Hawaii Youth Sports Concussion Law

What this actually means for your family

The statutory detail is further down, and it is all sourced. But if you are here because your child got hit this week, these are the six things you came to find out.

My child took a hit to the head. Does the coach have to take them out?

Yes. If your child shows signs of a concussion, or is suspected of having one, they have to come out of that practice or game right away. This is the part of the law that is nearly identical everywhere, and it does not require anyone to be certain — a suspicion is enough, and the coach is not supposed to wait for a diagnosis before acting.

Can they go back in the same day?

In practice, no. Hawaii law does not use the words 'same day,' but it bars a return until a provider has examined your child and put a clearance in writing. That is not something that realistically happens between the third and fourth quarter, so the effect is the same.

Whose note does the school have to accept?

Hawaii names specific professions in the law, so this one is worth checking before you book — if your provider is not one of them, the school does not have to take their note.

Physicians and osteopathic physicians, physician assistants, advanced practice registered nurses and neuropsychologists. Athletic trainers and physical therapists are recognized elsewhere in the law but cannot sign the return authorization.

The exact wording, if you need to show it to a school

• advanced practice registered nurse
• neuropsychologist
• physician assistant
• physician
• osteopathic physician

That list comes straight from Act 262, Session Laws of Hawai'i 2016 (amending Act 197 of 2012) (data.capitol.hawaii.gov). This is the text a school, a coach or an athletic director is bound by, so it is the page to print or forward if anyone tells you the rule is something other than what you have read here. Where a state's law runs across several sections, the rest of them are in the sources at the foot of this page.

Is there a minimum number of days out?

Not in the law. This surprises people, but the statute sets no minimum number of days — it just requires a provider to sign off. How long your child sits out is a clinical decision, not a legal one, and a provider who returns a child quickly is not breaking any law. This is the single biggest gap between what these statutes require and what current concussion medicine actually recommends.

Does the school have to help with schoolwork while they recover?

Yes. Hawaii is in the minority here — it requires a plan for getting back to the classroom, not just back to the field, and it does so in the statute itself. You can ask the school for it by name rather than as a favor.

What if the team is not run by their school?

Yes. This is worth knowing, because it is not true everywhere: Hawaii wrote its law to cover organised youth sport generally, not just the teams a school runs. A club, a travel team, a municipal rec league — the same removal rule and the same clearance requirement apply. If a club coach tells you the concussion law is a school thing, they are wrong, and you can say so. One honest caveat. The 2016 act broadened the definition to youth athletic activity generally, but the operative wording is written around schools — the clearance provision talks about the school's athletic trainer — and the sources available do not settle how cleanly the duties transfer to a club with no school connection. Ask your league directly rather than relying on the statute here.

Read the law itself, in full: Act 262, Session Laws of Hawai'i 2016 (amending Act 197 of 2012) (data.capitol.hawaii.gov). This is the text a school, a coach or an athletic director is bound by, so it is the page to print or forward if anyone tells you the rule is something other than what you have read here. Where a state's law runs across several sections, the rest of them are in the sources at the foot of this page.

If this happened in the last few days

Rule out the emergencies first.

A concussion is not usually a medical emergency, but a small number of head injuries are. Go to an emergency department now for a headache that keeps getting worse, repeated vomiting, seizures, slurred speech, weakness or numbness, one pupil larger than the other, or a child who cannot be woken or is unusually confused or drowsy. None of this is what the concussion statute is about, and none of it should wait for a clearance appointment.

Get the evaluation booked, and book the right kind.

The clearance your school needs has to come from a provider the law recognizes, and that list is different in every state — it is the third question above. Confirming that before the appointment saves families a wasted visit and a second co-pay more often than you would think.

Write down what happened while it is fresh.

The date and time, what the hit looked like, who saw it, what symptoms appeared and when, and who was told. This helps the clinician far more than a general 'he got hit at practice,' and if there is ever a dispute with the school about what was reported, it is the only contemporaneous record anyone will have.

