extant calls into question the way decisions are made and carried through within the upper ranks of the football and basketball community. that's on my mind. i'm going to say that and also that that's the last thing i will say. this hearing is adjourned.

c-span's 2014 student cam competition is under way. this competition for middle and high school students will award 150 prizes. create a five to seven minute documentary on the topic, the three branches and you. videos need to include c-span programming, show varying points of view and be submitted by january 20, 2015. go to studentcam.org for information. grab a camera and get started today. >> tonight on c-span, american history tv examines spying in the u.s. we'll start at 8:00 with a tour of the cia museum. then a look at spying during the civil war. after that german espionage against the u.s. during world war ii. later a conversation about the soviet and u.s. spies of the cold war. >> this weekend on the c-span networks. tonight at 9:00 p.m. eastern on c-span, a memorial service for

president reagan's press secretary james brady. saturday at 9:00 p.m. eastern former secretary of state colin powell talks about world affairs. sunday evening at 8:00 on q & a, author robert timburg talks about how as a marine in vietnam a land mine explosion nearly killed him and changed his life. tonight at 8:00 on c-span 2, author and activist ralph nader calls for an alliance between parties to take on issues that plague america. saturday at 10:00 on aft after words, atul gawande on why he thinks science should do more for the aging and dying. and naomi cline on free market capitalism and the impact on climate change. tonight at 8:00 on american history tv on c-span three, curator and director of the cia museum in virginia explains the mission of preserving and presenting the agency history.

saturday at 8:00 p.m. eastern the king joernls war of the 1740s. how it helped the american columnists establish regional identities and gather experience for their own resolution. saturday night at 8:00 president ford's congressional testimony on the nixon pardon. find our television schedule at c-span.org. let us know what you think about the programs you are watching. call 202-626-3400. e-mail us at comments@c-span.org. or send us a tweet @c-span # comments. like us on facebook. follow us on twitter. jay rockefeller is retiring after 30 years representing west virginia in the senate. he's a democrat but shelly moore capitow is believed to have the edge against west virginia's democratic secretary of state natalie tenant. they debated this week.

>> would you vote again today to repeal aca which means 160,000 west virginia yans would lose insurance? >> i would vote to repeal and replace. i voted for that 50 times. i also recognize that the aca has very good things about it. first of all, making sure people don't get cut off their insurance for a pre-existing condition. absolutely for that. was for that before the president decided to take it in a larger and much more detrimental direction. i believe keep ing our students on until they are 26. that's a good thing. there are good things. we need to keep what's good, replace with what will work. get rid of the businessman date. make sure our businesses aren't having a 30% increase in premiums which we are seeing. 7,000 west virginians lost their health care plan. remember the president who, i will remind you, my opponent supported and supports his policies and his health care policies said. if you like your health care

plan, you can keep it, period. that didn't work out well. it was sold as a bill of goods basically. we are hearing people losing their physicians whose deductibles have gone up into the thousands of dollars. it's unaffordable. were things wrong, yes, with the health care system. i wish we'd worked in a bipartisan way to find a way to keep folks on insurance now. the 140,000 medicaid. we want to keep them insured. that's important to them and us as a state. >> your response? >> well, there she goes again. i wish -- she says one thing and votes another way. she says she's for all of these things in the aca but has voted to repeal it. i won't vote to repeal it. i know what it's like to go without health care. my daughter delaney had open heart surgery when she was a week old.

many folks in west virginia prayed for her. those prayers were answered. that surgery saved her life. she's a healthy, happy 12-year-old right now. when my husband and i started our small business we wanted to buy insurance. so he called. i can remember the day i came home and he said, i talked to the insurance companies, trying to get insurance for us and the business and the family. he said, they will cover me and you but they wouldn't cover delaney because of her pre-existing condition. i was devastated. i thought, what parent takes something their child can't have? i will never go back to the days when insurance companies can deny insurance for someone with a pre-existing condition. for the congresswoman to say she's for that, too, that she's voted to take that away. >> virginia's democratic senator mark warner is seeking a second term. he's being channelled by a former republican national

committee chair ed gillespie. they debated in the northern virginia suburbs outside washington, d.c. here are a few minutes of that. >> there are differences. when you're not in the white house, my party doesn't have one thing to stand up to. i will share things i'm at odds with members of my party. i believe in the early '90s when congress passed mandatory minimum sentence that is we swung too far. we need to revisit those in particular for nonviolent offenders and allow more discretion for judges and the state to get the proper sentencing guidelines. in terms of federal sentencing, mandatory minimum sentences.

i believe in redemption and in reconciliation. we also need to look at the prospect of banning the box in terms of checking after you have served your time and you have paid your price in terms of time in prison for certain crimes and for certain jobs. i don't think you should be required to check the box as a felon which only increases resit vimpl. if people paid their debt to society, they need to make it easier for thoem come back in. for certain crimes and certain physicians. >> i appreciate you asking the question. my opponent's whole campaign has been pretty much based on this bogus charge. the 97% charge. independent political analysts called it both misleading and not reflective of my record. the national journal which does a review of all the votes, not just a subsection ranks me right in the sensible center.

let me go through a list. i support drilling off the coast of virginia as long as we get a share of the royalties. i support the keystone pipeline. i have been protested against in harrisonburg because of the support. i stood up repeatedly on the president's foreign policy choices as we talked about with isil and in terps of being stronger against russia. start calling early in march for these stronger oppositions to his activities in ukraine and around europe. it's that reason that virginians know my record. it's that reason why, again, in this campaign i'm happy to have the support of more republicans than i had the first time. it is a political sound bite attack charge that comes from somebody who spent their career

as a partisan operative. >> more campaign debates over the weekend on c-span. tonight live from wisconsin, scott walker debates mary burke in the first of two debates in the wisconsin fwov nor's race starting at 8:00 p.m. eastern. saturday at 8:00 eastern a debate in the race to replace tom harkin. bruce brayly debates joanie ernst live on c-span. sunday michigan's incumbent governor rick snyder faces former congressman mark schauer live on sunday at 6:00. earlier this year a house subcommittee looked into brain injuries from football, hockey and other sports. officials with the nhl and the national hockey league talked about addressing the issue. we hear from professional and student athletes. congressman literary chaired the hearing. it's about three hours.

all right. i want to thank every for being here. we are now with the full committee ranking member, the gentleman from california, joins us. we now have the ability to start our hearing so i will introduce you after my statement and before you start your testimony. so good morning and welcome to

this morning's hearing. today it's my hope to learn what steps are being taken to make sports participation safer for all athletes. every day parents make choices about whether or not to let their son or daughter play soccer or what kind of mouthpiece to buy their son for his first day of pop warner football. unfortunately it seems like every day we hear how participation can be dangerous. it's easy to understand you how what parents see in the news inevitably affects youth participation in sports. case in point, earlier this year, president obama said publicly that if he had a son, he wouldn't let him play pro football. then the first lady wants us all to move. seems to conflict messages. we want a better understanding of the innovations being made by sports leagues, equipment manufacturers and the medical community to make all sports safer. one clear example is the nhl which has been working to make hockey safer. dating back to 1997, the nhl recognized the dangers of head injuries and took the proactive step of forming a joint concussion committee. additionally the nhl also established a department of player safety at its headquarters, the first of its kind for any professional league. usa hockey and usa football, two organizations that help oversee youth sports in the united states, have followed the lead of their professional counterparts by employing a multipronged approach to making participation safer. usa hockey requires coaches to

complete and online education module specific to the age group they are coaching at. and that includes safety information, concussion education, proper techniques. usa football which is endowed by the generosity of the nfl and nflpa was the first national governing body for any sport to participate in the cdc's heads up concussions in youth sports. initiatives also engaged in providing youth with nontackling alternatives to develop their skills. additionally, usa heads up football program encompasses six elements to make youth football safer including coach education and concussion recognition. proactive actions like the ones i just mentioned are exactly what parents need in order to be assured that everything possible is being done to keep their child as safe as possible while they're on the field or ice. researchers have also been hard at work to improve the tools that coaches and doctors have at their disposal when treating an athlete. for example, who runs the biology and behavior society inside the huskers stadium has been developing ap-mri machine to assess a head injury. it would allow medical staff to determine if a player has suffered a concussion, how

severe the injury is and if that player is able to return. equipment manufacturers are also using technology to reduce injuries. i feel confident saying that given the recent rule changes and the rate at which technology is advancing, playing a contact sport today is likely safer than it has been in the past. however, we must accept that there is no silver bullet, no helmet or pad will prevent 100% of the injuries 100% of the time. this is why we need to consider a multipronged approach aimed at keeping our kids safer while still promoting youth participation, aimed at keeping

