1. Policy Research Shop Support for the Policy Research Shop is provided by the Ford Foundation and by the Fund for the Improvement of Postsecondary Education, U.S. Department of Education. Policy Research Shop Concussion Education, Management and Prevention Policy Research Elizabeth Ballantyne, Emily Clegg, Amrita Sankar The contents of this report were developed under grant P116B100070 from the U.S. Department of Education. However, these contents do not necessarily represent the policy of the U.S. Department of Education, and you should not assume endorsement by the Federal Government.

2. Policy Research Shop Objective Explain why concussion management is important to New Hampshire Provide information on other state legislation Suggest policy options for the state of New Hampshire

3. Policy Research Shop

4. 1 Study for Injury Research and Policy: National High School Sports-Related Injury Surveillance Study 2010-11

5. Policy Research Shop 1 Study for Injury Research and Policy: National High School Sports-Related Injury Surveillance Study 2010-11

6. Policy Research Shop Participation in High School Athletics Total Number of High Schools In NH Total Number of NHIAA High Schools Total Enrollment in NHIAA High Schools Total Number of Students who Participate in NH HS Athletics Estimated NH HS Athletics Participation Rate National Average HS Athletics Participation Rate 886857,02546,05980.7%55.2% 1 School Data collected from New Hampshire Department of Education Enrollment 2010-11 2 Participation Data collected from 2010 High School Athletics Participation Survey conducted by The National Federation of State High School Association.

7. Policy Research Shop Health Costs of a Concussion Short Term: headache, nausea, confusion, difficulty performing daily tasks, change in mood Long Term Side Effects of Severe Concussion or SIS: permanent brain swelling, neurological damage, brain development in adolescents

8. Policy Research Shop Number of NH High School Athletes 1 Estimate Average % of Student Athletes who will sustain a concussion 2 Estimated Annual Concussions for NHAA High Schools Estimated Cost of mTBI Visit with CT Exam to Hospital 3 Estimated Total Annual Cost to NH Hospitals 46,05910%3,685$160$736,944 1 Participation Data collected from 2010 High School Athletics Participation Survey conducted by The National Federation of State High School Association. 2 CDC Estimate for Year 2010-2011 3 National Center for Research Resources (NCRR): The Economic Impact of S-100B as a Pre-Head CT Screening Test on Emergency Department Management of Adult Patients with Mild Traumatic Brain Injury Cost to New Hampshire Hospitals

9. Policy Research Shop Current Concussion Management in New Hampshire Brain Injury Association of New Hampshire –State Advisory Council on Sports Related Concussion Current High School Programs Resources Available at Hospitals Current Legislation

10. Policy Research Shop Legislative Options Lystedt Law – Education – Player Removal – Return-to-Play

11. Policy Research Shop Legislation in Other States

12. Policy Research Shop

13. Alternative Options Private sector concussion management

14. Policy Research Shop Cost of a Comprehensive Program Testing Costs Pupils per School Per School Annual Cost Total # Schools in NH # Schools with Athletics Estimated Cost Small 0-500$3504128 $9,800 Medium 501-1000$5002720 $10,000 Large 1001+$7502018 $13,500 Subtotal $33,300 HR Salary for full time medical official$70,000 Miscellaneous administrative costs$1,000 Total$104,300

15. Policy Research Shop Moving Forward Advancing future policy options Continuing to pass advisory legislation Investigating potential private options