Finding a provider who can sign it

Knowing what the law requires is one half of it; finding someone who can actually do the evaluation is the other. Our directory lists 42 verified concussion providers in Hawaii across 8 cities, and you can filter by the kind of clinician the answer above calls for.

Browse Hawaii concussion specialists →

What makes Hawaii's law different

Hawai'i's law departs from the standard model in more ways than almost any other state's. First, its concussion law was never codified — it lives in session law (Acts 197/2012 and 262/2016) and appears only as a note under HRS ch. 302A, so there is no HRS section number to cite. Second, it is a genuine return-to-learn statute: clearance is required before returning to academics, not just to sport, and the recovery plan is framed around cognitive rest and graduated cognitive load. Third, the law splits its provider categories — 'licensed health care provider' is defined broadly to include certified or registered athletic trainers and physical therapists trained in sports concussion management, but the operative clearance provision names only APRNs, neuropsychologists, PAs, physicians, and osteopathic physicians, so ATs and PTs are recognized but cannot sign the return authorization (the AT's role is instead to monitor the graduated return). Fourth, it goes beyond the model law by funding baseline cognitive testing for high school athletes and requiring continuous concussion data collection and monitoring, which is how the Hawai'i Concussion Awareness and Management Program (HCAMP) operates. Finally, its age floor is 11.

The statute in detail

Everything above is the short version. This is what the law actually says, section by section, for anyone who needs the precise wording — a school administrator writing policy, a coach checking a duty, or a family that has hit a disagreement with a district.

Who the law covers

Originally (Act 197, 2012) a Department of Education and Hawai'i High School Athletic Association concussion educational program for high school students aged roughly 14-18 in public and private schools. Act 262 (2016) extended it to 'youth athletic activity' — organized athletic activity where the majority of participants are 11 or older and under 19, engaged in organized competition or practice — while excluding college activities, instruction-only programs, and activities where athletics are only incidental. 'Coach' covers paid and volunteer individuals working for, assisting, or managing a team.

Education and acknowledgment

Annual concussion training is required for coaches, administrators, faculty, staff, and sports officials, covering signs and symptoms, the need for medical attention and clearance before return, the risks of continuing to play, and return-to-activity protocols. Participants and their parents must receive the education annually and must sign a concussion information sheet attesting that they attended, received, and viewed the concussion awareness education.

Hawaii Return-to-Play Law: Removal From Play

Immediate removal from a game, practice, or other activity is required for any participant suspected of having a concussion or exhibiting signs, symptoms, or behaviors consistent with a concussion — the law gives examples including loss of consciousness, headache, dizziness, confusion, and balance problems. No single actor is designated as the one who must order removal.

Hawaii Return-to-Play Law: Getting Cleared to Return

The concussed student must obtain written clearance before returning to academics and athletics, stating that the student is capable of resuming participation in the particular sport. The clearance may impose a recovery plan including periods of cognitive and physical rest while symptoms persist and progressive reintroduction of cognitive and physical demands, and the student's return to physical activity must be monitored by the school's State of Hawai'i registered athletic trainer where the school employs one.

Who the law lets sign the clearance

• advanced practice registered nurse
• neuropsychologist
• physician assistant
• physician
• osteopathic physician

Return to learn

Yes, and unusually explicitly. The written clearance is required before returning to academics as well as athletics, and the clearance may require a recovery plan built around cognitive as well as physical rest while symptoms persist, with cognitive and physical demands reintroduced on a progressive basis to prevent symptoms from reemerging or worsening; the law also contemplates classroom adjustments.

How the law has changed

• 2016 — Act 262 (S.B. 2557) substantially rewrote the program: it extended coverage beyond high schools to non-school 'youth athletic activities' for participants 11 to under 19, added statutory definitions of 'coach' and 'licensed health care provider' (adding physical therapists), mandated annual coach/administrator training and signed concussion information sheets, spelled out the immediate-removal rule and the written-clearance and recovery-plan requirements, and appropriated funds for baseline cognitive testing of high school athletes and ongoing concussion data collection.

