1. ASSOCIATION OF GOVERNMENTAL RISK POOLS GOVERNANCE & LEADERSHIP CONFERENCE Colliding Dynamics Mapping a Head Injury Prevention Program J. Brett Carruthers, CSP, RSSP Vice President and Director of Risk Management Wright Public Entity and NYSIR

2. Head Injury Prevention Program Head Injury Prevention Program Roadmap Analysis and Research Decision Points Subscriber Survey Program Components

3. Analysis and Research Neuro Cognitive Testing Product Vetting Head Injury Claims Allegations Training Concussion Law Analysis and Research

4. Claim Allegations Failure to Protect Allegation Failure to Respond Allegation Failure to Treat Allegation Inadequate Equipment Allegation Failure to Fit Allegation Failure to Recognize

5. Claim Allegations Miss Matches Allegation No EMS Onsite Allegation No Baselines Allegation No Protocol Allegation Cumulative Effect Allegation No Trainer

6. CONCUSSION LAW

7. Concussion Law Concussion Law Training Parent/Guardian Student Athletes Coaches Nurses PE Trainers Other Components Role of Trainer Return Protocols Website Materials Baselines – “ Best Practice” Concussion Team Members Athletic Director; Coaches; School Nurse; Administrators; Parent; Trainer

8. NEUROCOGNITIVE TESTING

9. WHAT IS NEUROCOGNITIVE TESTING? Baseline tests are typically taken prior to a sport season when an athlete has not yet had exposure to training and/or competition. These tests are computerized assessments that measure Reaction Time, Memory Capacity, Speed of Mental Processing, and Executive Functioning of the brain. They also record baseline concussion symptoms and provide extensive information about the athlete's history with concussions.

10. WHAT IS THE VALUE OF NEUROCOGNITIVE TESTING? In the event a concussion is received during the season, the same test (a "post-injury") is taken again by the athlete, yielding comparative scores from before and after the injury. Comparing post-injury test results to baseline test results can assist health care professionals in identifying the effects of the injury and making more informed return to school and play decisions.

11. Neurocognitive Tests Evaluated Concussion Resolution Index CRI Computerized Cognitive Testing Tool CCAT Concussion Vital Signs CVS Immediate Post Concussion Assessment & Cognitive Testing ImPACT TRAZER ANAM Automated Neuropsychological Assessment Metrics

12. Location Scientific Test Validity False Positive Logistics Experience HIPPA Breach Software Compatible Secure Data Whose Data Data Storage Acceptance Cost $ Certainty TimeExtra $ WhoEase Neurocognitive Testing Evaluation Vetting Points

13. Training Evaluated District Training Staff Concussion Law Mandated Training Certification Trainers Concussion Training

14. SUBSCRIBER SURVEY

15. Subscriber Survey QUESTIONS All Subscribers Surveyed # of Students Participating in HS Sports Baseline Testing Conducted Baseline Testing Programs Used

16. Subscriber Survey QUESTIONS Sports Tested # of Baselines and Post Tests Athletic Trainer Use Other Providers of Care

17. Survey Highlights RESULTS 57% Testing 93% ImPACT 7% ANAM Lacrosse; Hockey and Field Hockey Football; Soccer; Wrestling; Basketball; Cheerleading Athletic Trainers – 37%

18. DECISION POINTS

19. Reputation Subscribers Ownership Data Controls Logistics Documentation Costs $ Certainty Vulnerability Data Storage HIPPA Breach What Sports Which Kids Delivery Controls AccessWhen WhatTest? Decision Points Program Components and Testing

20. PROGRAM COMPONENTS

21. Head Injury Prevention Program Head Injury Prevention Program Components Baseline and Post Concussion Tests Athletic RM Training Focused Concussion Training Playing Surface Research

22. BASELINE AND POST CONCUSSION TESTING

23. Certified Post Tests Baseball Basketball Football Ice Hockey Lacrosse Cheerleading Baselines 12 Sports Softball Soccer Field Hockey Alpine Skiing Wrestling Diving JVVarsity 3069-12 Baseline and Post Concussion Testing Components

24. FOCUSED CONCUSSION TRAINING

25. Focused Concussion Training CONCUSSION RESPONSE CONCUSSION RECOGNITION LIVE & ONLINE CASE STUDIES CONCUSSION TEAM

26. ATHLETIC RISK MANAGMENT TRAINING

27. Athletic Risk Management Training HAZING SUPERVISION HEAD INJURIES REGIONAL ITEMS LIVE & ONLINE CHEERLEADING ATHLETICS & PE

28. PLAYING SURFACE RESEARCH

29. Playing Surface Profile Playing Surface Research Synthetic or Natural Age GMax Force Results Warranty

31. THE END