Ontario bill aims to improve training on concussions in sports

Proposed legislation that could lead to a requirement for the Ontario School Boards’ Insurance Exchange (OSBIE) to track student concussion injuries – and to require that high-risk sports athletes and their parents to sign participation agreements – was tabled Wednesday in the legislature in Toronto.

Bill 149, if passed into law, would establish a committee to review recommendations from a coroner’s jury into the death of an Ottawa area high school rugby player who suffered a head injury.

Rowan Stringer, 17, died May 12, 2013 in Ottawa at the Children’s hospital of Eastern Ontario. She had malignant cerebral edema due to second impact syndrome, due to traumatic brain injury.

She had been playing rugby in the Ottawa community of Barrhaven, said Lisa Macleod, the Progressive Conservative MPP for Nepean-Carleton. MacLeod made her comment Wednesday when she tabled Bill 149 for first reading at Queen’s Park.

If passed into law, Bill 149 would establish the Rowan’s Law Advisory Committee, which would review the 49 recommendations made by a coroner’s jury and published June 3, 2015. That committee would also make recommendations on how to implement those recommendations and other recommendations on preventing and treating head injury.

Two years after Stringer died, the coroner’s jury recommended that the Ministry of Education, the Ontario Physical and Health Education Association (OPHEA) and the OSBIE “develop a method of tracking student concussion injuries.” Those organizations should also “follow and ensure those students with concussions are treated appropriately, to ensure the Return to Learn and Return to Play process is respected and to provide clear data to assess the effectiveness of concussion prevention and management,” the jury recommended this past June. “The anonymized data should be available for public reporting and assessment of the effectiveness of concussion prevention efforts.”

The coroner’s jury also recommended that the Ontario Ministry of Tourism, Culture and Sport mandate that prior to the start of any “higher risk” youth sports activity, that parents and athletes sign a participation agreement “confirming that they have participated in a pre-season concussion awareness and management sessions” and that they “understand the signs and symptoms of concussion.”

The jury recommended that “higher risk” activity be defined by Ontario Physical and Health Education Association.

The jury also recommended that the Ontario Medical Association and other organizations ensure that physicians do not charge fees to provide documentation “to assess a student for a suspected concussion when providing guidance for Return to Learn and Return to Play.”

Also among the jury’s recommendations were that the Tourism, Culture and Sport department “require the use of a standardized Coach’s Binder, containing sample forms and material such as: medical and emergency contact information forms, tracking tools for specific player injuries, a concussion recognition tool, contact information form for coaches of other concurrent sports, forms to help track attendance at practices and mandatory injury prevention sessions, permission forms and other documentation of best practices in the particular sport.”

The Ontario School Boards’ Insurance Exchange – as well as the school boards and rugby organizations – should “adopt a policy of zero tolerance of head hits and high tackles at any level of play in rugby, and should be penalized with progressive penalties, including expulsion for repeat offenders,” the coroner’s jury recommended as a result of the death of Stringer.

The jury also said students enrolled in Bachelor of Education programs should get first aid certification, including concussion awareness, prevention and management. Ontario Bachelor of Education students should also “receive a mandatory athletic coaching course, to ensure standardized training of all new teachers whether or not they plan to coach athletics, and to encourage teacher participation as athletic coaches,” the coroner’s jury added.