Leadership Service Advocacy

© 2012 Pennsylvania School Boards Association Concussion Management Policy and Administrative Regulations May 29, 2012

© 2012 Pennsylvania School Boards Association Objectives Attendees will understand: What is policy What is an administrative regulation Distinction between Board policy and administrative regulations

© 2012 Pennsylvania School Boards Association Objectives Legal requirements/legal liability Roles and responsibilities Reasons for continually evaluating and maintaining policy

© 2012 Pennsylvania School Boards Association Objectives Concussion Management Policy Sports-Related Concussion/Mild Traumatic Brain Injury Administrative Regulation (AR) Other relevant policy and AR considerations

© 2012 Pennsylvania School Boards Association Definition - Policy Policies are statements that set forth the purposes and prescribe, in general terms, the organization and programs of a school system Policies tell what is wanted, why, how much, who is responsible

© 2012 Pennsylvania School Boards Association Why is Policy Important? Policies create a framework within which the Superintendent and staff can discharge assigned duties with positive direction

© 2012 Pennsylvania School Boards Association Definition – Administrative Regulation Administrative regulations contain procedural information such as step-by-step processes, specific responsibilities, timelines, amounts, percentages, etc. Administrative regulations tell how, by whom, where, when

© 2012 Pennsylvania School Boards Association Why are Administrative Regulations Important? Administrative regulations are the mechanics and details needed for administrators and staff to put a policy into effect Administrative regulations assist in ensuring consistency in implementation throughout the district Protection from liability

© 2012 Pennsylvania School Boards Association Common Elements Common Elements Comply with state and federal laws, regulations, and court decisions Consistent when addressing the same issue Superintendent is involved with process Communication tool

© 2012 Pennsylvania School Boards Association Policy vs. Administrative Regulation Policies must be approved by the Board at a public meeting, in accordance with Board policy governing policy revisions and adoptions Administrative regulations do not require Board approval, only Board review

© 2012 Pennsylvania School Boards Association Differences Administrative Regulations Related to specific element related to issue Precise statement with specific details Subject to administrative changes Communicated mainly to staff Directives for staff actions Related to “how to do” Reviewed by Board Policy Related to general topic Broad statement allowing discretion Applicable over time Communicated to public Equivalent to law Related to “what to do” Adopted by Board

© 2012 Pennsylvania School Boards Association Characteristics of Effective Development Process Includes input from major stakeholders Collaborate with the experts Research best practices Sample policies and administrative regulations –

© 2012 Pennsylvania School Boards Association Characteristics of Effective Policy and Administrative Regulations Clarity –clearly conveys necessary information to stakeholders Consistency –ensures fair, consistent treatment –sends same message as other internal documents

© 2012 Pennsylvania School Boards Association Characteristics of Effective Policy and Administrative Regulations Current –With law and relevant to district practices –Continuous review and awareness of required changes –Timely consideration of information provided by feedback from stakeholders

© 2012 Pennsylvania School Boards Association Characteristics of Effective Policy and Administrative Regulations Communication –All stakeholders –Easy accessibility Post online – policies Intranet – Administrative Regulations –Training and Inservice Continuity

© 2012 Pennsylvania School Boards Association Characteristics of Effective Policy and Administrative Regulation Compliance –Local needs –Legal requirements Safety In Youth Sports Act –Legal insurance –Allows discretion where appropriate

© 2012 Pennsylvania School Boards Association Safety In Youth Sports Act Effective July 1, 2012 –Requires development of educational materials –Standards for removal from and return to play –Establishes training requirements –Sets penalties –Addresses civil liability

© 2012 Pennsylvania School Boards Association Safety In Youth Sports Act Policy is not required - Legal liability - Protects students, coaches, district Policy News Network (PNN) – Volume II Policy Policy News Network+ (PNN+) – Volume II Policy and Administrative Regulations

© 2012 Pennsylvania School Boards Association Concussion Management Policy Concussion Management –PSBA policy guide – tracks law Consider local practices Involve internal expertise Consult with solicitor Revise as deemed necessary Present to Board for adoption

© 2012 Pennsylvania School Boards Association Concussion Management Policy DEFINITIONS Appropriate Medical Professional Trained in evaluation and management of concussions (EMC)  Licensed physician - EMC  Licensed or certified health care professional - EMC Designated by a licensed physician with training in EMC  Licensed psychologist neuropsychologically - EMC or who has postdoctoral training in neuropsychology and specific training in EMC

© 2012 Pennsylvania School Boards Association Concussion Management Policy DEFINITIONS Athletic Activity  Interscholastic athletics  Athletic contest or competition sponsored by the school  Noncompetitive cheerleading  All practices, interschool practices and scrimmages

© 2012 Pennsylvania School Boards Association Concussion Management Policy Concussion and Traumatic Brain Injury Information Sheet –Student and parent/guardian responsibility Informational Meetings –Optional –Brackets { } indicate choices

© 2012 Pennsylvania School Boards Association Concussion Management Policy Sections in policy relating to: Removal from play Return to play Training Penalties

