EDU-11-12-00011-P Concussion Management and Awareness

3/14/12 N.Y. St. Reg. EDU-11-12-00011-P

NEW YORK STATE REGISTER

VOLUME XXXIV, ISSUE 11

March 14, 2012

RULE MAKING ACTIVITIES

EDUCATION DEPARTMENT

PROPOSED RULE MAKING

NO HEARING(S) SCHEDULED

 

I.D No. EDU-11-12-00011-P

Concussion Management and Awareness

PURSUANT TO THE PROVISIONS OF THE State Administrative Procedure Act, NOTICE is hereby given of the following proposed rule:

Proposed Action:

Addition of section 136.5; and amendment of section 135.4 of Title 8 NYCRR.

Statutory authority:

Education Law, sections 207(not subdivided), 305(1), (2), (42) and 2854(1)(b); and L. 2011, ch. 496

Subject:

Concussion management and awareness.

Purpose:

To establish criteria relating to mild traumatic brain injury sustained by pupils during instruction or school activities.

Text of proposed rule:

1. Section 136.5 of the Regulations of the Commissioner of Education is added, effective June 13, 2012, to read as follows:

§ 136.5 Concussion Management and Awareness.

(a) Applicability.

(1) The provisions of this section relate to pupils who have sustained, or are believed to have sustained, mild traumatic brain injuries (also referred to as a "concussion") while receiving instruction or engaging in any school sponsored or related activity.

(2) The provisions of this section:

(i) shall apply to each school district and charter school;

(ii) may be implemented by nonpublic schools if they so authorize; and

(iii) shall be deemed to be the minimum standards that must be complied with; provided that nothing in this section shall prohibit any public school or nonpublic school from adopting and implementing more stringent standards.

(b) Course of instruction.

(1) Each school coach, physical education teacher, nurse and athletic trainer, who works with and/or provides instruction to pupils engaged in school sponsored athletic activities, shall complete, on a biennial basis, a course of instruction relating to recognizing the symptoms of mild traumatic brain injuries and monitoring and seeking proper medical treatment for pupils who suffer mild traumatic brain injuries.

(2) Components of such course shall include, but not be limited to:

(i) the definition of a mild traumatic brain injury:

(ii) signs and symptoms of mild traumatic brain injuries;

(iii) how mild traumatic brain injuries may occur;

(iv) practices regarding prevention; and

(v) guidelines for the return to school and school activities of a pupil who has suffered a mild traumatic brain injury, regardless of whether such injury occurred outside of school.

(3) Such course shall be completed by means of instruction approved by the Department including, but not limited, to courses provided online and by teleconference.

(c) Information.

(1) The Department shall post on its internet website information relating to mild traumatic brain injuries including, but not limited to:

(i) the definition of a mild traumatic brain injury;

(ii) signs and symptoms of mild traumatic brain injuries;

(iii) how mild traumatic brain injuries may occur; and

(iv) department guidelines for return to school and school activities of a pupil who has suffered a mild traumatic brain injury, regardless of whether such injury occurred outside of school.

(2) A school shall include the information required under paragraph (1) of this subdivision in any permission form or consent form or similar document that may be required from a parent or person in parental relation for a pupil's participation in interscholastic sports.

(3) A school shall include the information required under paragraph (1) of this subdivision, or reference how to obtain such information from the websites of the State Education Department and the Department of Health, on the school's internet website if one exists.

(d) Removal from athletic activities.

(1) A school shall require the immediate removal from athletic activities of any pupil who has sustained, or who is believed to have sustained, a mild traumatic brain injury. In the event that there is any doubt as to whether a pupil has sustained a concussion, it shall be presumed that the pupil has been so injured until proven otherwise.

(2) No such pupil shall resume athletic activity until the pupil has been symptom free for not less than twenty-four hours, and has been evaluated by and received written and signed authorization from a licensed physician; and for extra class athletic activities, has received clearance from the medical director to participate in such activity.

(i) Such authorization shall be kept on file in the pupil's permanent health record.

(ii) The school shall follow any directives issued by the pupil's treating physician with regard to limitations and restrictions on school attendance and activities for the pupil.

(e) Concussion Management Team

(1) Each school or school district, in its discretion, may establish a concussion management team.

(2) The concussion management team may be composed of:

(i) the athletic director;

(ii) a school nurse;

(iii) the school physician;

(iv) a coach of an interscholastic team;

(v) an athletic trainer; or

(vi) such other appropriate personnel as designated by the school or school district.

