Summary Matrix of State Laws Addressing Concussions in Youth Sports
According to the CDC, an estimated 248,418 children aged 19 or younger were treated in U.S. emergency departments for sports and recreation related injuries that included a diagnosis of
concussion or traumatic brain injury. Science is increasingly beginning to realize the severe impacts of brain injuries especially to children and teenagers even if they are not immediately felt or
noticed. Public health law is working to reduce the risks of head injuries to young and professional athletes through federal, local and state laws.
This table contains information on state concussion laws, including which states require return-to-play protocols for student athletes, which type of provider can issue a return-to-play clearance, and
whether or not the law applies to recreational sports.
Laws as of December 31, 2018
State Citation
Date First
Enacted/
First
Effective Changes/ Amendments since Initial Enactment
Requires Training
for coaches
1
Education (Parent)
Education (Youth
Athlete)
Return-to-play
(RTP) Restrictions
Medical clearance
required
Type of provider that can issue RTP clearance
Applies to recreational
sports?
AL Ala. Code
1975 §22-
11E-2
June 2011/
June 2011
2012: Requires local school systems to develop
concussion guidelines (original law required only
sports governing bodies to do so). Also added same-
day return prohibition to existing RTP provision.
Licensed physician Yes
TRAUMATIC BRAIN INJURY IN YOUTH SPORTS
Fact Sheet
Page 2
2018: Added requirement for all coaches (paid or
volunteer) and athletics personnel to complete a
course on injury mitigation and information, including
concussions and head trauma. Replaced immunity
clause to provide a defense from liability upon
establishing completion of the course and reasonable
conformity of one’s conduct to the course’s safety
techniques and methods.
Also required state department of public health to
promulgate rules to implement and enforce the law.
(Ala. Admin. Code r. 420-11-3-.01,
Promulgated Sept. 2018. See below.)
Ala.
Admin.
Code r.
420-11-3-
.01
Sept 2018/
Nov 2018
Yes
AK AS
§§14.30.1
42 and
14.30.143
May 2011/
Aug 2011
2012: Added athletic trainers; clarified that RTP
included return to practice.
An athletic trainer or other qualified person who has
received training, as verified in writing or
electronically by the qualified person, in the
evaluation and management of concussions. Law
defines “qualified person” as a licensed health care
provider or a person acting at the direction of and
under supervision of a licensed physician.
No
AZ A.R.S.
§15-341
(24)(b)
April 2011/
April 2011
2012: Non-substantive.
Health care provider trained in the evaluation and
management of concussions and head injuries. Law
defines “health care provider” as a licensed physician,
athletic trainer, nurse practitioner, or physician
assistant.
Yes, if organization uses
school property.
AR A.C.A.
§§6-18-
708 and 6-
18-710
April 2011/
July 2011
2013: Added concussion education, guideline
development, and RTP requirements and extended
applicability to recreational youth sports.
Licensed healthcare provider trained in the evaluation
and management of concussions.
Yes
Page 3
2017: House Bill 1509 established penalties for
coaches who fail to meet training requirements. Law
is effective beginning with the 2019-2020 school year.
Ark.
Admin.
Code
005.22.7-
7.0
Aug 2014/
Sept 2014
2014: Provides that athletic coaches obtain training in
recognition and management of specified events or
conditions, including concussion, at least once every
three years.
2016: Non-substantive.
CA Cal. Educ.
Code
§49475
and
§35179.5
Cal.
Health &
Safety
Code
§124235
Oct 2011/
Jan 2012
2013: Added charter and private schools.
2014: Limited full-contact practices to twice per week
and stipulated that full-contact portion of a practice
cannot exceed 90 minutes per day (high school and
middle school football).
Required that, if licensed health care provider
determines an athlete sustained concussion or head
injury, athlete must complete a graduated RTP
protocol of no less than 7 days in duration under the
supervision of a licensed health care provider.
Urges California Interscholastic Federation to adopt
rules to implement both provisions.
2016: Expands athlete removal and return-to-play
provisions to youth sports organizations and lists 27
designated sports to which the law applies. Requires
parental notification of injury and requires coaches
and administrators of youth sports organizations to
successfully complete concussion and head injury
education at least once. Became effective January 1,
2017.
(for
youth
sports
orgs.
only)
Licensed health care provider trained in the
evaluation and management of concussions and
acting within the scope of his or her practice.
Yes
CO C.R.S.A.
§§25-43-
101 to 25-
43-103
March
2011/ Jan
2012
None
Health care provider, which law defines as a doctor of
medicine, doctor of osteopathic medicine, licensed
nurse practitioner, licensed physician assistant or
licensed doctor of psychology with training in
neurophysiology or concussion evaluation and
management. (After RTP clearance, a registered
athletic trainer with specific knowledge of the athlete’s
Yes
Page 4
condition may manage athlete’s graduated RTP.)
Also, a chiropractor with training and specialization in
concussion management may provide clearance for
an athlete who is part of the U.S. Olympic training
program.
