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.
Nurturing Our Lower Level Programs
May 15, 2014
By John E. “Jack” Roberts
MHSAA Executive Director
When I’ve been faced with the most difficult choices as to different courses of action for the MHSAA, I’ve tried to face up to this reframing of the issue: “If we were creating the MHSAA for the first time today, would we do this, or would we do that?”
For example, would we or would we not limit coaches’ contact with athletes out of season? Would we have a 90-day period of ineligibility for transfer students or would it be 180 days?
There are other examples of such “either, or” questions I could provide, but none is as difficult or defining as this: Should school sports under the MHSAA’s auspices provide more opportunities for 7th- and 8th-graders and new opportunities for even younger students?
I won’t be coy about what I think our answer should be. I haven’t always felt this way, and I recognize it is a different opinion than some who are quoted in this publication; but today it’s my belief that if we were creating the MHSAA for the first time in 2014, the MHSAA would allow more contests and longer contests for 7th- and 8th-graders, and the MHSAA would have competition policies and programs for younger middle schoolers too.
I believe this is what parents want for their children and what students want for themselves; and I believe, within reason, that the better we serve these students in their junior high/middle school years, the stronger high school sports will be and the better these programs will support the educational missions of schools.
I believe we must begin to serve middle school students more comprehensively, and that our doing so today is the best hope we have for retaining comprehensive programs for high school students tomorrow. Not only does the lower profile and pressure of lower level programs nurture the highest ideals of educational athletics, they provide our highest hope for preserving those ideals at the high school level.
The Lasting Impact of First Impressions
The over-arching question before us is how to maintain policies that encourage multiple sport experiences for students at the junior high/middle school level while at the same time adjusting those policies in terms of grade level served and the numbers and lengths of contests allowed in order to be more attractive to junior high/middle school parents and to school districts which desire additional competition opportunities in the school setting for students prior to high school.
There is a good healthy discussion in our midst about the scope of junior high/middle school athletics – how much should occur and how young it should commence; and the result of these discussions may have long-lasting effect on students, schools and the MHSAA.
Here are two central issues:
1. Contest Limits
Many people over many years have contributed to developing the current season limitations for the number of contests permitted by MHSAA member junior high/middle schools. These good people have believed in a philosophy of sports at this level that encourages students to try multiple sports.
“Kids haven’t fully matured yet,” they say. “Kids haven’t been exposed to some sports yet. They don’t know what they might like or be good at. So let’s have policies and programs that encourage new opportunities and experiences at this level.”
The season limits that have been put in place allow some junior high/middle schools, or their entire leagues, to fit four distinct seasons in a nine-month school year, consistent with this over-arching philosophy to encourage these students to try new things and learn.
There is another educationally grounded and equally astute group of administrators and coaches who are concerned that the current limits are too severe in comparison to non-school youth sports programs. For example, community/club basketball or soccer programs may schedule 15 or 18 or more games per season versus the MHSAA limit of 12 at the junior high/middle school level.
These folks think these restrictive limitations create a disincentive for kids to play school sports, and that many of those who have no place in junior high/middle school sports have no interest later in high school sports.
2. 6th-Graders
Historically, the popular opinion among educators has held that 7th and 8th grade is early enough for schools to provide competitive athletics, early enough to put youth into the competitive sports arena, and early enough to pit one school against another in sports.
Today, however, many educators and parents point out that such protective philosophies and policies were adopted about the same time “play days” were considered to be the maximum exertion females should experience in school sports. Some administrators and coaches argue that both our severe limits on contest limits at the junior high/middle school level, and our refusal to serve 6th-graders, are as out of date and inappropriate as play days for females.
Today, in nearly four of five school districts with MHSAA member schools, 6th-graders go to school in the same building with 7th- and 8th-graders. But MHSAA rules don’t allow 6th-graders to participate with and against 7th- and 8th-graders. In fact, the MHSAA Constitution doesn’t even acknowledge that 6th-graders exist.
Today, in many places, 6th-graders have aged-out of non-school, community sports, but they are not permitted to play on MHSAA junior high/middle school teams.
Last school year, 50 different school districts requested this rule be waived for them, and the MHSAA Executive Committee approved 46 of 50 waivers, allowing 6th-graders to compete on 7th- and 8th-grade teams. During 2011-12, 37 of 40 requests for waiver were approved, in all cases for small junior high/middle schools. Many of these schools want, and some of them desperately need, these 6th-graders to fill out junior high/middle school teams.
Young people are starting sports much younger today than 100 years ago when the MHSAA was created. Younger than even 50 years ago when the MHSAA was incorporated. If the MHSAA were created today to serve any students before 9th grade, I’m certain it would not leave out 6th-graders who are walking the same halls with 7th- and 8th-graders, and who have been playing competitive sports almost since the first day they started walking at all.
Eyes on the future
The most important thing we can do to enhance high school sports is to grow junior high/middle school sports programs. The earlier we disconnect young people from non-school sports and engage them in school-sponsored sports, the better our chances are of keeping high school athletic programs healthy, and the better our prospects are of keeping both participation rates and conduct standards high.
School sports are in competition for hearts and minds of young people. Our competition includes movies, jobs, cars, video games, boyfriends and girlfriends and club sports ... especially club sports. School sports needs to market itself better, and part of better is to be available earlier – much sooner in the lives of youth. More contests at the junior high/middle school level and more opportunities for 6th-graders should be parts of our marketing strategies on behalf of educational athletics generally.
For at least 50 years there have been predictions by people outside of our member schools that the system of school-sponsored sports that is almost unique to the United States would someday give way to the system of most countries where youth sports is provided by non-school community groups and private athletic clubs. Some people challenge school-sponsored sports on a program basis – for example, that competitive athletics creates a distraction to the core educational mission of schools. Others may challenge school-sponsored sports on a financial basis – that interscholastic athletics compete for the limited resources communities have to support their schools.
Today there also exists among our member schools a small percentage of administrators who have come to their leadership roles without involvement in school sports and who either desire and believe that interscholastic sports will be moved from schools to communities or who do not want but predict that such will occur as resources for schools continue to shrink.
I believe this is more likely to happen, or to happen sooner, if we do not change our approach to junior high/middle school sports. If we continue to restrict 7th- and 8th-graders to so few contests of such limited length compared to what those students have in non-school sports, and if we continue to offer nothing for younger students, we essentially and effectively force these students to non-school sports.
It is an often cited statistic that between 80 and 90 percent of all young people who ever begin playing competitive athletics stop playing before they reach the age of 13, meaning the vast majority of young people never, ever are involved in school programs. Thus, it is no mystery why people question the future of school sports. We’re doing nothing to make programs available to them. They have no experience in them.
Our restrictive and possibly outdated policies and procedures regarding contest limits and lengths and the age at which we begin to serve junior high/middle school students may assure that the dire predictions about school sports’ future will be accurate. We are doing too little, too late. It is marketing at its worst.
In my mind there is little doubt that we are doing too little too late with junior high/middle school students. Now the challenge before us is to think beyond “we can’t afford it” and make some necessary changes, while still avoiding a system that allows or even encourages schools doing too much too soon.