Someone has a an appointment at four o'clock.

So the hour haven't reached two p.m.

I'd like to call to order the meeting of the Cook County Health and Hospitals Committee's special meeting, roll call.

Commissioner Aguilar.

Commissioner Aguilar is absent.

Commissioner Burton.

Here.

Commissioner Burton is present.

Chairman Daly.

Commissioner Dagna.

Commissioner Dagnan is out of the room.

Commissioner Gaynor is excused for today.

Commissioner McCaskill.

Commissioner McCaskill is present.

Commissioner Miller.

Commissioner Miller is currently out of the room.

Commissioner Moore.

Is present.

Commissioner Marita.

Commissioner Moran.

Commissioner Marita is present and connected remotely.

Commissioner Kevin Morrison.

Commissioner Sean Morrison is absent.

Commissioner Scott.

Present.

Commissioner Stamps.

Present.

Commissioner Trevor.

Here.

Commissioner Vasquez.

Chairman is present.

Present.

Chairman, you have all members present with the exception of Commissioner Aguilar, who is currently out of the room.

Commissioner Dagman.

An excuse absence for Commissioner Gaynor.

Absence for Commissioner Miller and absence for Commissioner Shamore.

So you do have a quorum.

Commissioner Britton now moves to allow remote participation, seconded by Commit Commissioner Scott.

Roll call.

Commissioner Aguilar is absent.

Vice Chair Naya.

Commissioner Britton.

Aye.

Commissioner Daly.

Commissioner Dagna is absent.

Commissioner Gaynor is excused.

Commissioner McCaskill.

Commissioner Miller is absent.

Commissioner Moore.

Commissioner Marita.

Commissioner Marita is aye.

All previous votes were aye.

Commissioner Kevin Morrison.

Aye.

Kevin Morrison I.

Commissioner Shah Morrison is absent.

Commissioner Scott.

Aye.

Commissioner Scott is aye.

Commissioner Stamps.

Aye.

Commissioner Stamps is aye.

Commissioner Trevor.

Aye.

Commissioner Trevor is aye.

Commissioner Vasquez.

Aye.

Commissioner Vasquez is aye.

Chairman, your vote?

Aye.

Chairman's vote is aye.

Chairman, you have 12 ayes, five absent.

Thank you.

Any additions to the agenda?

You have no additions to your agenda.

Public speakers.

Would you explain the process and let's go?

Yes, sir.

Public speakers authorized as a public speaker should only be granted to those individuals who have registered to speak.

24 hours in advance of the meeting.

Authorized public speakers.

Where is the public speaker?

There we go.

When addressing a board, failure to act appropriately or failure to adhere to the time requirements may result in expulsion from the meeting and or disqualify the person from providing future testimony.

Our first public speaker is Liz Nicholson.

Liz Nicholson, followed by Bob Ryder.

Great.

Would you add Commissioner Miller to the role, please?

Hi, everybody.

Can you hear me?

We can hear you.

My name is Liz Nicholson, and first of all, I'm very happy to be here today.

Um many of you I know, and I was here maybe in February, and um I just wanted to reintroduce myself and uh very quickly before I pass it on to my colleague Bob Ryder.

I just wanted to let you know that I am the wife of what I like to call a football lifer.

Jerry Sullivan is my husband, who currently has Alzheimer's and suspected CTE.

And um before I go on, I want to thank Commissioner Tara Stamps and Jameer Atkins for really bringing this issue to light here at the county level.

Um and I just wanted to thank everybody in the room today because this is such a an issue that's obviously near and dear to my heart because it's personal to me.

But I think that um you're gonna hear from my colleagues just how uh pervasive it is with context sport athletes.

So again, my husband started playing uh Pop Warner, went on to uh OPRF high school, then went to Illinois, and then he was drafted in 1974.

He's a lot older than me.

Um and he played nine years in the NFL, two more in the USFL.

And I've been dealing with um CTE symptoms for many, many years now.

He was diagnosed in his early 50s, excuse me, with uh dementia, and he um all the signs are there that he's got CTE, but obviously it can't be diagnosed until post-mortem.

Um and all the symptoms of rage.

Um, and all the symptoms of rage, uh very, very, very bad aggression, suicidal ideation, addiction problems.

And when I talk about rage, um the last thing I would want anyone to experience is the kind of rage and violence, uh, frankly, that these guys um and and women too that are contact sport athletes uh experience.

So, anyways, I'm not gonna stand up here very long because many of you already heard my story, but it's a very um yeah, I'm so happy and thankful to you, Commissioner Stamps, and everybody in the room for bringing awareness to this issue that is very near and dear to my heart, and also it's not just professional athletes that get CTE.

In fact, you'll hear from my colleagues that it's very very pervasive now in high school, and uh folks that uh you know maybe went on to college or didn't even go on to play college sports, uh, contact sports.

So, anyways, I just wanted to say that um the other uh big thing that you've seen recently in the news, our very good friend Steve Mongol McMichael.

Um NFL football players are four times more likely to develop ALS as a result of um their uh football, and we're gonna tie that in probably to CTE.

So they experience ALS Parkinson's and then what my husband has, which is Alzheimer's.

And I almost like to say garden variety Alzheimer's because so many of his colleagues, so many of his contemporaries from the NFL have it.

