FIRSTREGULARSESSION
HOUSEBILLNO.844
103RDGENERALASSEMBLY
INTRODUCEDBYREPRESENTATIVEHRUZA.
2086H.01I JOSEPHENGLER,ChiefClerk
ANACT
Torepealsections167.624and170.310,RSMo,andtoenactinlieuthereoffournewsections
relatingtohealthandsafetymeasuresinpublicschools.
BeitenactedbytheGeneralAssemblyofthestateofMissouri,asfollows:
SectionA.Sections167.624and170.310,RSMo,arerepealedandfournewsections
2enactedinlieuthereof,tobeknownassections160.111,160.485,167.624,and170.310,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;
HB844 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.
HB844 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;
HB844 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
HB844 5 160andifanyofthepowersvestedwiththegeneralassemblypursuanttochapter536to
161review,todelaytheeffectivedate,ortodisapproveandannularulearesubsequently
162heldunconstitutional,thenthegrantofrulemakingauthorityandanyruleproposedor
163adoptedaftertheeffectivedateofthissectionshallbeinvalidandvoid.
160.485.1.Thissectionshallbeknownandmaybecitedasthe"StoptheBleed
2Act".
3 2.Asusedinthissection,thefollowingtermsmean:
4 (1)"Bleedingcontrolkit",afirstaidresponsekitthatcontainsatleastthe
5following:
6 (a)Tourniquetsthatare:
7 a.EndorsedbytheUnitedStatesDepartmentofDefenseCommitteeonTactical
8CombatCasualtyCareoritssuccessorentity;or
9 b.ApprovedforuseinbattlefieldtraumacarebytheArmedForcesofthe
10UnitedStates;
11 (b)Bleedingcontrolbandages;
12 (c)Latex-freeprotectivegloves;
13 (d)Permanentmarkers;
14 (e)InstructionaldocumentsdevelopedbytheUnitedStatesDepartmentof
15HomelandSecurity'sStoptheBleednationalawarenesscampaignortheAmerican
16CollegeofSurgeonsCommitteeonTrauma,orboth;and
17 (f)Othermedicalmaterialsandequipmentsimilartothosedescribedin
18paragraphs(a)and(b)ofthissubdivision;
19 (2)"Department",thedepartmentofelementaryandsecondaryeducation;
20 (3)"Emergencymedicalservicespersonnel",paidorvolunteerfirefighters,law
21enforcementofficers,firstresponders,emergencymedicaltechnicians,orother
22emergencyservicepersonnelactingwithintheordinarycourseandscopeofthose
23professions,butexcludingphysicians;
24 (4)"Schoolpersonnel",anyemployeeofapublicschooldistrictorcharter
25school,oranyvolunteerservingatapublicschoolorcharterschool,whoisdesignated
26touseableedingcontrolkitunderthissection.
27 3.(1)BeforeJanuary1,2026,thedepartmentshalldevelopatraumaticblood
28lossprotocolforschoolpersonneltofollowintheeventofaninjuryinvolvingtraumatic
29bloodloss.Theprotocolshallmeettherequirementsofthissectionandshallbemade
30availabletoeachschooldistrictandcharterschool.
