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HOUSE DOCKET, NO. 1738 FILED ON: 1/15/2025
HOUSE . . . . . . . . . . . . . . . No. 2485
The Commonwealth of Massachusetts
_________________
PRESENTED BY:
Jay D. Livingstone
_________________
To the Honorable Senate and House of Representatives of the Commonwealth of Massachusetts in General
Court assembled:
The undersigned legislators and/or citizens respectfully petition for the adoption of the accompanying bill:
An Act concerning the cardiac health of children and student athletes.
_______________
PETITION OF:
NAME:DISTRICT/ADDRESS :DATE ADDED:Jay D. Livingstone8th Suffolk1/15/2025 1 of 8
HOUSE DOCKET, NO. 1738 FILED ON: 1/15/2025
HOUSE . . . . . . . . . . . . . . . No. 2485
By Representative Livingstone of Boston, a petition (accompanied by bill, House, No. 2485) of
Jay D. Livingstone relative to the cardiac health of children and student athletes. Public Health.
The Commonwealth of Massachusetts
_______________
In the One Hundred and Ninety-Fourth General Court
(2025-2026)
_______________
An Act concerning the cardiac health of children and student athletes.
Be it enacted by the Senate and House of Representatives in General Court assembled, and by the authority
of the same, as follows:
1 SECTION 1. Chapter 111 of of the General Laws, as appearing in the 2022 Official
2Edition, is hereby amended by inserting after section 244, the following section:-
3 Section 245. Children’s cardiac safety
4 (a) “health care professional” means a physician, advanced practice nurse, or physician
5assistant.
6 (b) A registered, licensed, and certified health care professional who performs an annual
7physical examination of a child 19 years of age or younger shall include as part of that
8examination questions that evaluate a child’s family history related to cardiac conditions
9contained in the “Preparticipation Physical Evaluation” form developed jointly by the American
10Academy of Family Physicians, American Academy of Pediatrics, American College of Sports
11Medicine, American Medical Society for Sports Medicine, American Orthopaedic Society for 2 of 8
12Sports Medicine, American Osteopathic Academy of Sports Medicine and the American Heart
13Association's 14 point screening for heart disease in youth.
14 The evaluation shall include, but not be limited to: (1) A question regarding the biologic
15heart health history of the child, including any history of sperm or egg donors and biological
16parents; (2) Four specific questions regarding biologic heart health history during cardiac
17screening in well-child visits and in preparticipation physical examinations, including: (a) Have
18you ever fainted, passed out, or had an unexplained seizure suddenly and without warning,
19especially during exercise or in response to sudden loud noises, such as doorbells, alarm clocks,
20and ringing telephones; (b) Have you ever had exercise related chest pain or shortness of breath;
21(c) Has anyone in your immediate family (parents, grandparents, siblings) or other, more distant
22relatives (aunts, uncles, cousins) died of heart problems or had an unexpected sudden death
23before age 50; (d) Are you related to anyone with hypertrophic cardiomyopathy or hypertrophic
24obstructive cardiomyopathy, Marfan syndrome, arrhythmogenic cardiomyopathy, long QT
25syndrome, short QT syndrome, Brugada syndrome, catecholaminergic polymorphic ventricular
26tachycardia, Wolff-Parkinson-White syndrome or anyone younger than 50 years with a
27pacemaker or implantable defibrillator?
28 (c) The department of elementary and secondary education and the department of public
29health shall set forth guidance to both public and private schools and require that prior to the
30participation of any student enrolled in grades kindergarten to 12 on a school or community
31organization sponsored interscholastic or intramural athletic team or squad, the student shall
32have a physical examination using the “Preparticipation Physical Evaluation” form developed
33jointly by the American Academy of Family Physicians, American Academy of Pediatrics,
34American College of Sports Medicine, American Medical Society for Sports Medicine, 3 of 8
35American Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of
36Sports Medicine and the American Heart Association’s 14 point screening for heart disease in
37the young. The Preparticipation Physical Evaluation form shall include the History and Physical
38Examination components, and the additional questions required pursuant to Section 3 of this act.
39The Preparticipation Physical Evaluation form shall also include a certification statement, to be
40signed by the registered, licensed, and certified health care professional who performed the
41physical examination, attesting to the completion of the current professional development
42module established pursuant to this Act.
43 (d) This physical examination shall be conducted within 6 weeks to the first day of
44official practice in an athletic season and shall be conducted by a registered, licensed, and
45certified health care professional. All preparticipation physical evaluations must be updated in
46accordance with the PPE Monograph developed jointly by the American Academy of Family
47Physicians, American Academy of Pediatrics, American College of Sports Medicine, American
48Medical Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and
49American Osteopathic Academy of Sports Medicine and the American Heart Association’s 14
50point screening for heart disease in the young and ask if the student has: (1) been advised by a
51registered, licensed, and certified health care professional defined as physician, advanced
52practice nurse, or physician assistant (MD, DO, PA, or APN/NP) not to participate in a sport; (2)
53sustained a concussion, been unconscious or lost memory from a blow to the head; (3) broken a
54bone or sprained, strained, or dislocated any muscles or joints; (4) fainted or blacked out; (5)
55experienced chest pains, shortness of breath, or heart racing; (6) had a recent history of fatigue
56and unusual tiredness; (7) been hospitalized, visited an emergency room, or had a significant
57medical illness; (8) started or stopped taking any over the counter or prescribed medications; or 4 of 8
58(9) had a sudden death in the family, or whether any member of the student’s family under the
59age of 50 has had a heart attack or heart trouble, and (10) asked specifically the new 4 questions
60listed in subsection (b) regarding the heart health history during cardiac screening in well-child
61visit and/or PPE.