(3) The concussion management team shall oversee the implementation of subdivision (42) of Education Law section 305 and the provisions of this section as it pertains to their associated school and may establish and implement a program which provides information on mild traumatic brain injuries to parents and persons in parental relation throughout each school year.

2. Sub-item (2) of item (c) of subparagraph (i) of paragraph (7) of subdivision (c) of section 135.4 of the Regulations of the Commissioner of Education is amended, effective June 13, 2012, to read as follows:

(2) Teachers with coaching qualifications and experience certified only in areas other than physical education may coach any sport in any school, provided they have completed:

(i) the first aid requirement set forth in section 135.5 of this Part; [and]

(ii) an approved pre-service or in-service education program for coaches or will complete such a program within five years of appointment. Such program shall include an approved course in philosophy, principles and organization of athletics, which shall be completed within two years after initial appointment as a coach, and approved courses in health sciences applied to coaching, and theory and techniques of coaching that is sport specific, which shall be completed within five years after initial appointment as a coach. Such approved programs for coaches will consist of one of the following (credits and hours vary depending upon the contact and endurance involved in the sport): a department-approved college program of from two to eight credits; or a department approved in-service education program, conducted by schools, colleges, professional organizations or other recognized groups or agencies, from 30 to 120 clock hours; or an equivalent experience which is approved by the Commissioner of Education. Upon application to the Commissioner of Education in a format prescribed by the commissioner and setting forth the reasons for which an extension is necessary, the period in which to complete such training may be extended to no more than seven years after such appointment; provided that coaches who have a lapse in service due to maternity leave, military leave, or other extenuating circumstances may apply to the commissioner for an additional extension of no more than two years to complete course work; and

(iii) on a biennial basis, a course of instruction relating to mild traumatic brain injuries pursuant to section 136.5(b) of this Title.

3. Sub-item (3) of item (c) of subparagraph (i) of paragraph (7) of subdivision (c) of section 135.4 of the Regulations of the Commissioner of Education is amended, effective June 13, 2012, to read as follows:

(3) Temporary coaching license. Except as provided in subclause (4) of this clause and notwithstanding the provisions of section 80-5.10 of this Title, other persons with coaching qualifications and experience satisfactory to the board of education may be appointed as temporary coaches of interschool sport teams whether in a paid or non-paid (volunteer) status, when certified teachers with coaching qualifications and experience are not available, upon the issuance by the commissioner of a temporary coaching license. A temporary coaching license, valid for one year, will be issued under the following conditions:

(i) . . .

(ii) . . .

(iii) candidates for the first renewal of a temporary license shall have completed or be enrolled in an approved course in philosophy, principles and organization of athletics; [and]

(iv) candidates for any subsequent renewal of a temporary license shall have completed an approved pre-service or in-service education program for coaches which shall include an approved course in philosophy, principles and organization of athletics, which shall be completed within two years after initial appointment as a coach, and approved courses in health sciences applied to coaching, and theory and techniques of coaching that is sport specific, which shall be completed within five years after initial appointment as a coach. Such approved programs for coaches shall consist of one of the following (credits and hours vary depending upon the contact and endurance involved in the sport): a department-approved college program of from two to eight credits; or a department approved in-service education program, conducted by schools, colleges, professional organizations or other recognized groups or agencies, from 30 to 120 clock hours; or an equivalent experience which is approved by the Commissioner of Education. Upon application in a format prescribed by the Commissioner of Education and setting forth the reasons for which an extension is necessary, the period in which to complete such training may be extended to no more than seven years after such appointment; provided that coaches who have a lapse in service due to maternity leave, military leave, or other extenuating circumstances may apply to the commissioner for an additional extension of no more than two years to complete course work; and

(v) on a biennial basis, candidates shall have completed a course of instruction relating to mild traumatic brain injuries pursuant to section 136.5(b) of this Title.

4. Sub-item (A) of item (i) of subclause (4) of clause (c) of subparagraph (i) of paragraph (7) of subdivision (c) of section 135.4 of the Regulations of the Commissioner of Education is amended, effective June 13, 2012, to read as follows:

(A) the candidate has completed the requirements set forth in items (3)(ii), (iii) [and], (iv) and (v) of this clause; and

5. Item (xi) of subclause (2) of clause (d) of subparagraph (i) of paragraph (7) of subdivision (c) of section 135.4 of the Regulations of the Commissioner of Education is amended, effective June 13, 2012, to read as follows:

(xi) professional development and responsibilities, including:

(A) . . .