CT Conn.
Gen. Stat.
Ann.
§§10-
149b, 10-
149c, and
21a-432
May 2010/
July 2010
2014: Added concussion education plan for local and
regional boards of education. Added education
requirement for student athletes and
parents/guardians, and informed consent form for
parents/guardians.
Added state commissioner of public health to parties
developing concussion training courses, review
materials, informed consent form, and concussion
education plan.
Added requirements for concussion refresher course:
best practices in the field of concussion research and
treatment, and for football coaches, current best
practices on coaching (e.g., frequency of games and
full contact practices and scrimmages) as identified
by governing authority for intramural and
interscholastic athletics.
Added requirement that parent/guardian be notified
within 24-hours of student athlete’s removal from
activity for suspected concussion.
Added new section, effective 7/1/2014, requiring
annually: (1) school districts to collect and report
concussion incidence data to the state board of
education, (2) state board of education to report
concussion data to state department of public health,
and (3) state commissioner of public health to report
on concussion findings to certain joint standing
committees of the state general assembly pursuant to
C.G.S.A. § 11-4a.
Established a task force to study concussion in youth
athletics and make recommendations for possible
legislative initiatives.
2015: Included youth sports organizations in
education-related provisions only by adding § 21a-
432, which requires operators of youth athletic
Licensed health care professional, which law defines
as a licensed physician, physician assistant,
advanced practice registered nurse or athletic trainer
trained in the evaluation and management of
concussions.
2
See note
Page 5
activities to make available a written or electronic
statement to youth athletes and parents/guardians
upon registration for the activity. The statement must
be consistent with the most recent information
provided by the CDC regarding concussions and
must include, at a minimum: (1) the recognition of
signs or symptoms of a concussion, (2) the means of
obtaining proper medical treatment for a person
suspected of sustaining a concussion, (3) the nature
and risks of concussions, including the danger of
continuing to engage in youth athletic activity after
sustaining a concussion, and (4) the proper
procedures for allowing a youth athlete who has
sustained a concussion to return to athletic activity.
Law also p
rovides civil immunity for operators who fail
to comply. Became effective January 1, 2016.
DE
14 Del.C.
§303
16 Del. C.
§ 3004L
Middle
school: 14
Del.
Admin.
Code
1008
High
school: 14
Del.
Admin.
Code
1009
July 2011/
July 2011
2016: Certified and emergency coaches must
complete approved concussion course
Added new section to Del. Stat. Title 16, which
applies educational and return-to-play provisions to
youth recreational sports. Requires initial and periodic
training of coaches and officials.
Added a new public health code section that pertains
to youth athletic activities. Requires immediate
removal from play, forbids same-day return to athletic
activity, requires evaluation and clearance by a health
care provider and prompt notice of parent of
guardian. (Effective Sept. 2017.)
Evaluation can be performed by a “qualified
healthcare professional,” defined as a licensed MD or
DO, or a school nurse, nurse practitioner, physician
assistant or athletic trainer with collaboration and/or
supervision by a MD or DO. Written clearance can be
given by a qualified physician (MD or DO) only.
For recreational sports: a licensed physician (MD or
DO) or such other licensed health-care professional
as may be designated by the Division of Public Health
through regulation.
Yes
DC D.C. Code
§§7-
2871.01 to
7-2871.05
July 2011/
Oct 2011
2013: Non-substantive; directed Department of
Health to issue a competitive grant for creation of
comprehensive concussion care protocol for children
Licensed or certified health-care provider. Yes
Page 6
CDCR 22-
B620
FL
Athletic
coaches
for
independe
nt
sanctionin
g
authorities
: FL ST
§943.0438
Athletics in
public
schools K-
12: FL ST
§1006.20
April 2012/
July 2012
2013: Non-substantive
2014: Athletic coach definition updated to include
coach, assistant coach, or referee
3
See
note.
Appropriate health care practitioner trained in the
diagnosis, evaluation, and management of
concussions as defined by the Sports Medicine
Advisory Committee of the Florida High School
Athletic Association
Yes
GA
Ga. Code
Ann., §20-
2-324.1
April 2013/
Jan 2014
None
4
See
note
Health care provider, which is defined as a licensed
physician or another licensed individual under the
supervision of a licensed physician, such as a nurse
practitioner, physician assistant, or certified athletic
trainer who has received training in concussion
evaluation and management.”
Yes, except those offered
through a church or
synagogue
HI 2012
Hawai’i
Session
Laws Act
197 (H.B.
2273)
July 2012/
July 2012
2016: Expanded coverage to recreational youth
sports; added physical therapists to list of licensed
health care providers that can issue RTP clearance.
Clarifies that school athletic activities encompass
those for grades 9-12.
Expands provisions of the concussion monitoring and
education program for school athletics. The University
Licensed health care provider, which law defines as
an advanced practice registered nurse, certified or
registered athletic trainer, neuropsychologist,
physician assistant, physician, osteopathic physician,
or physical therapist trained in the management of
sports concussions.
