Bill widens return-to-play authority after concussion
A bill to expand the types of health professionals who can medically release a student athlete to play after a concussion is headed to the Oregon House.
The Senate unanimously approved Senate Bill 1547 on Feb. 19 and the House Health Care Committee voted 9-2 on Friday to send the legislation to a full vote of the House before the end of the current 35-day session.
Health care committee members Rep. Knute Buehler, R-Bend, an orthopedic surgeon, and Rep. Cedric Hayden, R-Roseburg, a dentist, voted against the proposal. The bill also was opposed by the Oregon Medical Association, Oregon Association of Orthopedic Surgeons and the Osteopathic Physicians and Surgeons of Oregon.
The Senate Health Committee proposed the law change, describing it as a "child safety" bill, after convening a work group on treatment of athlete concussions and hearing the group's recommendations. Under existing law, only medical doctors, osteopathic doctors, physician assistants, nurse practitioners and psychologists are allowed to medically release a student athlete with a suspected concussion.
The bill would expand that authority — with online training and certification — to athletic trainers, physical therapists, occupational therapists, chiropractic physicians and naturopathic physicians.
Online concussion training by Oregon Health & Science University would be required to release students to play unless the provider is a physician, who are exempt from the training. Some lawmakers, including Rep. Alyssa Keny-Guyer, D-Portland, said they see the training exemption for physicians as a weakness in the bill.
"If we were to do an amendment, the one that I think would have been more important is that the physicians also get the specific training because ... there is so much emerging research," Keny-Guyer said.
Last Friday, Buehler, a physician who is running for governor, proposed removing athletic trainers from the list of qualified providers in the bill. Athletic trainers do not all have master's degrees. Another concern is that athletic trainers have greater potential conflicts of interest in whether an athlete returns to play, Buehler said.
"Athletic trainers don't have the separation that many of the other providers on that list have from undue conflict of interest," he said, "and I think many times athletic trainers are under significant pressure to get kids back into games, and it puts them in an awkward position."
Other representatives on the health care committee blocked that change. Rep. Rich Vial, R-Scholls, said trainers work with student athletes the most and need specialized training in concussions.
"I have become convinced in the last couple of days that the trainer being closest to the situation of anybody and with our increasing consciousness about the very profound effects of these brain injuries, I am inclined to support having the trainers both get the certification and continue to be in a position to help us," Vial said.
Dan Meek of the Oregon Progressive Party testified that the law change puts children at risk, especially those in contact sports. Traumatic brain injury was found in 110 of 111 former NFL players whose families donated their brains to the Boston University School of Medicine, according to a study published last year by the Journal of the American Medical Association.
"Senate Bill 1547 makes it more likely that Oregon students will suffer CTE (chronic traumatic encephalopathy) because it allows more people to approve having a student return to playing on a school team, after having suffered a blow that resulted in symptoms of concussion," Meek wrote in testimony to lawmakers.
CTE, caused by head trauma, can lead to dementia, memory loss, suicidal thoughts, and personality and mood changes, among other progressive symptoms, Meek testified. A study in the Journal of the American Medical Association showed that CTE was found in the brains of three of 14, or 21 percent, of high school players and 48 of 53, 91 percent, of college players.
The bill also "rewrites the law to more broadly exempt anyone and any entity involved in school sports from any liability for harm caused to players," Meek testified.
The debate in Salem over youth concussion treatment comes as InvestigateWest and the Pamplin Media Group are preparing to publish a series of reports on traumatic brain injuries sustained in youth sports. Preliminary reporting for the investigative series, which included requests for concussion records from all public high schools in Oregon, found that athletic trainers play a key role in prevention and treatment of concussions among Oregon students.
Learn more about the project at www.invw.org/2017/10/05/media-collaborative-launches-youth-concussion-project/