Concussions

CARE Consortium finds higher incidence of concussion, head impact exposure during football preseason and practice

The latest findings from the Concussion Assessment, Research and Education Consortium show that disproportionately higher concussion rates and head impact exposure in college football occur during the preseason and practice — not regular-season games.

Concussion Reporting Process Step-by-Step Instructions

The purpose of this document is to provide step-by-step instructions that can be used by member institutions to satisfy legislated annual concussion reporting requirements (Division I Constitution 4.3.4.21; Division II Constitution 3.3.4.18; Division III Constitution 3.2.4.18).

The reporting portal will open to Association membership on July 1, 2020. The annual cycle for reporting concussions is from July 1 to June 30 of the following year. This cycle parallels the footprint of a typical academic year. Schools may report at any time during the year, but it is anticipated that most schools will elect to report late in the cycle to ensure that they have an accurate accounting of the concussions that occurred during the preceding academic year. The NCAA Sport Science Institute will provide an annual reminder to schools of the reporting requirements well ahead of the June 30 deadline.

Note: In the initial 2020-21 annual cycle, NCAA legislation requires schools to report concussions that are diagnosed from May 18, 2020 forward. As the reporting cycle does not begin until July 1, 2020, schools will be expected to report all concussions that are diagnosed from May 18, 2020 to the end of the first annual reporting cycle on June 30, 2021.

For example: a school electing to submit an initial report on June 1, 2021 will report all concussions diagnosed from May 18, 2020 until June 1, 2021. In subsequent years, schools    will report those concussions occurring since the date of their last reporting.

The school should identify one employee who will report on behalf of the school (School Reporter). While the oversight responsibilities of the Athletics Health Care Administrator should place that individual in a beneficial position to perform this reporting function, member institutions have flexibility to designate reporting responsibility as they deem appropriate. At a minimum, it is reasonable to expect that the Athletics Health Care Administrator will, as part of their broader oversight responsibilities, verify that this personnel decision has been addressed. Schools are not obligated to submit their designated school reporter to the NCAA national office as this information will be captured at the time of report (see step #2 below).

Instructions

  1. Once the reporting website opens (July 1, 2020), the School Reporter should access the website by clicking here. The initial website page will provide the School Reporter with some important preliminary information that will facilitate the reporting activity. After reviewing the preliminary information, the School Reporter will click the gold box at the bottom of the page to move forward with reporting.
  2. Clicking on the gold box will bring the School Reporter to the reporting page where the reporting process begins with  a request for basic demographic information, including the name of the School Reporter, the school for which they are reporting, as well as an institutional email address and phone number (see screen shot example below). The School Reporter should complete the information as indicated.

  3. Once the demographic information is complete, the School Reporter will move on to the second and final section at the bottom of the page, entitled “Reportable Concussion Information.” In this section, the School Reporter should input the requested concussion and resolution information and complete the “I am human” inquiry activity by following the prompts (see screen shot example below). Once complete, the School Reporter should click the “Submit Report” button.

  4. Once the report is submitted, the School Reporter will receive an email confirming that the concussion reporting process has been completed. The email will originate from the address noreply@datalyscenter.org and will include a submission confirmation number, the concussion data provided by the School Reporter, information about where to report questions, and a prompt to archive the confirmation email for future reference. Member institutions are encouraged to retain a copy of the confirmation email on file.

Members with technical issues about the concussion reporting website may contact the site administrator directly by phone at 855-832-4222 or email at  info@datalyscenter.org. Substantive questions about the NCAA concussion reporting requirements should be directed the NCAA Sport Science Institute at: ssi@ncaa.org.