Yes
Page 7
2016
Hawai’i
Session
Laws
Act
262 (S.B.
2557)
of Hawaii, state department of education, and the
Hawaii High School Athletic Association must jointly
develop program. Must provide training for coaches,
administrators, faculty, staff, and sports officials on
concussion signs and symptoms, proper medical
clearance, and academic and cognitive issues,
including adjustments for returning to school.
Requires cognitive testing and continuous data
collection and monitoring. Effective July 1, 2016.
ID I.C. §33-
1625
April 2012/
July 2012
2016: Coaches, referees, game officials, game
judges, and athletic trainers shall review guidelines
identifying signs and symptoms of concussions
biennially (every other year) as opposed to biannually
(twice a year).
Adds education and informed consent provision for
parents/guardians.
Adds return-to-learn provisions, acknowledging that
students who have sustained a concussion may need
informal or formal accommodations, modifications of
curriculum, and monitoring by medical or academic
staff until the student is fully recovered. Requires that
student athletes be able to resume all normally
scheduled academic activities without restriction or
accommodation prior to receiving authorization to
return to play.
Qualified health care professional who is trained in
the evaluation and management of concussions,
which includes any of the following: physician or
physician assistant, advanced practice nurse,
licensed health care professional trained in the
evaluation and management of concussions who is
supervised by a licensed directing physician
No, encouraged. If they
comply, they are afforded
same liability protections.
IL 70 ILCS
1205/8-24;
105 ILCS
5/22-80;
105 ILCS
25/1.15;
and 410
ILCS
145/15
July 2011/
July 2011
2012: Renumbered; non-substantive.
2014: Added section requiring athletic association or
interscholastic athletics entity to develop online
certification for high school coaching personnel and
athletic directors in concussion awareness and
reduction of repetitive sub-concussive hits and
concussions. Certification course is mandatory for all
high school coaching personnel and athletic directors
and must be taken every 2 years. Content must be
updated annually.
Added requirement that high school coaches and
athletic directors annually require student athletes to
A treating physician, athletic trainer (under the
supervision of a physician), physician assistant, or
registered advanced practice nurse
Yes, if park district is
directly responsible for
organizing and providing
a sponsored youth sports
activity as a youth sports
league by registering
players and selecting
coaches as defined in the
law
Page 8
watch video on risk of concussion and sub-
concussive hits to the head. Requires high school
coaches and athletic directors to encourage coaches
of youth sports organizations to consider certification.
2015: 105 ILCS 5/10-20.54 and 105 ILCS 5/34-18.46
repealed and renumbered to 105 ILCS 5/22-80,
effective November 2015. Extends applicability to
park districts. Establishes medical clearance
requirements, return to play and return to learn
protocols, parent/student education requirements,
and concussion oversight teams, which become
effective for the 2016-2017 school year. 410 ILCS
145/15 encourages youth sports leagues to make
available concussion and head injury educational
materials.
2017: Added “who is working under the supervision of
a physician” to the definition of “athletic trainer.” Adds
physician assistants, advanced practice nurses, and
athletic trainers to those licensed healthcare
professionals who can make RTP clearance. Notes
that a concussion oversight team, required for each
school by law, may be composed of only one person,
but that person may not be a coach. Also requires
licensed and non-licensed healthcare professionals
who serve on concussion oversight team to take
concussion-training course at least once every 2
years. Allows certain licensed healthcare
professionals to take professional continuing
education to fulfill this requirement. (Effective
September 2017)
2018: Requires the state department of public health
to develop, publish, and disseminate a brochure to
educate the general public on the effects of
concussions in children, including warning signs and
risk of delayed learning development. Requires the
department to distribute the brochure free of charge
to any child or parent/guardian of any child who has
sustained a concussion.
Adds “registered” before each reference to “advanced
practice nurse.”
Page 9
Requires state board of education to adopt rules to
administer the law, and adds return-to-learn
provision: rules must include “informal or formal
accommodation of a student who may have sustained
a concussion during an interscholastic athletic
activity. (Effective Jan. 2019)
IN IC 20-34-
7-1
through 7,
IC 20-34-
7-1.5, and
IC 20-34-
7-6
May 2011/
July 2011
2014: Added 24-hour waiting period for athlete with
suspected concussion to return to activity. Added
non-school “organizing entities” that use government
property. Required football coaches and assistant
football coaches to complete a course (with specified
elements) on player safety and concussions at least
once every 2 years. Provided civil immunity for
football coaches in certain circumstances.
2016: Defines school as public and accredited
nonpublic school; defines student athlete as student
who attends school grades 5-12 and participates in
any interscholastic sport (including cheerleading).
Effective June 30, 2017, interscholastic and
intramural coaches must complete a certified
coaching concussion education course at least once
every 2 years. Require coaches (head and assistant)
to complete a test demonstrating comprehension of
the course player safety content and receive a
certificate of completion. The course must be
approved by the state, in consultation with a licensed
physician who has expertise in the area of
concussions and brain injuries. Requires schools to
maintain certificates of completion. Provides liability
immunity for complying coaches providing services in
good faith (except for gross negligence).
