Dr. Tim Romanoski and Del. Mark Chang, (D) Anne Arundel County, testify regarding legislation that would penalize youth coaches if they allow a player who has suffered a concussion to return to the field. (Algerina Perna/Baltimore Sun video)
Lawmakers in Annapolis are considering whether public school coaches should be suspended if they let players return to a game despite having suffered an apparent concussion.
Prompted by growing national concern about brain injuries to athletes from professional to youth leagues, an Anne Arundel County delegate has proposed a bill that that would, at minimum, suspend for the season any coach who lets potentially concussed athletes play.
"There's just a lot of pressures for just a win — win at all costs," said Del. Mark Chang, an Anne Arundel County Democrat. "I think it's important that safety comes first."
Proponents say the measure would strengthen a state law that seeks to protect young athletes who might have suffered head injuries. Others see the proposed penalty as unnecessarily harsh and say better education for coaches and hiring athletic trainers would be a more effective way to protect players.
The legislation was the subject of a hearing in the House Ways and Means Committee this week. Among those supporting it are the Maryland PTA and the state chapter of the American Academy of Pediatrics. Among those opposed are Maryland's school superintendents and school boards, as well as some coaches.
"It's good in spirit, but it's punitive in nature," said Rich Holzer, head football coach at Mount Saint Joseph High School in Baltimore.
In recent years, a growing body of scientific evidence has raised deep concerns about the effects of concussions. The topic was recently highlighted in "Concussion," a feature film starring Will Smith.
Criticized for years for not addressing a concussion problem that could threaten the sport's future, the NFL is working now to get ahead of it, changing rules to minimize the injuries and funding research into new technologies at Aberdeen Proving Ground and elsewhere through a competition sponsored by Under Armour and General Electric.
Smith plays a forensic pathologist who took on the NFL as he exposed the sometimes fatal long-term impact of repeated head injuries on professional football players — a condition known as chronic traumatic encephalopathy (CTE).
Most of the attention to concussions has been focused on men and boys who play football, but Bryan Pugh, executive director of the Brain Injury Association of Maryland, said the problem is much more extensive.
"Concussion is not a football issue. Women get concussions from cheerleading. Women get concussions from lacrosse. Women get concussions from soccer. Men get concussions from basketball," he said.
Pugh's association is not taking a position on the bill, but he is skeptical that penalizing coaches is the answer.
House Speaker Michael E. Busch, who for seven years coached football at St. Mary's High School in Annapolis, has not taken a position but said he welcomes the bill's introduction.
"It is an issue that needs to be discussed," said Busch, an Anne Arundel County Democrat.
He remembers how concussions were viewed when he played high school and college football in the 1960s.
"They used to call it 'getting your bell rung.' Split an ammonia tablet under your nose, bring you back to life and send you back in," Busch said. Now, he said, "the rule of thumb is: If there's doubt, keep them out."
Chang said he introduced his bill at the suggestion of Dr. Tim Romanoski, a sports medicine physician in Queen Anne's County, who testified in favor of the measure.
The legislation would build on a 2011 law that that requires a young athlete to be medically cleared before returning to play.
The new law, if approved, would impose an escalating series of sanctions on coaches — from suspension for the remainder of a season for a first offense to a permanent ban for a third — that would be levied by the local superintendent and subject to approval by the local school board. Local school systems' costs might increase minimally, according to the legislature's fiscal analysts.
Romanoski said he contacted the delegate, a friend, after learning about a similar law in Pennsylvania. He said his primary concern is not CTE, but a condition called second-impact syndrome.
Athletes under 23 years old — whose brains are not fully developed — are especially vulnerable to the condition, Romanoski said. When a young person suffers a second concussion soon after a first, he said, the consequences can include death or serious disability. In 2011, 22-year-old Frostburg State football player Derek Sheely died during preseason training after doctors believe he suffered two concussions in a matter of days.
Romanoski said Chang's bill would protect coaches from overaggressive parents. He told lawmakers he saw those pressures after he ordered that players be benched for medical reasons while acting as a team doctor during football games in West Virginia.
"I had parents pressuring me to put the kids back in because they were being scouted," he said.
Holzer, who also has coached at Meade High in Anne Arundel County, said he has not had many problems with pushy parents — largely because he has worked in programs where trainers, not coaches, have the final say on whether an athlete plays. Parents, he said, tend to defer to a trainer's judgment.
"Me personally, I love having a trainer there," Holzer said. He said a better approach for the legislature would be to provide the resources to have trainers at every game.
Holzer said coaches take head injuries very seriously.
"You can't look at a profession as large as ours and say there are no bad apples," he said. But Holzer said most coaches put the interests of their players first — and know they face consequences if they don't.
"If you knowingly play a player who's injured, there's going to be serious repercussions," he said. "It's not worth jeopardizing the safety of the kid, and it's not worth jeopardizing your own job."
Tom Hearn, a Montgomery County father who became an activist on head-injury issues after his son suffered a concussion in a junior varsity football game in 2011, said Chang's bill might not be strict enough.
"Most coaches wouldn't knowingly put a kid at risk, but they're all human," Hearn said. "If it's in the heat of a close game, they might be inclined to discount symptoms and put a kid back in."
Greg Penczek, president of the Maryland Athletic Trainers Association, said his group will not take a position on the legislation. Speaking personally, he said that if it were coupled with a move to put athletic trainers in each secondary school, it could have a beneficial effect. Now, he said, about 61 percent of high schools in Maryland have trainers, with none in Baltimore public schools and spotty coverage in Baltimore County.
"If this gets passed and at some point ATs are put in every secondary school, I don't think there will be an issue of coaches being noncompliant with this," he said.
The Maryland Association of Boards of Education contends that the bill could make it harder to fire a coach who breaks the rules. John R. Woollums, the group's government relations director, said the bill would provide appeal rights to coaches who can now be removed at the will of the local boards.
Dr. Robert G. Graw, founder of the Crofton-based HeadFirst Sports Injury and Concussion Care Centers, said the most immediate need is to bolster educational requirements for coaches, not the sanctions they face. He said that under the current policy, coaches must sit through training courses on head injuries but do not have to pay attention. He said they should have to pass a rigorous test.
"They should be as good as any athletic trainer in recognizing the symptoms of a head injury," he said. "The penalty is probably premature until there's a well-thought-out education and certification for every coach."