Medical Advisory Committee Meeting - 09-13-26 transcript

At this time, I certify that there is a quorum present. My name is Jesse Dele from San Antonio, Texas. I've been appointed to chair this committee. Will the committee members and UIL staff uh introduce yourselves, please? >> Start. >> Dr. John Puig, Laredo, Texas. >> Dr. Gomez, um, sports primary care sports medicine, Texas Children's Hospital, Houston. >> Marian Hendricks, family practice, Corpus Christie, Texas. >> Al Herganro, uh, primary care sports medicine, Houston, Texas, Baylor College of Medicine, and Texas Children's.

Arie Fenrich, uh, pediatric cardiology, electrophysiology, Austin, Texas. Okay. UIL >> Mondo Schneider, Midland, Texas. >> Valerie Duran, athletic trainer, North Crowley High School. >> Joe Martin, executive director, Texas High School Coaches Association. >> Andy Green, executive director, Texas State Athletic Trainers Association. Sam's frozen. >> I'll help him out. He is Sam Typton, the executive director of the >> I don't know about y'all, but I have a terrible connection [clears throat] >> association.

I'm Jamie Harrison, executive director of UIL. >> Ray is a paid athletic director of UIL. Joel Noli, director of compliance services, UIL. >> Mark Cousins, UIL. >> Jessica Walker, UIL. >> Kelsey Wickliff, UIL. >> All right. [clears throat] Thank you all very much. Um, unless there's an objection, uh, the committee meeting will be conducted in accordance with the UIL constitution and common rules and Robert's rules of order.

Uh if there's no uh objection, business meeting will be held as a public meeting. Um and we will follow the printed agenda. Uh I reserve the right to deviate from this order if it becomes necessary. Uh will the members of our committee um that have have reviewed our minutes? Let's have a proposal to accept, alter, or reject the minutes. I make a proposal that they be accepted the minutes from the last meeting. >> I will second be.

Any objections? >> Okay, they are accepted. Purpose of this committee is to examine the health and safety of students involved in intercolastic activity. It should be the goal of our committee to work cooperatively with the UIL standing committee and the legislative council to address sports medicine issues as they impact rules and the health and safety of the participants. Any recommendation from this committee will be presented to the UIL legislative uh council athletic committee.

We now will begin our business meeting. Jamie, do we want to start? >> Yes, sir. We start um our business with written proposals from the public. Um in your packet, you will find uh the first written proposal from the public. Um recommending required mandatory vitals checks and unrestricted uh water access for student athletes. Uh the proposer uh lists um some cases, some unfortunate cases, tragic cases. Um as well as uh that describing why they're presenting the proposal.

Um it's there is some uh interpretation uh left to the reader. I believe what the proposer is suggesting is uh recognizing that vital checks of course are a part already of the pre-participation physical exam um and policy already requires u unrestricted access to water uh but is looking for a way to better verify that those bottles were checked and that that water is available. Uh we believe policy addresses this uh but are open to uh hearing from the committee on any changes you guys think we need to make.

Jamie, was it uh did I read it wrong or were they asking for vitals to be done pre- uh activity, not pre- each activity, not on the pre-articipation physical? >> Um they may be, as I said, the way it's written, it's a little it leaves somewhat uh leaves it somewhat open to interpretation to the reader. Uh I'll read from it. Mandatory pre-participation physical evaluations must explicitly mandate clinical measurement of vital signs. >> Yeah. >> So [clears throat] I I think they're concerned about the pre-articipation physical examine examination if establishing a baseline for each student.

Um but you may be correct, Mr. Chair. They may be asking for it before every practice or every game for example. >> Yeah. I I think we can't really it's it's hard to render an opinion when there is no specific proposal. And if they are intending for it to be pre-activity, then uh there's no standards for what a heart rate, blood pressure are when it's 30 minutes before a game and the kids are warming up and they're excited.

So I I think we'd have to say what specifically you're proposing before we can support any change in the policy. Anybody else? Okay, then let's [clears throat] have a motion that we ask for clarification. >> So moved. >> Second. >> I second. >> Okay. All in favor? >> I. >> Anybody? Anybody opposed? >> Um, who? Anybody opposed? Okay. All right. Next, Jamie. >> Uh, the next proposal uh from the public is one similar at least to proposals we've seen before.

Um, requesting [clears throat] that uh we put some regulation in that ultimately leads to an uh what the proposer describes as an appropriate amount of sleep uh for students. um uh [clears throat] requiring practices to end or games to end by no later than a certain time and not to begin no earlier than a certain time uh to protect sleep time uh for students. Again, this is a proposal we've seen at least in similar form uh multiple times in the past.

Uh open to comments from the committee. >> Do we have any background on on what what prompted that proposal? Was it was it the fact that a lot of teams were beginning football practice at 5:45 in the morning or 5:15 in the morning uh to to avoid exposure to heat or was there some other impetus for that? >> I I believe the impetus was a combination of what you just described plus very late practices or late game times.

Um you know games are going to be much more difficult to restrict I would suggest to the committee because there there does need to be uh travel time We try to protect the school day as much as possible so they can only start at a certain time because one team is on the road. Um so I I don't think it's just early morning practices or just late night activities. I think it's it's trying to um regulate that both don't happen at the same time that you have both early morning activities and late night activities followed again by early morning activities which would uh limit the amount of sleep a student can get.

I I do believe our school people are aware of this. I mean, again, no one is is more incentivized to make sure that these students are alert and ready to learn and uh performing well academically than the school is. Um and and there are outline situations where, you know, a game may go into overtime or extra innings or experience a weather delay um where it does end up late. But in my experience, most schools do a good job when those when those outlying situations occur of adjusting the following day and recognizing that students will be, you know, getting home very late. >> I think I'm I think I'm conceptually on board with the idea of and there should be a minimum amount of sleep.

Um, however, that should be local control. That's up to the local principal, school board, coaching staff, etc. So, at some point, you can't regulate if the game's over at 11:00. I I don't know how you regulate that. They have to have eight hours of sleep before they come back the next day. So, I think this has to be under local control. And I don't know if the UIL can mandate. >> How is it enforceable is what I want to know.

How can you say, "Son, you have to go to bed as soon as you get home." They're going to get on their phone. they're going to talk to their friends. It's not enforcable. We can do the best we can to make sure that the games end on time and I think that's very acceptable. Jamie, how about how about a statement from the committee to the school districts to keep u [clears throat] this concept u on the forefront. In other words, that they they they try to keep the late games and early practices uh so they're not in sequence or something to that effect.

Just that we what we're doing is acknowledging the importance but leave it to the local people to implement it. >> We could absolutely do that. Ray, would you like to speak to, you know, what we already cover and >> your experience with how schools are implementing it? >> Yeah, I think I think the impetus for this is I think I think all of you guys would agree there's much more uh specific information out there now about the importance of sleep that I think everybody is very aware of much more data.

I would I would suggest possibly that you direct us to look at the mandated safety training that we have for students and staff and ensure that we have uh information in that training relative to the importance of sleep and uh I think we could capture um your intent Dr. Dele by by by looking at those two products themselves and including information about the importance of sleep but I do agree with Dr. If we get this would be operationally impossible to not only enforce but even to monitor. >> Any other comments? >> Let's have a motion to that effect.

If there's confusion about what to that effect means um and related to the motion, I I agree with what Ray laid out that if the committee directs us to include uh information about this and the mandatory safety training that's that coaches have to uh complete annually that we will absolutely include that in the training. Jamie, can I also add too, we have specific training for the students that is mandated by state law.

We could we could look at both of those products and include information about the importance of sleep in both of those products. >> I move we include the importance of sleep um in both the coaches and in the student u mandatory safety training. >> And I will second the motion. >> All in favor? I >> I >> Anybody opposed? >> Okay, Mr. Mr. Har Dr. Harrison, what's next? >> Uh the next proposal uh is a very thorough and and well-written proposal um that we require emergency preparedness standards for student athletes with diabetes.

I know the committee has read through that proposal. Um uh it again is very detailed uh and very thorough. Uh I I do want to bring the to the committee's attention that there are some things that are in and have been for a bit in state law uh related to this. Dr. Cousins, you want to lay that out? Yeah, there has been for a number of years uh requirements in state law, K12, that the any school that has a student uh with diabetes that may end up seeking treatment for that element at school, this by law, they must already have an individual health plan uh available for those students.

And I'd kind of like to hear from Val and uh Hondo and Andy in reference to their experience dealing with that already. Uh but yeah, it's my understanding that school districts in Texas for every student K12 that's a diabetic already are required to have an individual health plan in place for those students to address those concerns when those students need to get treatment for that uh during the school day or when they're involved in any activity which certainly would include extracurricular activities like ours.

And Ry and Jamie mentioned our safety training. We have a section in our safety training related to allergies, asthma, and diabetes where these issues are covered in the safety training that our coaches uh do annually. But again, I'd like to hear from the couple of those trainers that have been out there in the schools, how they've seen that and been dealing with that throughout their careers uh knowing that that's something that's already been in place with having those individual health plans uh for students that are diabetic K12 and Texas schools.

Mark, I had one question. Does that law only pertain to type 1 diabetics or is it a blanket statement for any student that has type 1 or type two diabetes? >> I don't know that off the top of my head. I can do some looking while y'all are talking and see if I can find that specifically. Uh but I'm not sure if it's specific to what type. >> I think it's a blanket. I'm pretty sure it's just if it's diagnosed and reported. >> So again, I I as Mark described there, there is something in state law related to this, but uh for those of you in the field, if you could describe how you've seen those individualized plans for students with diabetes um interact with athletics participation in particular and whether you guys believe we should do something further.

Well, first first and foremost on our health history form, we have a requirement we put in many years ago that someone has to review the form and I know that doesn't happen as often as it should and on that form there is a question concerning this and if there is a yes answer to that I would it is recommended in our field that you know the school nurse is going to have that on file as well and that should lead down to us and and uh we still got to remember that we've got small schools, junior high coaches that athletic trainers are not always there and di training and diabetic care is not something you can do in a fiveminute session.