31 (2)Thetraumaticbloodlossprotocolshall:
32 (a)Requirethatableedingcontrolkitbeplacedinareaswherethereislikelyto
33behightrafficorcongregation,suchasauditoriums,cafeterias,orgymnasiums,and
HB844 6 34areaswhereriskofinjurymaybeelevated,includingvocationalclassessuchas
35woodworkingorautomotiveclasses,ofeachschooldistrict'sschoolbuildingsandeach
36charterschoolinaneasilyaccessiblelocationofsuchareastobedeterminedbylocal
37emergencymedicalservicespersonnel;
38 (b)Includebleedingcontrolkitsintheemergencyplansofeachschooldistrict
39andcharterschool,includingthepresentationanduseofthebleedingcontrolkitsinall
40drillsandemergencies;
41 (c)Requireeachschooldistrictandcharterschooltodesignateaschoolnurseor
42schoolhealthcareprovider,orifnoschoolnurseorschoolhealthcareprovideris
43available,aschoolpersonnelmember,ineachschoolbuildingwhoshallobtain
44appropriatetrainingannuallyintheuseofableedingcontrolkitincluding,butnot
45limitedto:
46 a.Theproperapplicationofpressuretostopbleeding;
47 b.Theproperapplicationofdressingsorbandages;
48 c.Additionalpressuretechniquestocontrolbleeding;and
49 d.Thecorrectapplicationoftourniquets;
50 (d)Requireeachbleedingcontrolkitinschoolinventoriestobeinspected
51annuallytoensurethatthematerials,supplies,andequipmentcontainedinthebleeding
52controlkithavenotexpiredandthatanyexpiredmaterials,supplies,andequipmentare
53replacedasnecessary;and
54 (e)Requireableedingcontrolkittoberestockedaftereachuseandany
55materials,supplies,andequipmenttobereplacedasnecessarytoensurethatthe
56bleedingcontrolkitcontainsallnecessarymaterials,supplies,andequipment.
57 4.(1)Thedepartmentshall,incollaborationwiththeUnitedStatesDepartment
58ofHomelandSecurityandthestatedepartmentofpublicsafety,includerequirementsin
59thetraumaticbloodlossprotocolforschoolpersonneltoreceiveannualtraininginthe
60useofbleedingcontrolkits.
61 (2)Thetrainingrequirementsshallbesatisfiedbysuccessfulcompletionand
62certificationunderthe"STOPTHEBLEED"courseaspromulgatedbytheAmerican
63CollegeofSurgeonsCommitteeonTraumaortheAmericanRedCross.
64 (3)Thetrainingrequirementsmayallowonlineinstruction.
65 5.(1)Ableedingcontrolkitmaycontainanyadditionalitemsthat:
66 (a)Areapprovedbyemergencymedicalservicespersonnel,assuchtermis
67definedinsection190.600;
68 (b)Canadequatelytreataninjuryinvolvingtraumaticbloodloss;and
69 (c)Canbestoredinareadilyavailablekit.
HB844 7 70 (2)Quantitiesofeachitemrequiredtobeinableedingcontrolkitmaybe
71determinedbyeachschooldistrict.
72 6.(1)Thedepartmentandeachschooldistrictandcharterschoolshallmaintain
73informationregardingthetraumaticbloodlossprotocolandtheStoptheBleednational
74awarenesscampaignoneachentity'swebsite.
75 (2)Uponrequestbyaschooldistrictoracharterschool,thedepartmentmay,in
76collaborationwiththedepartmentofpublicsafety,directtheschooldistrictorcharter
77schooltoresourcesthatareavailabletoprovidebleedingcontrolkitstotheschool
78districtorcharterschool.
79 7.(1)Exceptasotherwiseprovidedinthissubsection,eachschooldistrictand
80charterschoolshallimplementthetraumaticbloodlossprotocoldevelopedunderthis
81sectionbeforetheendofthe2025-26schoolyear.
82 (2)Therequirementsthatableedingcontrolkitbeplacedasrequiredin
83paragraph(a)ofsubdivision(2)ofsubsection3ofthissection,thateachkitberestocked
84asnecessary,andthatschoolpersonnelreceivetrainingunderthissectionshallbe
85subjecttoanappropriationtocoverallcostsrelatedtosuchrequirementsbythegeneral
86assembly.
87 (3)Anyschooldistrictorcharterschoolmayreceivedonationsoffundsforthe
88purchaseofbleedingcontrolkitsthatmeettherequirementsofthissectionandmay
89receivedonationsofbleedingcontrolkitsthatmeettherequirementsofthissection.