Concussion Management Updates: Frequently Asked Questions

The purpose of this document is to facilitate and support the efforts of NCAA member institutions to comply with applicable divisional concussion safety legislation. In early 2015, the Concussion Safety Protocol Committee created the Concussion Safety Protocol Checklist (Checklist) to encourage and support institutional compliance with industry best practices and applicable concussion legislation. Consistency with the Checklist is now specifically referenced as part of the requirements in each of the three divisional manuals. The NCAA Committee on Competitive Safeguards and Medical Aspects of Sports (CSMAS) recently approved an updated version of the Checklist and, while the NCAA has, through its governance process, relaxed many of the legislative requirements related to submission and reporting deadlines in response to the impact on schools resulting from the COVID-19 pandemic, member schools still need to ensure that institutional concussion management practices are consistent with applicable legislative and policy requirements and should incorporate a thorough analysis of the recent updates to the Checklist and any other concussion-related legislative and policy changes as part of that process. Specifically, schools should carefully review and understand the most recent updates to the Checklist, and related concussion management legislation, policies and guidance, and work with applicable institutional personnel to ensure any necessary adjustments to their concussion management practices are properly and timely implemented. In this Frequently Asked Questions document we have provided responses to some of the most anticipated membership questions related to those institutional review and update activities.

Q1. Have there been any legislative or policy updates related to concussion management since 2020?

A1. No. There have been no changes to divisional legislation related to concussion management since the publication of the last frequently asked question in 2020. However, as a reminder, a portion of Division I Constitution 3.2.4.20.1 (Concussion Safety Protocol) was updated in 2019 to require that an institution's Concussion Safety Protocol must be consistent with the Checklist. In addition, the Interassociation Recommendations: Preventing Catastrophic Injury and Death in Collegiate Athletes, which contain content specific to concussion management, were unanimously endorsed by the NCAA Board of Governors and announced as Association-wide policy under the Uniform Standard of Care Procedures in the summer of 2019and all three divisions are required to comply with those materials.

Q2. Has the Checklist been updated since 2020?

A2. Yes. CSMAS approved updates to the Checklist at its most recent committee meeting in February of this year. These changes became effective immediately upon approval.

Q3. How is the Checklist updated?

A3. The NCAA Board of Governors designated CSMAS to prescribe the process and format recommendations related to applicable concussion legislation. The Concussion Safety Advisory Group (CSAG) was created by CSMAS for the purposes of providing focused review and advice around emerging developments in concussion science and policy, including those that may warrant an update to the Checklist and related policy and educational materials. CSAG meets annually in the spring to review and discuss available research data and accepted industry practices and how they may impact Checklist content. At its February 2021 meeting and based on input from the CSAG, CSMAS approved several minor changes to the Checklist.

Q4. How do I know what has changed with the Checklist?

A4. The updated version of the Checklist can be accessed here. All updated content has been highlighted so that changes from the previous version can be easily identified.

Q5. Aside from the legislative and policy updates described in Item Q1 above and the updates to the Checklist, are there any other legislative or policy requirements related to concussion management that we should review or be aware of?

A5. Yes. While certain details of applicable concussion legislation vary depending on division, and each school should carefully review all legislative and policy requirements related to concussion management, all three divisions require that the following provisions be included as part of a school’s concussion management plan:

  • An annual process that ensures student-athletes are educated about the signs and symptoms of concussions. Student-athletes must acknowledge that they have received information about the signs and symptoms of concussions and that they have a responsibility to report concussion-related injuries and illnesses to a medical staff member;
  • A process that ensures a student-athlete who exhibits signs, symptoms or behaviors consistent with a concussion shall be removed from athletics activities (e.g., competition, practice, conditioning sessions) and evaluated by a medical staff member (e.g., sports medicine staff, team physician) with experience in the evaluation and management of concussions;
  • A policy that precludes a student-athlete diagnosed with a concussion from returning to athletics activity (e.g., competition, practice, conditioning sessions) for at least the remainder of that day; and
  • A policy that requires medical clearance for a student-athlete diagnosed with a concussion to return to athletics activity (e.g., competition, practice, conditioning sessions) as determined by a physician (e.g., team physician) or the physician’s designee.

Q6. Who is responsible for assuring the implementation of applicable concussion management updates at my institution?

A6. Independent Medical Care legislation in all three divisions requires the designation of an Athletics Health Care Administrator (AHCA) who independently oversees the administration and delivery of athletics health care on behalf of the institution. While we anticipate that the creation and implementation of any necessary concussion management changes and practices may require input from a variety of institutional medical and other personnel, it is reasonable to consider these activities as part of the broader administration and delivery of health care at each institution.