our kids safer while still promoting participation in sports, this involves listening to how leaders and top researchers are partnering to make sports safer. these are needed to give parents the assurance take that all the possible steps are being taken to improve the safety of their child on the field. and i'd like to thank our panelists for joining us here today. willing to answer our question. and i would especially like to thank you for making the trips to washington, d.c. from lincoln, nebraska. and my team is over, so i will recognize the ranking member, jan schakowsky, from illinois. >> thank you, mr. chairman. this is a very important hearing

on improving sports safety. i look forward to hearing from all of our witnesses on both panels about the perspectives, experiences, proposals about how to make sports safer for everyone from children to professional athletes. athletes are continually becoming bigger and faster and stronger and much work remains. 300,000 sports related traumatic brain injuries occur annually in the united states. sports are the second leading cause of traumatic brain injury among people age 15 to 24, second only to motor vehicle accidents. this is a crisis and this

subcommittee should do everything in its power to address. we'll hear today from a high school senior who suffered a severe head injury during a lacrosse game in his sophomore year. despite his impressive recovery, that hit later identified as his third head injury left him with a limited ability to enjoy the types of activities many of his high school classmates take for granted. his story should serve as a reminder that youth sports injuries can have devastating and lasting consequences. and we'll also hear on this panel from brianna scurry, an olympic and world country soccer champion, a goalie, forced from the field after a career ending traumatic brain injury almost four years ago. her struggle to overcome the cognitive physical and psychological injuries that followed illustrate that even our sports heros are vulnerable. both ian and brianna should be commended for their courage and their willingness to testify. dave duerson, a super bowl winning safety and former member of my hometown chicago bears tragically committed suicide just over three years ago.

in doing so, he shot himself in the chest to avoid any impact on his brain which he asked to have donated to medical research in order to allow scientists to study the impact of the brain raw made he suffered over his professional career. it was later disclosed duerson suffered from a moderately advanced case of chronic traumatic encephalopathy, a disease linked to repeated blows to the head which can result in memory loss, depression and dementia. career ending sports injuries can occur at any level of competition and duerson case should make it clear that the impacts of brain trauma go way beyond an athlete's days on the field and can become more severe over time. we will also hear today from medical and scientific experts who have studied the impacts of brain injuries. and we'll hear about the importance of taking athletes off the field of play as soon as there is suspicion of a brain injury and keeping them off

until they are cleared by a responsible and trained individual. and finally, we'll hear from the nhl, the nfl, youth hockey and football leagues responsible for mitigating raw mat tick brain injury in their sports. i hope to learn what changes they have implemented to rules, practices and other aspects that will reduce the risk of brain injury moving forward. i'm not advocating for an end to sports, but i also feel strongly that 300,000 head injuries per year are too many to overlook. we should take reasonable steps to reduce the risk and i look forward to hearing from all of our witnesses. i hope this hearing will help the subcommittee to better understand the safety risks in sports and what we can and should be doing to limit these risks. i yield back. >> thank you very much. at this time i recognize vice chairman of the committee, mr. lance, of new jersey.

>> thank you very much, mr. chairman. thank you for holding this extremely important hearing. i want to thank dr. james johnston who will be one of the witnesses who came to my office earlier this morning. thank you, dr. johnston. experts generally agree that a concussion can be classified as a brain injury ranging in seriousness from mild to dramatic. the center for disease control states a concussion is caused by a bump, a blow he or a jolt to the head or a blow to the body. it causes the head to move quickly. according to the cdc, the sports that reported the highest number of traumatic brain injuries are bicycling, football, playground activities, basketball and soccer. from 2010 through 2013, the participation rate of children in youth soccer and football dropped considerably.

some have pointed to the increased risk of tbis as a result of participating in these sports. as a reason for the drop in that participation. the increased spotlight on concussions in sports has resulted in increased amount of research in brain injuries as well as research on how to improve sports equipment in order to prevent such injuries from occurring. collegiate and professional sports leagues have implemented standards and revised their rules in order to decrease the number of brain injury incidents. the nhl as has been indicated has required its players to wear helmets on the ice and nfl instituted new standards for evaluating concussions on the sidelines after 223 concussions in just over 300 games in the 2010 season. and state and federal governments have also baby involved in tightening safety standards. and since 2009, all 50 states in the district of columbia have adopted laws protecting athletes from returning to play too soon

after suffering a concussion or potential concussion. this hearing will focus on what more can be done to prevent brain injuries and this is at the youth level, amateur level and the professional level. and i look forward to the testimony of our distinguished panelists. thank you, mr. chairman. i have 2 1/2 minutes remaining. is there any other member on the republican side who would like to speak with an opening state? i yield back. >> do they play sports? on behalf of the big ten, i want to welcome rutgers for the big ten.

>> thank you very much. >> five minutes to the full ranking member of the energy and commerce committee, mr. waxman. there thank you very much. decades ago, many thought head injury was serious only if a player was completely knocked out unconscious or suffered a severe contusion after frequent painful blows, even a young athlete could continue to play. but we now have strong indications that the effects of repeated brain trauma in sports even those received during one's youth can accumulate with consequences that are long term debilitating and even life threatening. these consequences can stem from injuries once considered minor known as subconcussive blows which may not be accompanied by any immediate adverse symptoms. serious psychological and emotional disorders have been

documented among former athletes who suffered repetitive brain trauma. researchers a number of times found evidence of the neurodegenerative disease cte when examining the brain tissue of dozens of deceased former nfl players. new imaging technologies have been able to show the metabolic changes in the brain associated with concussions and subconcussive blows. brain injuries in sports can occur in a wide variety of situations. and different athletes' brains may respond differently to an injury. sports related brain injury is a complex matter, requires addressing many interconnected issues. so when the title of this hearing suggests we take a multifaceted approach to improve sports safety, i could not agree more. first we need to have more neuroscience research, radiological and longitudinal research methods can lead to earlier and more accurate diagnosis, better understanding of the risk factors, and maybe better treatment options for brain injuries.

second, doctors league associations, coaches, parents, players, need to work together to establish health regulations, game rules and a sporting culture that reflects the seriousness of brain injury and put the athlete's health first. third, we must address the health and safety risks associated with the athletic equipment and pursue a better understanding of how this equipment might be improved. three years ago, congressman butterfield and i wrote to then chairman calling for hearings about inadequate testing standards, lax certifications and helmets. we'll touch on some of those issues today, but i believe those issues merit deeper considerations than they're likely to get at today's hearing and the subcommittee chairman

might consider holding a separate hearing on these matters. i think it's valuable that the national football league is testifying here today given recent and be ongoing disputes between the league and its players on this very topic. however i believe its players organization should also testify. unfortunately the late notification of the nfl testifying made it difficult for us to secure a players' witness. mr. chairman, today's hearing is important. i appreciate the subcommittee review of sports related brain injuries. and i look forward working together with all of us on this issue in the months ahead. thank you for holding the

hearing. look forward to the testimony of thwitnesses. yield back my time. >> still have a minute left if the gentleman from utah wanted to use it. >> i might just point out that moving physically and conditioning the body is not anywhere near dangerous as subjecting one's self to brain injuries. >> interesting, but the issue is we want kids to go out and play. we want them to join youth leagues. >> and we want sports. but we want to make it as safe as possible. >> absolutely. and this is one of those where jan and i both agreed was necessary. so this has been a bipartisan effort. so with that, let's move on to our witness panel. and i'm going to introduce the entire panel now and then we'll start with mr. daly. so we are blessed to have mr. william daley iii.

next to him, david ogrean. and then we have mr. jeff miller, player health and safety policy, national football league. thank you very much for being here. and then scott hallenbeck, executive director usa football. and then a face of a brain injury, multiple concussions within soccer, brianna scurry, former professional goalkeeper, u.s. women's national soccer team. in the next panel, we'll have ian, the other face of high school level concussions. with that, mr. daily, you are now recognized for your five minutes. >> i'd like to thank you for inviting me to testify regarding the proactive steps to keep hockey players safe. it's the only professional sport with no out of bounds, hockey is a physical game. at the nhl level, our players want to be physical and our fans

want to be physical. but importantly all constituent groups associated with the group also want it to be safe. this objective necessarily includes promoting safe and responsible play in our game and the national hockey league working together with the national hockey league players association has gone to elaborate lengths to do that and will continue to do so. we are pleased to have this opportunity to share with this subcommittee some of the measures enacted in this pursuit. national hockey league was the first to launch a league wide program to evaluate players after they incur head injuries. beginning in 1997, the nhlpa concussion program has required that all players on all clubs

undergo pre-season baseline neuropsychological testing. after diagnosis, he undergoes post testing and they're compared to determine when the player returns to neurological baseline. data collected and analyzed confirmed to us early on that neuropsychological testing results had added value and should be taken into account along with player reported symptoms. the committee has taken proactive steps to issue league wide protocols regarding the diagnosis, management and treatment of concussion. education regarding concussions importantly the issuance of

warnings to players related to the risks of returning to play before recovery is complete have been a core component of the nhlpa concussion program since its inception. education is provided regularly to all relevant constituencies in our league including players, club personnel and nhl on-ice officials. in addition to enforcing existing playing rules and more stringently penalizing dangerous contact, several new rules have been adopted to prohibit contact regarding a player's head. current rule prohibits any contact when the contact is otherwise avoidable and the head is the main point of contact. changes this season to adopt the hybrid icing rule and modification to rules regarding fighting have further enhanced

player safety. with respect to the fighting issue in particular, while it remain as small part of the game, its role is diminishing. through 75% of the 2013/2014 regular season, 60% have been free of fighting. in addition, the number of major penalties assessed for fighting is down 15% from last season and down 31% from the 2009/2010 season. in this important area, it would be the league's intention to raise, discuss and negotiate any potential rule changes directly with the players association. ultimate enforcement of the rules is in the hands of the department of player safety.

