FIRSTREGULARSESSION
HOUSEBILLNO.628
103RDGENERALASSEMBLY
INTRODUCEDBYREPRESENTATIVEPETERS.
1611H.01I DANARADEMANMILLER,ChiefClerk
ANACT
Torepealsections167.624and170.310,RSMo,andtoenactinlieuthereoffournewsections
relatingtohealthandsafetymeasuresinpublicschools.
BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows:
SectionA.Sections167.624and170.310,RSMo,arerepealedandfournewsections
2enactedinlieuthereof,tobeknownassections160.111,167.624,170.310,and170.321,to
3readasfollows:
160.111.1.Asusedinthissection,thefollowingtermsmean:
2 (1)"Automatedexternaldefibrillator"or"AED",adevicethat:
3 (a)Isusedtoadministeranelectricshockthroughthechestwalltotheheart;
4 (b)Hasbuilt-incomputerswithinthedevicetoassessthepatient'sheartrhythm,
5determinewhetherdefibrillationisneeded,andadministertheshock;
6 (c)Hasaudibleorvisualprompts,orboth,toguidetheuserthroughtheprocess;
7 (d)HasreceivedapprovalfromtheU.S.FoodandDrugAdministrationofits
8pre-marketmodificationfiledunder21U.S.C.Section360(k),asamended;
9 (e)Iscapableofrecognizingthepresenceorabsenceofventricularfibrillation
10andrapidventriculartachycardiaandiscapableofdeterminingwithoutintervention
11byanoperatorwhetherdefibrillationshouldbeperformed;and
12 (f)Upondeterminingdefibrillationshouldbeperformed,eitherautomatically
13chargesanddeliversanelectricalimpulsetoanindividual'sheartorchargesand
14deliversanelectricalimpulseatthecommandoftheoperator;
EXPLANATION—Matterenclosedinbold-facedbrackets[thus] intheabovebillisnotenactedandis
intendedtobeomittedfromthelaw.Matterinbold-facetypeintheabovebillisproposedlanguage. 15 (2)"Cardiacarrest",acondition,oftensudden,thatisduetoabnormalheart
16rhythmscalledarrhythmiasandthatisgenerallytheresultofsomeunderlyingformof
17heartdisease;
18 (3)"Cardiopulmonaryresuscitation"or"CPR",acombinationofrescue
19breathing,chestcompressions,andexternalcardiacmassageusedtosustainan
20individual'slifeuntiladvancedassistancearrives;
21 (4)"Defibrillation",administeringanelectricalimpulsetoanindividual'sheart
22inordertostopventricularfibrillationorrapidventriculartachycardia;
23 (5)"Department",thedepartmentofelementaryandsecondaryeducation;
24 (6)"Emergencymedicalservices",thetransportationandmedicalcareprovided
25totheillorinjuredpriortoarrivalatamedicalfacilitybyalicensedemergencymedical
26technicianorotherhealthcareproviderandthecontinuationoftheinitialemergency
27carewithinamedicalfacilitysubjecttotheapprovalofthemedicalstaffandgoverning
28boardofthatfacility;
29 (7)"Extracurricularevent",anyschool-sponsoredprogramorvoluntary
30activitysponsoredbytheschool,localeducationagency,oranorganizationsanctioned
31bythelocaleducationagencyatwhichstudentscompeteforthepurposeof:
32 (a)Receivinganaward,rating,recognition,orcriticism;
33 (b)Qualifyingforadditionalcompetition;or
34 (c)Preparingforandinvolvementinpublicperformances,contests,athletic
35competitions,demonstrations,displays,andclubactivities;
36 (8)"Programcoordinator",anindividual,appointedbytheschooldistrict,who
37isresponsibleforadministrationoftheAEDprogramforsuchindividual'spublic
38schoolcampus;
39 (9)"Protocol",currentlyapprovedandacceptedproceduresdescribingspecific
