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Youth Sports Concussion Safety Laws: Texas

One of the most comprehensive and detailed in nation

On June 20, 2010, Texas governor Rick Perry signed into law H.B. No. 203, the state's youth sports concussion safety law.  Dubbed Natasha's Law after Natasha Helmick, a moving force behind the law, the Texas statute is one of the most detailed and comprehensive of the twenty-six enacted to protect youth athletes since the Zackery Lystedt Law was signed by Washington Governor Christine Gregoire in May 2009.

Concussion oversight teams.

The Texas law includes a first-in-the-nation provision for the creation of concussion oversight teams by each school district or charter school participating in interscholastic sports.

  • Membership: The team must include a physician and one or more of the following (all of whom must have had training in the evaluation, treatment, and oversight of concussions at the time of appointment):
    • an athletic trainer (if employed by the school district or charter school, the ATC must be a member of the team)
    • an advanced practice nurse
    • a neuropsychologist, or
    • a physician assistant.
  • Responsibilities: Each concussion oversight team must establish a return-to-play protocol, based on peer-reviewed scientific evidence, for a student's return to interscholastic sports following a suspected concussion.
  • Continuing education: Members of the concussion oversight team must take a concussion education course from an authorized training provider at least once every two years.  A physician on the concussion oversight team is required, to the greatest extent practicable, to take an appropriate continuing medical education course on concussions, while an athletic trainer must take a course on concussions as approved by the Department of State Health Services Advisory Board.  Proof of timely completion of an approved course must be submitted to the school district superintendent.  Licensed health care professionals who fail to comply with the training requirements may not serve on the concussion oversight team in any capacity.

Parent and Athlete Education/Consent

Students may not participate in sports until both the student and the student's parent or guardian have signed a form for that school year acknowledging that they have received and read written information explaining concussion prevention, symptoms, treatment, and oversight, and that includes guidelines for safely resuming participation following a concussion.

Removal from play

Students must be removed from a practice or competition immediately if one of the following persons believes the student might have sustained a concussion:

  1. A coach;
  2. A physician;
  3. a licensed health care professional; or
  4. the student's parent or guardian (Note: Texas joins Arizona as one of only two states that give an athlete's parent the right to remove him or her from a game if they suspect a concussion).

Return to Play

The Texas law contains more detailed provisions on return to play than any of the other youth sports concussion safety laws enacted thus far.  An athlete may not return to practice or competition following a suspected concussion until:

  •  the student has been evaluated, using established medical protocols based on peer-reviewed scientific evidence, by a physician chosen by the student or the student's parent;
  • the student has successfully completed each requirement of the return-to-play protocol established by the concussion oversight team (see above) necessary for the student to return to play;
  • the treating physician has provided a written statement indicating that, in the physician's professional judgment, it is safe for the student to return to play; and
  • the student and the student's parent or guardian has:
    • acknowledged that the student has completed the requirements of the return-to-play protocol;
    • has provided the treating physician's written statement to the person designated by the school superintendent as being responsible for compliance with the return-to-play protocol, who may be an athletic trainer but may not be a coach, who also may not authorize a student's return to play; and
    • have signed a consent form indicating that the person signing
      • has been informed concerning and consents to the student participating in returning to play;
      • understands the risks associated with the student returning to play and will comply with any ongoing requirements in the return-to-play protocol;
      • consents to the disclosure to appropriate persons, consistent with federal HIPA (e.g. privacy) laws of the treating physician's written statement; and
      • understands the immunity provisions of the law (see below).


The Texas law does not:

  • waive any immunity from liability of a school district or charter school or its officers or employees;
  • create any liability for a cause of action against a school district or charter school;
  • waive any immunity from liability under existing law; or
  • create any cause of action or liability for a member of the concussion oversight team arising from the injury or death of a student participating in sports based on the service or participation on the concussion oversight team.

Updated June 24, 2011