(B) . . .

(C) educating the community of health care professionals as to the role of the certified athletic trainer; [and]

(D) informing parents, coaches and athletes as to the importance of quality health care for the physically active; and

(E) on a biennial basis, completing a course of instruction relating to mild traumatic brain injuries pursuant to section 136.5(b) of this Title.

Text of proposed rule and any required statements and analyses may be obtained from:

Mary Gammon, State Education Department, Office of Counsel, State Education Building, Room 148, 89 Washington Ave., Albany, NY 12234, [phone], email: [e-mail]

Data, views or arguments may be submitted to:

Ken Slentz, Deputy Commissioner P-12 Education, State Education Department, State Education Building, 2M West, 89 Washington Ave., Albany, NY 12234, [phone], email: [e-mail]

Public comment will be received until:

45 days after publication of this notice.

Regulatory Impact Statement

1. STATUTORY AUTHORITY:

Education Law section 207 empowers the Regents and Commissioner of Education to adopt rules and regulations to carry out State education laws and functions and duties conferred on the Education Department by law.

Education Law section 305(1) and (2) provide the Commissioner, as chief executive officer of the State education system, with general supervision over schools and institutions subject to the provisions of education law, and responsibility for executing Regents policies. Section 305(20) authorizes the Commissioner with such powers and duties as are charged by the Regents.

Education Law section 305(1) empowers the Commissioner of Education to be the chief executive officer of the State system of education and the Board of Regents and authorizes the Commissioner to enforce laws relating to the educational system and to execute educational policies determined by the Board of Regents.

Education Law section 305(2) authorizes the Commissioner to have general supervision over all schools subject to the Education Law.

Education Law section 305(42), as added by Chapter 496 of the Laws of 2011, authorizes the Commissioner of Education, in conjunction with the Commissioner of Health, to promulgate and review as necessary rules and regulations relating to pupils who suffer mild traumatic brain injuries, also referred to as concussions, while receiving instruction or engaging in any school sponsored or related activity.

Education Law section 2854(1)(b) provides that charter schools shall meet the same health and safety, civil rights, and student assessment requirements applicable to other public schools, except as otherwise specifically provided in Article 56 of the Education Law.

2. LEGISLATIVE OBJECTIVES:

The proposed rule is necessary to implement and conform the Commissioner's regulations to Chapter 496 of the Laws of 2011 which requires the Commissioner of Education, in conjunction with the Commissioner of Health, to promulgate regulations with regard to pupils who sustain, or are believed to have sustained, mild traumatic brain injuries, also referred to as a "concussion," while receiving instruction or engaging in any school sponsored or related activity.

3. NEEDS AND BENEFITS:

The proposed rule is necessary to implement and conform the Commissioner's regulations to Chapter 496 of the Laws of 2011 by establishing standards for the required instruction of key school personnel in the signs and symptoms of mild traumatic brain injuries and monitoring and seeking proper medical treatment for pupils suffering such injuries. The needs and benefits of the proposed rule rest upon the knowledge that inadequate identification and management of a mild traumatic brain injury may result in long term disability or death.

4. COSTS:

a. Costs to State government: None.

b. Costs to local governments: None.

c. Costs to private regulated parties: None.

d. Costs to the regulating agency for implementation and continuing compliance: None.

The proposed rule is necessary to implement and conform the Commissioner's regulations to Chapter 496 of the Laws of 2012 and does not impose any additional costs on the State, local governments or the State Education Department beyond those imposed by the statute. The proposed rule does not apply to nonpublic schools unless they authorize implementation of the rule. Further, the Department anticipates approving a course of instruction relating to recognizing the symptoms of mild traumatic brain injuries and monitoring and seeking proper medical treatment for such pupils, which will have no costs to school districts and charter schools.

5. LOCAL GOVERNMENT MANDATES:

The proposed amendment is necessary to implement and conform the Commissioner's regulations to Chapter 496 of the Laws of 2012 and does not impose any additional program, service, duty or responsibility upon local governments beyond those imposed by the statute.

