Ontario Introduces Legislation To Establish Concussions Advisory Committee

On November 25, 2015, Ottawa-area MPP Lisa MacLeod introduced Bill 149, Rowan's Law Advisory Committee Act, 2015 ("Rowan's Law") in the Ontario Legislature. Although a private member's bill, Rowan's Law has received all-party support (including support from the Premier and the Minister of Tourism, Culture and Sport). Rowan's Law received Second Reading on December 10, 2015 and was referred to the Standing Committee on the Legislative Assembly where it will be considered before being returned to the Legislature for Third Reading and Royal Assent.

Rowan's Law is named for 17-year old Rowan Stringer, an Ottawa secondary school student who passed away from concussion-related injuries on May 12, 2013. In the spring of 2015, an inquest was held into Rowan's death. The verdict of the Coroner's Jury was released on June 3, 2015, and it contained 49 recommendations that would affect a variety of governments and organizations, including school boards.¹

1. Adoption of legislation that governs all youth sport, and establishes the International Concussion Consensus Guidelines (Zurich) on Management of Concussion in Sports as the standard of practice for concussion management;
2. Ministry of Education funding to school districts to support the full implementation of Provincial Policy Memorandum 158 ("PPM 158"), including the costs associated with Ontario Physical and Health Education Association safety guidelines and coaching/first aid certifications;
3. Development of a Ministry of Education evaluation program to ensure compliance with PPM 158;
4. Development of a PPM 158 for private schools;
5. Revision of the Ontario curriculum to ensure concussion awareness and management is a mandatory part of elementary and secondary curriculum, specifically the Ontario Grade 9 Health and Physical Education program, integrated into science, health and physical education;
6. Adoption of an annual awareness opportunity or module in Ontario elementary and secondary schools to ensure awareness among all students;
7. Development by the Ministry of Education and the Ontario School Boards' Insurance Exchange (OSBIE) of a system for tracking student concussion injuries;
8. Requiring school boards to ensure that all students, parents/guardians, teachers, school administrators, coaches, trainers, and referees are educated about the symptoms and signs of concussion;
9. Requiring school boards to confirm that, before the start of any higher risk school team sports activity, parents and athletes sign an agreement confirming that they have participated in a pre-season concussion awareness and management session related to engaging in higher risk sports activities;
10. Mandating the use of codes of conduct for all players, coaches and parents, which seek to foster a culture of fair play in youth sport;
11. Adoption of pre and post game/practice mechanisms to identify injuries or concerns about a player's well-being; and
12. Adoption of a practice whereby athletes are held out of games if they are believed to have a concussion.²

The Coroner's Jury verdict also contained various recommendations directed at other organizations, including the Ontario Physical and Health Education Association, the Royal College of Physicians and Surgeons of Canada and the Ontario Ministry of Health.

Purpose of Rowan's Law

If passed, Rowan's Law will establish the Rowan's Law Advisory Committee (the "Committee"). The Committee will consist of the following members:

1. at least three members appointed by the Minister of Children and Youth Services;
2. at least three members appointed by the Minister of Education;
3. at least three members appointed by the Minister of Health and Long-Term Care; and
4. at least three members appointed by the Minister of Tourism, Culture and Sport.

The Committee is required to:

• review the recommendations of the Coroner's Jury;
• make recommendations on how to implement those recommendations; and
• make any other recommendations the Committee “deems advisable with respect to head injury prevention or treatment.”

The Committee's report will be provided to the Minister of Tourism, Culture and Sport within one year of Rowan's Law coming into force. Rowan's Law will come into force three months after the day it receives Royal Assent.

Current Law And Policy Relating To Concussions

At present, there are no laws governing concussions and related risks in Canada. Ontario sought to require school boards to comply with policies and guidelines respecting head injuries and concussions of students when then-Minister of Education Laurel Broten introduced Bill 39, Education Amendment Act (Concussions), 2012 on March 6, 2012. That legislation died on the order paper when then-Premier Dalton McGuinty prorogued the Legislature in October 2012.

In March 2014, the Ontario Ministry of Education introduced the Policy/Program Memorandum 158 3 ( PPM 158), "School Board Policies on Concussion". This Policy advised school boards to develop strategies to raise awareness of the seriousness of concussions, strategies for the prevention and identification of concussions, management procedures for diagnosed concussions, and training for board and school staff. The policy applies to publicly-funded elementary and secondary schools in Ontario.

More specifically, PPM 158 requires school boards to implement a policy on concussion management. The policy must include strategies aimed at the development of awareness, the prevention and reduction of risk of sustaining a concussion, the safe removal of an injured student and the identification of a concussion, management procedures for a diagnosed concussion, and training of school board employees and volunteers. School boards were expected to have their policies fully implemented no later than January 30, 2015.

PPM 158 makes individual school boards responsible for the design and implementation of concussion programs. The Ministry of Education is available to assist, if a school board reports issues implementing its concussion program. In all other situations, the school board is responsible for tracking and evaluating implementation.

Although none of the provinces and territories currently have concussion safety legislation, the legislature of British Columbia attempted to pass a similar bill in 2011, known as Bill M 206. Health Minister Terry Lake recently stated that the province will not be following in Ontario's footsteps and will be taking an education-based approach before pursuing legislative change.⁴

Other jurisdictions have taken active steps to mitigate the risks associated with concussive injury. All 50 U.S. states have enacted laws to deal with youth concussions, the first of which was adopted in 2009 in the state of Washington.⁵ Such laws are premised on three action steps: (1) the education of coaches, parents and athletes, (2) the removal of an injured athlete from play, and (3) the requirement that the injured athlete obtain permission to return to play.⁶

Conclusion

If passed, Rowan's Law will likely result in further requirements for school boards, and other organizations involved in youth sports, relating to preventing concussions and educating students, parents, teachers and coaches about the symptoms and management of concussion injuries. We will continue to monitor the progress of Rowan's Law and any recommendations for further legislation and/or policy that will affect school boards and independent schools.

¹ Verdict of the Coroner’s Jury dated June 3, 2015.

² Stringer (Re), 2015 CanLII 65870 (ON OCCO).

³ Ministry of Education, "School Board Policies on Concussion", Policy/Program Memorandum No. 158 (Ottawa: MOE, 19 March 2014).

⁴ " Ontario's proposed youth concussion law needed in B.C., says football association", CBC News British Columbia (28 November 2015).

⁵ Ibid.

⁶ "Get a Heads Up on Concussion in Sports Policies: Information for Parents, Coaches, and School & Sports Professionals", National Centre for Injury Prevention and Control.