40stepsaproviderisrequiredtofollowinassessingandtreatingapatient;
41 (10)"Provider",schoolpersonnelofapublicschoolcampuswhohave
42completedtraininginCPRinadditiontohavingknowledgeandunderstandingofan
43AED'soperationanduseundertherequirementsofthissection;
44 (11)"Publicschool",thesamedefinitionasinsection160.011;
45 (12)"Schoolcampus",anypublicschoolbuildingorclusterofbuildings,and
46groundsaroundsuchpublicschoolbuildingorclusterofbuildings,usedforanypublic
47schoolpurposeincluding,butnotlimitedto,anextracurricularactivity,organized
48physicalactivitycourses,earlychildhoodeducationprograms,orschooldistrict
49administration;
HB628 2 50 (13)"Schoolpersonnel",aschooldistrictemployeeapprovedbytheschool
51boardoracontractemployeeoftheschooldistrictwhoisrequiredtofollowschool
52policyandprocedures;
53 (14)"School-sponsoredevent",anyeventoractivitysponsoredbythepublic
54schoolorschooldistrictincluding,butnotlimitedto,athleticevents,boosterclubs,
55parent-teacherorganizations,oranyactivitydesignedtoenhancetheschoolcurriculum
56whetherontheschoolcampusornot;
57 (15)"Ventricularfibrillation",themostcommonarrhythmiathatcausescardiac
58arrestandaconditioninwhichtheheart'selectricalimpulsessuddenlybecomechaotic,
59oftenwithoutwarning,causingtheheart'spumpingactiontostopabruptly.
60 2.Forthe2026-27schoolyearandallsubsequentschoolyears:
61 (1)Eachschoolcampusshallinstallautomatedexternaldefibrillatorsas
62requiredinthissection;
63 (2)Appropriateschoolpersonnelshallhavebeenadequatelytrainedintheuse
64ofsuchAEDsasrequiredunderthissectionbeforethebeginningofthe2026-27school
65year;and
66 (3)Appropriateschoolpersonnelshallbetrainedannuallyintheuseofsuch
67AEDsasrequiredunderthissection.
68 3.(1)Anautomatedexternaldefibrillatormeetstherequirementsofthissection
69ifsuchAEDis:
70 (a)ApprovedbytheU.S.FoodandDrugAdministration;
71 (b)Anautomatedkindofexternaldefibrillatorrequiringproviderintervention
72toinitiateadefibrillationshock;and
73 (c)Capableofautomaticallycollectingdata.
74 (2)NomodificationsshallbemadetoAEDequipmentbytheproviderorthe
75servicethatresultsindeviationfrom:
76 (a)Theoriginalmanufacturer'sspecifications;or
77 (b)AEDprotocols,whichare:
78 a.Earlyaccess,whichiscalling911;
79 b.EarlyCPR,whichisstartingCPRimmediately;
80 c.Earlydefibrillation,whichisusingtheon-siteAEDwithinthreetofive
81minutesofonset;and
82 d.Earlyadvancedcare,whichistrainedhealthcareprovidersarrivingto
83provideadvancedcare.
84 4.(1)Eachschooldistrictshalldesignateappropriatepersonneltobe
85responsibleforthemaintenanceofeachautomatedexternaldefibrillator.
HB628 3 86 (2)AllcomponentsofeachAEDandintegrateddatarecordingsystemshallbe
87inspectedbyaqualifiedservicetechnicianatleastonetimepercalendaryearoras
88recommendedbythemanufacturertoensurethattheAEDequipment:
89 (a)Meetsoriginalmanufacturer'sspecifications;and
90 (b)Maintainsthecurrentlyapprovedtreatmentprotocolsbasedonthecurrent
91AmericanHeartAssociationscientificguidelines,standards,andrecommendationsfor
92theuseoftheAED.
93 (3)ThebatteryoftheAEDshallbemaintainedandreplacedinaccordancewith
94manufacturer'sspecifications.
95 (4)Allmaintenanceandrepairsshallbeperformedbyaqualifiedservice
96technicianrecognizedbythemanufacturer.
