0979S.03C
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SENATE COMMITTEE SUBSTITUTE
FOR
SENATE BILLS NOS. 166 & 155
AN ACT
To amend chapter 160, RSMo, by adding thereto one new
section relating to cardiac emergency response plans.
Be it enacted by the General Assembly of the State of Missouri, as follows:
Section A. Chapter 160, RSMo, is amended by adding thereto
one new section, to be known as section 160.482, to read as
follows:
160.482. 1. As used in this section, the following
terms mean:
(1) "Automated external defibrillator" or "AED", a
lightweight, portable device that:
(a) Is used to administer an electric shock through
the chest wall to the heart;
(b) Has built-in computers within the device to assess
the patient's heart rhythm, determine whether defibrillation
is needed, and administer the shock;
(c) Has audible or visual prompts, or both, to guide
the user through the process;
(d) Has received approval from the U.S. Food and Drug
Administration of its pre -market modification filed under 21
U.S.C. Section 360(k), as amended;
(e) Is capable of recognizing the presence or absence
of ventricular fibrillation and rapid ventricul ar
tachycardia and is capable of determining without
intervention by an operator whether defibrillation should be
performed; and
(f) Upon determining defibrillation should be
performed, either automatically charges and delivers an
electrical impulse to an individual's heart or charges and
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delivers an electrical impulse at the command of the
operator;
(2) "Cardiopulmonary resuscitation" or "CPR", a
combination of rescue breathing, chest compressions, and
external cardiac massage used to sustain an individual's
life until advanced assistance arrives;
(3) "Defibrillation", administering an electrical
impulse to an individual's heart in order to stop
ventricular fibrillation or rapid ventricular tachycardia;
(4) "Emergency services provider", any public
employer, or ground or air ambulance service as those terms
are used in chapter 190, that employs persons to provide
fire fighting, dispatching services, and emergency medical
services;
(5) "Extracurricular event", any school-sponsored
program or voluntary activity sponsored by the school, local
education agency, or an organization sanctioned by the local
education agency at which students compete for the purpose
of:
(a) Receiving an award, rating, recognition , or
criticism;
(b) Qualifying for additional competition; or
(c) Preparing for and involvement in public
performances, contests, athletic competitions,
demonstrations, displays, and club activities;
(6) "Project ADAM (Automated Defibr illators in Adam's
Memory)", a national, nonprofit organization focused on
education around preventing and planning to respond to
cardiac arrest;
(7) "Protocol", currently approved and accepted
procedures describing specific steps a provider is r equired
to follow in assessing and treating a patient;
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(8) "Public school", the same definition as in section
160.011;
(9) "School campus", any public school building or
cluster of buildings, and grounds around such public school
building or cluster of buildings, used for any public school
purpose including, but not limited to, an extracurricular
activity, organized physical activity courses, early
childhood education programs, or school district
administration;
(10) "School personnel", a school district employee
approved by the school board or a contract employee of the
school district who is required to follow school policy and
procedures;
(11) "School-sponsored event", any event or activity
sponsored by the public schoo l or school district including,
but not limited to, athletic events, booster clubs, parent -
teacher organizations, or any activity designed to enhance
the school curriculum whether on the school campus or not;
(12) "Sudden cardiac arrest", a condit ion that occurs
when the heart malfunctions and stops beating unexpectedly,
is due to abnormal heart rhythms called arrhythmias, and is
generally the result of some underlying form of heart
disease;
(13) "Ventricular fibrillation", the most commo n
arrhythmia that causes cardiac arrest and a condition in
which the heart's electrical impulses suddenly become
chaotic, often without warning, causing the heart's pumping
action to stop abruptly.
2. For the 2026-27 school year and all subsequen t
school years, each public school shall develop and implement
a cardiac emergency response plan that addresses the
appropriate use of school personnel to respond to incidents
involving an individual experiencing sudden cardiac arrest
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or a similar life-threatening emergency while on a school
campus.
3. Members of each public school's administration
shall coordinate directly with local emergency services
providers to integrate the public school's cardiac emergency
response plan into the local emergency services providers'
protocols. A cardiac emergency response plan shall
integrate evidence-based core elements, such as those
recommended by the American Heart Association guidelines,
Project ADAM, or another set of nationally recognized,
evidence-based standards or core elements.
4. The cardiac emergency response plan shall
integrate, at a minimum, the following core elements:
(1) Establishment of a cardiac emergency response team;
(2) Activation of the team in response to a sudden
cardiac arrest;
(3) Implementation of AED placement and routine
maintenance throughout the school campus;
(4) Dissemination of the plan throughout the school
campus;
(5) Maintenance of ongoing staff training in CPR and
AED use;
(6) Practice of the cardiac emergency response plan
using drills annually;
(7) Integration of the plan into the local emergency
services providers' protocols; and
(8) Both annual and continuous reviews and evaluations
of the plan.
5. Appropriate AED placement shall be dictated by the
cardiac emergency response plan and in accordance with
guidelines set by the American Heart Association or
nationally recognized guidelines focused on emergency
cardiovascular care. An AED should be identified with
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appropriate signage and be on -site or placed and made
available in an unlocked location on school property.
6. For schools with an athletic department or
organized school athletic program, an automated external
defibrillator shall be clearly marked and easily accessible
in an unlocked location at each school athletic venue and
event. The AED shall be accessible during the school day
and any school-sponsored athletic event or team practice in
which pupils of the school are participating. An AED should
be placed on a person experiencing cardiac arrest within
three minutes.
7. Appropriate school personnel shall be certified in
first aid, CPR, and AED use following guidelines set forth
by the American Heart Assoc iation or nationally recognized
guidelines focused on emergency cardiovascular care. The
school personnel required to be certified shall be
determined by the cardiac emergency response plan and shall
include, but shall not be limited to, athletic coac hes,
school nurses, and athletic trainers.