This chapter implements Education Article, §7-433 and Health-General Article, §14-501, Annotated Code of Maryland, to establish a program of concussion awareness and prevention throughout the State of Maryland for student-athletes, their parents or guardians, and their coaches. In this chapter, the following terms have the meanings indicated. Terms Defined. “Concussion” means a type of traumatic brain injury (TBI) causing an immediate and usually short-lived change in mental status or an alteration of normal consciousness resulting from a bump, blow, jolt, shaking, or spinning of the head or body. “Graduated return to play protocols” means the progressive return to play stages included in the Policies and Programs on Concussions for Public Schools and Youth Sport Programs (Maryland State Department of Education, updated through December 2012). “Return to play” means participation in a non-medically supervised practice or athletic competition after a period of exclusion. “School personnel” means those directly responsible for administering or coaching interscholastic athletic program within a school or county and those employees of the school or school system with overall responsibility for student-athletes’ academic performance and medical well-being. “Student-athlete” means a student participating in any try-out, practice, or contest of a school team. “Youth sports program” means a program organized for recreational athletic competition instruction for participants who are younger than 19 years old. The Policies and Programs on Concussions for Public Schools and Youth Sport Programs (Maryland State Department of Education, updated through December 2012) is incorporated by reference. Each local school system shall train each coach in concussion risk and management. At a minimum, the coach’s training shall include: The nature of the risk of a brain injury; The risk of not reporting a brain injury; Criteria for removal and return to play; Understanding concussions; Recognizing concussions; Signs and symptoms; and Response and action plan. Each school system shall require a certificate of completion from a coaches’ training course with refresher training every 2 years as a condition of coaching employment. Each school system shall require all Physical Education teachers to provide a certificate of completion of concussion education training. Each school system shall implement policies consistent with this chapter and the Policies and Programs on Concussions for Public Schools and Youth Sport Programs to assure student-athletes, parents, or guardians and school personnel receive an informational sheet describing: The nature and risk of a concussion or head injury; The criteria for removal from play and return to play; The risks of not reporting injury and continuing to play; and Appropriate academic accommodations for diagnosed concussion victims. Under the policy, each school system shall require every student-athlete and at least one parent or guardian to verify in writing that they have received information on concussions and sign a statement acknowledging receipt of the information before a student participates in an authorized interscholastic athletic activity. By August 15, 2013, each local school system shall implement policies consistent with the Policies and Programs on Concussions for Public Schools and Youth Sport Programs that: Identify and ensure appropriate academic accommodations and restrictions are made available to student athletes during the recovery phase from a concussion; Ensure that the parent, guardian, or emergency contact person is notified in person or by telephone and in writing immediately after a student athlete sustains a suspected concussion; and Ensure that the athletic director and school nurse are notified before the start of the next school day of a student athlete who has sustained a suspected concussion. By August 15, 2013 the MSDE in collaboration with an appropriate medical, academic and athletic advisory team shall: Identify collision, contact, and noncontact sports; and Recommend limitations of contact exposures in those sports. Any student-athlete suspected of sustaining a concussion shall immediately be removed from practice or play. Each school shall use the graduated return to play protocols instituted in the Policies and Programs on Concussions for Public Schools and Youth Sport Programs. The student-athlete may not return to play until the student receives written clearance after receiving an appropriate medical assessment by one of the following: A licensed physician trained in the evaluation and management of concussions; A licensed physician’s assistant trained in the evaluation and management of concussions in collaboration with the physician assistant’s supervising physician or alternate supervising physician within the scope of the physician assistant’s Delegation Agreement approved by the Board of Physicians; A licensed nurse practitioner trained in the evaluation and management of concussions; A licensed psychologist with training in neuropsychology and in the evaluation and management of concussions; or A licensed athletic trainer trained in the evaluation and management of concussions, in collaboration with the athletic trainer’s supervising physician or alternate supervising physician and within the scope of the Evaluation and Treatment protocol approved by the Board of Physicians. To assist student-athletes, parents, and school personnel, to manage concussion events, each local school system shall provide to all involved persons: Written notification of possible head injury; Medical clearance forms for gradual return to sports participation following concussion; and Graduated return to play protocols. Youth sports programs seeking to use school facilities shall verify in writing distribution of concussion information to parents or guardians and receive verifiable acknowledgement of receipt. Each youth sports program shall annually affirm to the local school system their compliance with concussion information procedures. Education Article, §7-433; Health-General Article, §14-501; Annotated Code of Maryland Effective date: June 10, 2013 (40:11 Md. R. 975)