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(A) The provisions of this Section shall be applicable to any elementary, middle or secondary school in the city, public or private, and any community center, public or private, which organizes and sponsors extracurricular athletic activities including games and practices for its student athlete(s).
STUDENT ATHLETE shall mean a student who prepares for or participates in an extracurricular athletic activity. EXTRACURRICULAR ATHLETIC ACTIVITY shall have the same meaning as that provided for in the Department of Public Health Regulations, 105 CMR 201.005; provided however, that the provisions of this Section shall also be applicable to any community center that organizes and sponsors noninterscholastic youth sports programs for athletic competition or instruction for participants under the age of 18.
(B) All schools and community centers shall ensure that all coaches, certified athletic trainers, trainers, volunteers, school and team physicians, school nurses and athletic directors annually complete a head injury training program approved by the Department of Public Health as found on the Department’s website. Schools and community centers may, in addition to on-line training programs approved by the Department, participate in live training programs that provide training in the recognition, management, response and prevention of concussions and other sports-related head injuries.
(Ord. 2012 c. 5 § 1)
(A) A student athlete who sustains a head injury or suspected concussion, or exhibits signs and symptoms of a concussion, or loses consciousness even briefly, shall be removed from play by the student athlete’s coach or certified athletic trainer as set forth in 105 CMR 201.010. The coach shall notify the parent or legal guardian of the student athlete as set forth in 105 CMR 201.010.
(B) A student athlete who has been removed from play may not return to play until the student athlete receives appropriate medical clearance as set forth in 105 CMR 201.011.
(Ord. 2012 c. 5 § 1)
(A) Before the first use of a facility owned by the city, any independent athletic organization must certify on a form approved by the Boston Parks and Recreation Department or the Boston Center for Youth and Families that such organization requires training programs and has policies in place for its coaches, athletes, referees and athletic trainers including, but not limited to, the nature and risk of concussions and other sports-related head injuries; the prevention and management of such injuries; and the criteria for removal from and return to physical participation. The independent athletic organization shall be responsible for verifying that its coaches, athletes, referees and athletic trainers have received the required training and information and such organization shall be responsible for maintenance of such records.
(B) INDEPENDENT ATHLETIC ORGANIZATION shall mean a youth sports program organized for athletic competition or instruction for participants under the age of 18.
(Ord. 2012 c. 5 § 1)
(A) Definitions. For the purpose of this Section, the following definitions shall apply unless the context clearly indicates or requires a different meaning.
ATHLETIC PROGRAM. An intercollegiate athletic program at any institution of higher education within the meaning of division (B) below.
ATHLETIC SCHOLARSHIP. Financial aid provided to a college athlete by an institution of higher education that is provided in exchange for, but not exclusively in exchange for, that college athlete’s participation in that institution of higher education’s athletic program.
COLLEGE ATHLETE. Any college student who participates in an intercollegiate athletic program of an institution of higher education.
INSTITUTION OF HIGHER EDUCATION. Any four-year college or university that maintains an intercollegiate athletic program.
INTERCOLLEGIATE ATHLETIC EVENT. Any game, match, meet, race or other event during which college athletes from athletic programs of more than one institution of higher education compete against each other.
NCAA. National Collegiate Athletic Association.
(B) Concussion Defined.
(1) For purposes of these Sections,
CONCUSSION means a complex pathophysiological process affecting the brain induced by biomechanical forces. Several common features that incorporate clinical, pathologic and biomechanical injury constructs that may be utilized in defining the nature of a concussive head injury include:
(a) CONCUSSION may be caused either by a direct blow to the head, face, neck or elsewhere on the body with an “impulsive” force transmitted to the head;
(b) CONCUSSION typically results in the rapid onset of transient impairment of neurologic function that resolves spontaneously. However, in some cases, symptoms and signs may evolve over a number of minutes to hours;
(c) CONCUSSION may result in neuropathological changes, but the acute clinical symptoms largely reflect a functional disturbance rather than a structural injury and, as such, no abnormality is seen on standard structural neuroimaging studies; and
(d) Concussion results in a graded set of clinical symptoms that may or may not involve loss of consciousness. Resolution of the clinical and cognitive symptoms typically follows a sequential course; however, it is important to note that, in some percentage of cases, postconcussive symptoms may be prolonged.