Q7. What is the NCAA Concussion Protocol Template and why was it created?

A7. To facilitate and support member compliance with concussion legislation, CSMAS approved a Concussion Safety Protocol Template (Template) that includes all components of the Checklist. The Template is available for download in Microsoft Word format and allows schools to individualize certain areas of the document and to otherwise modify the Template to accommodate and reflect individual needs and practices.

Q8. Which institutions can access and use the Template?

A8. The Template is available to every NCAA member institution and may be utilized by institutional staff as an educational and compliance tool.

Q9. Where can I find a copy of the Template and does it reflect the most recent Checklist updates?

A9. Yes. We have revised the Template to reflect the most recent changes to the Checklist and the updated version of the Template can be accessed here. All updated content has been highlighted so that changes from the previous version can be easily identified.

Q10. Will there be Checklist changes in the future?

A10. The NCAA Sport Science Institute (SSI) will continue to work with CSMAS and the corresponding CSAG at least annually to identify and review information that may inform recommendations about future Checklist changes.

Q11. How does the Checklist and other legislative and policy requirements relate to the certification requirement arising from the Arrington settlement?

A11. While many of the member obligations in Section IX.A of the Settlement Agreement are similar to or overlap with certain existing NCAA health and safety legislation, policies and guidance materials, each set of obligations is distinct from and, in some instances, different from the other. Compliance with one set of obligations should not be deemed to automatically or entirely satisfy compliance with the other. Therefore, it is important to consult with school legal counsel and other risk management staff as necessary to fully understand these differences and to evaluate your institutional practices and compliance with respect to the member obligations as they relate to the Arrington matter and applicable NCAA legislation, policy and guidance. Additional detailed information about institutional obligations related to the Arrington matter, and the differences between those and NCAA legislative requirements, has been provided to all member institutions by email in the form of two Frequently Asked Questions documents, which can be found here.

Q12. I have a question not covered here. Who can I contact?

A12. If you have reviewed the content of this FAQ and cannot find the answer, please email the Sport Science Institute at: ssi@ncaa.org.


Additional Considerations for Division I Schools

Q13. Are Division I autonomy schools still required to submit a concussion management protocol for review by the Concussion Safety Protocol Committee?

A13. No, not at this time. NCAA legislation requires all Division I institutions to participate in a Concussion Safety Protocol review each year. A waiver of this submission requirement was approved for the 2020 reporting year due to the impacts of COVID-19. In anticipation of a continuing burden on institutional resources across divisions as athletics health care personnel manage and support heavy practice, competition and championship schedules, and in recognition of the availability of the Checklist, corresponding Template and other NCAA educational resources, the CSMAS recommended that the waiver be extended for the 2021 reporting year. As was previously communicated to all Division I institutions by email, the NCAA Division I Council Coordination Committee recently approved the recommendation and extended the original waiver for the 2021 reporting year such that no protocol submission will be required for the 2021 academic year. The waiver does not change an institution’s obligation to maintain an appropriate concussion management plan, including a Concussion Safety Protocol that is consistent with the Checklist. 

Q14. If the May 1 protocol submission deadline has been waived, what is the new deadline for Division I autonomy schools to submit their institutional protocols for review?

A14. The 2021 submission deadline has been waived and it is not anticipated that a new submission 2021-22 deadline will be established. We will communicate that information about submission activities to occur after that time frame as that information becomes available.

Q15. Can my institution utilize the Template that was created to conform to the updated Checklist?

A15. Yes. The Template may be used by every NCAA member institution as an educational and compliance tool.

Q16. My institution submitted its protocol in 2019 for review and the Concussion Safety Review Committee confirmed that it was consistent with the Checklist. Do we need to do anything this year?

