JJIF

Adoption Date: 12/11/2011, Revised: 10/23/2013
J - Students

JJIF Head Injuries and Concussions in Extracurricular Athletic Activities

Head Injuries and Concussions in Extracurricular Athletic Activities

Rationale

All school districts and schools shall have policies and procedures governing the prevention and management of sports-related head injuries within the school district or school. The School Committee shall adopt policies and procedures governing the prevention and management of sports-related head injuries within the school district or school, following development of a proposal by a team consisting of, at a minimum, a school administrator, school nurse, school or team physician if on staff, athletic director, certified athletic trainer if on staff , neuropsychologist if available, guidance counselor and teacher, in consultation with any existing school health/wellness advisory committee. Policies and procedures shall address sports-related head injuries occurring in extracurricular athletic activities but may be applied to all head injuries in students. Review and revision of such policies and procedures shall occur as needed but at least every two years. At a minimum, these policies shall be reviewed by:

Head Injury Policy Development Team

Superintendent of Schools

Dudley-Charlton Regional School Committee Member

Shepherd Hill Regional High School Principal

Dudley Middle School Assistant Principal

Charlton Middle School Assistant Principal

School Nurse

Athletic Trainer

Athletic Director

Assistant Athletic Director

Charlton Middle School Athletic Coordinator

Dudley Middle School Athletic Coordinator

Health Teacher


I. Policy

The following persons shall complete annually one of the head injury safety training programs approved by the Department as specified on the Department’s website:

(1) Coaches; (2) Certified athletic trainers; (3) Trainers; (4) Volunteers; (5) School and team physicians; (6) School nurses; (7) Athletic Directors; (8) Directors responsible for a school marching band, whether employed by a school or school district or serving in such capacity as a volunteer; (9) Parents of students who participate in an extracurricular athletic activity; and (10) Students who participate in an organized school-sponsored athletic activity generally occurring outside of school instructional hours under the direction of a coach, athletic director or band leader. Alternatively, the school district may use DPH-approved written training materials to meet the training requirement.

This training shall be completed annually (on or after July 1st of each school year or prior to the students’ participation) and a certificate of completion must be supplied to the high school athletic director for high school personnel and to the middle school principal for middle school coaches/advisors. The director for the school marching band shall present the certificate of completion to the principal or designee. Parents/guardians of a student who participates in an extracurricular athletic activity and students who participate in an extracurricular athletic activity will complete a sign off indicating they have received head injury material and/or completed a course.

B. Each coach, trainer, and volunteer will be provided written information from the athletic director, band director, or student activities advisor (a) to teach form, techniques, and skills and promote protective equipment use to minimize sports-related head injury, and (b) to prohibit athletes from engaging in any unreasonably dangerous athletic technique that endangers the health or safety of an athlete, such as using a helmet or any other sports equipment as a weapon.

C. Upon initial participation in athletics and in two year intervals, student-athletes will be given a neurological baseline test, administered by the athletic trainer. If a concussion is diagnosed by a physician or suspected by the athletic trainer or nurse, follow-up tests will be given post injury, during the recovery period and shared with the student-athlete’s physician.

II. Pre-Participation

A. Each student athlete and parent/guardian with a student-athlete involved in an extracurricular athletic activity covered by 105 CMR 201.000: Head Injuries and Concussions in Extracurricular Athletic Activities (the regulation) shall be required to have a consent form completed. The form shall include: (a) annual training requirement, (b) procedure for the school to notify parents when an athlete has been removed from play for a head injury or suspected concussion sustained during an extracurricular athletic activity, (c) protocol for obtaining medical clearance for return to play and academics after a diagnosed concussion, (d) parent’s responsibility for completion of the pre-participation form, or school-based equivalent, and (e) parent’s responsibility for completion of the Report of a Head Injury Form, or school-based equivalent.

1. Each student and parent/guardian with a student-athlete involved in an extracurricular athletic activity covered by the regulation shall be required to complete a consent form before they may try out for, practice, or participate with any interscholastic athletic team.

2. At the high school level all students shall have an approved physical in place before they may try out for, practice, or participate with any interscholastic athletic team. The athletic director or athletic coordinator at the middle school shall keep a master list of students with approved physical exams. High school coaches must check the approved physical list before a student may try out for, practice, or participate with any interscholastic athletic team. For other extracurricular athletic activities covered by the regulation at the high school and middle school the school nurse shall review all Department of Public Health Pre-participation Forms indicating a history of head injury in consultation with the appropriate coach/advisor.

For other extracurricular athletic activities covered by the regulation the school nurse shall maintain a list of approved physicals.

3. The procedure for sharing information concerning an athlete’s history of head injury and concussion, recuperation, reentry plan, and authorization to return to play and academic activities shall be on a need to know basis consistent with requirements of the regulation and applicable federal and state law including but not limited to the Massachusetts Student Records Regulations, 603 CMR 23.00, and the Federal Family Educational Rights and Privacy Act Regulations, 34 CFR Part 99, and shall be signed off by the parent/guardian on the Pre-participation Consent Form.

4. Each student athlete and parent/guardian with a student-athlete involved in an extracurricular athletic activity covered by the regulation shall be required to have a district consent form (concussion statement) completed; the form shall include current information regarding an athlete’s history of head injuries and concussions.

For high school interscholastic athletic activities the athletic director shall review all Pre-participation Forms indicating a history of head injury in consultation with the appropriate coach.

III. Medical Clearance

The protocol for medical clearance for return to play after a concussion at minimum will comply with 105 CMR 201.011

A. Coach/advisor/band director shall complete the Report of Head Injury Form immediately after the game or practice for head injuries that result in the student being removed from play due to a possible concussion. The coach or designee shall communicate the nature of the injury directly to the parent in person or by phone immediately after the injury occurs for which a student has been removed from play and shall communicate, by the end of the next business day, with the Athletic Director, athletic trainer and school nurse that the student has been removed from practice or competition for a head injury and suspected concussion, signs and symptoms of a concussion, or loss of consciousness.

For other extracurricular athletic activities covered by the regulation at the high school and middle school the principal or designee shall be informed by the appropriate coach/advisor/director. At the middle school the assistant principal/principal shall be informed by the appropriate coach/advisor as soon as possible. The school nurse will be informed.

B. Each student who is removed from practice or competition for a head injury or suspected concussion, or a loss of consciousness, even briefly, or exhibits signs and symptoms of a concussion, shall obtain and present to the school nurse or athletic trainer, a Medical Clearance and Authorization Form, prior to resuming the extracurricular athletic activity.

C. The athletic trainer, in communication with the physician, will determine an appropriate progressive Return to Play (RTP) criteria on an individual basis.

D. If required, an academic plan shall be developed by the student’s teachers, the student’s guidance counselor, school nurse, neuropsychologist if available or involved, parent, members of the building-based student support and assistance team or individualized education program team as appropriate and in consultation with the student’s primary care provider or the physician who made the diagnosis or who is managing the student's recovery.

Summary

Regulatory Authority: 105 CMR 201.000: MGL c 111 §222

Appendices

Department of Public Health Forms:

1. Pre-participation Head Injury/Concussion Reporting Form for Extracurricular Activities

2. Report of Head Injury During Sports Season

3. Post Sports-Related Head Injury Medical Clearance and Authorization form

MIAA form

1. Return to Athletic Participation

District Form

1. Student-Athlete and Parent/Guardian Concussion Statement

Legal Reference: 105 CMR 201.000: Head Injuries and Concussions in Extracurricular Athletic Activities.

Adopted December 14, 2011

Amended October 23, 2013

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