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House approves return-to-play authority

The House approved a bill expanding the types of health professionals who can medically release a student athlete to play after showing symptoms of concussion.

JAIME VALDEZ/PORTLAND TRIBUNE - 2018 Oregon Legislative AssemblySALEM — A bill expanding the types of health professionals who can medically release a student athlete to play after a concussion is closer to law.

The Oregon House of Representatives on Friday passed the bill 52-to-6 following emotional debate on the floor. The bill — which also mandates concussion-specific training for those professionals — remained controversial despite an amendment Thursday to remove athletic trainers from the expansion.

Having unanimously approved the original bill Feb. 19, the Senate concurred with the House's changes early Saturday with a 26-to-3 vote. The bill now proceeds to Gov. Kate Brown to be signed into law.

Existing law allows only medical doctors, osteopathic doctors, physician assistants, nurse practitioners and psychologists to medically release a student athlete who has had a suspected concussion. The bill expands that authority — with online training and certification — to physical therapists, occupational therapists, chiropractic physicians and naturopathic physicians.

The bill is intended to expand access to providers who can release student athletes after a brain injury and to boost concussion-specific training for those providers. The proposed policy change stemmed from a work group that studied providers' training on concussions and worked with a medical doctor who specializes in concussions.

Care providers who are not medical doctors would have to take online concussion training offered by Oregon Health & Science University as a condition to releasing students to play.

Rep. Alyssa Keny-Guyer, D-Portland, said the exemption for medical doctors is the legislation's major weakness. She said she supported expanding the authority to release student athletes to athletic trainers.

The exclusion of athletic trainers started in the House Health Care Committee where Rep. Knute Buehler, a Bend-based surgeon who is running for governor, first made the proposal. He argued that athletic trainers do not all have master's degrees and that they have greater potential conflicts of interest in whether an athlete returns to play.

Other representatives on the health care committee blocked that change, but once the bill came to the House floor, it became clear other lawmakers shared Buehler's opinion. The bill was at risk of defeat and was sent back to House Rules for amendments.

Even after changes, Rep. Mark Meek, D-Oregon City, opposed the bill on the House floor. He said the expansion would put more student athletes at risk of irreparable brain injuries.

Rep. Bill Kennemer, R-Oregon City, a former psychologist, disagreed. He said the required training in the bill would enhance student athlete safety.

Professional licensure restricts health care professionals to treating conditions they're competent in, Kennemer said.

"We each have that responsibility that gives a safeguard," he said.

Traumatic brain injury was found in 110 of 111 former NFL players whose families donated their brains to Boston University School of Medicine, according to a study published last year by the Journal of the American Medical Association. Chronic traumatic encephalopathy (CTE) results from head trauma and can lead to dementia, memory loss, suicidal thoughts and personality and mood changes, among other symptoms. CTE was found in the brains of three out of 14, or 21 percent, of high school football players and 48 out of 53, 91 percent, of college players, according to the study.

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