62 The board of education of a public school district and the governing board or chief school
63administrator of a nonpublic school shall not permit a student enrolled in grades kindergarten to
6412 to participate on a school or community based organization sponsored interscholastic or
65intramural athletic team or squad unless the student has a completed a Preparticipation Physical
66Evaluation form and, if applicable, a completed health history update questionnaire as required
67under this Act.
68 (e) The department of health shall create a single form, including the contents in
69subsection (c), to be utilized in all Preparticipation Physical Evaluations statewide.
70 (f) The department of elementary and secondary education and the department of public
71health shall establish a Childhood Cardiac Screening professional development module to
72increase the assessment skills of those health care practitioners who perform well-child physical
73examinations and screenings. The departments shall either develop a module adhering to
74requirements in this Act, or adopt the module created by the New Jersey Commissioners of
75Education and Health in consultation with the New Jersey Chapter of the American Academy of
76Pediatrics, the New Jersey Academy of Family Physicians, the American Heart Association, and
77the New Jersey Chapter of the American College of Cardiology.
78 If the Commissioners of department of elementary and secondary education and the
79department of public health choose to develop a new module they shall, in consultation with the 5 of 8
80state chapter of the American Academy of Pediatrics, the state chapter of the Academy of Family
81Physicians, the American Heart Association, and the state chapter of the American College of
82Cardiology, develop, by the 2026-2027 school year, a Childhood Cardiac Screening professional
83development module to increase the assessment skills of those health care practitioners who
84perform well child physical examinations and screenings. The module shall include, but need not
85be limited to, the following: (1) how to complete and review a detailed medical history with an
86emphasis on cardiovascular family history and personal reports of symptoms; (2) identifying
87symptoms of sudden cardiac arrest that may require follow up with a cardiologist; (3)
88recognizing normal structural changes of the athletic heart; (4) recognizing prodromal symptoms
89that precede sudden cardiac arrest; (5) performing the cardiovascular physical examination; (6)
90reviewing the major etiologies of sudden unexplained cardiac death with an emphasis on
91structural abnormalities and acquired conditions; and (7) when to refer a student to a cardiologist
92for further assessment.
93 The module shall be posted on the websites of the department of elementary and
94secondary education and the department of public health and links shall be made available to the
95American Academy of Pediatrics, the Academy of Family Physicians, the American Heart
96Association, the American College of Cardiology, the Athletic Trainers’ Society, the State Board
97of Medical Examiners, Board of Nursing, and the Society of Physician Assistants.
98 Providers completing the Childhood Cardiac Screening will be registered in a database to
99ensure all providers have successfully completed the required modules. This data shall be held
100for 10 years. 6 of 8
101 The department of public health shall compile and publish on its website an annual report
102containing the total number of exams that were completed and the number of referrals that were
103made to cardiology . The report shall also analyze the outcomes of this legislation.
104 (g) The commissioner of elementary and secondary education, in consultation with the
105commissioner of public, the American Heart Association, and the American Academy of
106Pediatrics, shall develop a pamphlet that provides information about the disease that can cause
107sudden cardiac arrest to children and their parents. The pamphlet shall include an explanation of
108sudden cardiac arrest, its incidence, a description of early warning signs, and an overview of the
109options that are privately available to screen for cardiac conditions that may lead to sudden
110cardiac arrest, including a statement about the limitations of these options.
111 The commissioner shall distribute the pamphlet, at no charge, to all school districts in the
112Commonwealth. The commissioner shall update the pamphlet as necessary, and shall make
113additional copies available to nonpublic schools upon request.
114 Beginning in the 2026-2027 school year, each school district shall annually distribute this
115pamphlet to the parents or guardians of students participating in school sports as part of the
116student’s preparticipation physical examination and completion of athletic permission forms. A
117student and their parent or guardian shall certify in writing that they received and reviewed the
118pamphlet.
119 (h) A registered, licensed, and certified health care professional who performs annual
120physical examinations of children 19 years of age or younger, including examinations prior to
121the student’s participation in a school or community based organization sponsored interscholastic
122or intramural athletic team or squad as required under this Act, shall complete the Childhood 7 of 8
123Cardiac Screening professional development module established by the department of public
124health under this Act and read the associated pamphlet every four years.
125 A contract between a school district and a school physician shall include a statement of
126assurance that the school physician has completed the Childhood Cardiac Screening professional
127development module and associated pamphlet under this Act within the past four years.
128 A registered, licensed, and certified health care professional who completes the
129Childhood Cardiac Screening professional development module as required pursuant to this Act
130shall retain on file at that person’s professional office a hard copy of the certificate of completion
131of the module. The hard copy of the certificate of completion of the module shall be made
132available upon request.
133 Upon every renewal of a certification, biennial registration, or renewal of a license by a
134health care professional who performs annual physical examinations of children 19 years of age
135or younger, the health care professional shall attest to the completion of the module within the
136past four years to the Board of Medical Examiners or the Board of Nursing, as appropriate. An
137application for renewal of a certification, biennial registration, or renewal of a license shall
138include a check box for attestation regarding the health care professional’s compliance with this
139Act
140 Upon performing a pre-participation physical examination required under this Act, the
141physician, advanced practice nurse, or physician assistant shall sign the certification statement on
142the Preparticipation Physical Evaluation form required pursuant to this Act attesting to the
143completion of the module. The board of education of a public school district and the governing
144board or chief school administrator of a nonpublic school shall retain the original signed 8 of 8
145statement to attest to the qualification of the health care practitioner to perform the physical
146examination required under this Act.
147 (i) The office of consumer affairs and business regulation, the office of public safety and
148inspections, and the department of elementary and secondary education, pursuant to the
149“Administrative Procedure Act” and in consultation with the department of public health, shall
150adopt rules and regulations to effectuate the purposes of this act.