Um I just wanted to say uh Steve McMichael, his brain went to B U CTE Brain Bank and he had stage three CTE in addition to ALS.

So I'll let my colleagues talk about that.

But thank you, thank you for allowing me to tell my story.

Thank you, Commissioner Stamps and Jameer Atkins and all my colleagues for being a part of this.

Thank you very much.

Thank you.

Our next speaker, Bob Ryder.

Following Bob Ryder and Johnson Mr.

Chairman, Commissioners, um, my name's Bob Ryder.

Among other things, I'm uh president of the Chicago Federation of Labor.

I'm the finance chair of the Cook County Health and Hospital System.

I'm not appearing before you in the either of those roles, but in the role of Bob Ryder, who was a um football athlete for eight years, concluding starting in sixth grade, concluding in my freshman year of college.

Um I'm also a member of the Chicago Advisory Board for the uh concussion and CTE Foundation, which I've been active in several years for several years.

Um as Liz mentioned, a CTE diagnosis is made post-mortem.

Uh I I'd be sort of that's all right.

I'd be shocked if um my brain was looked at at that at that point, and I would not have some level of CTE damage.

What is interesting about CTE is regardless of whether you have stage one, stage two, or stage three CTE, depends on where the CTE lesion appears in your brain and how it um how it impacts you.

You can have what would be diagnosed as a mild case of CTE, but have more extreme um symptoms in terms of behavior than uh someone who has a more severe case that has a different part of their brain injured.

And there's no way to know what part of your brain is uh suffering injury after you receive the concussion.

Because it when you're a football player, you take a head-on hit and then you hit the ground, or in my case, my first major concussion was I was chasing a downfield runner, pinched his jersey, went um went over the top of them, and as an eighth grader, rolled what and felt my head bouncing inside my helmet for about five to ten yards.

My last concussion as a football player was in a practice where I saw my toes at eye level on a blind sight hit by one of my teammates.

This is something that um one goes on across our communities.

And let me highlight why this is important.

Concussions don't just occur in sports, but so many of our youth use sports as a way to get to college.

I'm one of those people coming from a working class family.

Those scholarships matter.

A friend of mine um donated his brain um upon his death this last year, and he was diagnosed with CTE.

He was a professional wrestler, but his day job was actually at one point being a building service manager, um, running security for uh downtown buildings, grew up in Melrose Park, and um was about as blue collar as it gotten.

Thirty seconds.

Kids chase their dreams and end up with lifelong injuries.

My hope is that we're doing better today, but we can always do better.

You'll see over the course of the next 10 years how much more we're gonna be dealing with these injuries.

My time playing as a football player, the impacts started to get harder, swifter, and more devastating as we had the illusion of safety, starting with improvements in helmets and pads that weren't really improvements that made us feel more invulnerable.

We need coaches, doctors, adults, the standby children to make sure that their health and safety is protected in whatever sport they engage in.

We need to take, we need to make sure that a worker when they're in an industrial accident is looked after after they receive the concussion because shaking it off can be can be something devastating that happened that that visits itself upon your family later in life.

I know to be on the lookout for whatever symptoms I have and make sure that while I while I have my faculties and I hope I have them for a long time.

I prepare my family for what could come next.

So folks like Liz who are married to a um or married or living with or have a have a relative that is suffering from those symptoms, they're prepared for what comes next and not learning about it as it were on the fly.

So I am I'm excited that we're having this discussion because our children and whether they're the child of an athlete or athlete themselves or someone who who was in a bad car accident that were on the lookout to make sure that everybody is that we're protecting their health.

Thank you.

Our next public speaker is Ann Johnson.

You're connected virtually.

Thank you, commissioners, for having me.

My name is Ann Johnson.

I'm a 30-year-long educator, and I've been um involved with the concussion and CTE Foundation for over a decade.

I have a son who's a student athlete, a football player, lacrosse player.

Youth sports are one of the greatest gifts that we can give our children.

When kids play team sports, they learn lessons that stay with them for life.

They learn how to work together and share a goal.

They learn discipline, responsibility, and perseverance.

They build friendships, confidence, and resilience.

They learn how to win with humility and how to lose with grace.

But along with all of these incredible benefits comes an important responsibility, making sure the games that our children love are safe for them to play.

Every year in the United States, millions of sports-related concussions occur, and many of them involve children and teenagers whose brains are still developing.

A young athlete takes a hard hit during a game, maybe during a soccer header or football tackle or a collision in hockey.

The player feels dizzy for a moment, maybe their head hurts, but they shake it off, they look at their coach, they look at their teammates, and think one thing.

I can keep playing.

Many young athletes are taught to be tough, to push through the pain, and to never quit on their team.

Those are valuable lessons in sports, but when it comes to head injuries, that mindset can be very dangerous.

This happened to my son who played football in high school, and during a preseason practice, he was concussed.

Fortunately, he played at a school that had teamed up with the concussion and CTE Foundation to educate and train the coaches and athletic trainers.

He was pulled from playing and entered concussion protocol and eventually returned to play and went on to have a successful college career with a perspective of advocacy for himself.

A concussion is not just getting your bell rung.

It's a brain injury caused by a blow or a jolt to the head that the body causes the body to jolt and the brain to move rapidly within the skull.