Consistent with the statute, the proposed rule:

(1) requires each school coach, physical education teacher, nurse and athletic trainer, who works with and/or provides instruction to pupils engaged in school sponsored athletic activities, to complete, on a biennial basis, a course of instruction relating to recognizing the symptoms of mild traumatic brain injuries and monitoring and seeking proper medical treatment for pupils who suffer such injuries. The proposed rule establishes standards for the required instruction including how such injuries occur, practices regarding prevention, and guidelines for the return to school and to school activities of a pupil who has suffered a mild traumatic brain injury, regardless of whether such injury occurred outside of school;

(2) requires the State Education Department to post on its internet website information regarding mild traumatic brain injuries, and requires schools to place such information on their websites, or reference on their websites how to obtain such information from the websites of the State Education Department and the Department of Health. In addition, schools are required to include such information on any permission form or consent form or similar document that may be required from a parent or person in parental relation for a pupil's participation in interscholastic sports;

(3) requires the immediate removal from athletic activities of any pupil who has sustained, or is believed to have sustained, a mild traumatic brain injury, and provides that such pupil may not resume athletic activity until he/she has been symptom free for not less than 24 hours, and has been evaluated by and received written and signed authorization from a licensed physician. The proposed rule requires that such authorization shall be kept on file in the pupil's permanent health record, and that the school follow any directives issued by the pupil's treating physician with regard to limitations and restrictions on school attendance and activities for the pupil; and

(4) provides standards for schools that decide to establish Concussion Management Teams to oversee and implement the statutory and regulatory provisions relating to concussion management and awareness.

6. PAPERWORK:

The proposed amendment does not impose any additional reporting or paperwork requirements beyond those imposed by Chapter 496 of the Laws of 2011.

Consistent with the statute, the proposed rule requires schools to:

(1) include in any permission form or consent form or similar document that may be required from a parent or person in parental relation for a pupil's participation in interscholastic sports, information relating to mild traumatic brain injury including the definition of mild traumatic brain injury, signs and symptoms of mild traumatic brain injuries, how such injuries may occur, and guidelines for return to school and school activities of a pupil who has suffered such injury;

(2) include such information, or reference how to obtain such information from the websites of the State Education Department and the Department of Health, on the school's internet website, if one exists; and

(3) maintain in the pupil's permanent health records, the written, signed authorization of a licensed physician permitting a pupil who has sustained, or is believed to have sustained, a mild traumatic brain injury, to resume athletic activity.

7. DUPLICATION:

The proposed amendment does not duplicate, overlap or conflict with any other State or federal statute or regulation, and is necessary to implement and conform the Commissioner's regulations to Chapter 496 of the Laws of 2011 of the State of New York.

8. ALTERNATIVES:

There are no significant alternatives and none were considered. The proposed amendment is necessary to implement and conform the Commissioner's regulations to Chapter 496 of the Laws of 2012 and does not impose any additional compliance requirements or costs beyond those imposed by the statute.

9. FEDERAL STANDARDS:

The proposed amendment does not exceed any minimum federal standards.

10. COMPLIANCE SCHEDULE:

It is anticipated that regulated parties will be able to achieve compliance with the proposed amendment by its effective date.

Regulatory Flexibility Analysis

Small Businesses:

The proposed rule is necessary to implement and conform the Commissioner's regulations to Chapter 496 of the Laws of 2011 which requires the Commissioner of Education, in conjunction with the Commissioner of Health, to promulgate regulations with regard to pupils in public schools who sustain, or are believed to have sustained, mild traumatic brain injuries while receiving instruction or engaging in any school sponsored or related activity.

The proposed rule does not impose any adverse economic impact, reporting, recordkeeping or any other compliance requirements on small businesses. Because it is evident from the nature of the proposed amendment that it does not affect small businesses, no affirmative steps are needed to ascertain that fact and none were taken. Accordingly, a regulatory flexibility analysis for small businesses is not required and one has not been prepared.

Local Governments:

The proposed amendment applies to all school districts and charter schools in the State. At present, there are 695 school districts (including New York City) and approximately 190 charter schools.

1. COMPLIANCE REQUIREMENTS:

The proposed amendment is necessary to implement and conform the Commissioner's regulations to Chapter 496 of the Laws of 2012 and does not impose any compliance requirements upon local governments beyond those imposed by the statute.

