Concussion Legislation in the USA

The push for national concussion legislation continues throughout the United States. In the spring of 2010, NFL Commissioner Roger Goodell sent a letter to 44 U.S. Governors to encourage them to push for concussion legislation to protect young athletes in their states:

“Given our experience at the professional level, we believe a similar approach is appropriate when dealing with concussions in all youth sports.  That is why the NFL and its clubs urge you to support legislation that would better protect your state’s young athletes by mandating a more formal and aggressive approach to the treatment of concussions.”  – Roger Goodell

In 2014, Mississippi became the 50th state to respond by passing legislation to protect young athletes from the risks associated with concussion in sport.

There are three main tenets of each state’s concussion legislation:

1.  To mandate educational outreach to coaches, parents and athletes;
2.  To mandate immediate removal from play of any athlete who sustains a concussion or who exhibits signs, symptoms or behaviors consistent with the injury AND
3.  To only allow those athletes who exhibit such signs, symptoms, or behaviors to return to physical activity after receiving written clearance from an appropriate health care provider who is trained in concussion management

To ensure the educational message is being received, many state laws also require parents to sign an acknowledgment form prior to allowing their child to play contact sport that they have received information on concussion and acknowledges concussion risks involved with sport.

Why Aren’t All State Laws the Same?

Each state Legislature was challenged to create laws that catered to their own individual needs.  While nearly all laws include the three tenets above, many state laws vary on what sport programs must comply, what penalties exist for those who do not comply, and what medical providers are “appropriate” to make return to play decisions.   Of the fifty-one concussion laws (includes District of Columbia) in the books (as of April 2014), seven (AL, DE, KS, ME, ND, RI, and TX) designate the written clearance to come only a licensed physician.  Twelve other states  (AZ, CO, CT, ID, IA, LA, MA, NC, NM, PA, SC, and TN) also include language to specifically allow for physician assistants, nurse practitioners, and/or neuropsychologists.  Ten states (AZ, CT, IA, MA, ME NE, NM, NV, PA, and SC) have language to specifically include athletic trainers and two states (IA and NV) name physical therapists.   Thirty of the laws include language to designate a health care provider specially trained in the evaluation and management of concussion but do not specifically name who those providers are.  Most youth sport concussion laws are only applicable to school-sponsored sport programs, as many states do not have direct oversight capability of privately run youth sport organizations.  However, there is growing legal precedent and an increased standard of care for immediate recognition and appropriate management of concussion at all levels of sport.

Youth Sport Concussion Laws in the USA

The current state of the legislative effort is highlighted on the map below. States blue in color have since passed concussion legislation and yellow states have partial concussion legislation. Click on a state to learn about concussion laws in that state.

Click here to find out about the push for national legislation, led by New Jersey Congressman William Pascrell (D-NJ8):  Washington D.C. Legislation.

usMap Hawaii Hawaii Hawaii Hawaii Hawaii Hawaii Hawaii Alaska Florida New Hampshire Michigan Michigan Vermont Maine Rhode Island New York Pennslyvania New Jersey Delaware Maryland Virginia West Virginia Ohio Indiana Illinois Connecticut Wisconsin North Carolina Massachusetts Tennessee Arkansas Missouri Georgia South Carolina Kentucky Alabama Louisiana Mississippi Iowa Minnesota Oklahoma Texas New Mexico Kansas Nebraska South Dakota North Dakota Wyoming Montana Colorado Idaho Utah Arizona Nevada Oregon Washington California Alaska