The symptoms are not always obvious.

A child might experience headaches, dizziness, confusion.

And sometimes the symptoms don't appear right away.

Sometimes the athlete doesn't even realize that something is wrong.

That's why awareness matters so very much.

Parents need to recognize the signs.

Coaches need to take head injuries seriously.

And young athletes need to know that speaking up about symptoms is a sign of strength and not a sign of weakness.

The truth is most kids don't want to come out of the game.

They worry about letting their team down.

They worry about missing the next match, so they stay quiet.

But playing through a concussion can lead to longer recovery times and more serious injuries.

That means creating a culture in Cook County where safety comes first for our children, encouraging honest conversations about injuries and ensuring every athlete who may have a concussion receives the care they need before returning to play.

Because protecting a child's brain protects their future, their education, their opportunities, and their quality of life.

And when we truly commit to protecting young athletes, we must do more than just raise awareness.

We must make sure that their health is within reach.

And I'm sure that Cook County can do this for our students.

Thank you.

Thank you, Chairman.

That concludes your public speakers.

Thank you to our speakers for sharing wisdom in your personal stories.

Vice Chair and I now moves to defer item 26-0649 a resolution requesting that the Cook County Department of Public Health in conjunction with Cook County Health develop CTE damage awareness programs and help to facilitate referrals to concussion clinics for athletes that the state of Illinois regulate NIL deals and that the federal government fund research on how the portal and NIL deals may affect CTA, CTE injuries and the mental health of young athletes.

Seconded by Commissioner Stamps.

Commissioner Stamps, would you like to speak to the resolution?

And leave to address Yes, sir.

Thank you.

Thank you to the public comment speakers.

Good afternoon, colleagues, partners in public health, medical professionals, coaches, parents, and members of the community.

Today today we gather to discuss an issue that is both deeply personal to me and critically important to the health and safety of young people across the county.

As a mother, I stand before you not only as a commissioner, but as someone who has lived this experience firsthand.

I am the proud mother of two sons who played football since the ages of eight and nine.

Like so many parents, I sat in stands, cheering them on, celebrating their victories, and trusting that the sport they loved would help shape their discipline, teamwork, and character.

But as a parent, I also carried a quiet concern, one that many families share.

Every hit, every tackle, every moment when a player stayed down just a little longer than expected.

Made me ask difficult questions.

Are they safe?

Are we doing enough to protect them?

And what are the long-term consequences of the game they love?

Okay.

Those questions are what brings us here today.

Chronic traumatic encephalopathy, commonly known as CTE, is a progressive neurodegenerative disease associated with repeated head trauma.

It has been identified in athletes, veterans, and individuals exposed to repeated brain injuries over time.

And what makes CTE particularly concerning is that it can currently only be definitively diagnosed after death.

The reality should compel all of us, policymakers, educators, coaches, health care providers, and certainly parents with an act to act with urgency and responsibility.

Here in Cook County, we recognize that sports are a vital part of youth development.

Sports build confidence, create opportunities, and open doors to scholarships, careers, and lifelong friendships.

But participation in sports must never come at the expense of long-term health.

Research has shown that young athletes who participate and tackle football can experience significantly more head impacts than those in non-contact sports and even impacts that do not result in diagnosed concussion can accumulate over time and contribute to neurological and behavioral health challenges in life.

This is not out of fear, but it's out of a discouraging participation or discouraging participation in sports.

It's about responsibility.

It is about making sure that when our children step onto the field, they do so in an environment that prioritizes safety education and prevention.

I want to thank Jameer for these wonderful comments that he put together because he've heard me talk about this for so many times.

But I I just want to speak to you all sincerely because I was getting a headache reading all of those words because people have said them.

Let me just say this.

My two boys who I oh I I I can't it's inexplicable how much you you may love your you love your children.

But my two boys have played football since they were very young.

And maybe around when they were 14 and 15, I started noticing differences in them.

Differences in how they reacted to their friends, differences in how they reacted to their parents.

And I've been a teenager, so I don't operate under this misnomer that I was born grown, although I think I was, but I would I I've been a teenager.

It was not the same.

What I was watching in my boys was not the same.

And it became even more alarming to me when they went off to college.

And as much as we want our children to go out to college and to be successful and to play the sports that they love and all of the things, college can also be trying.

It can be isolating.

There are people there who just care about how fast you run the ball, how quickly you got downfield, how many hits you can take, and none of them were paying attention to the fact that I was getting calls at two and three o'clock in the morning with boys who were inconsolable.

None of them were concerned when my sons were failing, or couldn't hold on to information, or couldn't retain anything that was said, or didn't know how to function in the class when all they were ever told was to run the ball.

What I'm saying is it became obvious to me that something else was going on with my children.

That is the reason that this is before you now.

Because I started recognizing differences in my boys that Liz shared about what she saw in her husband down the road.

And what I'm saying is our children are not safe.

And this country that we live in, that will spend more on a football game than they will in education, that will spend more on a sport on entertainment than they would on sending students to college, that prioritize the fact that you are football player and not that you are a 4.0 student, it's also a culprit.

And our babies are being forced to sacrifice themselves as they are put between NIL deals, being thrown into what seemingly looks like an auction block, which is called the portal, but you have babies, young people in there trying to demonstrate their worthiness that they still got it as they get passed around from team to team to team to give, take some more hits.

