STORAGE NAME: h1607d.EEC DATE: 4/17/2025 1 FLORIDA HOUSE OF REPRESENTATIVES BILL ANALYSIS This bill analysis was prepared by nonpartisan committee staff and does not constitute an official statement of legislative intent. BILL #: CS/HB 1607 TITLE: Cardiac Emergencies SPONSOR(S): Yarkosky, Rizo COMPANION BILL: CS/SB 430 (Simon) LINKED BILLS: None RELATED BILLS: None Committee References Education Administration 17 Y, 0 N, As CS PreK-12 Budget 14 Y, 0 N Education & Employment 21 Y, 0 N SUMMARY Effect of the Bill: The bill requires school districts to provide basic training in first aid, including cardiopulmonary resuscitation (CPR) once during middle school and once during high school in a physical education or health class. The instruction must allow students to practice the skills associated with performing CPR and use an automated external defibrillator (AED). The bill also requires, by July 1, 2027, that every public school, including charter schools, have at least one operational AED on school grounds. Each public school must also develop a plan for urgent life-saving emergencies (PULSE) to guide school personnel in responding to sudden cardiac arrest or similar emergencies on school grounds. Fiscal or Economic Impact: There is no state fiscal impact, but there is an indeterminate, negative fiscal impact to school districts and charter schools to comply with the provisions of the bill. JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY ANALYSIS EFFECT OF THE BILL: The bill requires school districts to provide basic training in first aid, including cardiopulmonary resuscitation (CPR) in middle school and revises the previously required training for high school students. The training must occur in a physical education or health class. The instruction in both the middle and high school courses must: Allow students to practice the psychomotor skills associated with performing CPR; and Include the use of an automated external defibrillator (AED). (Section 1). Under the bill, each public school must develop a plan for urgent life-saving emergencies (PULSE) that addresses the appropriate use of school personnel to respond to incidents involving an individual experiencing sudden cardiac arrest or a similar life-threatening emergency while on school grounds. The PULSE must integrate evidence-based core elements for schools responding to cardiac emergencies, like those recommended by the American Heart Association. Schools are required to work directly with local emergency service providers to integrate the PULSE into the community’s emergency responder protocols. (Section 2). The bill also requires that no later than July 1, 2027, each public school, including charter schools, must have at least one operational AED on school grounds. The defibrillator must be available in a clearly marked and publicized location. Schools are required to maintain the defibrillator according to the manufacturer’s recommendations and maintain all verification records for such defibrillators. The bill clarifies that a public school that is a member of the Florida High School Athletic Association (FHSAA) and required to maintain an operational AED on campus related to athletics does not constitute compliance with this requirement. Schools are also required to: Ensure appropriate school staff are trained in first aid, CPR, and AED use. Register the location of each AED with a local emergency medical services medical director. (Section 2). JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY 2 The bill provides that school employees and volunteers who use an AED are immune from civil liability under the Good Samaritan Act 1 and the Cardiac Arrest Survival Act 2. (Section 2). Finally, the bill requires the State Board of Education to adopt rules to administer the bill. (Section 2). The bill takes effect on July 1, 2025. (Section 3). RULEMAKING: The bill requires that the State Board of Education adopt rules to administer the requirements of the bill. Lawmaking is a legislative power; however, the Legislature may delegate a portion of such power to executive branch agencies to create rules that have the force of law. To exercise this delegated power, an agency must have a grant of rulemaking authority and a law to implement. FISCAL