2018: Non-substantive.
Licensed health care provider trained in the
evaluation and management of concussions and
head injuries
Yes, for organizing
entities that use property
owned, leased, or
maintained by the state
or other political
subdivision
IA
Iowa Code
Ann.
§§280.13
C and
272.31
April 2011/
April 2011
2012: Added definition of extracurricular
interscholastic activity
2016: Requires completion of a nationally recognized
youth sports concussion training course for
Licensed health care provider trained in the
evaluation and management of concussions and
other brain injuries. Law defines “licensed health care
provider” as a physician, physician assistant,
chiropractor, advanced registered nurse practitioner,
nurse, physical therapist or licensed athletic trainer.
No
Page 10
transitional coaching authorization form state
Educational Examiners Board.
2018: Non-substantive; added “of the United States
department of health and human services” after
mention of CDC.
KS
K.S.A. 72-
135
May 2011/
July 2011
None
Health care provider, which the law defines as a
person licensed by the state board of healing arts to
practice medicine and surgery
No
KY KRS
160.445
March
2009/
March 2009
2012: Added student athlete and parent education
with acknowledgment; immediate removal with RTP
restriction and prohibition on same-day return; venue-
specific emergency action plans
2013: Removed “certified” requirement for athletic
trainers to teach concussion course
2017: 2017 Kentucky Laws Ch. 160 (HB 241) clarified
that a coach may return an athlete to play if, after
evaluation by a physician or licensed health care
provider, it is determined that the athlete has not
sustained a concussion. The athlete must not return
to play if the provider performing the evaluation
determines that a concussion has occurred.
Initial evaluation can be done by physician or a
licensed health care provider whose scope of practice
and training includes the evaluation and management
of concussions and other brain injuries. Physician
must provide written RTP clearance.
No
702 KAR
7:065
Aug 2014
2014: Requires middle school athletes to adhere to
middle school sports medicine policies, including
concussion and other head injury policies.
LA LSA-R.S.
40:1089.1
to 1089.5
June 2011/
June 2011
2015: Non-substantive; Renumbered.
2018: Non-substantive wording changes (e.g., “health
care” to “healthcare.”)
Health care provider, which the law defines as a
licensed physician, licensed nurse practitioner,
licensed physician assistant or licensed psychologist,
who has received training in neuropsychology or
concussion evaluation and management
Yes
ME
Public
Laws of
2011
May 2011/
None
Licensed health care provider trained in concussion
management
No
Page 11
Chapter
688
Codified
provisions:
20-A
MRSA
§1001,
sub-§19
and §254,
sub-§17
Local
policies:
Jan 2013
All other
provisions:
May 2012
MD MD Code,
Education,
§7-433;
MD Code,
Health-
General,
§14-501;
and
COMAR
13A.06.08.
01 et seq.
April 2011/
July 2011
2011: Non-substantive; Renumbered and corrected
cross-reference
Licensed health care provider trained in the
evaluation and management of concussions
Yes
MA
M.G.L.A.
111 §222
July 2010/
July 2010
2016: Added provision that requires state bureau of
substance abuse services to provide educational
materials on the dangers of opiate use/misuse those
participating in the annual head injury safety program
already required by law. Requires materials to also be
distributed in written form to all students participating
in an extracurricular athletic activity prior their athletic
seasons.
Physician, neuropathologist, certified athletic trainer
or other trained/licensed health professional allowed
by DPH
No
105 CMR
201.001 et
seq.
July 2010/
Jan 2011
None
Licensed physician, licensed certified athletic trainer
in consultation with a licensed physician, licensed
nurse practitioner in consultation with a licensed
physician or licensed neuropsychologist in
coordination with the physician managing the
student's recovery
No
Page 12
MI
M.C.L.A.
333.9155
and
333.9156
Oct 2012/
Mar 2013
None
Appropriate health professional, which is defined as a
health professional who is licensed or otherwise
authorized to engage in a health profession and
whose scope of practice within that health profession
includes the recognition, treatment, and management
of concussions
Yes
MN
M.S.A.
§§121A.37
; 121A.38;
124E.03
Subd.
7(c); and
128C.02
Subd. 3b
July 2011/
July 2011
2017: Non-substantive amendment to §124E.03
(charter schools)
4
See
note
4
See
note
Provider trained and experienced in evaluating and
managing concussions. Law defines “provider” as a
health care provider who is: (1) registered, licensed,
certified or otherwise statutorily authorized by the
state to provide medical treatment; (2) trained and
experienced in evaluating and managing pediatric
concussions; and (3) practicing within the person's
medical training and scope of practice.
Yes
MS Miss.
Code Ann.
§37-24-1
et seq.