And what I'm saying is, I'm in a position, thank God, to bring this level of awareness to say what can we do about it as parents, as legislators, as a second largest county in the country with a huge hospital system.

Can we do more to pay more critical attention and can we put some pressure to laws that already exist to make sure that they are abiding them so that our children are safe?

And can we really look at the mental health impact that all of this is having on our children?

Because I don't know if you all have noticed, but the suicide rate among young people is skyrocketing.

And my son has already lost three friends.

My boys are only 23 and 24 years old, and since college, since high school, they have lost three friends to suicide who were football players with them.

Three who had not turned 25 yet.

So I'm just saying there's something else going on with our young people, and we need to pay attention, and we need to be active, and we need to see it as a sense of urgency.

It's more than just when I sounded the alarm about shop talk.

Something is going on with our children.

And it is happening on fields, and it's happening in classrooms all across this country, and I want us and our little space of the world to pay attention and to act.

Thank you.

Thank you, Commissioner.

Thank you.

All right, let's add Commissioner Aguilar to the role.

And Commissioner, would you like to be added as a I vote for all previous affirmative votes?

Yes.

Thank you, thank you, Chairman.

I'm going to grant leave for you, Commissioner Moore, to speak before our presenters, pursuant to your request.

Actually, you covered it.

I wanted to uh thank Commissioner School.

Many of our kids are playing these sports, boxing, football, soccer.

And a lot of us have just not educated on these things, especially CTE.

So I'm going to thank her for our passionate speech.

Okay.

I'm going to make a request.

I'm going to add Commissioner Degnan to the role.

And would you like to be added to previous votes in the affirmative?

Great.

I'd like to request colleagues that we speak, uh, share thoughts, ask questions after the presentations like we normally do.

I went out of order by special request of Commissioner Moore, but I'd like to get back to our regular course if that's allowable.

All right.

So thank you.

Thank you for that.

And with that, we're going to hear first uh we have a remote presentation by Dr.

Chris Snowinski.

Thank you.

Uh I'd like to thank Cook County Commissioner Terrace Stamps and the Cook County Commissioners for inviting me.

I'm going to spend uh 10 minutes uh supporting what Commissioner Stamps said with the science that this is a very serious issue, and and what she said was one of the most honest conversations I've heard about what is a real public health issue.

Um and so I'll begin by sharing my screen here.

Um so I'm Dr.

Kristen Witzka, I'm a behavioral neuroscientist.

Uh I'm disclosures I'm an advisor of the NFL PA and the Ivy League and do uh educate organizations from the WWE to World Rugby on this issue.

I uh CEO of the Concussion and CT Foundation.

Um the reality is I may have CTE from my participation in sports in Cook County.

So I grew up uh in Oak Park and Arlington Heights, uh went to John Hershey High School and was good enough to get recruited to play at Harvard University, so my career continued.

Um, and then I uh for fun went to join the WWE for a little while, where I had to retire from concussions uh years ago.

That experience led me to start this foundation to explore why the concussion protections weren't in place 20 years ago that we have today, as well as to understand what is happening with this disease CTE.

We've done a good job changing the culture on concussions.

We still need to be very vigilant on providing care for those injured athletes, but I'm gonna focus exclusively on CTE because that is the issue that we are not tackling uh and we're not addressing, and it is a dramatically larger public health issue than the concussion issue that we've been talking about for the last 20 years.

Most of the data I'm gonna show you is from the research center I helped found back in 2008 at Boston University and in partnership with the VA, where we started the world's first brain bank that exclusively is trying to understand the long-term effects of hitting children in the head thousands of times through sports, which is a way I don't usually put it, but it's a way we should put it for this conversation.

We have now diagnosed more than a thousand or about a thousand new cases of CTE out of eighteen hundred brains that we've looked at and published multiple hundreds of publications.

But to put that in historical perspective, this disease CT was once known as Punch Drunk.

Uh 1928, we they gave that name in a famous journal article.

And the world understood punch drunk, and by the 1950s, comedians would play punch drunk uh actors on TV, and parents stopped putting their kids into boxing because we knew what it did, and we stopped studying it and never looked outside of boxing.

So when we started our center, there were only 45 cases known worldwide of this disease, and almost exclusively in boxers.

So I have led outreach to families, including many in Illinois, after they've lost a loved one, to try to understand what happened.

And what we're learning is that CTE is extrem extremely prevalent in athletes who've had long careers.

So CT is a degenerative brain disease that causes problems with cognition, mood, behavior, and sleep.

It causes dementia.

Uh it starts while you're young as a teenager or in your twenties, and progresses after you stop getting hit in the head.

Uh studies suggest luckily it remains rare in the population.

You know, every study of brain historical brain banks has found less than one percent of the population has it.

But among those unfortunate souls like me who have taken 10,000 hits to the head or played contact sports for more than 20 years, uh it's in more than half.

And that we've that experience has been replicated in Australia, in the UK, uh, where any whether it's football, ice hockey, rugby, or soccer, long careers are associated with this disease.

Um this is another ways to understand how this looks.

Part of the reason why it's new is it's been hidden as misdiagnosed Alzheimer's disease.