And a lot of the people aren't prepared. They need to know if a kid's on an insulin or if they're all the different stuff that y'all already know about. And uh we need to take that in consideration we start talking about this. [clears throat] >> So I it's I mean again what you guys were talking about it's actually already implemented. So between myself or the school nurse whoever is basically the first one to get told.

So if I get a physical over the summer that has something with diabetes it immediately goes into their you know whatever EMR system. Um ours is synced with Skyward with the school. So, if the nurse gets it and it's already in their history, our EMR, cuz again, we we've gone to rank one, you'll get a little band-aid um next to the kid's name and when you click it, it says that they're diabetic. So, I mean, anything the coach has on their roster, it's going to signal that they have a diabetic on their roster.

So once that's established through the nurse, we make sure that they have their uh health plan with their doctor uh directives on there. Um the nurse will then send out emails to everybody that's on that kid's uh schedule, which will include their head coach. So the head coach will then be alerted, hey, you have a diabetic um on your roster. The head coaches then are responsible to assign some coach, one of their coaches on their staff to then you have to go and get your Etka training from the nurse.

Um, and it's extensive. Uh, I just did mine this past week. We just actually did all of our stuff this past week. Um, because we finally got have everything updated. Um, and those it's like 10 or 11 significant videos. It took a long time to get that stuff. So, you have to watch all of that stuff. You take a pretest. You take a post test. Then you go into the nurse and you have to practice skills like you do the p the prick on the finger.

You do the the glucose stuff. They show you how like if you're getting pulling up your kids health plan, what their corrections are. I mean, the what's required by law is extensive and that's enough. And then of course it's covered in CPR training every two years in addition to that happening every year. So it it's extensive and and I I believe in the proposal it was saying that at least one adult be trained. That's that's what's required already. >> And I agree and echo what Hondo and Valerie have said just from my clinical experience in secondary school setting having stepped away the last decade but doing PRN work.

It's also still collaboration with the school nurses at the schools that I go out to and cover, be it a middle school, be it a high school, to know what those plans are. And I've seen some really good utilization of setups to monitor student athletes when an athlete trainer is not present. That would be exemplars that could be used. But it I believe we've been following it most of our schools, maybe not all of them, but it's it has been in effect.

If I might add, I think, and again, Mark, I know you were looking this up. I think the law indicates what must be done and a lot of what is covered here in the proposal is actually covered in law. I think what I've seen operationally, both as a coach and athletic director of a very large school district, um, is that where there are failings, it's it's just like anything else, it's the fail failure of communication and execution.

Uh I don't know that additional um so I think that's kind of the issue more so than not understanding what needs to be done. It's just the consistency of exe execution communication down to the lowest level that would be be there actually able to provide care for a student athlete. Yeah, Dr. Quig, I was able to go find it just says a student di a diabetic student. It doesn't get into determining what type Can I ask did did the uh proposal come up because there was an incident?

U because it sounds like there's already checks and balances in place. Um so I I it's not clear to me why this proposal was u registered. >> I I do not think that's the reason. I think that this is just laying out a more holistic um more stringent requirement, more explicit regarding the training. um etc. In in working through situations like this with parents who have experience have uh students that have diabetes typically um this this has been um very common for those parents who deal with that on a regular basis to advocate for things of this nature.

And I think Valerie, Andy, and Hondo would say that if uh as they've worked in the schools when they have had have students that have had diabetes, it it's very typical for parents to have this perspective. I think that this is probably the where this originates from. >> Yeah. They describe at the beginning of their letter that they are parents of a student with type 1 diabetes. Well, and the other this other side of this is the kids that I've had that either wear the monitors or do the finger stick and all that.

The kids that have had diabetes for years, they know and they know what's coming and they generally know before anybody else and they'll come up and tell us and go from there. I mean, these the kids the kids know what's wrong with them and they know they know exactly what's coming most all the time. >> [snorts] >> Uh just real quick moving looking through the letter that the family um wrote, it says that they um it their gap is that there is not a standard prescribing requiring prescribed emergency diabetes supplies to accompany student athletes during every practice, competition, conditioning session, etc.

So it's a they their specific sentence is talking about emergency supplies. >> You know, usually those when when there's a student athlete at a school uh with for example with type 1 diabetes, there they should have an individualized uh treatment plan that includes measures to undertake when there's an emergency. And then and then I I thought it was it was the responsibility of of the student parent and their prescribing physician to provide uh you know insulin and in in in the case of an emergency glucagon etc.

So that could be that could be kept at the school >> that would be the same thing as a child school provides it. It in a setting like this for for is this potentially more a a student traveled somewhere um for a competition? What if their supplies were forgotten? Um, is this potentially that there should be something a a a backup or a subset? Um, I know from seizure standpoint, we've had some some problems because we we can't have our students um or our patients travel with their own um uh rescue medicine.

Um, and I wonder if if you know if a student like this is having an emergency, even if he does have his supplies, is he able to communicate where they are? I think I think Dr. Luke's hitting the the nail right on the head and very much similar to how we have requirements that AEDs are in place um where students are participating. Um could be something of that nature about having diabetes emergency supplies on hand to be able to handle any student that might be having that type of emergency.

Yeah, I mentioned this earlier and in our current safety training, we got a couple of slides on this diabetes management for athletes and both of those slides include statements and making sure that uh diabetic testing supplies are available and in working order and ensuring that insulin or other medications are stored safely and accessible. and also making sure that in the emergency action plans that schools are already have to have in place that they include diabetic response procedures in those emergency action plans.

And as I said, that is in our current safety training that coaches do annually. >> Mark, I think you would also say that we have updated all of that training within the past two years to include all of that information. Yes, >> that is correct. Do [clears throat] we address asthma in the same fashion? >> Yes sir. >> So what you're saying is that it is the school and trainer responsibility to have those medications available at all times.

We do include that. We do include that direction in our training. Now that I mean whether or not that necessarily carries the force of rule, but we do have that information and direction in our safety training that coaches do annually. >> And we do require schools to have emergency action plans for a variety of uh emergency situations, including medical emergencies. Um I I [clears throat] don't know that that emergency action plan requirement has a laundry list of very specific items that schools must uh address.

Um you know at some point it's it's going to be up to the school to make sure that they have you know plans in place to keep their students safe. >> [gasps] >> Um I I will point out if you get to the last page of the proposal um there's a a list of seven things um some of [clears throat] them are just like se section one they're providing as just applicability but uh to follow that the proposal is to add an emergency action plan specific to students uh an individualized emergency action plan for students with diabetes um designated trained personnel uh required training for that designated trained personnel, uh, emergency supplies, um, and then a statement that, um, you know, none of this precludes a student from, uh, taking care of themselves. >> Jamie, and I'd like to ask the the trainers, Hondo and Valerie and others, as a lot of this um, dialogue is directed to when an emergency develops.

Um, but the ADA, the American Diabetes Association guidelines, um, uh, take a preventative approach. So, I wonder if in your training, they talk about pre-event, like if you check a kid with type 1 diabetes, if you check their blood sugar before the event, less than 100, 100 to 250, greater than 250, there's specific guidelines about what they're supposed to do. So emergencies might be avoided if it's emphasized that pre-event some sort of assessment take place in a patient with type 1 diabetes.

Is that part of the training rather than just responding to an emergency if one occurs? >> Mark I think you might have the training there to look. >> We don't have anything in regard to pre-training. We talk about be aware of the symptoms like for both asthma and diabetes. Uh and then we talk about making sure that the supplies are available uh should an emergency occur. And then also making sure that both for allergy all all for asthma, allergies and diabetes that they be included in any emergency action plan that you have, but we don't necessarily have anything about checking it up front.

Uh, I think a lot of that go to go back to what Hondo was talking about earlier that generally the kids that have had diabetes for a while, they're the ones that are they they take care of that themselves and know where they're at. And then we've even made exceptions, I think, Ray, for those uh ones that are actually attached to the body for students to actually continue their participation with those glucose monitors attached to their body during participation so that they can make it easier for them to keep track of that while they're participating as well.

Absolutely. Yes, sir. >> Yeah. So, I think part of the issue is even if they have an emergency action plan, even if they have a diabet diabetist, um things happen um and kids don't get their insulin refilled or they skip breakfast and they still take their insulin. There's a lot of scenarios that even kids who are well monitored. My suggestion is that what be added to the training is um a review of the American Diabetes Association guidelines for patients with type 1 diabetes who exercise.

It's it's it's actually pretty concrete. You know, less than 100 what you do serum blood glucose 100 to 250. What that's the safe zone. If the blood sugar is greater than 250, you have to check urine for ketones. There's some things that can be done in advance even for kids who are well well monitored, well controlled, have insurance, have supplies, etc. A review of that might preclude the notion that a kid is going to have a diabetes emergency during the second quarter.

I just want to make sure that we before it becomes something like we're the discussion is making sure that the trainer has it or whatever. Like we don't go to everything. We're not everywhere. I have upwards of 16 venues. I mean it's just not going to happen like that. And so like even for even my asthma and all of them, I don't recommend that it just be kept with me because it's not going to help for me to have somebody's inhaler or diabetic supplies when they go to golf.

So I mean the that's why there's that's why there's individual health plans so that they have their stuff. I tell my coaches at the beginning of year, make sure you know who has who. Know where their stuff is in their bag. Know where they keep their snacks. Know where they keep their stuff. And individually, everybody has their check. I mean, it's just like to me, I tell them your inhaler, your diabetic stuff. It's just like having your pads, having your pads, having your ankle braces, whatever.