Jan 2014/
July 2014
None
“Health care provider,” which is defined as a licensed
physician or a licensed nurse practitioner, licensed
physician assistant or licensed health care
professional working within the person's scope of
practice and under the direct supervision or written
consultation of a physician. All health care providers
referred to in this act also must be trained in the
evaluation and management of concussions.
No
MO V.A.M.S.
167.765
and
167.775
July 2011/
Aug 2011
None
4
See
note
Licensed health care provider trained in the
evaluation and management of concussions
No
MT MCA 20-7-
1301 to
20-7-1304
April 2013/
April 2013
2017: Expanded coverage to private schools and
recreational youth sports organizations and added
immunity provision from civil liability for volunteers.
Clarifies language. For example, added “consistent
with current medical knowledge” to the definition of
“licensed medical care professional” authorized to
make RTP clearance. Clarifies that term “organized
youth athletic activity” does not include physical
“Licensed health care professional,” which is defined
as a registered, licensed, certified, or otherwise
statutorily recognized health care professional whose
training includes the evaluation and management of
concussions consistent with current medical
knowledge.
Yes
Page 13
education classes or recess. Adds expiration period
(1 year) for informed consent forms signed by
parent/guardian. (Effective Oct. 2017)
NE Neb.Rev.S
t. §§71-
9101
through
71-9106
April 2011/
July 2012
2014: Required establishment of a return-to-learn
protocol for students that have sustained concussion,
including informal or formal accommodations,
curriculum modifications, and medical monitoring.
1
See
note
Licensed health care professional, which is defined
as a physician or licensed practitioner under the
direct supervision of a physician, a certified athletic
trainer, a neuropsychologist or some other qualified
individual who (a) is registered, licensed, certified or
otherwise statutorily recognized by the state to
provide health care services and (b) is trained in the
evaluation and management of traumatic brain
injuries among a pediatric population
Yes
NV N.R.S.
386.435,
392.452,
455A.200
and NAC
386.832
May 2011/
July 2011
2015: Non-substantive, renumbered. N.R.S 386.435
renumbered as N.R.S. 385B.080.
2017: 2017 Nevada Laws Ch. 318 (S.B. 227) adds
advanced practice registered nurses to list of health
care providers that can issue RTP clearance.
5
See
note
Provider of health care, which is defined as a licensed
physician, a licensed physical therapist, a licensed
athletic trainer, or an advanced practice registered
nurse
Yes
NH N.H. Rev.
Stat.
§200:49
through
200:52
Aug 2012/
Aug 2012
2013: Expanded coverage from grades 9-12 to
“intramural sports programs conducted outside the
regular teaching day for students in grades 4-12 or
competitive athletic programs between schools for
students in grades 4-12”
2014: Changed language requiring, rather than
encouraging, concussion education information to be
distributed to all student athletes. Added definition of
head injury.
4
See
note
4
See
note
Health care provider, which law defines as a person
who is licensed, certified, or otherwise statutorily
authorized by the state to provide medical treatment
and is trained in the evaluation and management of
concussions
No
NJ N.J.S.A.
18A:40-
41.1
through
41.7 and
N.J.A.C.
6A:16–2.2
and
N.J.S.A.
Dec 2010/
Dec 2010
2011: Amended to include cheerleading
2013: New sports safety law required physical
examination and concussion history, among other
things.
2017: Amended to include intramural athletics
organized by a school.
Physician or other licensed healthcare provider
trained in concussion management
No
Page 14
18A:40-
41.7.b
NM N.M.S.A.
1978,
§§22-13-
31 and
22-13-31.1
March
2010/ May
2010
2016: Return to athletic activity expanded from at
least one week after brain injury to at least 240 hours
from the hour of the brain injury (10 days). Requires
medical release to be in writing. Requires
nonscholastic youth athletic activity taking place on
school property to sign certificate that the activity will
follow the brain injury protocols. Adds practicing
physical therapist to list of licensed healthcare
professionals authorized to issue RTP clearance;
adds definition of nonscholastic youth athletic activity.
Added new section (N.M.S.A. 1978, § 22-13-31.1) to
extend coverage to recreational youth athletics;
section mirrors school athletic activities brain injury
protocol but replaces “student” with “youth athlete”,
specifically under 19 years of age; authorizes
department of health to consult with brain injury
advisory council to promulgate concussion protocol
and content.
2017: Requires training on brain injury and RTP
protocols to be provided to student athletes (original
law required such training only for coaches)
Licensed health care professional, which law defines
as a practicing and licensed: physician or physician
assistant, osteopathic physician, certified nurse
practitioner, osteopathic physician assistant,
psychologist, athletic trainer, or practicing physical
therapist.