97 (5)Writtenrecordsshallbemaintainedforallmaintenance,repairs,and
98inspectionsperformedonallcomponentsformandatedannualstatereportingpurposes.
99 5.(1)Eachpublicschoolshalldesignateappropriateschoolpersonneltobe
100responsibleforensuringtheavailabilityofeachautomatedexternaldefibrillatoras
101providedinthissubsection.
102 (2)TheregularlocationofeachAEDshallbebasedonthefollowing:
103 (a)Thesizeandphysicallayoutoftheschoolcampus;
104 (b)Thenumberandagesofindividualsontheschoolcampus;
105 (c)Typesandlocationsofcurricular,extracurricular,andschool-sponsored
106events;and
107 (d)Designfeaturesthatareuniquetoparticularbuildingsontheschoolcampus.
108 (3)Duringschoolhours,anAEDshallbeplacedatdesignatedlocations.Such
109locationsshallbespecifictoeachschoolcampusbutshallallowsuchAEDtobeeasily
110seenbyschoolpersonnel.Suchlocationsshallallowschoolpersonneltoretrievesuch
111AEDoutsideofnormalschoolhours.
112 (4)Inconjunctionwiththelocationstandardslistedinsubdivisions(2)and(3)of
113thissubsection,AEDsshallbeplacedinareaswherethereislikelytobehightrafficor
114congregation,suchasauditoriums,cafeterias,orgymnasiums,andareaswhereriskof
115injurymaybeelevatedoneachschoolcampus,inaneasilyaccessiblelocationofsuch
116areas,tobedeterminedafterconsultationwiththelocalemergencymedicalservices
117systemoremergencymedicalresponseagency.
118 6.Theprogramcoordinatorshall:
119 (1)MaintaincurrentproviderstatusinCPRandtheuseofanautomated
120externaldefibrillator;
121 (2)Ensurethatprovidersontheschoolcampusreceiveappropriatetrainingin
122theuseandmaintenanceofthepublicschool'sAEDs;
HB628 4 123 (3)Overseetrainingoperationsforthepublicschoolandmaintain
124organizationaltrainingreports;
125 (4)EnsurethatAEDequipmentismaintainedaccordingtomanufacturerand
126treatmentprotocolspecificationsbasedonthecurrentAmericanHeartAssociation
127scientificguidelines,standards,andrecommendationsfortheuseofeachAEDand
128submitmaintenancerecordstothedepartmentasrequiredbythedepartment;
129 (5)Provideprofessionaldevelopmentopportunitiesannuallyforprovidersand
130allschoolpersonnel,ifapplicable;
131 (6)Verifycredentialsofschoolpersonnelfunctioningasaproviderwithinthe
132publicschool;
133 (7)RevieweachuseofeachAED;and
134 (8)Report,inaformatapprovedbythedepartment,eachuseofanAED.Such
135reportshallbecompletedandsubmittedtothedepartmentwithinthirtydaysfollowing
136suchuse.Suchformshallcontainatleastrelevantinformationregardingtheincidence
137anduseoftheAEDandtheclientoutcome.
138 7.Appropriatetrainingofprovidersandanticipatedrescuersintheuseofan
139automatedexternaldefibrillatorandinCPRshallincorporateatleastthefollowing:
140 (1)TestingofpsychomotorskillsbasedontheAmericanHeartAssociation
141scientificguidelines,standards,andrecommendationsfortheuseofeachAED,asin
142existenceonJanuary1,2022;
143 (2)ProvidingCPRaspublishedbytheAmericanHeartAssociation,American
144RedCross,orinequivalentcoursematerials,asinexistenceonJanuary1,2022;
145 (3)Coordinatingwiththelocalemergencymedicalservicessystemoremergency
146medicalresponseagency;and
147 (4)Anongoingqualityimprovementprogramtomonitortrainingandevaluate
148responsewitheachuseofanAED.
149 8.Automatedexternaldefibrillatorandcardiopulmonaryresuscitationtraining
150shallcountfullytowardprofessionaldevelopmentrequirementsundersection168.021.