You don't get to go or you don't get to participate if you don't have that stuff. But, I mean, making somebody, it's you have to be very careful with making somebody specifically responsible that's not always going to be there. So, that's that's part of the preparation. >> Yeah. to add to Valerie's point. Um, you know, it's important to remember that our schools range from, you know, high schools with 7,000 students and and huge staffs to our smallest high school that has less than 10 students in it in grades 9 through 12 and extremely limited staff and everywhere in between.

Um, so I do agree that any sort of specific identification of personnel can be problematic because personnel varies vastly from one school to another >> Yeah. theoretically. >> Go ahead. >> Uh, Valerie, can I ask when it's a patient who has has a seizure disorder and their rescue medicine, say they're in golf, um, who would take their rescue medicine with them? So again, if it's a prescription, then it would probably just be packed with one of the coaches.

And so yeah, but but I mean it's it would vary. Um I mean I know some kids have their favorite coach that they go and give their inhaler to and that's who keeps it in their pocket on the sideline. Do you know something like that? Um >> it's an adult that is >> it's an adult. Yes. >> Okay. >> I Dr. Dr. Luke, I I would suggest that that is going to vary widely, right, by sport, um, by school. I mean, the example you just gave was it's a student who's playing golf, and they may very well have a plan worked out where that parent says, "I'm going to be at every tournament, and I'm going to have it with me cuz I want to make sure my kid's safe." Um, or look, if I can't be there, I'm going to call the coach or I'm going to call the trainer or I'm going to call whoever it is and make sure that they have it.

I'm going to meet them and give it to them. that that can that for a a tennis tournament or a golf tournament that could look very different than for a swim meet and that could look very different for a football game or a volleyball game. Um or for a student participating in marching band. Um, so I I I do believe that being very being too specific uh could be problematic because it that there's so many different scenarios to try to address, you know, centrally versus letting those closest to the situation figure it out.

I I wonder and and I agree absolutely that's why I was actually asking that question that there in in what we tell through my seizure action plan we say we need a responsible adult that's what we say um we don't specify um cuz I don't know who will be there um but that may be part of uh what could be looked at is just making sure that there's terminology that responsible adult could be the parent Um it could be uh the school principal who happens to be on the trip.

Um and so that that was just my my input was a responsible adult. I think it's also important to look at two other points. One, [clears throat] the responsibility of taking care of a child with one of these diseases is purely the responsibility of the parent. And if we assume that responsibility, um, I'm not sure that's a good thing. Secondly, I think if you mandate any kind of having these supplies to to available at all times, you're putting the practice of medicine onto the people at the schools.

And I'm pretty sure that's not something we want to do. And so [clears throat] I think we've got to be very careful with this. But I I think we need to be sure that the parents and I'm fully aware of the fact that parents are not 100% the same but the school I'm not sure can take on that responsibility full time. >> Yeah, I I agree Dr. And I think also as well one thing to keep in mind is again state law already covers this uh for all students K through 12 and we can certainly go back and look and review our information that we provide to coaches and to students uh in reference to this and provide some additional information and direction if we feel like it's needed and can circle back with the MAC uh on any additions that we make for the next time we do those updates to safety training uh for next school year. uh and we can look at and see whether or not we need to increase the information or maybe provide a little bit more information in reference to these specific issues uh for not just diabetes like you said but for asthma, allergies, uh other things that kids have to deal with uh on a day-to-day basis.

Mark, I want to piggy back on to what you're saying that in the current safety training though, some of what is already being respectfully asked by this by these parents for us to consider today is is already included in the safety training that is provided including uh encouraging and uh recommending that there be a diabetes response plan in the emergency action plan for every every school has that already. So I think that that information is already contained and so several of these ask we're already taking care of and we can certainly look at resourcing to increase education in several different ways. >> I'd like to come back to some to the point that or one of the points that Dr.

Henroer made which is the ADA is pretty clear about their recommendations for a glucose monitoring before participation in in athletics whether that's practice or games. I'm I'm looking directly at at a uh a um diabetes management plan from the ADA and under the section glucose monitoring at school uh it says there's a section that says gluc monitor glucose and there's several check boxes before meals with physical complaints before exams before physical activity.

Now, I'm I'm assuming that most diabetists are are going to when they're completing that form are going to check before physical activity, but would it would it be something to add, for example, to the the training to say when you receive one of these uh diabetes management plans at school to make sure that that box is checked? And again, and this is just I I can't imagine that someone wouldn't do that, but let's say that box isn't checked, you know, check glucose before physical activity.

Would that be a safety measure that that that we could put in place just to say, you know, please make sure that that box is checked so that glucose is monitored before athletic activity? Well, I'm going to open up a Pandora's box on the on the health history form. I guarantee you there's probably as many kids fill out that health history as their parents do and they turn it in and bring the paperwork to get their physical by their doctor.

So, it's not I don't I've always had problem with that. It's you watch kids, they show up for back when we did mass physicals, the kids are in there filling out their own health history. The parents are nowhere around and that and that's a problem we've had forever. >> Well, it is, but I'm not sure it's a problem that's solvable. I mean, I I'll go back to the chair's comments earlier. I mean, at some point I >> agree. um a parent is responsible for their their own child's safety and and knowing that their their child is participating in these activities and knowing that physical examinations are going to occur, you know, that you can only legislate so much.

Um >> I agree with you. >> The other warning I would offer the committee and I you guys are far more um in tune to this than I am. Uh right now we're discussing quite specifically students with diabetes. But there there are a number of diseases um or ailments that students may suffer from. Some have been mentioned seizure related illnesses um asthma um any number of rare disorders that could occur. Um and so carving one of them out with very specific and um clear directives without carving all of them out um with the same thing is a it can be a little problematic.

Um something a little more general might be considered and that is to you know direct staff to make sure that in our training that we provide that every coach is required to complete um that in their emergency action plan uh preparedness that they include um prevention of and response to medical emergencies that can occur from any number of uh medical specific illnesses or ailments. ments that students may suffer from. >> Yeah, I I would second that.

Um uh Jamie, because you know the prevalence of type 1 diabetes is in the in the adolescent population is4%, the prevalence of seizures is 6%, the prevalence of asthma is 6.7%. When you roll those all up, you're approximating about 10% of the kids who are playing sports have some condition. And I like the general statement as I I think we should respond to the query from the public that we appreciate them bringing this to our attention and it's in the broader context of all chronic illnesses that need a medical plan that the just as Valerie was discussing um that the the the staff is aware of this and the emergency plan is is to be reviewed for each patient and it's more of an extension of what's done before school as opposed to the school becoming the medical home.

The the school cannot become the medical home. >> Exactly. >> It's in the UT training. Remember we you have to have the when you get the diabetic on your roster and you have to go get your utka training. Um it's that that's part of like the videos and stuff. I remember two of the post- test questions were about physical activity and what it does to glucose levels. So, I mean, they're getting they are getting trained and I mean, all I can do I know I just had a track girl that popped up on mine and when my track coach brought me the paperwork, I was like, "Make sure you find her.

Make sure where you keep her stuff." I mean, we're we're we're doing the best that we can and the coaches are doing the best that they can. I mean, she's going to go get trained. She's going to get all the stuff. I mean, I think we're already doing this. >> I think that should be our response. >> Anybody else? Okay, Dr. Harrison, what do we got? >> The next proposal from the public um is one um to mandate uh the use of guardian caps or the helmet additions that this committee has discussed at Nauseium.

Uh as a reminder, uh the committee just agreed um what last meeting or meeting before uh to allow uh guardian caps to be used in games. Um guardian caps are are and again that's a specific brand. There's a number of these. They are already allowed and have been allowed for some time in practice and are now allowed um to be worn uh during games. Uh this would like to take that significantly step forward. uh and require it. >> So I do I do want to add on when we did approve the use of uh elective use of this prior to the 2025 season uh we had distributed a study that was really the first study done on adolescence.

Um it involved over 2600 students in Wisconsin. The outcome of that study um was that there was it was not determinative that this actually showed to reduce impact in concussions. And I think Dr. Luke had a lot of great information when we actually were considering that. I think we again allow for elective use with a waiver being signed uh and probably would recommend that that be our continued approach given what is out there.

But Dr. Luke, I' I'd really like to hear from you from you related to this and then any thoughts the rest of the committee has. >> Um I am still in the same position I was before. I I agree with that. I don't think this can be something that's mandated. There's not [snorts] enough information out there that it is how preventative it actually would be. And as I had spoken before, the way that I talk about football and contact sports with my patients has adjusted significantly with the studies that have come out.

Not specifically about uh um the guardian caps, but specifically about risk of CTE. But I don't think there's anything to me that would mandate if if the professional teams don't mandate it. And we have no evidence for us that for our pediatric teen populations. I do not think that my stance would change at this time. I think the proposal is that we the UILAC um is against mandating generic or whatever guardian caps in the generic sense that we we are against mandating that >> I think it needs to be clear that what we're mandate we're what we're not mandating and the reason being that Science does not support the use of any of them above our standard helmets.

Agreed. >> I agree as well. >> All right. Anybody else? >> I agree too. I've always been in agreement. You can put 18 inches of bubble wrap on the outside of a helmet. The brain's still going to shake inside the head. Okay. The uh next proposal from the public is again one that this committee has discussed uh a lot over the last many many years and that's a proposal to require an ECG or EKG uh for every student athlete.

Dr. Her uh Dr. Finrich. >> Yes. Sorry Jamie. I'm having problems with my battery on my computer. Um uh you know we've talked about this multiple times over multiple years and um an unfended unfunded mandate that we do ECGs on everybody uh prior to participation has a lot of uh um it could be a positive um but there's so many negative issues that outweigh the positives at this point in time. Um there is one state, Florida, who made it mandatory.

Um and they just started that this year. Um I don't know how that is going and maybe um Mark can update us on anything he's heard at the uh national meeting. Um but I I I I understand and I hear what they're saying, but at this point considering a mandate to do ECGs on every uh every student athlete would be unwise. So our stance and the science hadn't changed. >> Correct. >> Just as a reminder to the committee, we did make a change to the medical history form that every student must complete.