Consistent with the statute, the proposed rule:

(1) requires each school coach, physical education teacher, nurse and athletic trainer, who works with and/or provides instruction to pupils engaged in school sponsored athletic activities, to complete, on a biennial basis, a course of instruction relating to recognizing the symptoms of mild traumatic brain injuries and monitoring and seeking proper medical treatment for pupils who suffer such injuries. The proposed rule establishes standards for the required instruction including how such injuries occur, practices regarding prevention, and guidelines for the return to school and to school activities of a pupil who has suffered a mild traumatic brain injury, regardless of whether such injury occurred outside of school;

(2) requires the State Education Department to post on its internet website information regarding mild traumatic brain injuries, and requires schools to place such information on their websites, or reference on their websites how to obtain such information from the websites of the State Education Department and the Department of Health. In addition, schools are required to include such information on any permission form or consent form or similar document that may be required from a parent or person in parental relation for a pupil's participation in interscholastic sports;

(3) requires the immediate removal from athletic activities of any pupil who has sustained, or is believed to have sustained, a mild traumatic brain injury, and provides that such pupil may not resume athletic activity until he/she has been symptom free for not less than 24 hours, and has been evaluated by and received written and signed authorization from a licensed physician. The proposed rule requires that such authorization shall be kept on file in the pupil's permanent health record, and that the school follow any directives issued by the pupil's treating physician with regard to limitations and restrictions on school attendance and activities for the pupil; and

(4) provides standards for schools that decide to establish Concussion Management Teams to oversee and implement the statutory and regulatory provisions relating to concussion management and awareness.

The proposed amendment does not impose any additional reporting or paperwork requirements beyond those imposed by Chapter 496 of the Laws of 2011.

Consistent with the statute, the proposed rule requires schools to:

(1) include in any permission form or consent form or similar document that may be required from a parent or person in parental relation for a pupil's participation in interscholastic sports, information relating to mild traumatic brain injury including the definition of mild traumatic brain injury, signs and symptoms of mild traumatic brain injuries, how such injuries may occur, and guidelines for return to school and school activities of a pupil who has suffered such injury;

(2) include such information, or reference how to obtain such information from the websites of the State Education Department and the Department of Health, on the school's internet website, if one exists; and

(3) maintain in the pupil's permanent health records, the written, signed authorization of a licensed physician permitting a pupil who has sustained, or is believed to have sustained, a mild traumatic brain injury, to resume athletic activity.

2. PROFESSIONAL SERVICES:

The proposed amendment does not impose any additional professional services requirements on local governments.

3. COMPLIANCE COSTS:

The proposed rule is necessary to implement and conform the Commissioner's regulations to Chapter 496 of the Laws of 2012 and does not impose any additional costs on local governments beyond those imposed by the statute.

4. ECONOMIC AND TECHNOLOGICAL FEASIBILITY:

The proposed amendment does not impose any new technological requirements. Economic feasibility is addressed above under compliance costs.

5. MINIMIZING ADVERSE IMPACT:

The proposed rule is necessary to implement and conform the Commissioner's regulations to Chapter 496 of the Laws of 2012, and will not impose any additional compliance requirements or costs on local governments beyond those imposed by the statute. Because these statutory requirements specifically apply to public schools it is not possible to exempt them from the proposed rule's requirements or impose a lesser standard. The proposed rule has been carefully drafted to meet statutory requirements and Regents policy while minimizing the impact on public schools. Where possible, the proposed rule provides for local flexibility in meeting statutory requirements.

6. LOCAL GOVERNMENT PARTICIPATION:

Copies of the proposed rule have been provided to the State Department of Health, the chief school administrators of the Big 5 city school districts, and to District Superintendents with the request that they distribute them to school districts within their supervisory districts for review and comment. Additionally, the Department has worked extensively with stakeholders on guidance documents which will provide assistance in the implementation of these regulations.

Rural Area Flexibility Analysis

1. TYPES AND ESTIMATED NUMBERS OF RURAL AREAS:

The proposed amendment will apply to all school districts, including those located in the 44 rural counties with less than 200,000 inhabitants and the 71 towns in urban counties with population density of 150 per square miles or less. The proposed rule also applies to charter schools. At present, there is one charter school in a rural area. The proposed rule does not apply to nonpublic schools unless they authorize implementation of the rule.

2. REPORTING, RECORDKEEPING AND OTHER COMPLIANCE REQUIREMENTS AND PROFESSIONAL SERVICES:

The proposed amendment is necessary to implement and conform the Commissioner's regulations to Chapter 496 of the Laws of 2012 and does not impose any reporting, recordkeeping or other compliance requirements upon local governments beyond those imposed by the statute.