90 8.Thissectionshallnotbeconstruedtocreateacauseofactionagainstaschool
91district,acharterschool,oranyschoolpersonnel.Anyschoolpersonnelwhoingood
92faithuseableedingcontrolkitasprovidedbythissectionshallbeimmunefromallcivil
93liabilityforanyactoromissionintheuseofableedingcontrolkitunlesstheactor
94omissionconstitutesgrossnegligenceorwillful,wanton,orintentionalmisconduct.
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
12automatedexternaldefibrillatorasrequiredinsection160.111.Eachschooldistrict
HB844 8 13shallcomplywithallapplicableprovisionsofsections160.011and190.092relatingto
14placement,maintenance,testing,andinspectionofautomatedexternaldefibrillators.
15Anytrainedemployeeshallbeheldharmlessandimmunefromanycivilliabilityforthe
16useofanautomatedexternaldefibrillatoringoodfaithandaccordingtostandard
17medicalpractices.
170.310.1.Forschoolyear2017-18andeachschoolyearthereafter,upon
2graduationfromhighschool,pupilsinpublicschoolsandcharterschoolsshallhavereceived
3thirtyminutesofcardiopulmonaryresuscitationinstructionandtrainingintheproper
4performanceoftheHeimlichmaneuverorotherfirstaidforchokinggivenanytimeduringa
5pupil'sfouryearsofhighschool.
6 2.Beginninginschoolyear2017-18,anypublicschoolorcharterschoolserving
7gradesninethroughtwelveshallprovideenrolledstudentsinstructionincardiopulmonary
8resuscitation.Studentswithdisabilitiesmayparticipatetotheextentappropriateas
9determinedbytheprovisionsoftheIndividualswithDisabilitiesEducationActorSection
10504oftheRehabilitationAct(29U.S.C.Section794),asamended. Instructionshallbe
11includedinthedistrict'sexistinghealthorphysicaleducationcurriculum.Instructionshallbe
12basedonaprogramestablishedbytheAmericanHeartAssociationortheAmericanRed
13Cross,orthroughanationallyrecognizedprogrambasedonthemostcurrentnational
14evidence-basedemergencycardiovascularcareguidelines,andpsychomotorskills
15developmentshallbeincorporatedintotheinstruction.Forpurposesofthissection,
16"psychomotorskills"meanstheuseofhands-onpracticingandskillstestingtosupport
17cognitivelearning.
18 3.Forthe2025-26schoolyearandallsubsequentschoolyears,instructionin
19cardiopulmonaryresuscitationunderthissectionshallincludeappropriateinstruction
20andtrainingintheuseofanautomatedexternaldefibrillatorasrequiredundersection
21160.111.
22 4.Theteacherofthecardiopulmonaryresuscitationcourseorunitshallnotbe
23requiredtobeacertifiedtrainerofcardiopulmonaryresuscitationiftheinstructionisnot
24designedtoresultincertificationofstudents.Instructionthatisdesignedtoresultin
25certificationbeingearnedshallberequiredtobetaughtbyanauthorizedcardiopulmonary
26instructor.Schoolsmaydevelopagreementswithanylocalchapterofavoluntary
27organizationoffirstresponderstoprovidetherequiredhands-onpracticeandskillstesting.
28Forpurposesofthissubsection,"firstresponders"shallincludetelecommunicatorfirst
29respondersasdefinedinsection650.320.
30 [4.]5.Thedepartmentofelementaryandsecondaryeducationmaypromulgaterules
31toimplementthissection.Anyruleorportionofarule,asthattermisdefinedinsection
32536.010,thatiscreatedundertheauthoritydelegatedinthissectionshallbecomeeffective
HB844 9 33onlyifitcomplieswithandissubjecttoalloftheprovisionsofchapter536and,ifapplicable,
34section536.028.Thissectionandchapter536arenonseverableandifanyofthepowers
35vestedwiththegeneralassemblypursuanttochapter536toreview,todelaytheeffective
36date,ortodisapproveandannularulearesubsequentlyheldunconstitutional,thenthegrant
37ofrulemakingauthorityandanyruleproposedoradoptedafterAugust28,2012,shallbe
38invalidandvoid.
âś”
HB844 10