I mean, in addition to what's required by state law that that they um receive some training on the symptoms of sudden cardiac arrest and response to uh sudden cardiac arrest, uh parents have the option on the medical history form of checking a box that says I would like my student to receive an ECG or EKG as a part of the pre-participation physical exam. Um at that point, uh it is it's on the parent or the school. the school can some schools do choose to take care of that.

Uh but that then becomes a required part of that student's pre-articipation physical exam. Um and parents have to get that provided for their student unless their school is voluntarily providing that. Um, so we've we've done a lot over the last several years in terms of education uh related to this issue uh and providing options for parents uh short of mandating. >> Anybody else? Okay, Dr. Harrison, what's next? >> Okay, that moves us to the uh next part of our agenda.

We're now under uh letter G, heat stress information. and I will turn that over to uh Razor Pay to present. >> Yeah, I'm just going to give you guys a quick update because we're still really in the middle, as you all well know, uh in the middle of our heat season. And so we'll have a much uh more complete report for you when we get out of this and get to the April meeting, not only statistically what our schools have been experiencing, but um kind of an evaluation of of how this year has gone.

Most generally though, I would say that implementation this year has been very encouraging. Uh you guys know that over the past 3 years, we have been recommending a very specific plan for use in our schools. Uh really recommending the use of the WBGT measure as their main means of measurement when making uh decisions regarding modifications of practices and activity levels. I will tell you, and again, I I think all of us that live here in Texas know this, this has been an especially challenging August and start to September.

I think September has been what's different in that the temperatures are not quite as high as they were two summers ago, but we still over the last 3 years have been dealing with historic heat conditions. And I I am proud to say that the work being done right now across our state by Texas coaches, athletic trainers, athletic directors has has really been admirable. Uh they've been making significant adjustments uh to not only their practice times that was mentioned earlier in this meeting.

They've modified equipment as necessary. Uh there's been great modification of conditioning as needed. Uh and even being very creative when it's come to accessing facilities for their students to to work out. Um I would also say that the UIL has uh has really improved our approach to education. Um, we have included a very robust FAQ now that gets into a lot of situations that trainers and and coaches will be dealing with uh as they as they try to implement our required plan.

Uh, anytime that we have questions that are not on the FAQ, we've been updating that on a regular basis. I do think our schools and I think our trainers here, I would love to hear from Valerie and Hondao and Andy, but I think our schools are more prepared than ever to deal with a heat illness and emergency. Um, we have seen a a a drastic ramping up of supplies on hand to deal with heat illness. And I think that where we are today regarding um education and understanding is light years away from where we were even 3 years ago.

I do want to add before I turn it over to them that the NFHS did release prior to the season updated guidance on differentiated conditioning for uh different football positions, especially offensive and defensive linemen. We did push that out to every single football coach across the state prior to the beginning of this season. And we have seen just anecdotally our coaches doing a great job of really modernizing the way that they approach conditioning for these uh specific positions in a way that keeps them safe.

My recommendation before turning it over to the group for comment would be that we maybe convene the uh the heat subcommittee maybe in January where we're in much better place to adequately address how this first year of rec required implementation has gone to review the plan and come back to you with specific environmental data from the entire summer in April along with any recommendations that the heat subcommittee might have.

But with that, uh, I'd love to hear from our athletic trainers and then really from the rest of the group. >> I I'll go first. Um, I'll tell you, I've been in this business for 44 years and u, we've come from inventing the wheel to a supersonic jet in a short period of time as far as heat illness goes. And you know, I remember back when I started, players did not even get fluids during practice. If they were lucky, they got a bucket of ice at sometime in between.

And from [snorts] where we were then to where we are now is phenomenal. And the coaches that I've worked with in the last couple of years at different schools, they have been gracious. They've been understanding. They've been accommodating to the readings on the WBGT whether they use Perryweather or handheld device or weatherbug or whichever their standard is because we don't have a required instrument in the UAL unless somebody's done it without my knowledge to measure WGBT.

And um but I and last year I got tons of complaints and phone calls about we're in class two or class three now. How come y'all are working out down there and we're not working out up here? And I go, "Well, cuz your weather's different today." I can't answer that question. But, um, overall, I think it has come to fruition that everybody's, it's like, hey, it's like getting through with your honeymoon. Once you get through with your honeymoon and a couple of years of marriage, you settle down, you get used to it.

And that's what we've done. And I think everybody's doing a very good job for the most part, without a doubt. I I think it's been going well too. The areas where I've been and seeing the changes that have come through continued conversation as well. You know, to kind of raise point about the FAQs, keep adapting based on the questions that come in. The dialogues have allowed some of our athletic trainers to improve what they were already doing and find new and creative ways of um having those cooling stations, having the cold water immersion, and utilizing new tools.

So, I think it's going well from what I can see. >> Yeah. So, the questions I actually get and I think it's a good problem to have is that um I've have athletic directors and coaches and athletic trainers that are so attention to detail oriented. So, they get all of that stuff that's on the UIL heat, you know, the recommendation and just being hyper vigilant and very very specific on what it, you know, those things say.

And that was never the intent. So the questions that I get were, you know, okay, I'm a single athletic trainer at this school. I teach all day. I only have 45 minutes between my last class and practice. What happens if I can't get my reading at 15 minutes? Well, you're not going to get sanctioned because you didn't get it at 15 minutes before. You know, if you have your opportunity to get it at 30 minutes before, you know, again, our recommendation is the 15 minutes and the 30 minutes in in practice, but you miss one or you're off by 10 minutes. that was never the intent.

Like I feel like the attention to detail sometimes they're going way too far. Um same thing with I had multiple questions on uh having to record the numbers. The recommendation is to do that. Nobody's going to get sanctioned if you don't. Especially the ones that I were getting had uh systems in place where you can actually go back and figure out what it was on that. Nobody's telling you you have to have another spreadsheet of your numbers. like we get so hammered into the details, which to me is a good problem to have.

They're really trying so hard uh to follow the the recommendations, but the WBGT numbers with the chart that tells you what to do, that's what we're telling you you have to do. how you implement, how you take your readings, how you record it, how you um, you know, monitor it, that's specific to what your policy, the stuff that you have access to, your personnel, you know, your venues, all of that. It we it can't be that specific.

We don't have universal mandates on that kind of specificity. Do you know what I mean? So again, the anything that I've gotten where they've panicked a little bit, it's because they're actually they're trying so so hard to make sure it's getting done correctly. Um, don't don't overthink it, you know, don't overthink it. Don't make it more than what it is. What we are doing is phenomenal. It is working. I think everybody has bought into it.

Um, I think we're doing really really well. >> I I will agree with that as well, Valerie. biggest question that I've got from my trainers down here in the South Texas area is what what happens when we go from red to black in the middle of a practice and you know do you immediately stop practice? Is it towards the end of practice? And so there was there there was a hypervigilance of of how to address that and and you know pretty much what was said was well you treat almost like a lightning strike and you're going to have to follow you know the higher guideline [clears throat] but the fact that everyone was aware of what we needed to do was was why I'm so happy with how the program's working. >> So Dr. too.

That's the initial questions that we've had and I would encourage all of the committee to possibly look at our FAQ because toward Valerie's Valerie's point um in situations like that, those were the the most frequent questions we've got. We've tried to address that and say you need to look at where you are in practice and there's no, as Valerie was just saying, a cut and dried way of approaching that. But the fact that we're wrestling with those questions and trying to collaborate between athletic trainers and coaches tells me that our kids have never been safer in what have been historically uh hot conditions here in Texas.

So really really proud of the work that everybody has done. Uh Joe from the coach's perspective of you know from you or Sam you got you want to add on to this because obviously you've been engaged with thousands upon thousands of coaches as we've implemented this. I I do want to hear from Joe and Sam, but uh coaches, if you don't mind, let me offer a couple of general observations. >> I think that that will help inform the comments we're looking for from you guys.

Um I I think generally what we have seen is as a reminder this was a recommendation for 3 years uh before it became a requirement and so we had a pretty significant runway and ramp up for people to get used to it. And by and large schools were following the recommendations. They struggled with them at first and then got better and got better and got better. And so the schools who were following the recommendations and paying attention to what this committee was recommending over the last 3 years um have really transitioned quite well into this requirement.

They've gotten very creative about times of practice, locations of practice, structure of practice. Uh they've done a really good job with that. Um we do have some outlying schools who really didn't pay attention to those recommendations over the last three years. uh and they have had a much more jarring entry um into this requirement. Uh so I I I think overall given the the just the sheer volume of schools and coaches and players that we deal with, this has been an exceptional addition and in echoing what Ray said, our students are safer now than they've ever been in practice.

That's a very very good thing. But we do have some schools who have lagged behind a little bit and and like I said, their learning curve has been a little steeper. They're still adjusting. Uh they're just having a little more difficult time adjusting. And it's important for me to say this, as silly as this is going to sound, uh I want to say this during this meeting, there are some elements of this that we know we have to look at. uh as Ry suggested, we need to get through this first hot period where we can have a a much more full data set and uh feedback u from schools uh to bring back to you at the spring meeting.

But there are some places like, you know, [clears throat] we all think of golf um in particular. I mean uh excuse me, not golf, we think of football uh in particular when it comes because of the the time of year and the pads and the number of kids and the physical exertion. But we also have golfers out there who are practicing. And there are times during um what what we have in our WGBGT recommendations that golf students are not able to go practice golf when there are hundreds of older, much less conditioned people on that same golf course playing.

And so we've got to find some common sense ways to address things like golf. And and we're committed to doing that. uh we would just like to get a a more complete data set and a little more time to get feedback from schools to bring that back to you in April. Uh so with those general comments, Coach Typton, Coach Martin, uh what are you guys hearing from your members? >> Well, I I would like to piggy back on to all the comments from our trainers, from UIL staff, and thank everybody on this call because our our student athletes are safer today than they've ever been when they're participating in outdoor sports in the fall.