Consistent with the statute, the proposed rule:

(1) requires each school coach, physical education teacher, nurse and athletic trainer, who works with and/or provides instruction to pupils engaged in school sponsored athletic activities, to complete, on a biennial basis, a course of instruction relating to recognizing the symptoms of mild traumatic brain injuries and monitoring and seeking proper medical treatment for pupils who suffer such injuries. The proposed rule establishes standards for the required instruction including how such injuries occur, practices regarding prevention, and guidelines for the return to school and to school activities of a pupil who has suffered a mild traumatic brain injury, regardless of whether such injury occurred outside of school;

(2) requires the State Education Department to post on its internet website information regarding mild traumatic brain injuries, and requires schools to place such information on their websites, or reference on their websites how to obtain such information from the websites of the State Education Department and the Department of Health. In addition, schools are required to include such information on any permission form or consent form or similar document that may be required from a parent or person in parental relation for a pupil's participation in interscholastic sports;

(3) requires the immediate removal from athletic activities of any pupil who has sustained, or is believed to have sustained, a mild traumatic brain injury, and provides that such pupil may not resume athletic activity until he/she has been symptom free for not less than 24 hours, and has been evaluated by and received written and signed authorization from a licensed physician. The proposed rule requires that such authorization shall be kept on file in the pupil's permanent health record, and that the school follow any directives issued by the pupil's treating physician with regard to limitations and restrictions on school attendance and activities for the pupil; and

(4) provides standards for schools that decide to establish Concussion Management Teams to oversee and implement the statutory and regulatory provisions relating to concussion management and awareness.

The proposed amendment does not impose any additional professional services requirements on local governments.

The proposed amendment does not impose any additional reporting or paperwork requirements beyond those imposed by Chapter 496 of the Laws of 2011.

Consistent with the statute, the proposed rule requires schools to:

(1) include in any permission form or consent form or similar document that may be required from a parent or person in parental relation for a pupil's participation in interscholastic sports, information relating to mild traumatic brain injury including the definition of mild traumatic brain injury, signs and symptoms of mild traumatic brain injuries, how such injuries may occur, and guidelines for return to school and school activities of a pupil who has suffered such injury;

(2) include such information, or reference how to obtain such information from the websites of the State Education Department and the Department of Health, on the school's internet website, if one exists; and

(3) maintain in the pupil's permanent health records, the written, signed authorization of a licensed physician permitting a pupil who has sustained, or is believed to have sustained, a mild traumatic brain injury, to resume athletic activity.

3. COSTS:

The proposed rule is necessary to implement and conform the Commissioner's regulations to Chapter 496 of the Laws of 2012 and does not impose any additional costs on local governments beyond those imposed by the statute.

4. MINIMIZING ADVERSE IMPACT:

The proposed rule is necessary to implement and conform the Commissioner's regulations to Chapter 496 of the Laws of 2012, and will not impose any additional compliance requirements or costs on rural areas beyond those imposed by the statute. The proposed rule has been carefully drafted to meet statutory requirements while minimizing the impact on public schools. Where possible, the proposed rule provides for local flexibility in meeting statutory requirements. The statute which the proposed rule implements applies to all public schools throughout the State, including those in rural areas. Therefore, it was not possible to establish different requirements for entities in rural areas, or to exempt them from the rule's provisions.

5. RURAL AREA PARTICIPATION:

Copies of the proposed amendment were provided to the Department's Rural Education Advisory Committee, which includes representatives of school districts in rural areas. Additionally, the Department has worked extensively with stakeholders on guidance documents which will provide assistance in the implementation of these regulations.

Job Impact Statement

The proposed rule is necessary to implement and conform the Commissioner's regulations to Chapter 496 of the Laws of 2011 which requires the Commissioner of Education, in conjunction with the Commissioner of Health, to promulgate regulations with regard to pupils in public schools who sustain, or are believed to have sustained, mild traumatic brain injuries while receiving instruction or engaging in any school sponsored or related activity.

The proposed rule will not have a substantial impact on jobs and employment opportunities. Because it is evident from the nature of the amendment that it will not affect job and employment opportunities, no affirmative steps were needed to ascertain that fact and none were taken. Accordingly, a job impact statement is not required, and one has not been prepared.