Yes
NY NY EDUC
§305 (42);
NY PUB
HEALTH
§206 (28)
March
2011/ Sept
2011
None
4
See
note
4
See
note
Licensed physician No
NC N.C.G.S.A
. § 115C-
12(23)
June 2011/
Oct 2011
None
1
See
note
Licensed physician with training in concussion
management, licensed neuropsychologist with
training in concussion management and working in
consultation with a licensed physician, licensed
athletic trainer or physician assistant or nurse
practitioner, consistent with limitations imposed
elsewhere in the law
No
Page 15
ND NDCC
15.1-18.2-
04
April 2011/
Aug 2011
2013: Clarified duties for student removal after
suspected concussion; changed “diagnoses and
treatment of concussion” to “evaluation and
management of concussion”; clarified medical
clearance requirements; added officials to those not
made liable by the law; and other non-substantive
changes.
Licensed health care provider who is acting within the
provider’s scope of practice and trained in the
evaluation and management of concussion, as
determined by the provider’s licensing board
No
OH R.C.
§3313.539
, R.C.
§3319.303
,
R.C.
§3707.511
, R.C.
§3707.521
, and R.C.
Title 47
(health
care
licensing)
Dec 2012/
March 2013
2013: Non-substantive amendment to clarify
language.
2014: Added to the list of providers that may make
RTP decisions “a licensed health care professional
who meets the minimum requirements” of the state’s
licensing agency.
Changed language to clarify that the provider granting
the RTP clearance must be the professional who
“assessed the student’s condition.”
Beginning in 2015, all physicians and health care
professionals conducting assessments and RTP
clearances must meet minimum educational
requirements set by the state’s licensing agency.
2016: Removed language in R.C. §3707.521
establishing concussion and head injury committee,
which had already met in 2014 and 2015.
“Physician,” which is defined as a person authorized
under state law to practice medicine and surgery or
osteopathic medicine and surgery, or a licensed
health care professional who meets the minimum
requirements of the state’s licensing requirements or
is authorized by the school district or nonpublic
school governing body to assess students. For
example, psychologists and athletic trainers may
assess and clear a student to return to play if certain
requirements in the licensing law (Ohio Admin. Code
4732-17-01.1 and Ohio Admin. Code 4755-43-13,
respectively) are met.
Yes
OK 70
Okl.St.Ann
§24-155
May 2010/
July 2010
2016: Expands coverage of law to include
recreational youth sports. Updates definition of health
care providers that can provide RTP clearance.
Requires state department of health to create a
concussion management section on its website and
provide necessary guidelines for each school district,
board of education, and youth sports organization for
developing their own policies and concussion
procedures.
Requires return-to-learn guidelines for teachers, a
Graduated Stepwise Return to Athletic Participation,
and links to free online concussion training programs
as provided by CDC and the National Federation of
State High School Associations (NFHS).
Individual who is registered, certified, licensed, or
otherwise recognized by the state to provide medical
or psychological treatment and who is trained and
experienced in the evaluation, management and care
of concussions.
Yes
Page 16
Requires each school district board of education and
youth sports organization to develop concussion
policies and procedures to inform and educate
coaches, game officials, and team officials. Requires
acknowledgment of information disseminated to
athlete and parent, and such completion to be
maintained by the school or youth sports
organization.
Adds annual concussion training requirement for
game and team officials, with records of completion
retained and available upon request. Requires game
and team officials to remove athletes from practice or
competition upon suspected concussion and prohibits
same-day return.
Authorizes governing boards to establish penalties for
violations (first violation: additional concussion
recognition and management education as
predetermined by the governing board; second
violation results in suspension from the sport until
appearance before the governing board; establishes
that monetary fines are not to be considered as a
penalty). (Effective Nov., 2016.)
OR O.R.S.
§336.485
and
§417.875
June 2009/
July 2009
June 2013/
January
2014
June
2015/June
2015
2013: Expanded coverage beyond high school to all
youth sports coaches (including rec sports); added
referees as required trainees; added athlete and
parental education and acknowledgment of receipt.
Became effective Jan. 1, 2014.
2015: Amended §336.485 and 417.875 to add
definition of health care professional; added language
to permit coaches to allow an athlete to return to an
athletic event if an athletic trainer registered by the
board of athletic trainers determines the athlete has
not suffered a concussion.
Amended §417.875 to add definition of health care
professional; added language to permit coaches to
allow a member to return to an athletic event if an
athletic trainer registered by the board of athletic
trainers determines the athlete has not suffered a
concussion; deleted language forbidding referees
(for non-
school
sports
only)
(for non-
school
sports
only)
Health care professional, defined as a medical doctor,
osteopathic physician, psychologist, physician
assistant or nurse practitioner licensed or certified
under the laws of this state.
An athlete may return to play upon determination by a
registered athletic trainer that the athlete has not
sustained a concussion.
Yes
Page 17
from allowing members of non-school teams from
playing after suspected concussion.
2017:Non-substantive; change in language re: health
care provider that adds internal citation to licensing
requirement.
OAR 581-
022--2215
June 2010/
June 2010
2017: Non-substantive; Renumbered.
Health care professional, which is defined as a
medical doctor, osteopathic physician, psychologist,
physician assistant or nurse practitioner licensed or
certified under the laws of this state.
