Health & Safety: A Look Back, Gallop Ahead
By
John E. (Jack) Roberts
MHSAA Executive Director, 1986-2018
August 7, 2015
We are just completing year six of eight during which we have been addressing the four important health and safety issues that, for ease of conversation, we call the “Four Hs.”
During the 2009-10 and 2010-11 school years, our focus was on Health Histories. We made enhancements in the pre-participation physical examination form, stressing the student’s health history, which we believe was and is the essential first step to participant health and safety.
During the 2011-12 and 2012-13 school years, our focus was on Heads. We were an early adopter of removal-from-play and return-to-play protocols, and our preseason rules/risk management meetings for coaches included information on concussion prevention, recognition and aftercare.
Without leaving that behind, during the 2013-14 and 2014-15 school years, our focus was on Heat – acclimatization. We adopted a policy to manage heat and humidity – it is recommended for regular season and it’s a requirement for MHSAA tournaments. The rules/risk management meetings for coaches during these years focused on heat and humidity management.
At the mid-point of this two-year period, the MHSAA adopted policies to enhance acclimatization at early season practices and to reduce head contact at football practices all season long.
Without leaving any of the three previous health and safety “H’s” behind, during the 2015-16 and 2016-17 school years, our focus will be on Hearts – sudden cardiac arrest and sudden cardiac death.
Coinciding with this emphasis is the requirement that all high school level, varsity level head coaches be CPR certified starting this fall. Our emphasis will be on AEDs and emergency action plans – having them and rehearsing them.
On Feb. 10, bills were introduced into both the U.S. Senate and House of Representatives, together called the “Safe Play Act (see below),” which addressed three of the four health and safety “H’s” just described: Heat, Hearts and Heads.
For each of these topics, the federal legislation would mandate that the director of the Centers for Disease Control develop educational material and that each state disseminate that material.
For the heat and humidity management topic, the legislation states that schools will be required to adopt policies very much like the “MHSAA Model Policy to Manage Heat and Humidity” which the MHSAA adopted in March of 2013.
For both the heart and heat topics, schools will be required to have and to practice emergency action plans like we have been promoting in the past and distributed to schools this summer.
For the head section, the legislation would amend Title IX of the 1972 Education Amendments and eliminate federal funding to states and schools which fail to educate their constituents or fail to support students who are recovering from concussions. This support would require multi-disciplinary concussion management teams that would include medical personnel, parents and others to provide academic accommodations for students recovering from concussions that are similar to the accommodations that are already required of schools for students with disabilities or handicaps.
This legislation would require return-to-play protocols similar to what we have in Michigan, and the legislation would also require reporting and recordkeeping that is beyond what occurs in most places.
This proposed federal legislation demonstrates two things. First, that we have been on target in Michigan with our four Hs – it’s like they read our playbook of priorities before drafting this federal legislation.
This proposed federal legislation also demonstrates that we still have some work to do.
And what will the following two years – 2017-18 and 2018-19 – bring? Here are some aspirations – some predictions, but not quite promises – of where we will be.
First, we will have circled back to the first “H” – Health Histories – and be well on our way to universal use of paperless pre-participation physical examination forms and records.
Second, we will have made the immediate reporting and permanent recordkeeping of all head injury events routine business in Michigan school sports, for both practices and contests, in all sports and at all levels.
Third, we will have added objectivity and backbone to removal from play decisions for suspected concussions at both practices and events where medical personnel are not present; and we could be a part of pioneering “telemedicine” technology to make trained medical personnel available at every venue for every sport where it is missing today.
Fourth, we will have provided a safety net for families who are unable to afford no-deductible, no exclusion concussion care insurance that insists upon and pays for complete recovery from head injury symptoms before return to activity is permitted.
We should be able to do this, and more, without judicial threat or legislative mandate. We won’t wait for others to set the standards or appropriate the funds, but be there to welcome the requirements and resources when they finally arrive.
Safe Play Act — H.R.829
114th Congress (2015-2016) Introduced in House (02/10/2015)
Supporting Athletes, Families and Educators to Protect the Lives of Athletic Youth Act or the SAFE PLAY Act
Amends the Public Health Service Act to require the Centers for Disease Control and Prevention (CDC) to develop public education and awareness materials and resources concerning cardiac health, including:
- information to increase education and awareness of high risk cardiac conditions and genetic heart rhythm abnormalities that may cause sudden cardiac arrest in children, adolescents, and young adults;
- sudden cardiac arrest and cardiomyopathy risk assessment worksheets to increase awareness of warning signs of, and increase the likelihood of early detection and treatment of, life-threatening cardiac conditions;
- training materials for emergency interventions and use of life-saving emergency equipment; and
- recommendations for how schools, childcare centers, and local youth athletic organizations can develop and implement cardiac emergency response plans.
Requires the CDC to: (1) provide for dissemination of such information to school personnel, coaches, and families; and (2) develop data collection methods to determine the degree to which such persons have an understanding of cardiac issues.
