A state House bill that would create guidelines for education, awareness and management of potentially dangerous youth concussions at all Hawaii High School Athletic Association schools is making its way through the Legislature.

The state Department of Education began a concussion management education program last year, but House Bill 2273 is designed to protect both public and private high school students.

The number of reported youth concussions in Hawaii increased to 446 from 213, or 109 percent, from the 2007-2008 school year to the 2010-2011 school year, the DOE athletic health care trainers program found.

In one high-profile case last year, Damien Memorial School quarterback Alan Mohika suffered bleeding on the brain and a concussion during a football game in August. The 5-foot-7-inch quarterback and defensive back got hit while completing a touchdown pass.

From the neurology unit at the Queen’s Medical Center, he said afterward he did not remember the hit. The season before, he had suffered a less severe concussion during a football scrimmage.

If passed, the bill would require all HHSAA coaches and athletic trainers to attend an annual educational session about the signs, symptoms and dangers of concussions and inform parents, athletes and school personnel about them. It also states that a young athlete suspected of suffering a concussion should be removed from a game or practice, and outlines that only a licensed health care professional can clear an athlete to resume play.

Ray Anderson, executive vice president of football operations for the National Football League, testified Friday before the House Health Committee in support of the bill.

"We accept the responsibility that comes with our popularity, and we know we have to set the right example for athletes at all levels and all sports," he said. "And that’s why we as a league have made it a priority to advocate for the passage of state laws governing youth concussion in all 50 states."

According to the NFL, 31 states, the District of Columbia and the city of Chicago have passed similar legislation so far.

A 2009 Washington State Concussion Law, better known as the Zackery Lystedt Law, paved the way. It came about after a middle school football player suffered brain injury in 2006 as a result of continuing to play with an undiagnosed concussion.

"After his injury the first question asked was, ‘Why was he allowed to continue to play?’" Cindy Clivio explained during her testimony on behalf of the Hawaii Association of Athletic Trainers. "The answer was that coaches, parents and students themselves are not trained to recognize the signs and symptoms of concussion."

Anderson encouraged the committee to extend the scope of the bill to cover younger athletes, which he said other states have done.

Clivio, however, said certified athletic trainers are only staffed at the high school level, and extending the program to other age groups cannot happen unless lawmakers provide additional funding.

"In theory we’d love to take it all the way to elementary," she said. "But if there wasn’t any funding, there isn’t anyone to do it. … We may need to do it one step at a time."

State Rep. Ryan Yamane (D, Wai­pahu-Mililani), chairman of the House Health Committee, agreed, and the bill was passed on to the House Education Committee without amendments Friday.

Yamane said he hopes the Legislature would consider amending the bill to include lower grades when funding for those positions becomes available.