Um, Hondao mentioned earlier, he's been in it for 44 years. I've been doing this for 48. Um, we didn't get buckets of ice back then. Hondo, we got a handful of ice and and it's changed dramatically since then. And I'm I'm I just, you know, tip a hat to the UIL staff, to leadership, to our trainers, and being able to get all this communication out there. We've been talking about this for three years. becomes a mandate this year.

And as Jamie mentioned, there's some that are lagging behind, but the vast vast majority of our coaches are understand exactly what they're doing and and what uh the needs are and our kids are safer. Obviously, there's some operational logistics um that we have almost in every school and that's our middle school athletes. um uh when you know we can adjust the high school athletes and we can practice them in the morning or we can practice them in the evening because they have transportation but our middle school athletes are locked in and and that is becoming a somewhat of a a [clears throat] bigger concern and and so uh we're communicating to coaches about being a little bit more creative about middle school football especially starting a little bit later in the year and something that we want to research and have a plan for moving into the 2728 school year.

Uh but uh I really appreciate this committee and everybody on here uh that's been engaged in the WBGT process uh because it's working and our kids are safer and um you know, not everybody's adhering to it exactly the way they need to, but the vast vast majority are and our kids are much safer. So I appreciate everybody's engagement. I want to jump on the comment that Joe made about uh middle school uh football. One of the changes that we made ahead of making this a requirement was to not have a a required start date for middle school football and so to allow great flexibilities for the schools to do what they feel is best for their junior high athletes given the impediments that uh coach Martin mentioned.

So, we have seen several school districts delay the start of a football season for middle school athletes, even if it's just a few weeks. Some of them have gone to right past Labor Day, etc. Some have even moved their season to the spring. Uh, so there have there has been some creative use of this allowance to to kind of deal with some of the issues that Coach Martin mentioned. Coach Typton, >> let's see if I can speak.

Uh, can you hear me? >> Yes, sir. >> I think there's a lot of things that need to be taken into consideration that happened. And one thing that I think has been a great great attribute to us being number one in the nation on heat related instances is the fact that the UIL allowed our coaches to work with our student athletes during the summer months and get a little acclamation of the heat that they're going to be taking place with.

Tammy cut out on us. So with with all of this being said, guys, it I think this has been a a great success. I will say this in closing in my report to you guys is I have figured out and I kind of knew this ahead of time with the uh type of participation numbers we have. Texas moves the needle when it comes nationally um related to th this topic especially and we've been fortunate enough to engage with a lot of leaders in this field national leaders in this field and I would tell you that we are leaning on them heavily right now to to kickstart uh their efforts to uh really look at the science that is available to see if and to pressure test uh uh what what we're doing um and and what I mean by that is we want to take care of kids in all areas of student safety and they've got to practice in order to obviously be fairly uh be uh able to safely participate.

And so um again uh I'm looking forward to what that's going to look like as as some of our partners uh start to really uh do some creative research and pressure test the science that's available. But we feel like we're doing the most good for the most right now with the implementation of these uh protocols. And uh again, it's been said several times today, super proud of our athletic trainers, coaches, and athletic administrators and how they have handled this implementation.

It's it's not been the easiest, but they've been the best. >> I I would bring up a couple of points to close. U no question this has been a tremendous success. I chuckle at Hondao's 44 and Joe's 48. [clears throat] I can remember, and I'm not going to give a years, but uh where there was not only no water, no ice, but there was a coach in the shower to keep you from drinking water. So, things have come a long way. Secondly, um I would be very careful about pushing this concept of specific training for specific positions.

I think if you look at it, it's not the position, it's the the body size and weight. And so while we encourage our our our coaches to treat the offensive lineman different, we need to have some statement in there. I mean, I've seen short and chubby tight ends and I've seen short and chubby fullbacks. So, we we have to be sure that we're we get the point across to them that that it's not it's not the fact that they play offensive guard, it's the fact that their their body habit is just different.

And and secondly, um is anybody, and I'm I'm addressing this to Al and and Jorge, is anybody related on field temperatures to wet bulb measurements? Ask that question one more time. Jesse, >> has anybody related wet bulb temperature readings to onfield temperatures? >> So, in other words, the measurement could be done in the coach's box or could be done on the track, but on for instance a synthetic surface, it might be quite a bit different.

Is that is that what you're saying? Yeah. >> Yeah. >> I'm not aware of that. >> I think And you know, it's just part of our >> Yep. Go ahead. >> We did back in the late 70s at my alma mater, Texas Tech up there where we had the old nasty original astroturf and we took a turf field reading and a wet bulb with the sling psychometer every day before practice. But I cannot remember any of those numbers, but it has been done. >> Okay.

I think we need to >> I mean >> as we go down the road that's something we need to be cognizant of. >> Last night the temperature at Memorial Stadium on the field was 163 degrees. What was the wet bulb reading? Are they related? And so I think as we go down the road with with our protocol we need to keep that in mind. I mean, it's pretty uh it's yeah, it's fairly clear from the few studies that are available and and those that include the high school level that it really depends on where you take where you take the measurement.

Jesse, if you're talking about, for example, using an app to get a wet bulb globe temperature, say for a region, [snorts] say like West Houston for example, does that does that wet bulb flow temperature different differ from the one you would get measuring it directly on the field? The answer is absolutely >> it can quite a bit. >> And again, Dr. Dele, if I could too, there have been a lot of discussion about the where and the how of doing the measurement.

And one of the things, and Valerie, I think you could speak to this as well. We wanted this really to be a guide to uh lead to more responsible uh decision making kind of in a general sense without being overly prescriptive and didn't want the uh the where and the how of how measurements were being taken and making it to be so difficult to do things that it led to problems with implementation. So, we haven't been super prescriptive uh with that, but have tried to also speak into awareness of where you're practicing at the hottest of times and encouraging um coaches to consider moving to grass, etc.

But Valerie, I don't know if you want to speak to Dr. Dele's concern just from an operational standpoint. >> Yeah. So, I think and y'all I think y'all even put it in the FAQ uh portion where we're talking about using professional judgment. Okay. So, again, I have multiple venues on just my single campus and then of course I have half a dozen satellite that are all over town that I I don't even go to. Um my, you know, if I do a a handheld wet bulb where, you know, in the middle of Panther Stadium, which is turf, but maybe on the back fields where we have grass, and then maybe band where they're on this asphalt kind of parking lot area, those are going to be vastly different.

And that's that's hard. That's hard to do. We don't I mean mo most schools probably don't have the resources to get you know $600 kestrels in 16 venues. So we use our one reading that is taken um on our app that's maybe not on any of those surfaces. But we just have to make sure that we understand that what we're doing is still significantly safer than what we were doing 5 years ago. So even though it's not ideal, maybe that one reading is not necessarily the same, you know, maybe a higher uh higher than what the grass is, but lower possibly where the where the asphalt is.

We understand that, but we have to use some kind of professional judgment where it's like, okay, actually where we're at, it's really bad. So h how about we move that inside or how about we we change a different field. We even have it where I mean technology is going to technology. We've already just this year our wet bulb was coming through and it didn't seem like it was right like the the one on our app. Well, and we're like, "Okay, no, it's it's really really not seemingly like it's right." So, we have a handheld.

We had somebody go out, we take we take it on, you know, uh turf or something and then that's what we used and we overrode our app system. So again, it's just being hyper aware, doing what's best for kids. Um having secondary and you know, even third options on how to take readings. Um but you have to use some judgment. But again, do doing a universal blanket um mandate or or even just even even the recommendations on doing it on every type of surface.

That's hard. That's hard for personnel. That's hard when you have venues. Um what we're doing is safe. Uh we're we're again we're doing the best that we can and I think the best that we're doing right now is really really good. >> I there's no question that that's true. My only my question was has anybody related these two measurements and we just need to have it that we have looked at that. Um, we're not there's no way we could we could mandate a specific turf or le or playing field for all the schools in Texas.

That's not the purpose of the question. The purpose of the question was, have they been related? And yes, we are aware of this as the committee. Period. >> Yes, sir. Jamie, what else? >> Yeah, unless there's other comments. Uh we'll bring uh more information to the committee at the spring meeting. Uh the next item on the agenda, it's that time of year uh where we review our medical forms uh so that we can make any changes that the committee recommends.

Um just as a reminder, we do that now because of timing. uh if we wait until the spring to do that and then we make changes often times schools have already gone through their forms collection process for the following school year with students and then they have to go back and redo all of that. Um so first form to look at is the uh pre-articipation physical evaluation medical history form. Um if any of our staff have um points of emphasis you would like to make please feel free to do it and otherwise ask the uh committee if there are any recommended changes to that.

Well, the Jimmy, one thing that we did provide on the physical exam form itself in the last meeting, if I recall correctly, there was a lot of discussion or at least some discussion in reference to changing to an annual physical examination requirement rather than it being every other year. So, what Jessica did on the form that y'all are looking at in your notebook is change the medical history form did not change in reference to that because that is already required annually.

What Jessica did on the second page for the physical exam itself was alter the language where it talked about what needed to be done uh to just say that the physical exam form must be completed annually prior to participation in grades 7 through 12. So that's just what the change would look like should this committee make that recommendation. So on the form itself, and Jessica, correct me if I'm wrong, that is really the only update to the form is should this committee make that recommendation.

This is what the change would be to the form as y'all requested to see at the last meeting. >> Yeah. So as a reminder of the conversation, prior rule was uh a pre-participation physical exam was required first year of participation in junior high athletics and first and third year of participation in high school athletics. Um [clears throat] while it's certainly not 100% uh the overwhelming majority of schools are conducting these annually anyway.