And we just published on this that essentially, if you look in the lower right corner at those two red brains, those the most advanced stages of CT and Alzheimer's, and at that stage, almost everybody has dementia.

But what we didn't realize until recently is with CTE, it starts in a different place, and it dramatically affects the cortex along its journey to the most severe stage, which dramatically affects behavior.

Dave Doerson is probably the most well-known Chicago case.

It's a case, the brain that I coordinated years ago when we lost him in uh 2010.

Uh, and he's a great example of how it's simply hits to the head that are causing this disease, and you could tell that from the physics of the lesion.

This is a brain uh split down the middle and sliced about here, and so the top is the top and the side is by the ear on the left side.

Um, and you see these dark spots are all at the bottom of these valleys.

It's called the depths of the sulcus of the brain.

That is the part of the brain that when you rotate a human brain rapidly, that is where the greatest energy goes that causes, we believe the pulling apart of the brain, uh the axons that are around blood vessels.

That's the holes in the in the part below.

Um, and it's just a physical injury to the brain that does not recover, and in fact, it continues to spread after the injury has happened.

And it is marked by severe inflammation that continues to progress.

Um we've now seen in boxing American football, ice hockey, soccer, rugby, Australian rules, football, lacrosse, mixed martial arts, wrestling, military service, as well as unfortunate individuals who took a lot of hits to the head through domestic violence or on the autism spectrum disorder and self-injurious behaviors.

Um we have seen that is a dose response disease, very much like smoking and lung cancer.

The more cigarettes, the more years, the greater your risk of lung cancer, and that is what we see here.

Uh we've worked it out mathematically.

Um, and I show you this slide to make the point that it's actually not concussions that predict who gets CTE at all in this brain bank of 600 football players.

Um, what does is the force to the brain?

Every thousand hits increases your odds of CT by 21%.

Uh, but even what even more predicts it is rotational acceleration.

And this is our, as of 2003, our experience, years of play on the bottom, um at percent of athletes with CTE, and you can see that once you've got over 10 years, it's more than half in our sample.

That does not say that everyone who played 10 years of football has it.

It is a biased sample.

We will have an upcoming publication that helps us understand how biased.

And uh the reality is it's not as biased as I would like it to be as a former football player.

And when you just take estimated force, cumulative force over career, it becomes a very clear line.

CT is simply a math problem.

Anybody, if anybody gets hit in the head 20,000 times, there's a very good chance they're gonna have this.

And their risk is just how many thousands they took.

Um we've also, this was a very recent publication.

We are studying 4,000 living football players, and we are finding their symptoms during life are correlated with simply how many years they played.

So the high school players are healthier than the college players who are healthier than the professional players, but even the high school players have abnormal levels of cognitive and neuropsychiatric disorders.

We also seen this in ice hockey and in rugby and other sports.

Uh, in our ice hockey study, uh, a hundred percent of those who played 25 years or more have CTE.

Well, it's only two of 20 who stopped after high school.

It's also being now found in female athletes.

Uh oddly enough, it's has not been found in older female athletes, it's the younger female athletes.

Uh, the effects of Title IX means that we don't, you know, we we now have equal opportunity to sports, but it's it's creating equal opportunity to CTE in sports like soccer in America.

Um, and then we just did publish earlier this year in the National Instance of Health put out a press release for it.

Severe CT is clearly linked to dementia.

More than 80% of those who have stage four CT are living with dementia.

50% of those with stage three.

Uh so this is a dementing, a preventable dementing illness where exposure begins as a child.

And this is unique in the world.

We there's no other disease that you are giving we are giving to children that is this destructive.

It's progressive in more cases.

Starts young while they're playing, caused by repetitive head impacts, not only causes dementia, causes Parkinson's Parkinsonism, and appears to cause ALS.

We don't know the prevalence because we can't diagnose the living people, which prevents us from treating it and curing it.

But we are making advances.

But what is known is it is entirely preventable.

We've done this to ourselves.

A window into the youngsters, this is uh we studied hundred, we have 152 brain donors who died before the age of 30 now.

Um these are their first sports pictures of the 63 or 41 percent of them who already had CTE when they died.

Uh a troubling statistic.

If you look at age and those who did and who didn't, is that when you look at under age 24, 80 percent did not have it.

When you look at over 24, the majority, two-thirds of them did have it, which suggests that there is a window between when they stop getting hit and when CT shows up.

There's a lag.

And so um this is a disease that is significantly impairing kids young, but now we also know that they are getting brain damage before CT even shows up.

The study published in the prestigious journal Nature showed that at the location of the lesion where we first see CTE, those images of Dave Doers and I showed.

Um, before they even have stage one CT, they've lost 50 percent of excitatory neurons in that era in the in the in that location.

And so this uh it's not we do believe that this is changing children in their teens and changing their behavior and changing how they feel and uh changing how they think.

We are trying to promote uh 15 years ago, there was not a concussion protocol in the country.

We now have them in every high school and every sports program in America.

But we can't even show those concussion protocols are improving outcomes.

I I support them completely.

I've written many of them, but the benefit uh we instead the conversation should be shifting to CT prevention protocols.

This is absolutely preventable dementia disease.

Um we can prevent this.

We're not trying, we're not talking about it, we're not educating coaches, we're not educating parents, we're not educating kids.