OR ECONOMIC IMPACT: LOCAL GOVERNMENT: The bill requires that all public schools, including charter schools, have at least one operational AED on school grounds by July 1, 2027. It is not known how many public schools, including charter schools, currently have an AED on its premises; therefore, the fiscal impact on school districts and charter schools to acquire AEDs by the July 1, 2027, deadline is not known. Additionally, there is an indeterminate fiscal impact to school districts and charter schools to provide maintenance requirements as well as the training requirements. RELEVANT INFORMATION SUBJECT OVERVIEW: Sudden Cardiac Arrest Heart disease is the leading cause of death in the United States. 3 Sudden cardiac arrest is the leading cause of death for student athletes. 4 Sudden cardiac arrest is the sudden loss of all heart activity due to an irregular heart rhythm. It can come on suddenly or in the wake of other symptoms. More than 356,000 cardiac arrests occur outside a hospital in the United States each year, 5 more than 23,000 of those who suffer cardiac arrests are children. 6 Nearly 90 percent of all incidents of out of hospital cardiac arrests are fatal. 7 Emergency treatment for sudden cardiac arrest includes CPR and shocks to the heart with an AED. Cardiopulmonary Resuscitation 1 Section 768.13, F.S. 2 Section 768.1325, F.S. 3 Centers for Disease Control and Prevention, Leading Causes of Death, https://www.cdc.gov/nchs/fastats/leading-causes-of- death.htm (last visited Apr. 15, 2025). 4 Mayo Clinic, Sudden death in young people: Heart Problems often blamed, https://www.mayoclinic.org/diseases- conditions/sudden-cardiac-arrest/in-depth/sudden-death/art-20047571, (last visited Apr. 15, 2025); University of Kansas Health System, The Scary Side of Sports, https://www.kansashealthsystem.com/news-room/blog/0001/01/cardiac-death- young-athletes (last visited Apr. 15, 2025). 5 American Heart Association, CPR Facts and Stats, https://cpr.heart.org/en/resources/cpr-facts-and-stats/ (last visited Apr. 15, 2025). 6 Sudden Cardiac Arrest Foundation, Latest Statistics, https://www.sca-aware.org/about-sudden-cardiac-arrest/latest- statistics (last visited Apr. 15, 2025). This report notes that data from 2015 showed that there were 7,037 incidents of cardiac arrest, but more recent research not reported in AHA statistics indicates that the incidence of OHCA in children is 23,514. Id. 7 Id. JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY 3 Though the vast majority of cardiac arrests occur at home, approximately 15 percent of adult cardiac arrests and 12 percent of juvenile cardiac arrests occur in public. 8 Bystander CPR can double or triple a person's chances of survival if started immediately. 9 A barrier to bystanders providing lifesaving care for cardiac arrest victims is a lack of training, especially in how to perform CPR. Only 46 percent of cardiac arrest victims receive CPR. 10 Most Americans are hesitant to perform CPR because they have no training or their knowledge has lapsed. 11 Automated External Defibrillators An AED is a computerized defibrillator that automatically analyzes the heart rhythm in people who are experiencing cardiac arrest. 12 If the AED detects cardiac arrest, it delivers an electrical shock to the heart to restore its normal rhythm. 13 Sudden cardiac events have an 85 percent survival rate when an AED is applied within 3 minutes of a collapse. 14 Florida Law In 2021, the Governor signed HB 157 into law, requiring that school districts provide basic training in first aid and CPR to students in grades 9 and 11. 15 Prior to HB 157 becoming law, districts were encouraged to provide basic training in first aid, including CPR, for all students beginning in grade 6 and occurring every 2 years thereafter. Now, school districts are required to provide first aid training—including at least 1 hour of CPR training—for students in grades 9 and 11. 16 School districts are encouraged to provide first aid and CPR training to students in grades 6 and 8. 17 Schools must only provide practice with the psychomotor skills associated with CPR and AED use if they have the equipment (AEDs and CPR training devices) necessary to do so. 18 Each public school that is a member of the FHSAA must have an AED on school grounds. 