Uh so this would bring policy more into line with practice uh rather than the every other year requirement having it actually uh be annual >> in in the initial roll out of this. Can we maybe further italicize or bold or underline the word annually? I mean, if if that is the direction committee chooses to go. Absolutely. Yes, sir. >> Well, I think the the fact to that is is that if we if you suggest that uh the school district employees are going to know that it's been changed to annual and they're going to make sure that they do it. >> We can emphasize that on the form.

We will also uh heavily communicate that the change out if in fact the change occurs. that can always go out in the superintendent note. >> There's a a a sentence in the medical history on the bottom about having that form done every year. Can you use that same sentence and only because I I need to make it's very very common to have confusion on whether that means participation like in competition or in season but that's before any participation practice athletic period right I feel I feel like it's on the medical history >> it's in the capitals right there where Jess is at right there >> yes can we do that maybe >> let me make sure what we're what are we on page one or page page two. >> Right now, we're showing the bottom of page one and the top of page two.

So, the bottom of the screen is where the update is occurring to page two, the physical exam form itself. That is the updated language that would replace what's in there now. And then what Valerie's talking about is a little bit up at the bottom of page one adding that additional uh information that makes sure that people are understand that this needs to be on file prior to any practice scrimmage performance or contest before during or after school.

So kind of going back to what Dr. Pri was saying having some additional emphasis on the the specifics for annually and that this must be on file before they do any type of practice or participation or performance. Uh but again, if that is something the committee directs us or makes a suggestion to do, we will certainly get the form in the correct format, get it signed off on by the the subcommittee before we would make any presentation to the council in reference to that.

Uh so the the first step would be for the committee to decide whether or not that is going to be the recommendation. If that is going to be the recommendation, then we can certainly get the form in the proper format and get it signed off on by this group before we present it to the council and the superintendent. So Mark, two things. Um, getting to Valerie's point, the language that I'm looking at reads, "This form must be on file prior to participation in any practice, scrimmage, performance, or contest before, during, and after the season." So I I that says it already.

What language would be changed? >> No, we would add that same Oh, that's what's going to be added. Okay. >> We would add that language to where we already now we're change. we would add it here. >> All right. I think that's I I would be in favor of that. So I you know my philosophy is we we've always done annual physicals every year anyway. So what has changed? Um I I heard um I think it was Ray said or somebody said the common maybe it was you Jamie the common practice is most schools are doing annual physical exams anyway and we're discussing whether or not it should be mandated.

What what is there something that has been changed where we're now considering mandating it annually? uh other than what you described no um the just the thought was uh because schools are already doing it annually but [clears throat] predominantly right I can't tell you that 100% of schools are doing that uh should we require it so that all schools are doing that >> so so the I think the vast majority especially of larger school districts are requiring annual physicals there are several though that default default to the minimum standard of every other year that is required and typically that is sometimes in smaller communities.

And I think where we left off after April was the committee wanted to wait to possibly consider an annual requirement for all students here at this time. >> So, and that's I'm thinking about the burden. Is there going to be a burden on 1A and 2A and 3A schools that have elected to meet the minimum standard? Number one. Number two is is there evidence that annual physical exams um improve the rate of detection of injuries, old injuries or other conditions that in fact would improve the student athletes safety?

Is is there any new evidence that would support making this annual recommendation? Again, my my policy has always been every kid needs an annual physical every year, but we're talking about something different here. That's why we brought it to the committee. Uh Dr. Hergen wrote, we don't have any specific research or um findings from you know medical science that suggests that uh it is it should be. U we also don't have any that suggest it should not be.

So, we were bringing it to you guys as the medical practitioners to tell us uh should it be a required annual instead of first year, first year, third year. >> Um, for the burden of 1A, 2A schools, is this going to be some a mandate that they may not be able to reach? >> I don't I don't think so myself. Would it might be a little bit more difficult in certain cases? Absolutely. but they're finding a way to get the physical every other year.

I don't I don't think that this is something that could not be overcome and there are several schools of that type that are elective electing to have a an annual physical. >> Jamie, would you >> So my my comments would be this. I'm not aware of a situation where a school would be unable or would have a significant uphill climb uh to meet the annual requirement. um that doesn't mean that it won't be uh some additional burden on them.

Of course, it would be. The question is, do the benefits of that outweigh uh the additional burden? And that's really, you know, why we're asking you guys as the medical specialists. So to me, a theoretical unknown is that you require annual physicals, but um there's kids who don't have a PCP and they're not doing the mass physicals at the school, for example, and what are we going to do about that kid who can't get that that annual physical done?

Um how are we going to address that situation? If it were required annually, um you we we would provide as much guidance as we could uh to those parents or to that school in that particular situation uh to help them overcome the challenges of getting the annual physical but it would again if it's required it would still be required. >> I don't there would be like an exemption a hardship exemption from it. >> Yeah. There's going to be some kids who are not going to play sports because they can't get a physical.

I don't know what prevalence it is, but I think it's going to be one or three or 5% who just can't can't the wherewithal is they can't get their physical done. >> Is there any science that would suggest that it would be more protective for us to mandate an annual physical? >> No, there isn't. I think it's mostly a consensus that even I think it's what a American Academy of Pediatrics and American College of Sports Medicine say bianual um is kind of the consensus of of what should be done.

There's nothing to compare doing it by annually versus annually in research. Nobody's nobody's researched it. >> So there was a study done by Jim Garrick. Those who've been around for a while remember Jim Garrick. There's a study that showed most of what's detected in a preseason physical is in the history and we are still requiring an annual history every year. Right. Yeah. And and new physical findings are rare in terms of picking up a new murmur or picking up new hypertension, etc., etc.

So, the science that I'm aware of would say that as long as they're filling out at least a history every year, which if then it's positive, I've passed out when I've been running, I've hurt my knee, then that would I think that would require further evaluation, but I don't know that the science is there to change it from from what it is right now to annual, even though I believe an annual physical is a good idea. >> And I'll second what Dr. hurting wrote just >> so I think the consensus is leave the rule as it is required first year of junior high participation first and third year of high school participation and recognize that most will do it annually which is a great idea but those who don't or who cannot can still meet the requirement of the rule with uh as it's written with no change >> right that that would be the motion Second. >> A second. >> Second.

All >> in favor? >> I opposed. >> All right. >> Uh the next form to review is the sudden cardiac awareness form. Um, I will defer to uh Arie to discuss any changes he thinks might be needed and and followed by any member of the committee. >> Yeah, I've reviewed it uh again this year. I didn't see anything that I would feel compelled to change in that form. >> Anybody else? >> Okay. Next. >> Next is the concussion acknowledgement form.

Uh same uh to the committee. Do you recommend any changes to this? >> I think I think it's good the way it is. >> Okay. Anybody want to make a change? >> Okay. >> Okay. Now we um are at the part of the agenda to uh offer to you guys an update from the National Federation of High School Associations uh sports medicine advisory committee. Dr. Cousins. >> Yeah, as we uh do anytime we uh meet, we try to provide y'all with the latest information from the National Federation Sports Medicine Advisory Committee.

Their meeting actually comes up here in a couple of weeks. So you see the agenda that they're going to cover. Couple of things or three things I'd really like to point out. Dr. Finrich, uh, your question in reference to how it's going in Florida with their mandated ECG program. The the National Federation is getting a specific report from representatives from Florida at that meeting. So, I will follow up with Bob Colgate once their meeting gets done to see if there's any information that he can share with us from that update.

So, you can we can try to keep you up to date and keep this group up to date on how the implementation of their mandatory ECG program is going in Florida. Uh and then a couple other things uh we always keep track of from the federation. Uh the updates that they do to their position statements uh that they put out regularly. We like to make sure that we keep the we link to a lot of their information and share a lot of their information.

So we want to make sure that we keep up with the latest updates and things they have for their position statements. And then this group just back in April did some updates to our lightning uh policy and information. Uh the Federation Sports Medicine Advisory Committee is going to get some additional updates from uh a group on lightning safety and some potential changes to their lightning safety information that we will certainly look at uh and evaluate once it gets done and bring back to this committee if that's something uh that that we feel like needs to be looked at again.

So we can make sure that the latest updates we made to our lightning policies match what's being done on the national level. So, we always try to be consistent and provide the most up-to-date information. Uh, and then as you look through what the states are facing and what they're dealing with in their reports. I mean, a lot of the things it's similar to the same things that we've been dealing with. Uh, it's I always find it interesting that we deal with most of these things way before the other states do.

And that's just a credit to this group and the work that y'all do that we are uh among the states in the National Federation. We always try to be outfront on these issues and making sure that we are doing what we can and staying up to date to make sure our activities are as safe as they can be. But you can see what states face across the nation is nothing different than what we face here. Uh and thanks to this group and the work that our schools do, uh we're always near the front of any changes and things that need to get done.

Uh, and if there's any other specific questions or information about that sports medicine advisory committee or stuff you'd like us to try to find out, as always, just let us know. And we've got a great relationship with Bob Colgate and the federation up there. So, we can generally get information out of them pretty quickly if we need to. >> Number 28, as far as the use of peptides in high school sports is something that's particularly interest.

I think I'd like to hear more about ne next meeting. Yeah, we certainly can do that and we'll talk about under new business, we had an update to our steroid education. Uh we worked with the Taylor Hooton Foundation and peptides is one of the things that is discussed in that updated steroid education and we'll cover that pretty quickly under new information toward the end, but you are definitely correct. >> Um I will also point out and bring to the committee uh for your consideration that Dr. >> [clears throat] >> Cousins, correct me if I say anything wrong here.

Uh, but the NFHHS Smack did recommend to all states who have a medical advisory committee like you guys um that you consider adding a mental health professional uh to the committee. Uh so uh we bring that recommendation to you for consideration now whether or not you would like to do that and how. So my experience with this is that um there's no question that athletes have mental health problems. I think that as we start to think about having a mental health professional, uh, first of all, I think everybody on the committee is pretty aware that mental health issues arise in student athletes and we try to address them to the extent that we can in the context of sports medicine.