What happens if the rules are not followed

This is the part families ask about most and the part these statutes handle least. Almost every one of these laws sets out duties without setting out a penalty for ignoring them, and most go further and grant the school and its staff protection from being sued over concussion decisions. What that protection covers, and where it stops, is a state-specific question:

Not addressed in the statute.

Two things are worth being clear about. Immunity clauses of this kind generally stop short of conduct that is willful or reckless, so they are not unconditional. And a school district's or athletic association's own rules sit on top of the statute and can be enforced through the school or the association even where the law provides no remedy — that route is often faster than any legal one. If you believe the rules were not followed and your child was harmed as a result, that is a question for an attorney licensed in your state. It is not something this page can answer, and it is not something a directory should pretend to.

Common questions

Whose note does a school have to accept to clear a concussion in Hawaii?

Hawaii names specific professions in the law, so this one is worth checking before you book — if your provider is not one of them, the school does not have to take their note. advanced practice registered nurse; neuropsychologist; physician assistant; physician; osteopathic physician

Can a student go back in the same day after a head injury in Hawaii?

In practice, no. Hawaii law does not use the words 'same day,' but it bars a return until a provider has examined your child and put a clearance in writing. That is not something that realistically happens between the third and fourth quarter, so the effect is the same.

How long does a student have to sit out after a concussion in Hawaii?

Not in the law. This surprises people, but the statute sets no minimum number of days — it just requires a provider to sign off. How long your child sits out is a clinical decision, not a legal one, and a provider who returns a child quickly is not breaking any law. This is the single biggest gap between what these statutes require and what current concussion medicine actually recommends.

Does Hawaii require schools to help with schoolwork after a concussion?

Yes. Hawaii is in the minority here — it requires a plan for getting back to the classroom, not just back to the field, and it does so in the statute itself. You can ask the school for it by name rather than as a favor.

Does Hawaii's concussion law apply to club and rec league sports?

Yes. This is worth knowing, because it is not true everywhere: Hawaii wrote its law to cover organised youth sport generally, not just the teams a school runs. A club, a travel team, a municipal rec league — the same removal rule and the same clearance requirement apply. If a club coach tells you the concussion law is a school thing, they are wrong, and you can say so. One honest caveat. The 2016 act broadened the definition to youth athletic activity generally, but the operative wording is written around schools — the clearance provision talks about the school's athletic trainer — and the sources available do not settle how cleanly the duties transfer to a club with no school connection. Ask your league directly rather than relying on the statute here.

When did Hawaii pass its youth concussion law?

2012. The statute is 2012 Haw. Sess. Laws Act 197 (H.B. 2273), as amended by 2016 Haw. Sess. Laws Act 262 (S.B. 2557) — uncodified; carried as a note to HRS ch. 302A rather than as a numbered HRS section. It has been amended in 2016.

How this summary was written

Each summary was built from the statutory text and, where the statute delegates, the state rule or athletic association policy it delegates to. Where a detail could not be traced to a primary source it was left out rather than guessed at, so a section reading “not addressed in the statute” means the law is silent — not that nothing applies.

Not legal advice. This is a plain-language summary of a statute, not legal advice, and it is not a substitute for reading the law or asking a lawyer about a specific situation. Statutes are amended; school district and athletic association rules sit on top of them and are often stricter. Every source used for this page is linked below so you can check it against the text.

Sources

• Act 262, Session Laws of Hawaii 2016 (Hawaii State Legislature, official)
• Hawaii S.B. 2557 (2016) bill history / Act 262 signing
• Hawaii H.B. 2273 (2012) — Act 197
• HRS ch. 302A note: 'Concussion educational program. L 2012, c 197; L 2016, c 262.'
• HCAMP — Hawai'i Concussion Awareness and Management Program
• Network for Public Health Law state matrix (cross-check)
• Hawaii S.B. 2557 (2016) full text — LegiScan copy