A removed student athlete may return to participation
if a registered athletic trainer determines the student
has not suffered a concussion.
No
PA 24 P.S.
§§5322
and 5323
Nov 2011/
July 2012
None
Appropriate medical professional, which is defined as
(1) a licensed physician who is trained in the
evaluation and management of concussions or a
licensed or certified health care professional trained
in the evaluation and management of concussions
and designated by such licensed physician; or (2) a
licensed psychologist neuropsychologically trained in
the evaluation and management of concussions or
who has postdoctoral training in neuropsychology and
specific training in the evaluation and management of
concussions
No, encouraged.
RI Gen.Laws
1956,
§§16-91-1
et seq.
June 2010/
June 2010
2011: Added required refresher course for coaches
and volunteers (removed course requirement for
trainers); added requirement that clearing physician
be trained in the evaluation and management of
concussion; clarified language of recommended
baseline testing.
2014: Added language that signs and symptoms of
concussion may manifest after injury during school
setting; added school nurses to those that must be
advised of concussion signs and symptoms and
treatment protocol.
Requires school nurses to complete concussion
training course and annual refresher course (original
law encouraged school nurses to complete such
A licensed physician, who may consult with an
athletic trainer, all of whom must be trained in the
evaluation and management of concussions.
Clearance must be made by licensed physician.
No, encouraged.
Page 18
training); encourages teachers and teachers’ aides to
complete training.
Adds RI Interscholastic League as entity making
concussion materials available (in addition to CDC).
R.I.
Admin.
Code 31-
1-37:18.18
July 2014/
Aug 2014
None
Licensed physician No
SC Code
1976 §59-
63-75
June 2013/
June 2013
None
4
See
note
Physician, which is defined elsewhere in the law as a
doctor of medicine or doctor of osteopathic medicine
licensed by the South Carolina Board of Medical
Examiners; physician assistant pursuant to scope of
practice guidelines, or nurse practitioner pursua
nt to a
written protocol
A removed student athlete may return to play if, as a
result of evaluating the student athlete on site, the
athletic trainer, physician, physician assistant
pursuant to scope of practice guidelines, or nurse
practitioner pursuant to a written protocol determines
that the student athlete did not suffer a concussion or
brain injury.
No
SD
S.D.
Codified
Laws §13-
36-9 et
seq.
March
2011/
March 2011
None
Licensed health care provider trained in the
evaluation and management of concussion
No
TN T.C.A.
§§68-55-
501 to 68-
55-503
Apr 2013/
Jan 2014
2016: Changed definition of health care provider to
include physician assistants.
(signatu
re if 18
or older)
Health care provider, defined by law as a Tennessee
licensed medical doctor, osteopathic physician,
clinical neuropsychologist with concussion training, or
physician assistant with concussion training who is a
member of a health care team supervised by a
licensed MD or DO.
Yes
Page 19
TX V.T.C.A.,
Education
Code §
33.202 et
seq.
June 2007/
June 2007
None
If
unconsci
ous
No
V.T.C.A.,
Education
Code
§38.151 et
seq.
June 2011/
June 2011
2017: 2017 Tex. Sess. Law Serv. Ch. 324 (S.B. 1488)
changes approving body for athletic trainers
concussion training courses from the State Health
Services Advisory Board of Athletic Trainers to the
Texas Department of Licensing and Regulation,
which must maintain an updated list of organizations
authorized to provide the training.
2017 Tex. Sess. Law Serv. Ch. 362 (H.B. 3024) adds
to the list of individuals under TX EDUC § 38.156 who
can determine whether a student has sustained a
concussion and should be removed from play “a
person licensed under Chapter 201, Occupations
Code” (chiropractor).
A treating physician chosen by the student or
parent/guardian
No
UT Utah Code
§§26-53-
101 et
seq.
March
2011/ May
2011
2013: Clarified definition of “sporting event”; makes
provisions regarding school nurses (may assess
concussion, but may not make RTP decision and
must refer to provider trained in evaluation and
management of concussion.
Qualified health care provider, which law defines as
one who is licensed to practice in the state and who
may evaluate and manage concussions within the
provider's scope of practice. Provider must certify, as
part of written clearance for returning a youth athlete
to play, that provider has completed a continuing
education course in concussion evaluation and
management within 3 years of the issued statement.
Yes
VT 16 V.S.A.
§1431
May 2011/
May 2011
2012: Clarified requirement for immediate removal
from play and role of coach
2013: Added legislative intent language with
epidemiology statistics; added to coaches’ required
training methods for reducing risk of concussion
(primary prevention); added mandatory training for
referees; requires schools to have concussion
management action plan; home teams must provide
health care provider during collision sports and notify
opposing team’s AT within 48 hours of suspected
Health care provider, which law defines as a licensed
athletic trainer, or other health care provider, who has
within the preceding five years been specifically
trained in the evaluation and management of
concussions and other head injuries.
No
Page 20
concussion; 24-hour parent notification; provisions for
data collection and reporting.