[clears throat] But sometimes there's this drift and it gets back to earlier comments that were made about um the school becoming the medical home is that um it from a mental health point of view. Let me give you a specific example. There's been some proposals that I'm familiar with that sports medicine clinics ask a question, have you been suicidal recently? For example, I mean there's there's standardized instruments PHQ9, GAD 7, etc. etc. that that that are being used in general clinics, pediatric, family medicine, etc.

The question is, if you're in a sports medicine clinic and somebody comes in with a knee injury or if you're a trainer in school and you're screening for this, what do you do with that information? So, I know that's not the question that you've posed, uh, Jamie, but I think if we add somebody, it's what problem are we trying to solve? It would be my question back to the the committee. >> Yeah, the federation when they uh made that recommendation, they did put out some information to that.

We shared that with Dr. Dele and we can share that with the rest of the committee. Uh, but that was one of the things they talked about in there was making sure when you're looking at getting a mental health person to be on your medical advisory committee, making those kind of decisions about what you're actually looking for, is it a researchbased person? Is it a practicalbased person? Uh, certainly someone who has some experience in athletics, adolescence, whatever it might be.

So, I mean, I think those would be the types of discussions that we would have as a group uh offline or sometime between now and the next meeting uh to have some determinations in reference to if that is a direction that this committee wants to go. answering some of those specific questions upfront and then trying to identify someone who would fit uh into that category and meet the criteria not only with what the federation uh is talking about and wants medical advisory committees to think about uh and then actually the the operational uh aspects of getting that person into the medical advisory committee and making sure that that role is something that's going to be beneficial to the committee and and stu safety of students as a whole.

You know, we've not had a mental health professional on the team for well, first of all, to suggest that we don't have a mental health professional on the team is to suggest that none of us are are aware of those issues, which I think would be a a misstatement. Everybody on this committee is aware of the mental health issues and we see them. We've not had a mental health professional since the founding of this committee.

And my question, a second question would be, have we have we not served the mental health needs of student athletes in Texas because we've not had a mental health professional on this committee? And my answer would be no. >> I would hardly agree with that. >> Just because everybody else just because everybody else is doing it, that doesn't mean it's that that doesn't mean it has utility. And that doesn't mean that it adds anything to what we're already doing. >> Dr.

Hendricks, >> I mean, I think I think I was going to say I think finding a a candidate is is is something that that that could be done there. There's certainly people that come come to come to mind, but I think we need to go back to the I guess the the root of this, which is why why is the the National Federation making this recommendation now? And what exactly is it that they they hope that that would accomplish above and beyond what we're already looking >> it it's certainly something given that it's a relatively new recommendation um you know we can hold and wait um let other states who do that uh report back to the smack the utility to use Dr.

Hergen wrote um word um that they found from it and see if we can get some more direction and more information from the National Federation Sports Medical Advisory Committee before moving forward if that's what the committee would like to do. >> This is something I think I brought up maybe a year ago just as a as a suggestion or something to contemplate. when you look at what subjects and what topics that we're dealing with and what we've been dealing with for the past, you know, couple decades, um, mental health isn't really the forefront of what we're dealing with with sports and safety for our student athletes.

We certainly, I mean, I think the closest thing that came towards it was sleep, but that's certainly something that we wouldn't need a mental health professional to step in and join the committee and help us with. that's something that all of the clinicians on this committee are wellversed in. Um, and so I don't think getting input from a mental health um, professional would be is ever a bad idea, but I don't know where that falls in our scope for the health and safety of these student athletes just within athletics and, you know, other UIL events. >> Dr.

Luke Yes, I would agree with what Dr. Hendrick said. Um, this is not this is something we all deal with all the time and to incorporate uh a mental health professional. I would want to know what we would specifically be able to do to apply to our student athletes. And to be fair, I think that may be really out of the scope of what this committee and what the schools and the trainers and the people involved with our athletes would be able to do.

You know, I I think if the need for uh further consultation with a mental health professional arises, it could be done independently and not necessarily have to be added to the committee because I agree that we all have the the capabilities of addressing these uh circumstances on a case-by case basis. >> Anybody else? I think if [clears throat] I think we continue to discuss this, to me, it borders on the idea that the medical advisory committee becomes the source of medical care for the population.

And that's not really our charge. I mean, this is something we all deal with. Um, and I think I think it would create a lot more problems than it would solve, but let's just let's just revisit this, Jamie, at the next meeting. Just put it on the agenda and we'll discuss it. People have had time to think about it to see if they really they really believe we would benefit it and would it help our charge? >> Yes, sir. We can do that.

Um, I need to apologize to the committee. I got a bit ahead of myself, which I am apt to do on occasion, and skipped an agenda item H, uh, the concussion update. We do have an update on our concussion training. Yeah, I'll I'll give that real quickly. Um, in the past, you guys, I think you guys know that uh, coaches are mandated to have two hours of training um, every two years. And in the past, the minimal concussion training that we provided for coaches only really satisfied one hour of that training or 30 minutes a year.

Um, we did work with uh Baylor, Scott, and White to uh to revise that training. They provided a new video training that actually does 100% satisfy the requirements of the state law um just in its entirety by a coach taking the training through our uh training platform. uh and I do think that that has proven to be at least initially helpful to coaches espec especially in rural areas that were not able to access training uh a training professional come in and service their coaches and so uh we have received very positive feedback on that but uh would like to share the training uh especially with uh Dr.

Luke and and anyone else that would love to uh see that and review that and be able to get some feedback as we kind of evaluate uh how that has gone in the first year of expanding that training. >> Yeah, Ray, if you could send around that link, I'd like to look at it. >> Yes, sir. >> And may I tell you guys, thank you so much for this. You have absolutely no idea. every single year us trying to find a different avenue and venue to try to satisfy that has honestly been a beating.

I think it's been phenomenal and I am so grateful. >> And I I also think it's a great idea. But I do have a question. If um someone go can they can an outside source of concussion training that satisfies the requirements be accepted in lie of what Baylor Scott and White's doing still like it used to be? 100%. And uh we've changed the language uh to to say suggest that if you have a provider or you have a source of information that you feel like would better serve your community that you can certainly do that. >> Perfect. >> Jamie, anything else? >> Yes, sir.

So, now we'll go back. Um, we are on item K, the injury update, uh, where we review the catastrophic injury forms submitted to us and the AED use forms submitted to us. Dr. Cousins. >> Yeah, as you see on there, there are four items uh, on uh, the list here. Uh, a couple of AED use reports, one on a patron and one on a student athlete. Uh, and then two catastrophic injury reports, both on student athletes. One from a soccer game back in the spring and March. uh where a collision occurred between a player and a goalie uh and the student ended up with a lacerated liver and then on the other catastrophic injury report.

Uh kind of want to let Val give us an update. You can see the information there. Uh but see if Val do you have any update or any information you'd like to share about that? Uh what I gathered was he was after the incident um referred to a neurologist because this happened um right at the end of the school year. A lot of the follow-up stuff didn't happen with us cuz we don't work over the summers. Um but he was kept in a cervical something or other.

I mean he was immobilized for about four weeks uh post injury. Um and then I believe it was 2 weeks later he was released to a slow progression back. So sometime over the summer has been released back um into participation and is participating with us now. >> Yeah. And as always we will continue to share these reports with uh the committee as we get them uh or we'll get them and make sure that they are summarized and submitted to you guys uh at the meetings.

And if you have any questions or any information, uh, just let us know and we'll try to gather as much information as we can and get information back to you. >> Hey Mark, um, as I read this this over, um, I want to make sure I understand this is a voluntary reporting system, right? No, we anytime we you guys recommended a couple years ago, I think all the way been a few years now, that anytime there is a catastrophic injury that meets the definition from the National Center for Catastrophic Sports Injury Research, that is a required report.

And anytime that a school uses an AED in association with a UIL practice or contest, it is a required report. So I would find it surprising and this is over the last 12 months or is this just since April? >> No, this just since our last meeting. >> I would be surprised, Arie, for example, that in six months there's only been one AED use in a in a sort of UIL sanctioned event, whether it's a athlete or or a a patron. Does that surprise you that there's only been one AED use? >> Um, a little bit, but I I know it's a mandatory form.

So, I I don't know if um if there's any way to to uh to review or to ensure that this is getting these forms are getting filled out and submitted. Um Mark, Jamie, you guys could probably comment better. >> Well, what I can tell you is this. As you said, it is required. Um I don't know that there is a way for us to offer you 100% certainty that every case has been reported. What I can tell you is our staff is very vigilant.

Um they have Google alerts and other things set up so that anytime there is something in the media um that's reported about this. Uh if we have not gotten a form, we follow up with that school. So again, that's that falls short of 100% certainty, but there is vigilance from our staff in following up on cases that uh we know about, including a number of ways for us to find out about them uh to make sure that we got the form.

Mark, is there anything you would add to that? >> I would just say timing. I mean, the we we had a meeting in April, late April, so I mean, really, there's only one month of the school year left uh for our activities to occur. Then you've got summertime to where uh I mean there's hardly any activities. I mean we got some practices going on strength and conditioning and then now we've only been back into competition uh for less than a month generally.

So I think it's more related to timing than it is with anything. But yeah, there's no way to know that we're 100% on these. But I can say that I know Ray and his staff and what I do. We watch out for these types of things. We track news reports and anytime there is a report in the news or any type of information, we do follow up with the schools to make sure that they're doing what they're supposed to do. So, no, we can't guarantee you we're capturing 100% of them.

But anytime we become aware of one, uh we we are very vigilant in making sure that those reports get filed as required. But timing I think is the biggest reason for why there's not as many in this report as you would normally see like in an April report where there's a lot more school year time involved. >> Related to the timing, I also want to mention there's always going to be a lag in reporting too. For example, we're aware of a situation that occurred uh on Labor Day with the school and are working with the school right now to get their required reports in.