151 9.BeforeAprilthirtiethineachschoolyear,eachpublicschoolshallreportto
152thedepartmentontheimplementationandstatusofautomatedexternaldefibrillator
153availabilityoneachschoolcampus.Thedepartmentshallcompilesuchdataandsubmit
154areporttothegeneralassemblybeforetheendofeachschoolyear.
155 10.Thedepartmentmaypromulgateallnecessaryrulesandregulationsforthe
156administrationofthissection.Anyruleorportionofarule,asthattermisdefinedin
157section536.010,thatiscreatedundertheauthoritydelegatedinthissectionshall
158becomeeffectiveonlyifitcomplieswithandissubjecttoalloftheprovisionsofchapter
159536and,ifapplicable,section536.028.Thissectionandchapter536arenonseverable
HB628 5 160andifanyofthepowersvestedwiththegeneralassemblypursuanttochapter536to
161review,todelaytheeffectivedate,ortodisapproveandannularulearesubsequently
162heldunconstitutional,thenthegrantofrulemakingauthorityandanyruleproposedor
163adoptedaftertheeffectivedateofthissectionshallbeinvalidandvoid.
167.624.1.Eachschoolboardinthestate,iftheschooldistrictdoesnotpresently
2haveaprogramasdescribedbelow,maydevelopandimplementaprogramtotrainthe
3studentsandemployeesofthedistrictintheadministrationofcardiopulmonaryresuscitation
4andotherlifesavingmethods,astheydeterminebest,andmayconsultthedepartmentof
5publicsafety,thestatefiremarshal'soffice,thelocalfireprotectionauthorities,andothersas
6theboardseesfit.Theboardmaymakecompletionoftheprogramarequirementfor
7graduation.Anytrainedemployeeshallbeheldharmlessandimmunefromanycivilliability
8foradministeringcardiopulmonaryresuscitationandotherlifesavingmethodsingoodfaith
9andaccordingtostandardmedicalpractices.
10 2.Forthe2025-26schoolyearandallsubsequentschoolyears,districttraining
11implementedunderthissectionshallincludeappropriatetrainingintheuseofan
12automatedexternaldefibrillatorasrequiredinsections160.111and190.1005.Each
13schooldistrictshallcomplywithallapplicableprovisionsofsections160.111and
14190.092relatingtoplacement,maintenance,testing,andinspectionofautomated
15externaldefibrillators.Anytrainedemployeeshallbeheldharmlessandimmunefrom
16anycivilliabilityfortheuseofanautomatedexternaldefibrillatoringoodfaithand
17accordingtostandardmedicalpractices.
170.310.1.Forschoolyear2017-18andeachschoolyearthereafter,upon
2graduationfromhighschool,pupilsinpublicschoolsandcharterschoolsshallhavereceived
3thirtyminutesofcardiopulmonaryresuscitationinstructionandtrainingintheproper
4performanceoftheHeimlichmaneuverorotherfirstaidforchokinggivenanytimeduringa
5pupil'sfouryearsofhighschool.
6 2.Beginninginschoolyear2017-18,anypublicschoolorcharterschoolserving
7gradesninethroughtwelveshallprovideenrolledstudentsinstructionincardiopulmonary
8resuscitation.Studentswithdisabilitiesmayparticipatetotheextentappropriateas
9determinedbytheprovisionsofthefederalIndividualswithDisabilitiesEducationAct
10(IDEA)(20U.S.C.Section1400etseq.,asamended)orSection504ofthefederal
11RehabilitationActof1973(29U.S.C.Section794,asamended). Instructionshallbe
12includedinthedistrict'sexistinghealthorphysicaleducationcurriculum.Instructionshallbe
13basedonaprogramestablishedbytheAmericanHeartAssociationortheAmericanRed
14Cross,orthroughanationallyrecognizedprogrambasedonthemostcurrentnational
15evidence-basedemergencycardiovascularcareguidelines,andpsychomotorskills
16developmentshallbeincorporatedintotheinstruction.Forpurposesofthissection,
HB628 6 17"psychomotorskills"meanstheuseofhands-onpracticingandskillstestingtosupport
18cognitivelearning.