the first league department of its kind in professional sports. this department monitors every one of our 1230 regular season games plus all of our playoff games and assesses every hit, indeed every play to ensure the league standards for safety and responsible play are being adhered to. when the department determines that the standard has been violated, supplemental discipline is assessed. the cumulative effect of the effort has begun to change the positive of the game in a positive way. since the adoption of the mandatory helmet rule in 1979, the nhl has continued to impose a series of additional regulations regarding player equipment relating to player safety generally but also the head injuries more specifically, including most recently a rule adopted prior to the start of this season that mandated the use of face shields by all incoming players, the effect of which should reduce headed injuries generally in addition to providing enhanced protection for players eyes. the nhl also has participated in concussion initiatives that

stepped beyond the nhl including its representatives participation in each of the four international concussion and sport conferences between 2001 and 2012, its support of federal and state legislative initiatives regarding concussions and the league support and assistance in the development of concussion educational programs for youth and junior age hockey players. to summarize, while recognizing there is are considerable work to be done, the national hockey league has been and will remain absolutely committed to promoting the safety of our players. it's the right thing for our players and also our business and maximizing interests by fans and consumers. again i thank the chairman, ranking member and subcommittee members for your time and attention. >> mr. ogrean, you're recognized for your five minutes. >> thank you. it's a privilege to be with you today to discuss an issue that is the top priority every day at usa hockey and that is the safety of our participants both

on and off the ice. we've adopted well to a changing environment over time and we have two particular leaders we wish to thank. one is dr. mike stewart, our chief medical officer. the other is dr. alan asher, the chair of our safety and protective equipment committee. that committee has been in existence for 40 years. and it's an important group helping to guide our board in making its decisions. we have a risk management committee which is concerned with the safety of the play environment and surrounding area. and in 1999 in cooperation with u.s. figure skating, we began an organization called serving the american rinks, or star, which is an education organization for

ice facilities focusing on a variety of operational aspects including safety issues in rinks. in terms of the safety of our participants, we believe we can and do positively affect the landscape through three primary areas. education, rules and rules enforcement and risk management. education happens on and ongoing basis. we have very fortunately direct electronic communication with every single home, every player, every parent, every official, and every coach in our organization through our database. we are constantly in communication with them with educational bulletins and news. our coaches have a huge influence in providing a safe and responsible environment, and our coaching education program has long been heralded as the gold standard for coaching education. as congressman terry referenced, this last year -- excuse me, two seasons ago we added and online

module that contains critical safety information. officials obviously play a very important part in how our game is made safe, as well, and they receive regular education and are sent video clips and also access to our national reporting system which tracks penalties to help us understand and assess behavior trends. we annually mail posters to every ice facility in the country and over the years they have focused on topics including concussion prevention, concussion education, playing rules emphases and our heads up don't duck program to name a few. we have modified our rules to adapt on and ongoing basis. another recent modification in usa hockey came in june of 2011 when our board voted to change the allowable age for body checking in games from the pee wee or 11 and 12 age level up to

the group of 13 and 14. this was done despite many voices around the country in opposition to change which nobody seems to like, but research based on both athlete development and safety guided our board decision. it is worth noting hockey canada followed our lead. regarding equipment and its impact on safety, usa hockey took a significant step in 1978 when it called for the creation of the hockey equipment certification council. hecc's mission is to seek out, evaluate and select standards for hockey equipment it for the purpose of product certification. it's similar to what football uses in certifying its helmets. it's an independent body made up of attorneys, engineer, testers, sports people. it validates the manufacturer's

certification that the equipment they produce has been tested and meets the requirements of the most appropriate performance standards and it's been an important part of our safety story for 35 years. before closing, i'd like to share with you briefly our newest off ice safety program called u.s. hockey safe sport following the lead of the united states olympic committee. this is regarding policy on hazing and abuse of any kind. we were one of the first to require screening of all adults that have access to our youth participants. we follow up on 100% of calls we receive around the country of alleged abuse and our 34 affiliate associations each have ale volunteer safe sport coordinator are that helps us as boots on the ground. our sport has enjoyed tremendous growth in the last 25 years. more than doubling in the number

of youth players that we have. as we continue to provide opportunities for young people, we know in doing so, we have the responsibility to make our game as safe as possible and will only continue to grow if we're successful in doing so. thank you. >> thank you. mr. miller, you're recognized for your five minutes. >> appreciate the opportunity to testify this morning on behalf of the national football league on an shove great importance to the league and i commend the committee for taking up this issue. there is nothing more important to the nfl than the safety of our player. commissioner goodell has said he spends more time on the issue of safety than any other issue before him. there are nearly 6 million kids who play tackle or flag football

across our country. another 1.1 million that play in high school. 75,000 in college. and so whether it's touch games in our backyards at thanksgiving or games played in our local parks by our kids or friday night high school games, saturdays with college or hopefully plenty of people watching the nfl on sundays and mondays and occasionally thursdays, football plays a significant role in our lives and with it comes a great deal of responsibility. and that's one that we embrace. we understand that decisions that we make at our level affect football at all levels and probably far beyond that. and so i appreciate the opportunity to share the nfl's work with the subcommittee on the health and safety of our athletes. now, football has always evolved. the rules have always changed. and so i'd like to share with the subcommittee a few examples of that and the impact that's

had. it's only been a couple years ago that we changed the kickoff line moving it forward five yards. we did that because we can identified the kickoff and kickoff return as the single most dangerous play in our sport. so by moving it forward five yards, we decreased the number of concussions by 40%. in addition, for those of who you are fans, you've seen a greater emphasis on eliminating helmet to helmet hits. you've seen fines and suspensions and penalties as a result of that. and these are the sorts of things that we're looking to to change the culture. we've encouraged players to lower their target zones. we've he emphasized there are better ways to go about what they're doing. and we've seen the results. in the past year alone, the nfl has seen a decrease in the number of concussions at our level by 13%. decrease in helmet to helmet hits causing concussions has been down 23% in one year alone. now, that's not a victory.

that's a trend. and one that we find encouraging. but there is more work to be done as we begin to change the culture of the sport as it results to that. and we've added other protocols to our side line to take care of our players. there is one rule that governs us and that is that medical concerns will always trump competitive ones. we've added unaffiliated neuro trauma consultants never city to help the team physician identify concussions and treat players. we've added athletic trainers in sky boxes. make sure the player is attended to appropriately. and everyone is working off of the same playbook and those are based on internationally accepted medical guidelines. and we know as we change the culture of our sport we have an impact far beyond. i'll cite two examples. one is our support for usa football and all hear from mr. hallenbeck in a moment. their heads up program among other offerings are changing the game in our parks and communities afternoon the country literally as we speak. the popularity of these programs have been tremendous and the nfl is a proud supporter of usa football and proud of his work particularly. in addition, the nfl used as an inspiration a young child named zachary who was a 13-year-old youth football player in washington state several years ago who suffered catastrophic injuries playing the sport. he was returned to play too soon after suffering a concussion. zachary still struggles with the

challenges that come from that. his advocates were able to pass a youth concussion law in washington state which our commissioner said we will replicate in all 50 states around this country to make sure that all youth sports, not just football, are played more safely, that kids and their coaches are aware of the risks of concussion, that they are removed from play should it appear they suffer concussion and most importantly not return to play up a medical professional has cleared them. just this past month, we're proud to say that the 50th state passed that law and now the nfl isn't solely responsible for that work. but we're happy to lead. and let me mention we're proud to work with the cdc. we've invested tens of millions of dollars in research, $30 million with the nih. washington state several years ago who suffered catastrophic injuries playing the sport. he was returned to play too soon after suffering a concussion. zachary still struggles with the challenges that come from that. his advocates were able to pass a youth concussion law in washington state which our commissioner said we will replicate in all 50 states around this country to make sure that all youth sports, not just football, are played more safely, that kids and their

