North Carolina Rep. Cairns concussion protocol amendment bill passes House and Senate

Passed bill sponsored by State Rep. Celeste C. Cairns seeks to update concussion protocols by authorizing licensed physical therapists to evaluate and clear student athletes for return to play after exhibiting symptoms, according to the North Carolina State House.

In the House, 37 Democrats and 63 Republicans voted in favor of the bill, while eight Democrats and three Republicans opposed it.

Meanwhile, in the Senate, 15 Democrats and 26 Republicans voted in favor of the bill.

Cairns filed the bill in the North Carolina House on April 10 during the 2025 regular session.

The legislation, known as HB 928, was passed on June 19 during the 2025 regular session.

According to the North Carolina General Assembly site, the bill’s official text was formally listed with the short title: “Allow PTs in School Concussion Protocol.”

The following is our breakdown, based on the actual bill text, and may include interpretation to clarify its provisions.

In essence, this bill amends North Carolina’s concussion protocol for student athletes by allowing physical therapists, licensed under Article 18E of Chapter 90 of the General Statutes, to evaluate and provide written clearance for athletes exhibiting concussion symptoms during interscholastic sports activities. Previously, only certain medical professionals were authorized to clear students for return to play. The bill specifies that if a student shows signs of a concussion, they must be removed from the activity immediately and cannot return until evaluated and cleared by an authorized professional. This act takes effect upon becoming law.

The bill was sponsored by Rep. Carla D. Cunningham (Democrat-106th District), Rep. A. Reece Pyrtle, Jr. (Republican-65th District), and Rep. Celeste C. Cairns (Republican-13th District), along with one other sponsor.

Bills in North Carolina follow a multi-step process before becoming law. A lawmaker starts by filing a bill, which is assigned to a committee for review. The bill must be read three times in each chamber. If one chamber changes the bill after the other passes it, both must agree on the final version. Once both chambers approve the same bill, it goes to the governor, who has 10 days (or 30 if the legislature is not in session) to sign, veto, or let it become law without a signature.

You can read more about the bills and other measures here.

Cairns graduated from the University of Georgia with a BBA.

Cairns, a Republican, was elected to the North Carolina State House in 2023 to represent the state’s 13th House district, replacing previous state representative Patricia McElraft.

Under North Carolina law, bills must receive three readings in each chamber. According to the UNC School of Government, once a bill “passes its constitutionally required second reading and moves to its constitutionally required third reading,” additional debate can occur, but the final stage is often treated as a formality. Unless a legislator requests a roll-call, the third reading may be approved by voice vote or unanimous consent without a separate recorded tally.