19 3.Forthe2025-26schoolyearandallsubsequentschoolyears,instructionin
20cardiopulmonaryresuscitationunderthissectionshallincludeappropriateinstruction
21andtrainingintheuseofanautomatedexternaldefibrillatorasrequiredundersections
22160.111and190.1005.
23 4.Theteacherofthecardiopulmonaryresuscitationcourseorunitshallnotbe
24requiredtobeacertifiedtrainerofcardiopulmonaryresuscitationiftheinstructionisnot
25designedtoresultincertificationofstudents.Instructionthatisdesignedtoresultin
26certificationbeingearnedshallberequiredtobetaughtbyanauthorizedcardiopulmonary
27instructor.Schoolsmaydevelopagreementswithanylocalchapterofavoluntary
28organizationoffirstresponderstoprovidetherequiredhands-onpracticeandskillstesting.
29Forpurposesofthissubsection,"firstresponders"shallincludetelecommunicatorfirst
30respondersasdefinedinsection650.320.
31 [4.]5.Thedepartmentofelementaryandsecondaryeducationmaypromulgaterules
32toimplementthissection.Anyruleorportionofarule,asthattermisdefinedinsection
33536.010,thatiscreatedundertheauthoritydelegatedinthissectionshallbecomeeffective
34onlyifitcomplieswithandissubjecttoalloftheprovisionsofchapter536and,ifapplicable,
35section536.028.Thissectionandchapter536arenonseverableandifanyofthepowers
36vestedwiththegeneralassemblypursuanttochapter536toreview,todelaytheeffective
37date,ortodisapproveandannularulearesubsequentlyheldunconstitutional,thenthegrant
38ofrulemakingauthorityandanyruleproposedoradoptedafterAugust28,2012,shallbe
39invalidandvoid.
170.321.1.Asusedinthissection,thefollowingtermsmean:
2 (1)"Naloxone",alifesavingemergencytreatmentthatreversesopioidoverdose,
3isapprovedbytheUnitedStatesFoodandDrugAdministrationforopioidoverdose
4reversalonanonprescriptionbasis,andisavailabledirectlytoconsumers.Theterm
5shallbeconstruedtoincludeNarcan4milligram(mg)naloxonehydrochloridenasal
6spray,otherformulationsofnaloxoneavailableasanonprescriptionproduct,andany
7otherdrugordeviceapprovedbytheUnitedStatesFoodandDrugAdministrationfor
8opioidoverdosereversalonanonprescriptionbasis;
9 (2)"Psychomotorskills",theuseofhands-onpracticingandskillstestingto
10supportcognitivelearning;
11 (3)"Publicschool",thesamedefinitionasinsection160.011;
12 (4)"Schooldistrict",thesamedefinitionasinsection160.011.
13 2.(1)Forthe2025-26schoolyearandallsubsequentschoolyears,upon
14graduationfromhighschool,pupilsinpublicschoolsshallhavereceivedatleastthirty
HB628 7 15minutesofinstructioninpreventingopioiduseandtrainingintheproperperformance
16ofadministeringnaloxone.Suchinstructionandtrainingrequiredunderthis
17subdivisionshallbegivenanytimeduringapupil'sfouryearsofhighschool.
18 (2)Forthe2025-26schoolyearandallsubsequentschoolyears,eachpublic
19schoolservinggradesseventhroughtwelveshallprovideenrolledpupilswith
20instructioninpreventingopioiduse.Studentswithdisabilitiesmayparticipatetothe
21extentappropriateasdeterminedunderthefederalIndividualswithDisabilities
22EducationAct(IDEA)(20U.S.C.Section1400etseq.,asamended)orSection504ofthe
23federalRehabilitationActof1973(29U.S.C.Section794,asamended).Such
24instructionshallbebasedonthemostcurrentnationalevidence-basedemergency
25guidelines,andpsychomotorskillsdevelopmentshallbeincorporatedintothe
26instruction.