coaches are aware of the risks of concussion, that they are removed from play should it appear they suffer concussion and most importantly not return to play up a medical professional has cleared them. just this past month, we're proud to say that the 50th state passed that law and now the nfl isn't solely responsible for that work. but we're happy to lead. and let me mention we're proud to work with the cdc. we've invested tens of millions of dollars in research, $30 million with the nih. and the first $12 million of that has gone out to study chronic traumatic en encephalopathy. and we have a partnership to find better ways to protect against concussion in the first place. these are ongoing issues. so i apologize for exceeding my limit, but i appreciate the

final. >> at this time mr. hallenbeck, you are recognized for your five minutes. >> chairman, members, thank fought invitation to testify. usa football creates and directs programs and resources that important standards rooted in education. for youth and high school football. we stand with experts in medicine, child advocacy and sport who believe that education changes behavior for the better. this is precisely what we're seeing through our heads up football program, which is already benefitting more than 25% of youth football leagues across the country in its first 14 months, and we expect to double that this year. we advance safety through evidence-based studies by independent experts. we also lead fun and dynamic instructional football initiatives for young players as well as a national noncontact flag football program.

more on these and other aspects of our work resides in my written testimony. the remainder of my time will be showing a video of how heads up football high school pilot program is improving player safety within the fairfax county public school system, which earned high marks from parents, coaches, and administrators in its first season. you'll pay close attention to hearing from the athletic directors it and principals of this school on how the program is making a difference. >> head up! >> when coaches get to the high school level, i think they assume that everybody who plays knows how to play and they're going to be under friday night lights and everything is going to be great, just like it is on tv. and it's not like that. you're going to get kids that have never played before, and you're going to get coaches, really, that have never coached before. you really need to be able to teach coaches how to coach.

>> through the heads up program, what you do, three pillars, as they say. one, concussion awareness. two, how to truly properly fit equipment. finally, here's how we're teaching the ultimate aspect of contact in tackling. >> this is the basics and the fundamentals. the more i thought about it, the more i thought as an educator this was a curriculum for football. >> squeeze! sink and step. >> it was really a no brainer to get involved with usa football and the heads up program. >> they're actually learning how to keep their head up, not to lead with their helmet. they're taught that from the beginning. >> it's limited the amount of concussions we've had this year. basically because we have worked on heads up tackling from day one. >> squeeze! right foot. squeeze, feet, explode. there you go. head up. eyes up. >> the coaches have completely

bought in and endorsed what we're doing. >> come on. get those elbows tight and high. >> what we really didn't anticipate was how aggressive that the coaches association here in virginia went after it, saw the need to make the game better and safer, and they ran with it. >> heads and eyes up. >> the days of popping the old smelling salt or the ammonia tabs are gone. and that's a good thing. >> heads up football has allowed concussions to become a topic of conversation in a positive way. >> i just think it's standardized everything. it becomes a much more consistent way of teaching the game. >> this kind of instruction keeps my staff in line. >> they're seeing a very distinct improvement and reduction in injury. and i think that says a lot about the program.

>> what this has really done, because we're hands on with the parents now, we're showing them how the progression goes. we're teaching them the terminology as well. it brings a level of comfort to them. >> i think it's really good that all the coaches are learning proper techniques on how to teach these kids to do it right. >> i'm so relieved that they're teaching these kids at such a young age. i was never taught that. >> in our family room, he'll demonstrate on his dad, not his mom, the techniques he's learning. >> his coaches not only employ the technique, they keep after the kids and make sure they're doing things correctly, and it shows me they really care about the kids. i'm not worried about whether he's going to get hurt on the field because i know that his safety is just as important to them as it is to me. >> our partnership with usa football is frankly a vital piece, not only of our football program, but of our athletic program in fairfax county. it's opened the door because now our lacrosse programs are talking about. everybody is talking, what are we going to do overall in a very positive light? >> we agree with the mission of usa football. that is to allow our students to participate in competitive athletics and learn so many wonderful life skills from that

experience, but to do it in a way that's healthy. >> i can truly look at a parent who has those questions and say, here's what we've done. here's what heads up football has brought to fairfax county public schools and what we've brought to heads up football. >> it's an awesome, awesome opportunity for coaches and parents and kids and officials and everybody to get on the same page to help kids. >> if you're an administrator at a high school, you're being asked the question, how are you making our program safer? what are you doing for my kids? we can answer that now. >> thank you. now, brianna scurry, appreciate you being here. you are recognized for five minutes. >> thank you very much. yes, my name is briana scurry and i'm 42 years old. i served as the starting goalkeeper for the united states women's national soccer team

from the years 1994 to 2008. during that time, i helped lead the team in winning two olympic gold medals in 1996 atlanta games and 2004 athens and played 173 international games over 15 years for the united states, which is a record among female goalkeepers. in the summer of 1999, my 20 amazing teammates and i captured the hearts of america by beating china in a penalty kick shootout live in front of 90,000 screaming fans at the rose bowl in pasadena, california. i was the one that made the single save during the penalty kicks before brandi chastain took off her shirt. yes. now, i'll bet many of you recall exactly where you were at that moment. it was the kind of event that transforms lives forever for the better. my passion and my mission was soccer. my ultimate reward was living my dreams and inspiring the dreams of countless others. today i'm here before you to

share my new mission with you. my new mission is to provide a new face and voice to those who have had and may suffer the long and difficult recovery of a devastating, traumatic brain injury, concussion. my life story reads like a script from oprah winfrey's "where are they now." like many of oprah's guests, i, too, have been lost in deep, dark places with my face in the dirt and have only recently begun to claw my way back to my life. on april 25th, 2010, my life changed forever. during that day i played a women's professional game against the philadelphia independence in philadelphia. in that game, i suffered a traumatic brain injury that abruptly ended my beloved soccer career. that was nearly four years ago.

i struggled with intense, piercing headaches that were so bad that by the evening it was all i could do not to cry myself to sleep. i had to take naps on a daily basis just because my sleep was so disrupted. i couldn't concentrate, and i was very moody. i felt completely disconnected from everything and everyone. i was anxious and depressed every day, and i wondered if i'd ever get better. i recently moved to d.c. to have bilateral occipital nerve surgery at georgetown to eliminate severe headaches that plague me daily. fortunately for me, the surgery appears to have worked. however, i'm still being treated for symptoms such as lack of concentration, balance issues, memory loss, anxiety, and depression. i've purposely and intentionally had my concussion recovery story

documented by media outlets such as the "usa today," "the washington post," and brainline.org in order to bring attention and a ray of hope to those suffering from tbi like me. in september i was alarmed to learn that the number of reported cases of concussion in soccer was second highest in the united states with only american football having more cases. additionally, a recent article published in november stated that one of two female youth soccer players will suffer a concussion while playing. i feel the numbers of reported cases are likely understated and didn't designate those who suffered multiple concussions like i have. statistics like these have solidified my urgency of purpose

to shed light on the high frequency of concussions in youth and the devastating emotional toll that prolongs symptoms often caused yet are too frequently dismissed. i sincerely hope that my presence here today will inspire increased awareness, understanding, and assistance to help the thousands of young tbi sufferers across this country. i thank you all for allowing me to give testimony. i am grateful and humbled to have been invited to do so. thank you. >> thank you very much. and that was powerful. so this is our opportunity now. each of us have five minutes to ask you questions. so ms. scurry, let me ask you this one. i, too, was shocked to learn that soccer had the second most concussions, which is a really dominant youth sport. are you seeing changes within soccer?