Simple guidelines, we need to reduce the number of hits to the head for these children.

We need to reduce the strength of the hits to the head to these children.

Um for example, a simple fix tackle football, average child takes 378 blows to the head, and flag football, they take eight.

So we advocate for flag football before 14.

Uh we but we absolutely need to be telling people what's going on, because uh children don't have informed consent, they can't really provide informed consent, but parents don't have that consent, and we're not even giving coaches the tools to prevent this.

We have to remember that 20 years ago or 15 years ago when this became an issue, the NFL and other sports organizations had a very big campaign to convince us that CT was not real.

They were wrong.

Those ideas still persist in the sports community.

I hear them all the time.

Go to my social media feeds.

They're not true.

We the science is so much stronger now, and it's time we push this forward.

So I want to thank all the scientists who've created this information, the families who create this information, and thank you for letting me share this.

Dr.

Nowinski, thank you.

Thank you, thank you.

Any questions, comments for Dr.

Chris Nowinski?

Anyway.

Commissioner Aguilar.

Doctor, just a question on CTE.

When youngsters, when the when there's when they um are diagnosed with CTE and they stop playing the sport, whatever it is, and they start getting injured in the head, the CTE continue to progress as they grow up into adulthood.

Even though they stopped getting, you know, uh hit in the head.

Yes.

Yeah, I mean, well, it we so we we can't say that with a hundred percent certainty because we only get the snapshot into CTE after they're dead.

So all those young people I showed to CT, we know that because they died.

But when I showed you the four stages, what I can say is the stages completely correlate by age.

And it basically is about 15 years between each stage.

So if you get stage one by the time you're 18, you can expect to be at stage two by 33, you can expect to be a stage three by 50, you can be at stage four, you know, in your 60s or 70s.

Not not everybody progresses, about 80 percent or 80 percent appear to progress extensively.

Some f some people might be genetically resilient to the progression.

So it's still progressive, even though they stop getting head injuries.

Right.

Absolutely.

I think like a fibrosis.

You know, get fibrosis in the lungs, it keeps it keeps mounting up eventually.

You mentioned that maybe uh with youngsters, grammar school kids have school kids.

I mean, flag football could be an alternative.

Yes.

No, we're I'm a big now that I've lived this and been part of the football, you know, culture.

I'm a big proponent that it that there's no, I'm confident there's no advantage to playing young.

It's not like you're building skills like you might be in other sports.

You know, it's just about being strong and fast and tough.

And uh so we could prepare if we if we want high school football to continue, we could prepare kids to high school football uh through FLAT.

And I still thank my mom Brenda, uh, who still is Darlington Heights for holding me out until high school.

Okay, thank you, Doctor.

Down.

Thank you again, Doctor.

Now we're gonna have another presentation on item 26-0649 resolution on chronic traumatic encephalopathy.

How'd I do, Liz?

Uh that'd be presented by Dr.

Joshua.

Doctor.

Thanks so much, Mr.

Chair.

Uh I want to thank uh Commissioner Stamps for her heartfelt comments um as well as all the speakers.

Uh particularly, I think Dr.

Newinski's comments really resonated.

I I thought they were uh incredibly well put together.

Um you've heard me talk about this issue previously, I believe, uh back in February, and so uh my presentation today is just really a brief update as to what we've been working on as a follow-on to this uh uh meeting.

I I I'd love to talk maybe a little bit more about some of the policy options given Dr.

Newinski's comments.

Um so first I just wanted to say if uh we could bring up the slides that uh we have been actively engaged in terms of uh spreading the word about this issue um through our social media channels.

March was brain injury awareness month, so very timely to share that information this month.

We're adding information and resources to our website.

We'll have a download downloadable fact sheet for school health staff.

Um I'm also aware that the third Friday in September is National Concussion Awareness Day.

I think that'll represent yet another opportunity to get the word out.

Um I recall at the last meeting there were some questions about park districts specifically and whether they're subject to the state legislation that is relevant to this issue, and indeed they are.

Um, and we are reaching out uh to them uh through our newsletters and uh other channels as well.

So I wanted to flag that for all of you.

Um we are definitely next slide focused heavily on schools specifically.

Um we're having our uh uh a webinar um with school nurses and administrators on May 15th.

Um, and uh thanks to Commissioner Stamps have an extended an invitation to Dr.

Nawinski uh to speak and share his wisdom to the school professionals that'll be attending that webinar.

Um we'd like to do the same potentially at our annual in-person school health meeting late summer, early fall, and we'll continue to uh beat their drum here on our monthly school health newsletters.

Um again, I I promised I'd make this quick.

That's it for my comments.

Um happy to answer any questions that you have.

Thank you, Doctor.

Questions or comments for for Dr.

Commissioner Miller.

I got a comment.

Are we ready for the comments?

Yes, we are.

Thank you, Chair.

And thank you for the presentations.

Um thank you, Commissioner Stamps, for bringing this issue to the forefront.

And um, I just wanted to say that this is something we should be made more aware of.

Um from a hospital standpoint and from a community standpoint and from a school standpoint.

Um I will say that my cousin actually played for the Super Bowl Bears, Stefan Humphreys, and he is a um rehab physician now who lectures across the country on CTE.