(2) Potential concussion signs (observable):
(a) Any loss of consciousness;
(b) Slow to get up following a hit to the head (“hit to the head” may include secondary contact with the playing surface);
(c) Motor coordination/balance problems (stumbles, trips/falls, slow/labored movement);
(d) Blank or vacant look;
(e) Disorientation (e.g., unsure of where he or she is on the field or location of bench);
(f) Clutching of head after contact; and
(g) Visible facial injury in combination with any of the above.
(3) Potential concussion symptoms (athlete reported, following direct or indirect contact):
(a) Headache;
(b) Dizziness;
(c) Balance or coordination difficulties;
(d) Nausea;
(e) Amnesia for the circumstances surrounding the injury (i.e., retrograde/anterograde amnesia);
(f) Cognitive slowness;
(g) Light/sound sensitivity;
(h) Disorientation;
(i) Visual disturbance; and
(j) Tinnitus.
(C) Scope. These Sections shall apply to any athletic program, regardless of domicile, participating in any intercollegiate athletic event that is:
(1) Sanctioned by the NCAA; and
(2) Located in any part of the city.
(D) Gameday safety protocol.
(1) An athletic program shall develop and write an Emergency Medical Action Plan (the “Plan”) for all practice, training and game venues. The medical staff of the athletic program shall discuss, practice and review the Plan regularly.
(2) If a college athlete participating in an intercollegiate athletic event becomes unconscious, the college athlete shall not return to the event during which the college athlete became unconscious. The college athlete shall not participate in any future practices, training sessions or intercollegiate athletic events in Boston until the college athlete receives written authorization for such participation from a licensed physician, or from another appropriately trained or licensed health care professional as determined by the Boston Public Health Commissioner. The college athlete must provide such authorization to his or her athletic program’s athletic director.
(3) If a college athlete participating in an intercollegiate athletic event suffers a concussion as diagnosed by a medical professional, or is suspected to have suffered a concussion, the college athlete shall not return to the event during which the concussion or suspected concussion occurred. The college athlete shall not participate in any future practices, training sessions or intercollegiate athletic events in Boston until the college athlete receives written authorization for such participation from a licensed physician, or from another appropriately trained or licensed health care professional as determined by the Boston Public Health Commissioner. The college athlete must provide such authorization to his or her athletic program’s athletic director.
(E) Additional requirement for football, ice hockey and men’s lacrosse.
(1) This Section shall apply exclusively to athletic programs that participate in NCAA Division I athletics.
(2) For an intercollegiate athletic event involving the sports of football, ice hockey and men’s lacrosse.
(a) The designated host athletic program shall provide an on-site neurotrauma consultant at the event venue. The neurotrauma consultant shall be a physician who is board certified or board eligible in neurology, neurological surgery, emergency medicine, physical medicine and rehabilitation, or any primary care CAQ sports medicine certified physician that has documented competence and experience in the treatment of acute head injuries. The neurotrauma consultant shall be present at the level of the event’s playing surface, and with full access to the benches and/or sidelines of any participating athletic program. The neurotrauma consultant shall be focused on identifying symptoms of concussion and mechanisms of injury that warrant concussion evaluation, working in consultation with medical staff of the athletic programs to implement concussion evaluations and observing exams of the head, neck and spine performed by medical staff. In the event a college athlete suffers or is suspected to have suffered an injury to the head, neck or spine, the neurotrauma consultant shall work with the athletic program’s medical staff in the diagnosis and care of the injury.
(b) If the injured college athlete’s athletic program has medical staff present at the event venue, ultimate injury diagnosis remains exclusively within the professional judgment of the medical staff of the athletic program of the injured college athlete.
(c) In the event there is no designated host athletic program for an intercollegiate athletic event, the participating athletic programs shall jointly provide the on-site neurotrauma consultant.
(3) The provisions of this Section shall take effect on July 1, 2015.
(F) Enforcement. The Boston Public Health Commission, or its designee(s), shall have the authority to enforce these Sections, and to promulgate regulations in accordance therewith. Anyone who desires to register a complaint of noncompliance under these Sections may do so by contacting the Boston Public Health Commission, or its designee(s).
(CBC 1985 12-15.4; Ord. 2014 c. 13 §§ 1-6)
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