and unlike there's an obvious top-to-bottom connection that we heard from the nhl and the nfl, is anything like that occurring in soccer? occurring in soccer? >> thank you for the question. i too was very surprised to read that statistic. it is so high in part because the explosion of players that are playing soccer now in the last years. i'm not finding that soccer ple completely grasped the situation. part of the reason i'm here today is to shed light that soccer too should be instrumenting different protocol like nhl and nfl are and the governing body for soccer, u.s. soccer will start to understand that our great sport is in

danger of having too many head injuries and that something does need to be done about it and something needs to be instrumented. >> thank you and i think your assessment of the game that you played in winning that. cha yonship ov championship. it was a great game. now, to mr. miller and nfl has taken i think seriously undertaken an effort to get the return to play guidelines adopted at all state levels. can you tell us more about what the guidelines are and how they are developed? >> sure. and thank you for the question. the law that is the model that was passed in washington state contained three primary elements, the first of which is

that parents and their kids would have to sign off on the risks and signs and symptoms before they were allowed to participate. the second is that a child who appeared to have suffered a head injury must be removed from play immediately. in other words the coaches were asked conservatively. finally that a licensed medical provider who has a training in concussion his to return every child to play. that was done in large part to eliminate the danger that zachary faced when he played too soon. all these laws are new. i know academics are studying them to see success, but as one anecdote that had the first one, in the years after the law was passed, they didn't see a single brain injury, blood on the brain of any football player in the state of washington. they had normally seen three or four on an annual basis and

those were e limitit nated. i commend the states that were making the laws more strict. they need to be expanded to the youth level. many are high school only. they need to be expanded to recreational spaces. and there is more that can be done. there those that are doing that and we are happy to work with those. >> thank you. >> have you seen a demonstratable reduction of head injuries in usa hockey after implementing new techniques? >> we don't have the same statistic for that. >> excuse me. we don't have the same statistic statistical data they they invested in. we are talking to the same company to do that sort of thing. we have any concussions are too

many. as we focused on research, education and rules enforcement. the statement was made regarding the culture of certain sports and obviously we know that a lot of sports at the youth level suffer from misplaced attitude. a lot of coaches think they are playing at the professional level. they are not. changing that is very, very important. we have been very, very strict about return to play rules. as you phrased, scott, that i appreciate very much, when in doubt, sit them out. i think when you are talking about a grass roots sport in our case, we have got 350,000 youth players and 2500 programs and that equates to about 25,000 teams. one of the big challenges is quality control. you can't get everyone to think the same way. we do know i think because of our emphasis on preventing head

injuries and what to do with them and how to recognize and treat them and how to respond and making sure the return to play decision is a medical decision and not a coach's decision. the number is dropping. >> great. my time is over. so the ranking member, you are recognized for your five minutes. >> my granddaughter has played ayso soccer since the first time that she could, now she is on a traveling team in high school. she is 16. i'm very concerned about what you are saying. even more concerned now that soccer seems to lag behind other sports. there has been studies that have compared the rates of reported concussions for male and female athletes that tend to show that female athletes have a higher rate of reported concussions than male athletes in the same

sport. what would you say that we need to do immediately? i really do worry about her now. and what could happen. what would your advice be to female soccer players and those who coach and treat them? >> i too find that stativity iblg very alarming. i think one of the things that needs to occur with soccer is officials and referees and coaches need to take their head out of the sand and realize it is something plaguing our sport as well. the video played earlier was fantastic and an example of where to start. you start with the coaches. teach the coaches the proper way to teach the players how to head. do certain drills that make sure the coaches know how to teach it

instead of letting the players let the ball hit them and instead teach them how to head the ball. improve the strength of the neck muscles. for females it's part of the issues. they are not as strong as the male counterparts. that needs to occur and there needs to be an understanding anda an education of what you are looking for when a head injury does occur. >> let me ask you a question. i don't know if soccer is the only sport where you use the head. is that an inherent problem? >> i don't necessarily think it's an inherent problem, but that scenario when there is a ball in the air, you are going to head, there is something highly probable that can happen. you will have injuries no matter what you do. certain things happen during a

heading is not the only time when concussions occur. mine in particular happened when i was playing in the goal going for a low ball from my left. the player came in from the right and hit me on the side of my head with her knee. that has nothing to do with heading at all. head to knee, head to foot, head to post is not part of that. >> i would love to get your advice on anything i could do outside of this body for my granddaughter. i wanted to ask you a question. retired nfl players face the biggest health challenges and benefits for former players are not on a par with major league baseball or national basketball association despite the fact that the nfl has more than $9 billion in annual revenue.

yes or no, does the nfl provide lifetime health insurance for player who is did not play under the current bargaining agreement? >> no. the players are able to continue their medical coverage when they leave the game, but they are not provided lifetime medical coverage. in the most recent bargaining agreement, there were in excess of $600 million who played pre1993 and added pensions and benefits. all of our programs are collectively bargained and i think during each iteration of our collective bargaining, you are seeing changes made to the programs for retired players, including this year, for example, this past one for example, a neurocognitive screening program. >> i understand that, but professional baseball and basketball do provide lifetime health insurance for former players and i understand the

plan. what could be the reason to not provide lifetime health insurance for former players? >> all of our players and benefits are bargained with the player's association. the improvements we have seen as far as care for players, whether it's the flan accounts for any player suffers from a diagnosis of dementia and joint and hip replacements, all those are improvements and made available for players. should they suffer from the issues. in addition a number of other practices and programs including help lines and the player care foundation and the association has player who is are in need at little or no cost. those programs exist today. >> mr. lands, you are recognized for five minutes. >> the changes you made in recent years, the rules change

and the increased penalties and suspensions for rule violations and reducing practice days. can you share with the committee data that you have that this i hope had a positive impact on concussion incidents that might encourage leaders at other levels of football. >> absolutely. we are happy to share with the committee greater information than i can offer. the most interesting number is when you count up the number, all of the concussions that were diagnosed in games and practices, preseason and preseason practices and postseason and postseason practices. you see a 13% decrease year over year. >> 13% between 2012 and 2013. >> very good. >> the emphasis is on eliminating the use of the head in the game. helmet to helmet hits. a cause of the injury. in those circumstances were two el mets colliding.

we have seen a decrease in the number of concussions by that cause by 23% in the past year. there is a lot more work to be done and the numbers could change year over year. i'm happy to go into it further. >> this is helpful and i hope that the improvements continue. mr. hollenbeck, i believe your testimony indicated that 15 high schools in 10 districts participated and you are anticipating 500 to 1,000 will participate this fall. i would imagine high school football is the football that most of us have experienced either through ourselves or through a child, in my case, a son. what are your plans for getting

more programs to participate and what does the outreach entail and how do schools learn about your program? the purpose of this hearing is multifacetted and one i would hope is to inform high schools across the country about your program as the video occurs in northern virginia. >> one of the common themes is inconsistency. football even at the high school level have significant challenges. what we are striving for is consistent teaching of technique and teaching of terminology. does and now getting out to the independent and high school programs, the good news is they are being responsive. if it's the superintendents or

athletic directors, they are being asked what are you doing about this? >> you are doing the asking or the parents and ptas? >> it's a combination. we are talking to high school state associations and coaches and directly to coaches. we are working with athletic directors and parent groups. national ptas rfl involved. we have every conceivable channel to communicate the experience of changing behavior. i'm sharing that there has been a positive response. that video by itself and the reason i decided to show it has been influential. in addition, we now have the big 10 and the pac 12 and the big 12 and the acc. we will eventually have the ncaa and all college conferences involved. every one of the coaches will be involved with the psa and things that help influence high school coaches and programs to embrace the heads of football program and change behavior. >> thank you. let me say if there is one

message i wish to leave this morning in my minutes of questioning, that i would hope that all of those involved at your level of football would examine what you are suggesting because after all, that touches virtually all of the american people. i commend the panel for its testimony. thank you. >> thank you, mr. lance. i editorialize we have nhl, youth hockey. nhl youth football. it seems that it trickles down. whatever set at the top, it gets pushed down to the youth. that was by design. the gentlemen from utah is recognized for five minutes. >> thank you. i first want to echo something that mr. waxman said. it may sound obvious, but this is a complicated issue. there is a lot of complexities and a lot we don't know about.

brain science. i think we all could agree that the notion that this is an issue that merits significant investment and research is something that is beyond even concussions in sports. we have traumatic brain injury in terms of soldiers in the field. this is an issue that is complicated and we want to approach it in a thoughtful and comprehensive way. thank you for scheduling this hearing today. mr. miller, without taking too long, can you walk us through the steps as information and research has brought more knowledge to the nfl. how is the league responding and how have you positioned yourself on the issues to address the issues of concussions and just to give walks through the history of how it evolved within the organization. >> happy to do it and thank you for the question. i think that the point that you

made that the science has evolved on neurological issues and neurogen rative disease is one that the second panel has a terrific expert lineup can talk to you. we rely on the outside advice of very well-known, well respected and international low known scientists to advise us to the state of the scientist and how best to go without changing our game to reflect that. that's creating a unified concussion protocol and return to play for our sideline. that's how we ended up with experts on the sideline. this is based on the advice of sideliners who say this is the best way to handle the players and treat the game. this is what you would do and we follow their advice strictly and meet with them frequently. >> your title as senior vice president of health and safety policy, is that positioned -- that has to be a position that didn't exist 20 years ago.