So maybe if you wanted to partner with him, that'd be great.

But I will say that when my boys were young, I asked him, do you think they should play football?

And the answer was absolutely not.

Just because of the equipment and um the lack of research that had been put forward on CTE, even from now back then to now.

So I do think education is warranted for parents so that they actually understand the risk involved and what they're getting their children into, and uh the long-term effects that have been uh identified as we see from the presentations that we're here today.

So thank you for highlighting this, and thank you for our Cook County, you know, health department taking an active role in being part of education.

I think we're missing a lot of steps as it relates to health care on the education piece and how that affects communities from a public health standpoint and just from an education standpoint and how it's intertwined.

So this is definitely a great step in the right direction.

Commissioner Stamps and Indeckman.

Oh, you're just making sure.

Okay.

Commissioner Degman.

Thank you.

Um I would like to thank Commissioner Stamps for bringing this to our board to um thank her personally for her story about her boys and the effect that she's seen it take in her family and telling personal stories like that and with a lot of emotion and a lot of caring isn't always something we do in a professional space, and the love that you share for your family, it really extends to ways that we can improve not just the love that you share for your for your boys, but for families all over Cook County.

So thank you for bringing this.

Thank you for sharing um for all of the speakers sharing information about how our county health and hospitals can be a better advocate in these areas and making sure that um kids know that there's options in sports, um, and that CTE is a real danger and how to make sure that we can advocate the best that we can.

Thank you.

Commissioner Kevin Morse.

Thank you, Chairman.

I wanna uh first thank Commissioner uh Tar Stamps for bringing this conversation on the floor today.

Um I found the information quite fascinating.

Now I might answer my own question, but I am curious uh as to why after death is the only uh way of seeing that an individual has been impacted by CTE.

I assume it must you know the lesions must be so tiny that you know you know, after death is the only way to test it.

Is there any research being done into technological improvements to be able to test for CTE lesions prior to death?

Yeah, um, that's my understanding.

It's ongoing research.

There's nothing that's been validated.

So to answer your question, there's no imaging tests that I can do that will um identify those lesions accurately.

Um and so I think they're working on that.

And there's also some research about uh biomarkers, which is just a fancy term for a lab test.

So nothing validated yet, though.

I appreciate it.

Chairman Daly.

Thank you, Mr.

Chairman.

I'd like to also thank the commissioner to bring and bring in this important issue before all of us.

Personal stories are always the key.

And we at Cook County and I uh health or public health are addressing it, but also the greater community of the high schools, colleges, and granted they should can do more, and hopefully they will.

But it is something that we all should address individually as parents, grandparents.

Thank you.

Commissioner McCaskill.

Um, just wanted to thank the speakers and also um Commissioner Stamps for bringing this forward.

I would be very interested in knowing whether or not um Pop Warner League, which starts at six years old, or AAU, um, not even just for the football, but for the soccer, because the ball is coming at such high speeds.

So you're having the exact same impact, and I know we're talking about we're speaking about high school, but I'm wondering if we should even go a lot deeper than that, because um that at that age, it is still excessively uh competitive with regard to how those even younger children at six are competing, and the helmets are not very effective.

They're very thick, they make it even heavier, so they're small necks.

I'm thinking that may be some additional um process or pressure there.

So thank you.

I think that's a completely correct observation, Commissioner.

I mean, you heard Dr.

Nowinski earlier.

The risk factors are really repetitive head injury and then the intensity of the trauma.

Um so it's it doesn't um it's not concussions per se, any kind of head injury can um down the line cause CTE.

Thank you.

Thank you.

Commissioner Trevor.

Thank you, uh Chair.

And I also wanted to thank my uh colleague uh Tara Stamps for this and for the story of what you've gone through with your own sons.

Um just in terms of personal experience here, a couple of things I wanted to bring up.

First of all, my sister-in-law is a pediatrician was a pediatrician uh at Kaiser in Oakland, California.

Um, and uh saw a lot of the consequences of of youth sports firsthand to the point where my nephew was not allowed to play football in high school.

So he went to soccer instead, still plays as a young man.

Um I think the assumption is that soccer is less dangerous.

Um I think the assumption is that soccer is less dangerous, and I think one of the things that I've gotten out of this this hearing, uh these hearings is that um uh that's not necessarily the case, and it's something that we really need to think about is more and more uh kids take up soccer these days.

Uh the other thing I wanted to um touch on is your uh point about um the emphasis, the disproportionate emphasis.

Uh and I think one of the speakers um the uh head of the uh um uh uh CFL.

I've had my own problems with concussions here.

Um, but um having been faculty at a Division I school, I can tell you firsthand seeing not only the the pressure put on athletes, but also the the negative consequences on the education that they get at those universities because they're in those sports programs, and I think there is something really screwed up with our priorities that first of all we need to put kids through this particular ringer to get scholarships, but then also our need for entertainment at that level then negatively impacts the education that they get once they're there.

And so I just wanted to thank you for making that point.

Thank you.

Thank you, and thank you, Dr.

Joshua, very much.

Thank you for the presentation.

Thank you, Mr.

Chair.

So it's been brought to my attention.

We have one more public speaker, so I'm gonna give that speaker leave to speak before I call the motion on the floor.

Brandy.

Thank you.