© 2012 Pennsylvania School Boards Association Concussion Management Policy Removal from play: –A student who, as determined by a game official, coach from the student’s team, certified athletic trainer, licensed physician, licensed physical therapist or other official designated by the district, exhibits signs or symptoms of a concussion or traumatic brain injury

© 2012 Pennsylvania School Boards Association Concussion Management Policy Return to play: –Evaluated and cleared in writing by an appropriate medical professional –District may designate the appropriate medical professional

© 2012 Pennsylvania School Boards Association Concussion Management Policy Training: –Annual training prior to coaching an activity Centers for Disease Control and Prevention National Federation of State High School Associations Another provider approved by PA Department of Health

© 2012 Pennsylvania School Boards Association Concussion Management Policy Penalties: –1 st violation – suspension from coaching for remainder of season –2 nd violation – suspension for remainder of current season and next season –3 rd violation – permanent suspension Required – July 1, 2014

© 2012 Pennsylvania School Boards Association Concussion Management Policy  Delegates responsibility to the Superintendent or his/her designee to develop administrative regulations to implement the policy  Policy is only effective if implemented appropriately

© 2012 Pennsylvania School Boards Association Administrative Regulations Brain Injury Association of Pennsylvania –Provided as a guide –Review, compare with local practices –Consult experts Coaches Athletic Directors School Nurse Physicians, Neuropsychologist Athletic trainers –Revise as deemed necessary

© 2012 Pennsylvania School Boards Association Administrative Regulations AR-0. Sports-Related Concussion/Mild Traumatic Brain Injury Signs of concussions Symptoms of concussions Concussion management protocol Return to play Return to classroom – BrainSTEPS

© 2012 Pennsylvania School Boards Association Administrative Regulations Signs of concussions: Dazed Forgets plays Slurs words Difficulty with balance or coordination Answers questions slowly or inaccurately Seizures or vomiting Changes in levels of consciousness – less than 10%

© 2012 Pennsylvania School Boards Association Administrative Regulations Symptoms of concussions: Headache Nausea Balance or dizziness Changes in vision Sensitivity to light or sound Sluggish Difficulty with short-term memory or concentration Difficulty sleeping Irritability or changes in personality and behavior

© 2012 Pennsylvania School Boards Association Administrative Regulations Concussion Management Protocol: Guidelines for when emergency medical treatment should be pursued Notification of appropriate school officials and parents/guardians Provision of information to parents/guardians for continued care of person with concussion BrainSTEPS referrals Evaluation by an appropriate medical professional Written clearance Complete physical, cognitive, emotional and social rest

© 2012 Pennsylvania School Boards Association Administrative Regulations Return to Play: Guidelines for a graduated return to play protocol –Six day process Tools –Symptoms checklists –Compare post injury performance to baseline –Balance testing Concussion symptoms recur –Return to pervious level of activity that caused no symptoms –Notify attending physician

© 2012 Pennsylvania School Boards Association Administrative Regulations Return to Play: Step One – Completion of full day of normal cognitive activities without re-emergence of any signs or symptoms. If no return of symptoms, next day advance to:

© 2012 Pennsylvania School Boards Association Administrative Regulations Return to Play: Step Two – Light aerobic exercise, which includes walking, swimming, or stationary cycling, keeping the intensity less than 70% of maximum predicted heart rate: no resistance training. If no return of symptoms, next day advance to:

© 2012 Pennsylvania School Boards Association Administrative Regulations Return to Play: Step Three – Sport-specific exercise including skating, and/or running; no head impact activities. If no return of symptoms, next day advance to:

© 2012 Pennsylvania School Boards Association Administrative Regulations Return to Play: Step Four – Noncontact training drills such as passing drills. May initiate progressive resistance training. If no return of symptoms, next day advance to:

© 2012 Pennsylvania School Boards Association Administrative Regulations Return to Play: Step Five – Normal training activities. If no return of symptoms, next day advance to:

© 2012 Pennsylvania School Boards Association Administrative Regulations Return to Play: Step Six – Return to normal play and activity.

© 2012 Pennsylvania School Boards Association Administrative Regulations Return to Classroom: Team approach Possible learning support accommodations necessary –Rest breaks –Shorter school day –More time for tests or assignments –Reduced time on computer, reading and writing Monitor performance BrainSTEPS

© 2012 Pennsylvania School Boards Association Related Policies and Administrative Regulations 122. Extracurricular Activities –Definition of athletic activity –Concussion and traumatic brain injury information sheet 122-AR-8. Concussion Information Sheet –Option A – PIAA Form –Option B – Centers for Disease Control and Prevention Form

© 2012 Pennsylvania School Boards Association Related Policies and Administrative Regulations 123. Interscholastic Athletics –Concussion and traumatic brain injury information sheet 123-AR-3. PIAA Forms 123-AR-4. Concussion Information Sheet –Option A – PIAA Form –Option B – Centers for Disease Control and Prevention Form 123-AR-6. Athletic Safety Checklist –Updated to include concussion related training –Reference to Concussion Management policy and AR

© 2012 Pennsylvania School Boards Association Contact Information Davelyn S. Smeltzer Director of Policy Services PA School Boards Association ext

Leadership Service Advocacy (800)