this is an exciting one. >> i then hearing on concussions, i have to ask one other question that may be a different topic. i communicated with the nfl about concerns about the issues of hume on growth hormone testing and something that was raised in the effort and an agreement later. can you give us an update on the human growth hormone? >> we don't have the testing yet. the league has been ready, able, and willing to pursue it since it was agreed upon. unfortunately the player's association has thrown up obstacles probably fair to say from our perspective, excuses for a period of time. >> the testing goes to the integrity of the game and the health and safety. sport. you don't know where this is coming from. who is giving it to a player or

players and you don't know what they put in their bodies. that's dangerous and the wrong example to set. sorry has not gotten accomplished yet. >> that's not this topic. since he was here, i had to ask the question. >> i think that's why we wanted the player's association here too. that was a strong criticism that you made. you had the players laz to respond. >> i will have to interject. they were asked and they declined. they were contacted before yesterday. they still requested it. where are these things doing? where do you see things going to the next five, 10, 20 years in terms of where technology will

take us? >> as part of the research with ge, the world's leader in diagnostics, we set aside the challenges to $10 million pots of money. we had people from 27 different countries offering ideas. we awarded 16 of them. in addition, we completed another challenge that protects the brain better. we had 40,000 people from 110 countries around the world visit the website. people offered ideas on new equipment. we are reviewing those now. i think that because there is a lot more attention fight this. hopefully we are one of the actors that are cat lidsing the science that you see changes in all of the places.

relatively soon. >> appreciate that. my time is up and i will yield back. >> the gentlemen from kentucky is here for five minutes. >> that quite honestly might be the only soccer game i watched from top to finish. my daughter was interested in soccer. >> no pun intended with the talk. >> no pun intended. that went over my head. i'm sorry. what a great sporting event and one of the great moments and the big part of that is something special. i think it was special because it was the underdogs or the great and determined. you brought up and not eye, maybe a little exuberance. it was a great moment and i appreciate you sharing. i played high school football. that's my claim to athletic

prowess, i guess. we practiced football in august one time in the south, 90 something degrees and we are running water breaks and some smart alex kicks another guy's foot and knocks the water over. the coach said if you guys don't know how to handle that, we won't have water today. that was over 30 years ago. that would never happen anywhere today. there was in louisville a young man who passed away on a football field and the coach went to trial over it. it turned out he was not convicted, but i think the awareness and stuff like i described in my youth would never happen anywhere today. i hope it wouldn't. you talked about your injury being not a change in tactics, but you are wearing cleats and short pants and a shirt and somebody hit you with their knee.

when you look at you have targeting and if you are in college football, you are ejected from the game. a lot of the injuries that you see with the quarterback gets knocked down and their knee hits them on the side of the head. i don't know how you change those and deal with that, but you are trying to do the connection neeks and not heading the ball in the right way. you are playing a sport or going 100 miles an hour, do you have comments on that? >> thanks for the question. that is relevant because my hit when i watched it last night from video, it doesn't seem to be a hit that would take me out of the game. i got hit & there wasn't even a foul called actually.

that's part of the problem. it doesn't seem to be anything that is a big deal, but my main focus is what is done after the hit occurs. to keep children and young players off the pitch after a blow occurs to assess them. that will return to play or not. that is the key for me and why i am speaking out about this. i have been around the country talking to organizations and i'm finding that kids are getting concussions, five, six six, seven because they are returning to play too soon. that's where the awareness and education can help. >> you should do everything you can to stop the head to head.

that's like john runnion hits the side. it's incidental, but you are right. you can't prevent and is that right? >> i think that's right. they are in the conference in zurich. to look at the playing rules of the game. in our case we have done that and others have as well. you create the best possible situation. there will be hits to the head and those problems occur. that's where it shifts to the appropriate treatment. >> i'm about out of time. i was leaning and moving as they were shooting against you and hopefully you felt my assistance and you were able to help us both together win one for the team. >> absolutely. >> i yield back.

good job and i'm glad to meet you. >> thank you. the gentlemen from maryland is recognized for five minutes. >> thank you, mr. chairman and thanks for the hearing and thanks to our panel. you have to talk about whether the school districts you have been working with that have been implementing this. has that affected the liability policies that they maintain as a jurisdiction? in other words, is there any trend towards that may be getting pushed towards the insurance industry? they say previously i would have provided liability coverage to your school district. these measures or assurances that the district made with respect to how it is conducting the sports program.

there is this program that enhances the safety of students and young people. we want to see that you implemented that in your district or else we will not provide the coverage or charge you a higher premium. you can look at it the other way. you get a discount off of your premium as a school district because you implemented these kinds of measures and i ask that because i think that increased awareness of some of the risks from the sports injuries may lead to pressure you will get some that may choose based on the premium that gets charged to

push the program out. because they don't want the liability that comes with it. i was curious whether your program has -- whether you are aware of that kind of effect from the program or more generally aware of how the liability concerns intersect with some of these safety efforts that are under way. >> thank you for the question. at the high school level, we are literally on the front one-yard line marching down the field. i will mention thatty woor having positive conversations with the state of maryland about participating in football across the state. so we have a lot to do there. we have not seen anything from that concern with fairfax county working closely with the schools and the districts about those issues. they told us and we checked ourselves, they felt we had the appropriate coverage. to your point at the youth level, we are absolutely seeing

insurance at large and really the largest provider of casualty and liability insurance step forward and actually stated that if youth football leagues participate in the heads of the program, they would receive a discounted program and a more comprehensive coverage. we are absolutely seeing a positive response by the insurance industry which has its merits. >> thank you, i yield back. >> do you have -- is there insurance liabilities at usa hockey? >> yes, mr. shareman. plenty of insurance liabilities that unlike usa football which is much more decentralized than are we, ours are insured by us as a national organization. whether it's player accident insurance or catastrophic or liability and even dno for the leagues, all of that is part of what our members pay us a

membership fee for. those claims or those premiums are based upon the number of claims. that's a reason why they came up with every every tecniques and policy. that's the safety of the reasons for us to want to make the game safer. >> i appreciate the important insights on the prevalence of concussions in sports. according to the cdc, 175,000 concussions impact youth

athletes a year and today's hearing has been constructively in helping us understand and alleviate that. i read much about the action taken across the united states to pass concussion laws. in my state of illinois, similar legislation was passed to require that education boards throughout the state work with the illinois high school association to adopt guidelines that raise awareness of symptoms and ensure students receive treatment before returning to the team. it's encouraging that the sports leagues are taking steps to address concussions not only in their own ranks, but working with leagues to bring attention to the issue. last year the chicago bears kicked off a pilot program to provide athletic trainers at three stadiums during the football games. such high profile initiatives are important to combatting this issue. a applaud them for leadership. i find the steps to be promising and we are confronting the

staggering numbers of youths. i would like to ask a few questions, maybe not take all five minutes. let's talk about the equipment issue. where are we at in terms of the equipment being utilized to protect. what advances were on the cusp of making or that we should make. is it backed by medical science? is it going into this idea? i will start with you and whatever you want to put into the subject will be great. >> thank you for the question. it's a very important issue obviously. the equipment issue is very important and something we are focused on jointly with our players's association. we have a protective equipment subcommittee that is part of the joint health and safety committee. we look at all aspects of

equipment and how they can particularly as it relates to head injuries, how we can improve equipment and perhaps reduce the amount of head injuries we have. we passed rules overtime with respect to some of the equipment we had seen develop over the years both in the shoulder and elbow area and those causing head injuries. we mandated padding over those areas of players equipment. the helmet issue is a difficult issue particularly in hockey in terms of preventing concussion. one of the things we are looking to look at manufacturers on is research in terms of dealing with the rotational forces that can cause concussions in a sport like hockey. whether a helmet can be designed to deal with those more effectively than it currently does.