VA VA Code
Ann. §
22.1-271.5
April 2010/
July 2010
2014: Added return-to-learn provisions. Required
state board of education to add effects of concussion
on student athletes’ academic performance to
guidelines and policies.
Required non-interscholastic youth sports programs
using public school property to either establish
concussion policies and procedures (consistent with
certain requirements) or follow the local school
division’s policies and procedures.
2016: Added return-to-learn protocol, requiring school
personnel to be alert to cognitive and academic
issues experienced by students that suffered a
concussion. Requires school personnel to develop
gradual return to full participation in academic
activities for affected students, based on
recommendation of student’s licensed health care
provider.
Licensed health care provider as determined by state
board of education
Yes, if using public
school property
WA West's
RCWA
28A.600.1
90
May 2009/
July 2009
2015: Added relevant provision that provides
immunity for school districts that allow youth sports
programs to use school facilities if the school district
requires such organizations to furnish a statement of
compliance with the policies for the management of
concussion and head injury in youth sports as set
forth in RCW 28A.600.190 (Wash. Rev. Code Ann.
§4.24.660).
Licensed health care provider trained in the
evaluation and management of concussion
No
WV
W. Va.
Code,
§18-2-25a
W. Va.
Code St.
R. §127-2-
14
May 2013/
Jul 2013
2014: Administrative rules adopted, as required by
section (c) of the statute, which implement the
provisions of the statute. Rules outline specific
provisions for content and dissemination of
educational information and annually signed
acknowledgment forms and content of head coaches’
training. Lists the licensed health care professionals,
with appropriate training in the evaluation and
management of concussion, who can make RTP
Licensed health care professional, who is a health
care provider whose licensed scope of practice
includes the ability to diagnose and treat an injury or
disease, trained in the evaluation and management of
concussions
No
Page 21
SUPPORTERS
The Network for Public Health Law is a national initiative of the Robert Wood Johnson Foundation.
This document was developed by Kerri McGowan Lowrey, J.D., M.P.H., Deputy Director and Director of Grants & Research at the Public Health Law Network – Eastern Region at The University of Maryland
Francis King Carey School of Law. This compilation includes only codified state statutes and administrative regulations, and does not include other types of policy, such as departmental guidance
documents, non-codified legislative actions, association bylaws, or opinions of attorneys general. This compilation also does not include pilot programs, laws establishing study groups, or laws that apply
to less than the entire state. Please seek legal counsel in your state for specific legal advice.
This fact sheet was updated in May 2019.
evaluations: MD, DO, DC, ARNP, PA-C, and ATC/R.
Stipulate that schools must report concussion
incidents within 30 days. WV Board of Education
must be notified if any of the forms mentioned in the
rules are amended or altered.
WI
W.S.A.
118.293
(Applicabili
ty: W.S.A.
119.04)
April 2012/
April 2012
2013: Provided that only one signed information
sheet needed per year per organization/school
(if the
athlete is
under 19
years
old)
Health care provider who holds credentials that
authorize that person to provide healthcare; is trained
and has experience in the management and
evaluation of pediatric concussions and head injuries;
and is practicing within the scope of that credential
Yes
WY W.S. 21-2-
202(a)(xxx
iii) and 21-
3-
110(a)(xxx
ii)
Feb 2011/
Feb 2011
None
4
See
note
4
See
note
No
Page 22
1
Applied only if the law re quires coaches to undergo periodic education or training in the recognition and management of concussion or head injury. For example, while North Carolina law (N.C.G.S.A. § 115C-12) requires coaches, among
others, to receive an annual concussion and head injury information sheet and participate in rehearsing a venue-specific emergency action plan, it does not require coaches to complete concussion education or training. Nebraska law (2011 NE
L.B. 260) requires that training be made available to coaches, but it is not required, and Florida law requires an independent sanctioning authority to develop guidelines to educate athletic coaches, among others, but periodic training is not
addressed. Similarly, Virginia law (Va. Code Ann. § 22.1-271.5) requires the state board of education to develop and distribute to each local school division guidelines on policies to inform and educate coaches, among others, but initial or
periodic training is not required.
2
Requires only that recreational youth sports organizations make available a written or electronic statement regarding concussions to athletes and their parent/guardian. No other provisions of the return-to-play law apply to recreational sports.
(Conn. Gen. Stat. Ann. §21a-432)
3
The Florida High School Athletic Association requires coaches to take a concussion-training course, but training for coaches is not required by law.
4
Law requires educational information or materials to be developed, distributed, and/or made accessible, but does not require acknowledgment of receipt or informed consent prior to a youth athlete’s participation in sports (i.e., “passive
education”). For example, information must be distributed to parents, posted on a Web site, or included on a parental permission form if such form exists (e.g., New York and Georgia).
5
Nevada’s Regulations of the Nevada Interscholastic Activities Association, NAC 386.832, requires school coaches to take the concussion training course offered by the National Federation of State High School Associations.
