Education and Labor ......... 1 Prepared statement of ............................................................................... 3 Additional submissions: Letter, dated September 22, 2010, from Roger Goodell, commis- sioner, the National Football League ............................................ 36 Prepared statement of Christopher Nowinski, Boston University Sports Legacy Institute .................................................................. 43 Prepared statement of the National Athletic Trainers’ Associa- tion (NATA) ..................................................................................... 58 Statement of Witnesses: Brearley, Rev. Dr. Katherine E., mother of the late Owen Thomas ............ 15 Prepared statement of ............................................................................... 17 Conca-Cheng, Alison, Centennial High School, Ellicott City, MD ............... 12 Prepared statement of ............................................................................... 14 Gioia, Gerard A., Ph.D., chief, division of pediatric neuropsychology, Chil- dren’s National Medical Center; director, safe concussion outcome, re- covery & education (SCORE) program, Children’s National Medical Center ............................................................................................................ 7 Prepared statement of ............................................................................... 9 Herring, Stanley, M.D., clinical professor, departments of rehabilitation medicine, orthopedics and sports medicine, and neurological surgery, University of Washington; co-medical director, Seattle Sports Concus- sion Program; team physician, Seattle Seahawks and Seattle Mariners; and member, National Football League’s head, neck and spine com- mittee ............................................................................................................. 27 Prepared statement of ............................................................................... 29 Morey, Sean, executive board member, NFL Players Association (NFLPA) ......................................................................................................... 22 Prepared statement of ............................................................................... 24 (III) H.R. 6172, PROTECTING STUDENT ATHLETES FROM CONCUSSIONS Thursday, September 23, 2010 U.S. House of Representatives Committee on Education and Labor Washington, DC The committee met, pursuant to call, at 10:03 a.m., in room 2175 Rayburn House Office Building, Hon. George Miller [chairman of the committee] presiding. Present: Representatives Miller, Kildee, Payne, Scott, Woolsey, McCarthy, Davis, Bishop of New York, Altmire, Hare, Courtney, Polis, Kline, Petri, and Platts. Also present: Representatives Pascrell and McIntyre. Staff present: Andra Belknap, Press Assistant; Calla Brown, Staff Assistant, Education; Daniel Brown, Staff Assistant; Jody Calemine, General Counsel; Jamie Fasteau, Senior Education Pol- icy Advisor; Ruth Friedman, Senior Education Policy Advisor (Early Childhood); Jose Garza, Deputy General Counsel; David Hartzler, Systems Administrator; Sadie Marshall, Chief Clerk; Bryce McKibbon, Staff Assistant; Alex Nock, Deputy Staff Director; Lillian Pace, Policy Advisor, Subcommittee on Early Childhood, El- ementary and Secondary Education; Helen Pajcic, Policy Assistant; Melissa Salmanowitz, Press Secretary; Dray Thorne, Senior Sys- tems Administrator; Daniel Weiss, Special Assistant to the Chair- man; Nu Wexler, Communications Director; Kim Zarish-Becknell, Policy Advisor, Subcommittee on Healthy Families; Mark Zuckerman, Staff Director; Stephanie Arras, Minority Legislative Assistant; James Bergeron, Minority Deputy Director of Education and Human Services Policy; Kirk Boyle, Minority General Counsel; Allison Dembeck, Minority Professional Staff Member; Brian New- ell, Minority Press Secretary; Susan Ross, Minority Director of Education and Human Services Policy; and Linda Stevens, Minor- ity Chief Clerk/Assistant to the General Counsel. Chairman MILLER [presiding]. The committee will come to order, a quorum being present. Good morning to everyone. Today we will be discussing new leg- islation I introduced this week to help raise awareness about con- cussions for student athletes and to improve students’ well-being both on the field and in the classroom. Concussions have always been part of the conversation about student athletes, but for far too long we have talked about what has happened without taking any action to help students manage (1) 2 those dangerous injuries. When the student suffers a concussion, it is not just their athletic future that is at stake. Without proper management, their performance in the classroom is also in jeop- ardy. The student athlete needs to be much more about the student than the athlete. We simply can’t talk about student athletes without really talk- ing about what brain injuries really mean for a student’s future. In the concussion management arena, there is a saying, ‘‘When in doubt, send it out.’’ Unlike a broken leg or a bruise, concussions are not easily identified, but they are equally, if not more, dangerous. Ninety percent of the concussions occur without a loss of con- sciousness, and many students simply don’t know if they are in- jured. A prolonged diagnosis when the pressure to play surpasses the need for treatment can mean dangerous and harmful results to students. In the past 4 years there were nearly 400,000 reported concus- sions in high school athletes, and experts believe that prevalence of sports-related concussions is much higher than reported. It is now commonly reported that 300,000 sports-related concussions occur annually, and once you factor in the recreation-related con- cussions like those occurring on the playground, the number rises dramatically. We need to empower students to know when they may be at risk. Students deserve to know the signs and symptoms and the risks of concussions so they will be able to take appropriate next steps to prevent further injury and to prevent their successes in school from suffering. Student athletes with information about the symp- toms of concussion are more likely to treat and manage their inju- ries. Many states have already taken action, but there is little regula- tion on the whole to ensure that the students in every state will have the same minimum protection. High school athletes are at greater risk with sports-related concussions than college or profes- sional athletes, because their younger brains are more susceptible to injury, and female youth athletes are even more likely to suffer concussions. The Protecting Student Athletes from Concussions Act will help improve concussion safety and management for student athletes by requiring school districts to develop and implement a standard community-based plan for concussions safety and management. It will require school districts