27 (3)Theteacherofthecourseorunitofinstructionrequiredunderthis
28subsectionshallberequiredtobeacertifiedinstructorofnaloxoneadministration.A
29publicschoolmaydevelopagreementswithanylocalchapterofavoluntary
30organizationoffirstresponderstoprovidetherequiredhands-onpracticeandskills
31testing.
32 3.(1)Thissubsectionshallbeknownandmaybecitedasthe"PublicAccessto
33Naloxone(Narcan)KitsAct".
34 (2)Anindividualwhoorentitythatacquiresnaloxoneshall:
35 (a)Complywithallregulationsgoverningtheplacementofnaloxonekits;
36 (b)Ensurethatnaloxonekitsaremaintainedandunexpiredaccordingtothe
37operationguidelinessetforthbythemanufacturer;and
38 (c)Ensurethataninspectionismadeofeachnaloxonekitplacedonthepremises
39atleasteveryninetydaysforpotentialissuesrelatedtotheoperationoradministration
40ofthekit,otherobviousdefectsthatmaysuggesttampering,orotherproblemsthat
41havearisenwiththekit'sfunctionality.
42 (3)Anyindividualwhogratuitouslyandingoodfaithrendersemergencycare
43byuseoradministrationofnaloxoneshallnotbeheldliableforanycivildamagesor
44subjecttoanycriminalpenaltyasaresultofsuchcareortreatment,unlessthe
45individualactsinawillfulandwantonorrecklessmannerinprovidingthecare,advice,
46orassistance.Theindividualwhoorentitythatprovidestrainingtotheindividual
47administeringnaloxone,theindividualorentityresponsibleforthesitewherethe
48naloxoneislocated,andtheindividualwhoorentitythatownsthenaloxoneshall
49likewisenotbeheldliableforcivildamagesorsubjecttoanycriminalpenaltyresulting
50fromtheuseoforadministrationofnaloxone.
HB628 8 51 (4)(a)Ifaschooldistrictorcharterschooldoesnothaveacurrentprogramfor
52naloxoneuseoradministrationasdescribedinsubsection2ofthissection,such
53district'sschoolboardorsuchcharterschool'sgoverningboardmaydevelopand
54implementaprogramtoeducateandtrainpupilsandemployeesofthedistrictor
55charterschoolintheuseandadministrationofnaloxoneasdeterminedbythedistrict's
56schoolboardorcharterschool'sgoverningboard.
57 (b)Inthedevelopmentandimplementationoftheprogram,theschooldistrict's
58schoolboardorcharterschool'sgoverningboardmayconsultwiththeMissouri
59departmentofhealthandseniorservices,theMissouridepartmentofpublicsafety,and
60otherMissouridepartmentsasdeterminedbythedistrict'sschoolboardorcharter
61school'sgoverningboard.
62 (c)Theschooldistrict'sschoolboardorcharterschool'sgoverningboardmay
63makecompletionoftheprogramarequirementforgraduation.
64 4.Thedepartmentofelementaryandsecondaryeducationmaypromulgateall
65necessaryrulesandregulationsfortheadministrationofthissection.Anyruleor
66portionofarule,asthattermisdefinedinsection536.010,thatiscreatedunderthe
67authoritydelegatedinthissectionshallbecomeeffectiveonlyifitcomplieswithandis
68subjecttoalloftheprovisionsofchapter536and,ifapplicable,section536.028.This
69sectionandchapter536arenonseverableandifanyofthepowersvestedwiththe
70generalassemblypursuanttochapter536toreview,todelaytheeffectivedate,orto
71disapproveandannularulearesubsequentlyheldunconstitutional,thenthegrantof
72rulemakingauthorityandanyruleproposedoradoptedaftertheeffectivedateofthis
73sectionshallbeinvalidandvoid.
âś”
HB628 9