>> he answered the question pretty well for our sport. >> as i mentioned, we have a safety committee of 40 years standing and they look at a variety of issues. the face mask is mapped tori. it is not in the national hockey league. the shields for incoming players are a standard. >> i will have to cut you off because of the time. >> football helmets were designed against skull fractures and they do a fabulous job of that. they were not designed to protect against concussions. we are not there yet. the league is doing what it can to insnir with the partnership and under armor to get new ideas around that. we do regular testing in concert with the friends in the player's

association. >> i would trickle down effect is important here. i am working with the sport and fitness association and the football council. we are getting insight and working on how to improve things. >> thanks. >> as you know, we don't wear equipment in the sport, but i want to commend your state for the illinois use association association that is taking a real lead in concussion awareness. i did an event last weekend for the association in talking about concussions. your organization is doing a great job. in terms of equipment for my sport, we don't really have anything right now that is widely used. hopefully in the future there can be something to help. >> great. i yield back. >> the gentlemen from west virginia is recognized for minutes. >> i had to slip out for another meeting and maybe these

questions have been asked. can you help me out on this? is there anything that we can learn from the defense department with concussion injuries that we are hearing from when we talked to the troops that come back. i wonder if there was a way to get help out of that. >> if there was something we fostered and a memorandum of understanding that went back a couple of years, that covers a variety of different things. we have gotten current and retired players together with returning active service members about the military that makes it difficult for somebody to remove themselves from play or certainly in the case of the military from the battle. we found a great deal on behalf of both populations to remove themselves from comrades or

teammates and instills a question as to how to tell their teammate or colleague, you don't look right. you should get off the field. we mead regularly to talk about the scientific perspective. we share our gender and ideas we have. they do with us as well. it's proven to be cooperative and beneficial. >> the other -- anyone else want to add to that? the second question has to do with states have workers. they deal with the various disorders and injuries. from my state, it is treated in a way that people don't have to take legal action to get help through the workers comp program. is that something that would be a benefit here in this program

for injuries? a friend of mine spent quite a few years in litigation with the nfl over this matter. is there a time we shoulda a worker's comp program for brain injuries? should that be included? they are not required to follow litigation to get help. >> if i made my case, it is worker's comp. i have gone through to get the different doctors and see different techniques that will help me. that is part of the reason why it's taken so long.

every time something is suggested or recommended, i have to go back to insurance companies to get permission and it takes a hearing to get everything moved forward. maybe stream lining that would be of great help. you talked about how can we help the military service people who have tbis? for me, one of the best things i think would help. more of the psychological side and testing depression and anxiety and panic attacks to make sure that each person gets help in that area, the emotional side and not just the physical. that would be helpful. >> thank you. any other thoughts? >> workers's compensation laws are different. jurisdiction by jurisdiction including us from canada. professional athletes are excluded from most worker's compensation laws.

it's certainly a mechanism of our former athletes that they are using in cases where they had debilitating injuries from their playing careers. >> would you -- what was your recommendation? you are saying yes? >> what i would say is i think it's generally available to our former athletes currently. the worker's compensation protection. >> i guess maybe some of what we are hearing is different from that. i want to raise it. thank you for your comment about that. i yield back. >> from florida, you were recognized for five minutes. >> thank you very much for holding this very important hearing. i wanted to thank her for speaking out. i appreciate it. ittic mas a difference and thanks if are your sacrifices.

you will make a real difference in kids's lives. i also want to get back to the protective gear, the helmets and what have you. how does the youth and we can ask all of you, how does the youth, the protective gear compare as far as safety, quality, to the nfl and nhl. can you give me an opinion on that? >> so i am certainly no expert on how that compares. my understanding is all of them have to pass that standard. how it compares to the nfl, but the padding and so forth is appropriate. i know it's sufficient based on

standards and so forth, but many of the kids though, the players by 10 and 11 and 12 years old, they are transitioning into high school or adult helmets. they are getting the best available. certainly i am aware that the technology is improving in helmets and shoulder pads and equipment. definitely improving. >> we worked on a program with the consumer product safety commission and others that we would put money towards reconditioning for yeeth leagues that have budget constraints as many do. we put a fair amount of money into that program in coordination with the cps and usa football runs a program as well. addressing those needs, we know a new helmet is better than an old. a reconditioned is better than

one that hasn't been. most importantly coaches learn how to fit the helmets. that will be the number one piece as it relates to kids. we are aware of the issues and try to make a difference there as well. >> in your opinion, the youth helmet or the high school is not as safe, but you have a program to help. is that correct? >> i don't know about that. i don't know about the safety of the helmets. that's a question -- >> can i talk to you about this program? i know that kids play high school football and the parent will purchase a better quality helmet for the child and concerned about the kids that don't have the money. i would appreciate working with you on this. there is an existing program out there, i would like to hear

about it. can i hear from the hockey as well? i think they are just as good. there is a three-year expiration date on every helmet. >> i would first echo the comments that helmets in our sport as well are designed to prevent skull fractures. sometimes they can dispurse in a way that prevents the concussion, but that's not the purpose. we have regulations and expect the replacing of helmets. each player is essentially asked on replace his home helmet at least once a season and the road

team at least two times a season. we are worried about effects and degradation that accompanies travel requirements for the team. frequent replacement is important for our league as well. >> the coaches educate and do they know which size fits the child? youth sports and hockey and football. >> they are. i agree with mr. miller. it is a -- it's a big difference maker in the helmet doing its job, but it's a fundamental part of what a coach has to do to make sure the players have the proper equipment and wear it in the right way. >> i would add that that is a cornerstone.

and they are looked up to by our children. do you have program that speak and maybe go to the schools and the football players that have professional to speak on the issues? >> one of the ailments that we included were offered up and was actually and they would get visits with a retired nfl player. we are trying to encourage them and they have done a terrific job of embracing the youth leagues and others so that they are around the facility more that they exact with coaches and trainers and certainly players.

that brings attention to that, but we have found our retired players thrilled to participate and helpful to the end. >> the gentlemen's time has expired. if any of you want to answer that question, you will have to do it by writing. it brings me to the point that -- you have a question. i'm sorry. i recognize the gentle lady. >> thank you, mr. chairman. i'm sorry i was late. i was at another hearing downstairs. mr. miller, i would like to ask this question. many tens of thousands of helmets are used that are more than ten years old. i understand that the nfl participated in a program initiated by the consumer product safety commission by donating to new helmets for pray players in low income communities. i want to commend them for this initiative. it will cost a lot more to get

to the point where all kids around the country who play football no longer wear old helmets that are likely degraded and obsolete. i am pleased about this because it strikes me as acknowledgement that wearing an old el met is not advisable. we heard that reconditioning those under years old is important to ensure the proper density and other graded parts are relaced. i wanted to ask you the following questions for a yes or no answer. i guess that's why i'm in chairman dingle's seat. can they support to prohibiting helmets over years old? >> in the use space? youth football older than ten

years now? >> i plead not enough familiarity with the issue. a couple of states will be happy to work with you to pursue it. the prime place as you mentioned that we work with in promoting new or refurbished helmets or through usa football as well. >> the first is prohibiting helmets on a field over ten years old. can you commit to policy position that helmets over ten years old present an unacceptable safety risk? that is the position taken by most of the industry. >> i see no reason why we have concern with that. that sounds appropriate. >> i strongly recommend their helmet should be discarded after ten years. can they recommend that helmets be discarded after ten years? >> we would support helmet

companies and how easy people to use the products? >> we heard players using beat up lucky college helmets or adjusting them by removing padding. will the nfl support a pps position that all players should wear helmets that are reconditioned properly? >> all of our players have choices in which they use as long as they pass and they have to pass the standard. >> they work with the players to make sure their helmets are in good working order.

>> medical research and fizz igices. physics when the doctor arrives. so panel 2, i will introduce you from mr. cleland on down. the division of seazing practices at the federal straight mission am we have ian

heaton, student ambassador for the national council on youth sports safety. if i might editorialize, i think sdwran a great job of juxtaposing a tbi and ian as a high school across the player is the face for the more specific based panel. thank you for taking your day away from school. i know how tough it is to be pulled out of school and come testify before congress just like a normal high school student. dr. robert graham in nuth at the institutes of medicine. at the famed university of

nebraska. dr. james johnston, the department of neurosurgery at the university of alabama, birmingham, star of screen. dr. tim gay, ph.d., professor of molecular and optical physic at the university of nebraska. ph.d. division of chief neuropsychology children's medical report. and not quite up to the level, we have the harvard medical school. professor of industry and radiology at brigham and women's hospital harvard medical school. thank you for a very impressive

and esteemed panel of scientists and experts. you are recognized for your five minutes. >> the green light is on. i'm assistant director if the the federal trade commission's bureau of protection. i'm pleased to have the opportunity to provide information about the actions we have taken over the past few years with respect to concussion protection claims that implicate serious concerns especially affecting children and young adults are always a high priority at the commission. the commission strives to protect consumers using a variety of means. first and foremost they enforce section five of the federal trade commission act that prohibits deceptive and unfair

acts or practices. interpreting section five, they determined that a representation omission or practice is deceptive if it's likely to mislead a consumer acting reasonably under the success circumstances and cereal that it is likely to affect the consumer's conduct or choice decision about a kk product at issue. it does not test products for safety and efficacy. all objective claims conveyed in an ad. they examine facts of the case to determine the type of evidence that will be sufficient to support the claim. when it involves health does not claim. the scientist evidence substantiating the claim. as the awareness has grown, they have begun making concussion claims for an increasing away of

products that include football helmets and mouth guards and other types of products. the decision announced a settlement with the makers of brain pad mouth guards and the commission's complaint alleged that brain pad lacked a renal basis that the mouth yards reduced the risk of concussions caused by lower jaw impacts and claimed that specific evidence proved that the mouth guards did so. the final order prohibits brain pad that any mouth guard or equipment designed to protect the brain from injury will reduce the risk of concussions unless it is true and substantiated by scientific evidence. the commission sent out warning letters to nearly 20 other manufacturers of sports equipment advising them of the brain pad settlement and warning them that they might be making deceptive claims about their

products. they have monitored the websites and working with them as necessary to motify their claims and in some cases ensure that the necessary disclosures and the staff continues it sur shay the market place and alert seazers who are making proper attic claims and the need for appropriate substandiation for such claims. the mission staff investigated concussion reduke made by three major manufacturers of football helmets. ? these matters, the staff determined to close the investigations without taking formal action by which time all three companies disconditioned the claims or agreed to do so. those are discussed in the commission's written testimony.