Directs the Department of Health and Human Services to award grants to enable eligible local educational agencies (LEAs) and schools served by such LEAs to purchase AEDs and implement nationally recognized CPR and AED training courses.
Amends the Elementary and Secondary Education Act of 1965 to require a state, as a condition of receiving funds under such Act, to certify that it requires: (1) LEAs to implement a standard plan for concussion safety and management for public schools; (2) public schools to post information on the symptoms of, the risks posed by, and the actions a student should take in response to, a concussion; (3) public school personnel who suspect a student has sustained a concussion in a school-sponsored activity to notify the parents and prohibit the student from participating in such activity until they receive a written release from a health care professional; and (4) a public school's concussion management team to ensure that a student who has sustained a concussion is receiving appropriate academic supports.
Directs the National Oceanic and Atmospheric Administration to develop public education and awareness materials and resources to be disseminated to schools regarding risks from exposure to excessive heat and humidity and recommendations for how to avoid heat-related illness. Requires public schools to develop excessive heat action plans for school-sponsored athletic activities.
Requires the CDC to develop guidelines for the development of emergency action plans for youth athletics.
Authorizes the Food and Drug Administration to develop information about the ingredients used in energy drinks and their potential side effects, and recommend guidelines for the safe use of such drinks by youth, for dissemination to public schools.
Requires the CDC to: (1) expand, intensify, and coordinate its activities regarding cardiac conditions, concussions, and heat-related illnesses among youth athletes; and (2) report on fatalities and catastrophic injuries among youths participating in athletic activities.
Century of School Sports: MHSAA Programs Prioritize Health & Safety
By
Geoff Kimmerly
MHSAA.com senior editor
April 29, 2025
Rank the top 10 conversations anyone would choose to have when it comes to school sports – be it talking up top teams, the latest stars, past champs, etc. – and advances in health & safety probably come in somewhere around No. 27.
But no topic has been or will remain more important to generating and maintaining successful athletic programs at every level of sport – including the high school and junior high/middle school levels administered by the MHSAA.
From the start of organized school athletics in Michigan more than 100 years ago, health and safety have been priorities. Sports safety concerns – especially in football – helped drive the creation of organized sport administration. Longtime policies – like the one ceasing activity for 30 minutes for lightning or thunder – have become part of daily life in athletics. Other measures, like MHSAA-provided insurance coverage to assist families who experience catastrophic injuries in school practices and competitions, aren’t even known by most – but can be life-altering for those who require those benefits.
For most of this century, the MHSAA’s health & safety initiatives have focused on the “4 Hs” coined by retired executive director Jack Roberts – Health Histories, Heads, Heat and Hearts. Those were the drive of much of his work especially over the final decade of his tenure before he retired in 2018 after 32 years.
Current executive director Mark Uyl’s time leading the association has seen the MHSAA begin work in mental health and create a Sports Medicine Advisory Committee (SMAC) during the 2019-20 school year. He also led the MHSAA through its successfully safe return to play amid COVID-19 and the pandemic’s aftermath.
Health and safety information is contained in every preseason coaches meeting, which all coaches (head and assistant) are required to take. The MHSAA also has a strong relationship with the Michigan Athletic Trainer’s Society (MATS), who have a representative serving on every MHSAA sport committee along with the SMAC.
Along the lines of major initiatives, here are highlights:
Histories: Although pre-participation physicals long have been required, the MHSAA took a significant step incorporating student and family history with the introduction of new physical forms in 2011. The current form includes several questions not only about the participant receiving the physical, but also heart-related questions about family members.
Heads: The MHSAA was among the first states to adopt a return-to-play protocol requiring an athlete to be cleared by a doctor, physician’s assistant or nurse practitioner, with that protocol also not allowing the athlete to return to participation until at least the next day after a possible head injury. At the start of the 2015-16 school year, the MHSAA launched the largest state-led sideline testing pilot program for concussions, providing a pair of screening tests so those injuries could be detected during practice and competition. Also since 2015-16, the MHSAA has required member high schools to report all potential head injuries and several details including when they took place (practice or competition) and how long students were treated before returning to activity – another first-of-its-kind initiative nationally. The MHSAA currently works with the University of Michigan Concussion Center to provide the most up-to-date information on the subject.
Heat: Long a megaphone for hydration and other best practices for preventing heat-related illnesses, the MHSAA took a major step with the creation of its “Model Policy for Heat and Humidity” for the 2013-14 school year that designates limits to activities (including a complete stop) based on heat index. While the policy is mandated for MHSAA Tournament activity, several schools have adopted the policy for the regular season as well. The MHSAA continues annually to renew awareness of heat management with its “Heat Ways” preseason guide for fall sports.