So there have been additional uses of particularly the AED as we've kind of gotten back in are in the process of working with schools and so you would probably see that those uses that have been most immediate on the on the report that will be delivered to you in April. >> Point of clarification the the mandatory reporting is for all size districts not just 6A 5A. Is that correct? >> Yes ma'am districts. Okay. >> And and let me ask, you mentioned something about you you'll look at the media to see if there's anything that may not have been reported and you'll go back to the school and inquire about it.

Is that is that what I heard? >> Yes, sir. >> That's pretty impressive. >> We are in a transition right from how to report since portal is going to rank one or whatever. >> AB: Absolutely. So Mark, you want to speak to that? Yes. So we are transition we transitioned to a different electronic provider. So the the reports generally were done through what we call the UIL portal. We we're in a different system now. The reports are not in that system yet.

So we developed our own reporting system. So here in the meantime, should something occur, even though you wouldn't report it in the same way that you did before, we have a separate distinct report for both AEDs and catastrophic injuries that gathers the same information. uh they just do it directly through an online form rather than through our electronic portal. But that is going to be in our electoral here pretty soon.

So it'll be done the same way it's been done in the past here pretty soon. But even in the interim, we have a way to gather the information for those required incidents. >> Mark, do we ever get the followup of the fatality in San Antonio from the autopsy? >> I don't know that we got the autopsy, but Ray, correct me if I'm wrong. I'm pretty sure the athletic director from that school district did submit information. Uh, and if I'm not mistaken, Ry, I think the determination was uh HCM on that student. >> Yes, that's that's correct.

That's correct. So, they did kind of get back to us after after the fact and uh indicated again, this was not we didn't get the formal report. We've got an informal update from the athletic director and it was as indicated as Dr. Cousins indicated. So Mark, don't we get the autopsies on these? >> We generally have done that request. I don't know that we've done that request for that particular student, but we got that information from the athletic director, and I would assume that he got that from uh the the autopsy report or from someone with the the county. >> Yeah.

Can are we going to get the autopsy report? >> We can make the request. >> Okay. Mark, just as a uh anecdote, um I wonder if you would if you would indulge me. We had in um this is from July of last year and this is public information so I don't know this is not a HIPPA violation. There was a um Cypress Spring football player named Jarvis Spires who had heat stroke and he ended up getting put on ECMO. And I wonder if we could go back and check in our reports to see if this was July 5th, 2025.

This report um patients names Jarvis Spires, Sci Springs, Cypress Springs. Just out of curiosity, I'd be interested to know if that was reported because it was in the newspaper. >> I recall correctly, Dr. Hergen Rotor. Um, Ray, that's your old neck of the woods. So, tell me if I'm wrong, that that occurred while the student was actually working with a private trainer and not while they were engaged uh in actual UIL activity. >> Yes, that's what happened. >> Very much aware of that situation.

Have have talked to staff at that school and have a lot of details related to that. uh it was not formally reported through the system again given that it was not attached to a workout at school etc. But we were in direct conversation with the school district related to what caused the incident to happen and the student's recovery. It would be uh important to say that the student is participating now which is which is nothing short of miraculous. >> Yeah.

Oh, that's awesome. Okay. >> All right. So, I guess the one thing left, Jamie, is subcommittee discussion and reports. And before Jamie gets too far into there, Dr. uh Finrich, what we included uh in here is the copy of the form that Florida is using for their mandatory ECG screening. Uh, and then if you go to the next part of that, uh, it's an actual part of Florida state law where they actually put this in place. And it really starts at D1, which is at the bottom of the first page.

Uh, and then goes all the way down to almost the bottom well before F uh, get get started. And that's just the information that we provided in reference to the law that Florida passed and the form that the Florida High School Association is utilizing uh for people to report uh and submit their clearance for the ECG screening program in Florida. >> Yeah, thank you for including that. I I have some friends who do what I do in Florida who whom I've talked to and they are um they're pulling their hair out. um trying to comply with this mandate. >> Yeah.

And we'll gather additional information like I said from the federation. They're getting a report on this and they're meeting here in a couple of weeks and we'll make sure and uh get that information and get that out to the committee as well as soon as we can once that get done so you can get get an additional update on that. >> You know, this is going to be another opportunity. We have a legislative session coming up and I can just imagine the conversations of advocates who say, "Listen, Florida's doing this.

Why is it Texas doing this?" >> Yeah. >> Yeah. I agree. I have that same concern, Al >> because we came pretty close. I think four years ago. I think it was a 4 to3 vote that voted against it. >> Yeah. and Texas would be immensely more challenging than a state like Florida with our the number of um large cities that we have and the the number of uh remote and locations and small schools uh throughout Texas. Yeah. I mean, I know it's been said already, but there's some urban schools here where this would be would have a significantly negative impact. um kids who have public insurance or no insurance and if they get a screen and it's a positive, they're not going to be able to go see a pediatric cardiologist and get evaluated and they're going to get they're not going to be able to play sports.

So, I think we need to continue to advocate in any way we can that this is a bad idea. This is not supported by science. I shouldn't say a bad idea. This is not supported by science. >> I think that's I think that's the key. It's not whether we put small schools in a bad situation or poor people in large schools. That's not the issue. The issue is science does not support this. And I think that's got to be our stance.

And plus in in Florida, if you look at what the who uh how they obtain ECGs, there's a company called Who We Play for that will um mail e uh ECG machines to schools. They charge $10 a person and they're read by people who I don't feel are qualified to be reading ECGs in in adolescence. Who's you reading the morning? >> Uh, I know in in Texas that there was a um adult um um family practice doctor that was reading them. >> Yeah. >> Yep.

That's a problem. >> It is a problem. And then they feel safe. Um which is not the case. Jamie, what's next? >> Uh, we have an update on uh our anabolic steroid training that's included in our coaches certification program. Uh, before we move on to that, I want to make sure I don't think there are any other subcommittee reports, but want to pause for a moment to make certain that there's not. I was just kind of from a cardiac standpoint.

I was going to uh I think I mentioned at the last meeting that uh uh me in conjunction with Brian Cannon who used to be on the UIL medical advisory committee and one of their fellows at Texas Children's um wrote up the experience of the uh UIL with since the AED use form became implemented and mandatory. That's going to be presented at the American Academy of Pediatrics meeting on October 3rd and the paper um is in the works as well. >> Hey, can you send a copy of that abstract around, Arie? >> I will. >> All right, Jamie. >> Okay.

Um, we have worked uh very closely with the Hooton Foundation um to improve our anabolic steroid education. Mark, if you want to walk us through the slides. >> Yeah, so I mean I think we sent this around for consideration to a number of you guys as they were going through and developing this. Uh Taylor Hooton Foundation has been around for a long time. Don and Don Jr. uh have been really uh communicative with us and and really helpful as far as information.

But you can see we updated uh we kept a lot of the same information in there because a lot of this is required under state law even though we're no longer actually steroid testing. The students are still required to agree to be tested for steroids should they get selected. And there's information, educational information that needs to be in there. Uh, so you can see as you go through here, uh, a couple of the additions that we talked about, I don't know that we actually specifically, and I mentioned this earlier, and I might have been a little bit off.

I know in the voiceovers and in the information that that Don provides, I know he mentions peptides in there, but the biggest thing that we added that haven't been here before, and a lot of you may know much more about this than I do, is what SARMMS, the selective andogen receptor modulators, uh, that are out there now. And obviously uh just the the the things that are coming along like peptides and those a lot of other things that are really just not much information known about yet.

So it's kind of hard to cover them and provide that information. Uh but we certainly uh tried to do a good job of providing the latest information and having somebody at the forefront assist us with this because that's basically what the Taylor Hooton Foundation does. Uh and I think one of the other things too, we added a couple of uh pieces to our resources, updated uh the information that the federation has on their NFHS learn course on the appearance and performance-enhancing drugs and substances and made sure that we had the latest information on their update to their position statement.

And then you can see we added some specific uh information for the Taylor Hooton Foundation and how coaches can talk to players and loved ones about this issue. but wanted to just as we did with the concussion education piece uh that we tried to update and make sure that we're providing the latest information, want to provide y'all with an update on how we did that with anabolic steroid CCP for our coaches as well. Uh and I think Ry, correct me if I'm wrong, it's I think we're around what 50,000 51,000 uh coaches that are signed up to complete this uh steroid training along with all the other trainings that we have in our CCP.

Yes, it's been it's been really good. And and uh one of the pieces of feedback that we've received from schools is very much like what you heard earlier from Valerie related to the concussion training is that the resources have improved greatly over the last uh two to three years. Um so pretty proud of that. >> And Mr. Chair, that's uh that's the end of our agenda. >> Okay. Anybody got any other business? Well, we want to thank all of you all for donating your Saturday Sunday mornings.

Uh we this committee has done a great job as we've mentioned and I'm proud to be a part of this committee. Very proud. >> We'll see y'all next April. >> Well, what is do we want to look at? When is the >> Yeah, let's pick a date. Jess >> April meeting. I'm trying to get an idea. >> Easter is on March 28th. So, April's pretty free from the standpoint of Easter. >> Yeah, it's in March. We were looking at uh the 18th. >> 18th of April. >> Mhm. >> Yes. >> Pencil it in. >> Sounds good. >> I I always have to qualify my acceptance because this is not my strength making um making appointments six months in advance.

So, I I'll give a qualified yes to that. >> Well, thanks to all of you for your time. We greatly appreciate you donating it and um I can't say enough. There's always room for improvement, but our students are participating in a safer environment uh now than they ever have and it's because of your work. So, thank you for that. >> Thank you guys. 10 four. >> Thanks everyone. >> You all take care. >> Yeah. Have a good one.