19 The AED must be available in a clearly marked and publicized location for every athletic contest, practice, workout, or conditioning session, 20 and an employee or volunteer with current CPR and AED training must be present as well. 21 Public and private partnerships are encouraged to cover the cost associated with the purchase and placement of the AED and training in the use of an AED. 22 Any high school, middle school, or combination school, including charter schools, virtual schools, private schools, and home education cooperatives, may become a member of the FHSAA; however, membership in the FHSAA is not mandatory. 23 Moreover, while they are permitted to join the FHSAA, only a small fraction of middle schools are FHSAA members. 24 As a result, elementary schools are not statutorily required to keep an AED on school grounds nor are numerous middle and high schools. 8 American Heart Association, Why People Fear Performing CPR on Women—and What to Do About It, https://www.heart.org/en/news/2020/11/23/why-people-fear-performing-cpr-on-women-and-what-to-do-about-it (last visited Apr. 15, 2025). 9 American Heart Association, CPR Facts and Stats, https://cpr.heart.org/en/resources/cpr-facts-and-stats/ (last visited Apr. 15, 2025). 10 CPR Select, Understanding SPR Success Rates: Effectiveness and Influencing Factors, https://www.mycprcertificationonline.com/blog/cpr-success-rate (last visited Apr. 15, 2025). 11 Id. 12 U.S. Food and Drug Department, How AED’s in Public Places Can Restart Hearts, https://www.fda.gov/consumers/consumer- updates/how-aeds-public-places-can-restart-hearts (last visited Apr. 15, 2025). 13 Id. 14 The National Federation of State High School Associations, Emergency Action Plans Should be Reviewed, Rehearsed Annually, nfhs.org/articles/emergency-action-plans-should-be-reviewed-rehearsed-annually/ (last visited Apr. 15, 2025). 15 Section 1003.453, F.S. 16 Section 1003.453(3), F.S. 17 Id. 18 Id. 19 Section 1006.165(1)(a), F.S. 20 Id. In 2020, the Legislature passed the “Zachary Martin Act” which imposed the AED placement and training requirements for athletic events. 21 Section 1006.165(1)(b), F.S. 22 Section 1006.165(1)(a), F.S. 23 Section 1006.20, F.S. 24 See Florida High School Athletic Association, 2024-2025 Membership List, available at https://fhsaa.com/documents/2024/8/26//Membership_List_2024_25.pdf?id=5659. JUMP TO SUMMARY ANALYSIS RELEVANT INFORMATION BILL HISTORY 4 Since July 1, 2024, all athletic coaches at public schools have been required to hold and maintain a certification in CPR, first aid, and the use of an AED. 25 The use of defibrillators by employees and volunteers is covered under the Good Samaritan Act and the Cardiac Arrest survival act. 26 RECENT LEGISLATION: YEAR BILL # HOUSE SPONSOR(S) SENATE SPONSOR OTHER INFORMATION 2024 CS/HB 865 Yeager Became law on July 1, 2024. 2021 CS/HB 157 Hawkins, Busatta Became law on July 1, 2021. BILL HISTORY COMMITTEE REFERENCE ACTION DATE STAFF DIRECTOR/ POLICY CHIEF ANALYSIS PREPARED BY Education Administration Subcommittee 17 Y, 0 N, As CS 3/27/2025 Sleap Blank THE CHANGES ADOPTED BY THE COMMITTEE: Revised student training in CPR and AED use by requiring training once in middle school and specifying that required training in middle and high school occur during specific courses and include equipment. Required that each public school develop a plan for urgent life-saving emergencies (PULSE) that addresses the use of school personnel to respond to sudden cardiac arrest or similar emergencies. Removed reporting of AED use to the Commissioner of Education. Removed reimbursement for 50 percent of the cost of the purchase of an AED for each school. PreK-12 Budget Subcommittee 14 Y, 0 N 4/14/2025 Potvin Bailey Education & Employment Committee 21 Y, 0 N 4/17/2025 Hassell Blank ------------------------------------------------------------------------------------------------------------------------------------- THIS BILL ANALYSIS HAS BEEN UPDATED TO INCORPORATE ALL OF THE CHANGES DESCRIBED ABOVE. ------------------------------------------------------------------------------------------------------------------------------------- 25 Section 1012.55(2)(a), F.S. 26 Section 1006.165(1)(c)-(d), F.S.