MCPS Concussion Baseline Testing? MCPS Athletics Has Higher Priorities For Keeping Student Athletes Safe

MCPS Superintendent Josh Starr included in his fiscal 2014 Operating Budget proposal $75,000 for concussion baseline testing at each of MCPS’s 25 high schools.  Because this would be a new expenditure and no budget savings from last year is identified, it is assumed that this $75,000 proposal would be among the $10 million in funding that has been proposed in excess of Maryland's maintenance-of-effort requirement.

If the County Council somehow funds $75,000 in the budget over MOE, MCPS high school students would be better served if the funds were used to hire a sports safety professional to advise it on incorporating best practices in operating a safe sports program in managing and preventing concussions, heat stroke, and other injuries. 

Alternatively, $75,000 could be used to fund athletic trainers at 3 or 4 high schools, probably best where students access to health care is most challenged, as a base of staffing that could be added in subsequent years.  Other Maryland school systems have taken this approach.

As to the proposal, there are certain questions about the $75,000 number.  The Superintendent’s September 5, 2012 press release on baseline testing indicated that currently the boosters clubs of 9 MCPS high schools pay $750 per school to obtain ImPACT baseline testing on students who participate in athletics.[1]  That rate multiplied by 25 high schools results in only $18,750.   Of this amount, $6,750 is currently paid by the booster clubs at the 9 schools where baseline testing is conducted. 

So it would appear that only $12,000 in additional funding is needed to obtain baseline testing at the other 16 schools.  Are there additional costs included in the $75,000 included in the recommended budget?  Is this the cost of having the testing conducted by trained neuropsychologists? 

From my own experience managing my son’s concussion, I have several observations about baseline testing.  First, the limitations of baseline testing must be understood.  As a physician at our school said last year at a concussion forum, “Baseline testing is not a vaccine against getting a concussion.”  Second, many people still expect comparing a post-concussion test against a baseline to be the equivalent of an X-ray or blood test for diagnosing a concussion.   It’s not.   Such post-concussion testing is just “one tool in the toolbox."  Other essential tools are balance evaluation and following gradual-return-to-play procedures.

Third, my overall concern is that funding concussion baseline testing is far down the priority list behind: (1) having athletic trainers on staff; (2) having clear policies for removing possibly concussed students from play, including policies in sports with multiple layers of head coach and assistant coaches; (3) notifying school nurses when a concussion is suspected; (4) having policies for following gradual-return-to play steps; and (5) having sport-specific protections, like limits on full contact practice in football.  (All but the first of these are budget neutral, yet we don’t do them in MCPS.)

So in the absence of these essential steps, implementing baseline concussion testing may be a form of sports safety theater, making people feel safer about letting their kids play contact and collision sports without actually increasing safety.

Questions? Email concussionchangemcps@verizon.net and follow on Twitter at Concussion MCPS-Md handle @concussionmcps

[1] http://www.montgomeryschoolsmd.org/press/index.aspx?pagetype=showrelease&id=3224&type=&startYear=&pageNumber=5&mode=