Hearts: The MHSAA has focused on providing tools so that as many people as possible are prepared to help during a cardiac event. Beginning with the 2015-16 school year, all varsity head coaches have been required to have CPR certification – and that requirement has been extended to head coaches at all high school and junior/middle school levels, ensuring that at least one person on site for every game and practice is trained in this life-saving technique. The MHSAA also has worked with MI HEARTSafe to in part get more AEDs into schools. Beginning this school year, the MHSAA required schools to build emergency action plans (EAPs) specific to sport and venue. And, as noted above, the preparticipation physical also asks questions about an athlete’s family history of heart health, so medical professionals can identify early situations that may require further investigation.
Mental Health: Annual rules meetings include required training in the be nice. program provided by the Mental Health Foundation of West Michigan. The MHSAA also has worked with Ithaca athletic director Terry Hessbrook to promote his B#4 Foundation and its work in suicide prevention and mental health awareness.
Sports Medicine Advisory Committee: The SMAC, made up of experts from the medical and educational communities, meets twice a year to consider topics and make recommendations relevant to health and safety in school sports.
Insurance: All the way back in 1940-41, the MHSAA became one of the first state associations nationally to provide accident benefit insurance to its constituents. The insurance provided over the years has evolved into a catastrophic claims policy beginning with the 1970-71 school year, and then in 2015-16 to include benefits specific to head injuries. The MHSAA’s insurance policy continues to cover deductibles and co-pays left unpaid by other policies for head injuries resulting during school practices or competitions, and at no cost to either schools or families.
There have been other notable moments over the years. Often, the MHSAA has taken action on health and safety issues before other governing bodies have produced mandates – for example, during the 1999-2000 season, MHSAA ice hockey players were required for the first time to wear neck guards that did not become mandatory nationally until this past winter.
More recently, the MHSAA instituted acclimatization rules specific to football and also limits on the amount of practice contact – to the minute – allowed per week. The MHSAA also has chimed in on air pollution created by wildfires, mosquito-borne eastern equine encephalitis and other situations that could potentially impact school sports, and partners with the United Dairy Industry of Michigan to provide nutrition information and awareness at events and on the MHSAA website.
These aren’t the first subjects that come to mind when fans talk about school sports – and that’s fine. But it’s our job, with school administrators, coaches and officials, to always have them front of mind – and we gladly do so to keep sports as safe as possible for hundreds of thousands of athletes whose achievements remain our favorite topics of conversation as well.
Previous "Century of School Sports" Spotlights
April 23: Patches Signify Registered Officials' Role in MHSAA Story - Read
April 16: Student Advisory Council Gives Voice to Athletes - Read
April 9: State's Storytellers Share Spring Memories - Read
April 2: Sharp Leadership Synonymous with MHSAA Success - Read
March 25: Athletic Directors Indispensable to Mission of School Sports - Read
March 18: 2025 Finals Begin Next Half-Century of Girls Hoops Championships - Read
March 11: Boys Basketball's Best 1st to Earn MHSAA Finals Titles - Read
March 5: Everything We Do Begins with Participation - Read
Feb. 25: Slogans & Logos Remain Unforgettable Parts of MHSAA History - Read
Feb. 19: MHSAA Tickets Continue to Provide Fan-Friendly Value - Read
Feb. 11: We Recognize Those Who Make Our Games Go - Read
Feb. 4: WISL Conference Continues to Inspire Aspiring Leaders - Read
Jan. 28: Michigan's National Impact Begins at NFHS' Start - Read
Jan. 21: Awards Celebrate Well-Rounded Educational Experience - Read
Jan. 14: Predecessors Laid Foundation for MHSAA's Formation - Read
Jan. 9: MHSAA Blazes Trail Into Cyberspace - Read
Dec. 31: State's Storytellers Share Winter Memories - Read
Dec. 17: MHSAA Over Time - Read
Dec. 10: On This Day, December 13, We Will Celebrate - Read
Dec. 3: MHSAA Work Guided by Representative Council - Read
Nov. 26: Finals Provide Future Pros Early Ford Field Glory - Read
Nov. 19: Connection at Heart of Coaches Advancement Program - Read
Nov. 12: Good Sports are Winners Then, Now & Always - Read
Nov. 5: MHSAA's Home Sweet Home - Read
Oct. 29: MHSAA Summits Draw Thousands to Promote Sportsmanship - Read
Oct. 23: Cross Country Finals Among MHSAA's Longest Running - Read
Oct. 15: State's Storytellers Share Fall Memories - Read
Oct. 8: Guided by 4 S's of Educational Athletics - Read
Oct. 1: Michigan Sends 10 to National Hall of Fame - Read
Sept. 25: MHSAA Record Books Filled with 1000s of Achievements - Read
Sept. 18: Why Does the MHSAA Have These Rules? - Read
Sept. 10: Special Medals, Patches to Commemorate Special Year - Read
Sept. 4: Fall to Finish with 50th Football Championships - Read
Aug. 28: Let the Celebration Begin - Read