Our next public speaker is Kenneth Newman.

Uh just to revisit our board rules, Kenneth, you will have three minutes to address the body.

I'll notify you at one minute and when 30 seconds are remaining.

Thank you.

Please proceed.

My name's Kenneth Newman.

I've been in soccer now.

I'm in my 54th year involved in soccer.

I've also played ice hockey, little league baseball.

Concussions happen in all of them, as well as American football, lacrosse, and other sports.

Rugby, occasionally.

The issues of concussions and soccer, as I have refereed at every level of the game, including professional, is still a huge issue, even though uh under the United States Soccer Federation, United States Youth Soccer Association, the Illinois Youth Soccer Association, mandated concussion training, as well as the IHSA for coaches.

However, in some youth football programs across the country, maybe in Illinois, those some of those coaches may not be getting concussion training.

I it hasn't happened very often.

I have close to 4,000 soccer games in my life, player coach and referee.

And I have seen a few players concussed.

Now you might think they that hitting heads causes concussions, but actually it's more likely that a head hitting a leg, a head hitting a goalpost, even a head hitting the ground, but that doesn't happen very often, would cause a concussion.

But I am really concerned as a referee because we are also mandated if we see a player who's a little wobbly on the field to tell the coach.

Whether that coach pulls the player off the field, it's the coach's prerogative.

However, we could obviously write a report if the coach kept the player in the game.

It is state law, however, on another health-related issue, AEDs, not an IHSA rule, but a state law that every athletic facility has to have an AED at the field or at the court.

And there are a lot of schools that don't have athletic trainers, probably close to 40 to 50 percent of all high school teams, all schools do not have athletic trainers.

And I question whether the coaches or the teachers of that school, especially at the elementary school level, have even had any training on the AEDs.

I had a coach die on me at a soccer high school soccer game while living in Miami.

I had another friend roughing a soccer game, and an adult player died on the field.

So it is important that this body and other local governmental bodies make sure that high schools, whether it's CPS, suburban, private charter, whatever, are adhering to state law on AEDs, and that all coaches of contact sports do have training in using AED and to recognize concussion problems.

I still fear that some coaches don't recognize concussion problems.

I've had plenty of training myself in being able to recognize that.

Thank you.

Thank you.

Thank you.

Yes, go ahead, Chairman.

Thank you for your presentation.

Do you say as a ref when you tell the uh you tell the coach to pull the um uh pull the uh player off the field?

The player off the field.

Is it if they don't comply?

Do you have a report that you filed?

Well, I would immediately have to write it down in the report.

However, I'm not sure because there are issues like frankly.

I've been officiating for I'm entering my 39th year, and because I've been at the pro level and the collegiate level, and I'm still doing collegiate games.

I don't put up with nonsense from coaches.

So who does it report you filed with the you have athletics oh yeah, I'll file it with the presence with the IHSA or if it was a youth game, the Illinois Youth Soccer Association.

Thank you very much.

But the bigger issue is that there are coaches who want to keep that good player on the field, but they may have the injury, so that's a problem.

All right, everyone, listen, we're gonna do three things.

We're gonna hear from Mr.

Blakemore.

I'm gonna call the vote on the motion, and we're gonna adjourn.

Mr.

Blakemore.

Health is wealth.

Both mental and physical health is wealth.

Mr.

Blake Moore.

When you got sick, where did you go?

You poor and oh, I went to Kukani.

And and the quality of service that you receive wasn't good.

They don't even have a cafeteria like they used to.

Everything's in with the machine.

I go back many years.

Ruth Rostein.

The quality of care that the citizens are receiving at the county have gone down, down, down the why at the pharmacy department.

It was packed.

The emergency department is packed.

Packed with coup.

What with the ethnic group?

Hispanics.

Illegal immigrants.

And Prattwick will say it, Chef Dots.

No, don't lock them up.

Don't do anything when they burn out.

She told Chef Docts, but the negative effect that it has on the hospital system.

And I talked to one of the farmers, say, Mr.

Blake More, it's ridiculous.

And then they had a desk to say, Mr.

Blake Moore, you got to pay co-pay.

I'm not paying no co-pay.

Why should I?

When I see these illegals again, there's free.

Mr.

Blakemore, you look like Gill.

They get all types of medical service.

And I have to wait in line two or three hours in the emergency room.

Because they're ahead of me.

And I'm a legal citizen.

So I'm outraged.

And you got these black faces in half places, same as that.

One minute.

The pharmacist department, just pack with them.

What motivates the black man to and black woman to want somebody ask to come over and get things that you have not been able to receive?

What's your motivation?

Money, honey.

Money.

They being paid off.

And when I talk to the head people with the farmers, they say they ever have to Blake Moore.

They everywhere.

That's why it's very important for a man of Mr.

Blake Moore Calibur to show up and show out and holler out.

That concludes Chair Public Speakers.

There's a motion on the floor to defer item 26-0649.

All those in favor say aye.

All opposed in the opinion of the chair, the ayes have it.

Chairman Daly now moves to adjourn, seconded by Commissioner McCaskill.

Pardon me?

Oh, leave to add all relative to the item.

All right, with that noted now, there's a motion to adjourn.

All those in favor say aye.

Aye.

Aye.

We adjourn.

See you tomorrow.