A16. Division I Constitution 3.2.4.20.1 (Concussion Safety Protocol) was updated in 2019 to require that a Division I institution's Concussion Safety Protocol must be consistent with the Checklist. Because the 2021 Checklist includes material updates, you should carefully review these changes and other relevant legislative and policy requirements and work with applicable institutional medical and other staff to identify and incorporate any necessary adjustments to your concussion management protocol and practices.

Q17. I understand that the May 1 submission deadline has been waived; but can we still submit our updated concussion protocol to the Concussion Safety Protocol Committee for review and feedback?

A17. No. Due to the travel and other resource restrictions and impacts resulting from the COVID-19 pandemic, neither the Concussion Safety Protocol Committee nor its designated subcommittee that has historically reviewed Division I non-autonomy opt in submissions will be convening for or conducting protocol review activities at this time. However, the NCAA SSI staff is committed to providing membership with all of the tools and information necessary to identify applicable updates to concussion management practices resulting from the recent Checklist changes and will work, in conjunction with CSMAS as applicable, to respond to all membership questions on the topic. Specific questions about the Checklist or the recent updates should be directed to ssi@ncaa.org.

Q18. I understand that the protocol submission deadline has been waived. Do we still need to sign the annual Compliance Certification Form?

A18. Yes. Division I Constitution 3.2.4.20.1-(g) still requires that a written certificate of compliance signed by the institution’s AHCA be included in the institution’s Concussion Safety Protocol. We recommend that the signed form is kept on file in the office of the institution’s AHCA along with a current copy of the concussion safety protocol and other concussion management materials.

Q19. Is there a specific Compliance Certification Form that my AHCA needs to use to meet the legislative requirement?

A19. No. However, to facilitate and support member compliance with this requirement, the NCAA has developed a standard Compliance Certification Form. A blank copy of the form is included as Exhibit A to the Template and can also be accessed here. We recommend that your AHCA print, sign and keep the form on file in his or her office along with a current copy of the concussion safety protocol and other concussion management materials. While not legislatively required, DII and DIII institutions may also elect at their discretion to keep a written certification on file and those schools can use the sample certification form for this purpose as well.

Updated: April 2021

Guidance to the NCAA membership about the Arrington Certification Process

The purpose of this memo is to provide membership with: (1) additional information about the availability of an online platform and process that has been established to facilitate membership certification under the Arrington Class Settlement Agreement; and (2) access to related educational and instructional materials. 

The content of this memo is being provided for informational purposes only and should not be construed as legal advice or a substitute for legal advice. We encourage you to review the content with applicable legal and other advisors and other institutional staff who might assist you in appropriately evaluating this information as it applies to your individual institutional decision about certification and related risks and practices.

REMINDER - Certifications must be submitted by May 18, 2020

In accordance with Section IX.B of the Settlement Agreement, certification is optional for NCAA member schools; but it provides certifying institutions with an opportunity to benefit from a release from certain legal claims that might otherwise be brought by members of the settlement class. To benefit from the release, member institutions must certify in writing, on or before 11:59 PM CDT (Chicago time) on May 18, 2020, that they have put in place a concussion management plan that meets the requirements of Section IX.A of the Settlement Agreement and must provide a copy of the certification to the Special Master, Class Counsel, and the Notice Administrator as described in the Settlement Agreement. Please note that, while all three divisions continue to explore the possibility of delaying certain other membership reporting obligations in response to the impact of COVID-19, the May 18 certification deadline is imposed by the terms of the Settlement Agreement which is a legal document. The Settlement Agreement does not provide for any opportunity for an extension or waiver of that deadline and the deadline should be considered permanent and immovable. 

Certification Process

A certification website and electronic certification process have been established and will be managed by third party settlement administrator Epiq Mass Tort (EPIQ). The certification website is immediately available to membership and step-by-step instructions for member institutions can be accessed here.

IMPORTANT - Prior to certification

Prior to accessing the certification website or implementing the instructions provided through the link above, it is important that each institution carefully reviews the content of Section IX and other related provisions of the Settlement Agreement, as well as the sample certification form. This review should be done with applicable legal advisors and other school staff who might assist in appropriately evaluating the certification requirements and decision, in each case as they apply to individual institutional risks and practices. A copy of the Settlement Agreement can be accessed here. A pdf copy of a sample certification form can be accessed here.