the commission lands to continue monitoring the market for products to ensure that advertisers do not mislead about the product's capabilities or the science under loiing them. at the same time we are mindful of the need to tread carefully. as to avoid inadvertently chilling research or immeading the development of new technologies and products that provide concussion protection. the commission appreciates the committee's interest this this very important area as well as the opportunity to discuss our agency's effort to ensure that the information being provided to consumers and in particular to the parents of young athletes is truthful and not misleading. thank you. >> thank you. now you are now recognized for your five minutes. >> chairman terry, ranking member and members of the subcommittee. thank you if are this opportunity to share today.

i'm here as a student ambassador for the national council on youth forts safety. i'm a senior in bethesda, maryland. i was a sor more playing in a la cross game when i sustained a serious head injury that we discovered was my third concussion. i did not appreciate what a great life i was living. i got good grades in challenging classes and working on my black bet and had a job i loved teaching tae kwon do and performed at the jazz ensemble and had an active social life. it was over in a commit second. my concussion left me with 5% of normal cognitive activity and i was almost immobilized. i spent 2 1/2 years recovering and wondered if i would ever get that life back. it has been a long, slow process. at first all i wanted to do was sleep. noise, light, and even moving my eyes caused headaches and

nausea. i was enrolled in the children's hospital score program that the doctor will describe later. i received ongoing cognitive evaluation and treatment for symptoms. after missing school after missing school for two weeks, i tried to go back but was unable to function. the frustration of trying to focus on lectures, moving through the pandemonium of the halls and constant sensory bombardment made a normal school day impossible. however, through my school i eventually enrolled in a home teaching program. with the help of tutors and family, was able to complete my semester course work at my own pace. i finally returned to school in december but was still far from recovered. i have spent the 2 1/2 years since my concussion slowly regaining organizational skills, the ability to learn and retain information and, most important, my personality. during this time, my friends and family learned to recognize the signs that meant i needed to

shut down from any kind of mental or physical activity for a day or two. these relapses were particularly tough and discouraging and meant that i had to drop a class, miss a band trip to chicago, among other things. the worst was when i had a crash and could not go to my first concert, the red hot chili peppers. the friend i gave my ticket to really owes me. the spring after my injury, i was medically cleared to return to sports but made the hard decision that i would not play lacrosse or other intensive sports again. i know that a lot of people recover and return to play, but the possibility of another concussion means i could lose everything again just like that and not come back the next time. i now look at my recovery as something that has made me stronger, but i know that i'm one of the very lucky ones that had the resources and medical attention i needed and a school system that is aware of concussion issues and provided an unusually high level of support. it is not over yet. my recovery continues. but my outlook is positive and i'm excited about the future as

i prepare for college. i'm thinking about becoming a high school math or science teacher. i now have a hard question. what can be done to create a safer sports environment and to ensure that when injuries do occur, the support for full recovery is available? we can't just do away with youth sports. i played baseball, travel soccer and league and high school lacrosse. and being on those teams not only gave me a healthy outlet but taught me important lessons. sports are one of the best parts of growing up and becoming a strong adult. they teach us that if we work hard, we'll become skilled and proud of our accomplishments. they teach us how to be part of a team, to have pride and success and learn the lessons of defeat. they teach us that sometimes we have to quit thinking of ourselves and think of the good of the team. for these and many other reasons, i hope that steps can be taken so that future young athletes have these opportunities. there are two important things i

think would make a big difference. the first is to change the cultures of hitting hard to take out a good opponent rather than playing to win through skill and brushing off injuries to get back into the game. while better equipment may decrease injuries, it is coaches, parents and players who have to back away from the need to win at all costs, or fear the losing status on the team to be out for an injury to be willing to recover fully before returning to play. it will take a while. if youth and professional sports are to survive, these attitudes must be embraced. second, when injuries do occur, we must have a way for qualified personnel to quickly assess injuries on the field, have players get immediate attention, and then support recovery through schools and medical institutions. these are the things that were

done for me and are the reason i've been able to return to normal. as a student ambassador for ncyss, the message i hope to give young athletes are this. you think you're invulnerable. you take risks and brush off injuries because you think you will recover quickly from anything that happens. you won't. don't be a hero, especially when it comes to your head. it's the only brain you'll have, and your personality is who you are. it's not worth a couple of seasons of glory to lose the opportunity of a lifetime. thank you. >> very good. dr. graham, you are recognized for five minutes. >> thank you very much. chairman terry, ranking member. my name is bob graham. i served as the chair of the institute of medicine sports related concussions and youth study. as you have my testimony before you and i think copies of the study itself, i will just try to take these minutes just to give you a summary. the institute of medicine is part of the national academy of science chartered to provide

advice on very scientific issues. we were specifically impaneled to look at the evidence about the causes and consequences of concussion in youth and military, the state of diagnosis management, role of protective equipment and regulation. we have 17 members on our committee. would worked in 2013. dr. molfese, who will follow me, was a member of that committee. we came with just six recommendations. the first was that the cdc needed to establish a better mechanism for national surveillance to comprehensively capture incidents of concussions. you've heard a number of figures about the concussions in one sport or another. we know what the incidence is where they are measured. we do not know what the incidence is in sports where they are not measure or where they are not more closely watched.

we need to have that baseline to really know the degree to which we have a problem and, as we take corrective measures, the success rate that we are having in making an impact on decreasing the incidence of concussion. number one, we need better surveillance, we need better epidemiology. number two, couple of recommendations related to research. we need the nih and dod to look more specifically at what metrics and markers are for concussions. how do you assess the severity of a concussion. how do you find diagnostically whether or not an individual has had a concussion. right now it's largely based upon observation, on self-report. but are there some physiologic markers that could be used to give us better documentation that a concussion has actually

occurred perhaps without the individual knowing it or without it being observed. secondly we need the nih and dod to look at more carefully longitudinally at the short and long-term consequences of concussions. we heard testimony in this panel, prior panel, individuals that have had one or more concussions. what are the long-term sequela of an individual or multiple concussions. that gives us a sense about not only, again, epidemiology of the problem we're dealing with but what treatment and interventions may be and what rehabilitation may be. fourth recommendation was to the ncaa and national federation of state and high school associations to look at age-appropriate techniques and roles and playing standards. again, your first panel talked a little bit about that. mostly at the professional level. but can you change the manner in which the sport is practiced, and the rules of engagement in

the sport that may decrease the risk of concussion. there was one example from the hockey area where they had changed the level where they allowed body-checking and felt that they saw a decrease in concussion. we think that that same sort of examination should take place at the college and elementary and high school level to see whether or not they can have the same impact. the fifth recommendation had to do with a better study of what the role may be for protective equipment. the first panel talked a lot about that. the committee had a number of questions about that. our committee found very little evidence that helmets protect against concussions. there's a lot of data in that. i think some of the other panelists will be talking about that. you may come away with an equivalence degree in physics this morning. it's a complicated issue.

but there are a number of suggestions that, we certainly did not recommend you don't use helmets. they do protect against bone injury and soft-tissue injury, but the suggestion that a helmet itself may decrease the incidence of concussion, the evidence does not appear to be there to us. and we think that the nih and dod again have a role in looking more specifically and what we may be able to do related to the biomechanical determinance and protection against concussions. and then our final recommendation had to do with the topic which has come up frequently and that is changing the culture and the way concussions are viewed. this is a significant injury. athletes need to be encouraged to report, take themselves out of the game. coaches and parents need to be encouraged to say for your own protection you need to be removed and give yourself a chance for recovery. thank you very much. >> thank you, dr. molfese you

are recognized for your five minutes. >> thank you chairman terry, ranking member schakowsky and members of the subcommittee for this opportunity. if we could have the slides. go to the next slide. yeah. so i think the earlier group talked about a number of -- if you can go ahead and put that on power point -- a number of sports where rate of concussion is particularly high. there are, of course, dr. gay will talk about some of that, in terms of weaknesses of women's necks relative to men's necks. that puts them perhaps more at risk for a concussion. concussion accounts for in the