After Certification

Upon successful completion of the certification process, the individual that certifies on behalf of the institution will immediately receive an email confirming that the certification document has been completed. The email will include a pdf copy of the signed certification and the signer will be able to review an online copy as well. EPIQ will subsequently send a confirmation email to the following school personnel at the address that was on file with the NCAA on March 15:

  • Director of Athletics.
  • Athletics Health Care Administrator.
  • Director of Compliance and General Counsel (or, where no General Counsel, the President/Chancellor).

The executed certification form will also be automatically uploaded to the settlement website.  Finally, EPIQ will provide a copy of the executed certification form to each of the Special Master, Class Counsel, and the Notice Administrator, on behalf of the certifying institution, as required under the Settlement Agreement. Please note that it may take EPIQ several days after completion of the certification process to fully complete these activities.

Please note that, to support membership certification efforts, EPIQ intends to send subsequent reminders of the certification deadline to the limited group of Association stakeholders identified above at member institutions that have not yet submitted a certification between now and the certification deadline.

Frequently Asked Questions

In addition to the instructional information about the certification process, we have developed a Frequently Asked Questions document that contains answers to anticipated membership questions related to the certification process. A copy of the Certification FAQ can be accessed here.

Recommended Next Steps

As indicated above, we encourage you to review the content of Section IX and other related provisions of the Settlement Agreement, as well as the sample certification form with applicable legal advisors and other school staff who might assist in appropriately evaluating the certification requirements and decision, in each case as they apply to individual institutional risks and practices. Links to relevant certification materials are provided again for your convenience below.

We appreciate the efforts required to comply with the certification requirements, especially during these extremely challenging times. We remain committed to working with the membership to support and facilitate compliance and we greatly appreciate your continued partnership toward that effort. As always, please contact us at ssi@ncaa.org in the event you have any questions.

Medical monitoring program launches for NCAA student-athletes

A medical monitoring program for NCAA student-athletes who are a part of the settlement class in several consolidated concussion-related class actions launched Feb. 18.

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By Angela Lumba-Brown, M.D. (Department of Emergency Medicine, Stanford), and Jamshid Ghajar, M.D., Ph.D. (Departent of Neurosurgery, Stanford) Despite increases in scientific literature on concussion, we still do not know how best to...

CARE Consortium: Identifying and evaluating concussion risk factors across multiple injury settings

To gain a better understanding of how concussions occur in day-to-day life, particularly among military populations, a team of researchers led by Kathryn Van Pelt, a postdoctoral research fellow at Kentucky, examined the concussion histories of more than 10,000 cadets at three military academies participating in the NCAA-Department of Defense Concussion Assessment, Research and Education Consortium study.

CARE Consortium: A data-driven approach to acute concussion assessment

Prominent concussion researchers previously have suggested incorporating levels of certainty into concussion diagnosis based on clinical experience. Gian-Gabriel Garcia, a postdoctoral industrial and operations engineering student at Michigan, led a team of researchers that sought to create a predictive model that could stratify concussion assessment and diagnosis based on objective data rather than clinical experience alone across a range of categories: no concussion, possible, probable or definite.

CARE Consortium: Accounting for variance in concussion tolerance between individuals

While concussion researchers have been using helmet accelerometers to measure head impacts for more than a decade, the connection between the biomechanical forces of the head impacts the players receive and the clinical effect of those impacts is poorly defined.

CARE Consortium: Estimated age at first exposure to contact sports and neurocognitive performance in service academy athletes

Age of first exposure to contact sport has uncertain implications for later life brain health. There are currently no prospective studies that have evaluated this possibility. This study, helmed by Jaclyn Caccese, a postdoctoral research fellow at Delaware, relied on data from the ongoing NCAA-Department of Defense Concussion Assessment, Research and Education Consortium study to examine the association between estimated age of first exposure to contact sport participation and neurocognitive performance and symptom ratings in male U.S. service academy NCAA athletes.

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