FIRST REGULAR SESSION
[PERFECTED]
SENATE SUBSTITUTE FOR
SENATE COMMITTEE SUBSTITUTE FOR
SENATE BILLS NOS. 166 & 155
103RD GENERAL ASSEMBLY
INTRODUCED BY SENATOR GREGORY (21).
0979S.06P KRISTINA MARTIN, Secretary
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 1
one new section, to be known as section 160.482, to read as 2
follows:3
160.482. 1. As used in this section, the following 1
terms mean: 2
(1) "Automated external defibrillator" or "AED", a 3
lightweight, portable device that: 4
(a) Is used to administer an electric shock through 5
the chest wall to the heart; 6
(b) Has built-in computers within the device to assess 7
the patient's heart rhythm, determine whether defibrillation 8
is needed, and administer the shock; 9
(c) Has audible or visual prompts, or both, to guide 10
the user through the process; 11
(d) Has received approval from the U.S. Food and Drug 12
Administration of its p re-market modification filed under 21 13
U.S.C. Section 360(k), as amended; 14 SS SCS SBs 166 & 155 2
(e) Is capable of recognizing the presence or absence 15
of ventricular fibrillation and rapid ventricular 16
tachycardia and is capable of determining without 17
intervention by an operator whether defibrillation should be 18
performed; and 19
(f) Upon determining defibrillation should be 20
performed, either automatically charges and delivers an 21
electrical impulse to an individual's heart or charges and 22
delivers an electrical impul se at the command of the 23
operator; 24
(2) "Cardiopulmonary resuscitation" or "CPR", a 25
combination of rescue breathing, chest compressions, and 26
external cardiac massage used to sustain an individual's 27
life until advanced assistance arrives; 28
(3) "Defibrillation", administering an electrical 29
impulse to an individual's heart in order to stop 30
ventricular fibrillation or rapid ventricular tachycardia; 31
(4) "Emergency services provider", any public 32
employer, or ground or air ambulance service as those terms 33
are used in chapter 190, that employs persons to provide 34
fire fighting, dispatching services, and emergency medical 35
services; 36
(5) "Extracurricular event", any school -sponsored 37
program or voluntary activity sponsored by the school, local 38
education agency, or an organization sanctioned by the local 39
education agency or charter school at which students compete 40
for the purpose of: 41
(a) Receiving an award, rating, recognition, or 42
criticism; 43
(b) Qualifying for additional com petition; or 44 SS SCS SBs 166 & 155 3
(c) Preparing for and involvement in public 45
performances, contests, athletic competitions, 46
demonstrations, displays, and club activities; 47
(6) "Project ADAM (Automated Defibrillators in Adam's 48
Memory)", a national, nonprofit orga nization focused on 49
education around preventing and planning to respond to 50
cardiac arrest; 51
(7) "Protocol", currently approved and accepted 52
procedures describing specific steps a provider is required 53
to follow in assessing and treating a patient; 54
(8) "Public school", the same definition as in section 55
160.011. The term shall be construed to include a charter 56
school; 57
(9) "School campus", any public school building or 58
cluster of buildings, and grounds around such public school 59
building or cluster of buildings, used for any public school 60
purpose including, but not limited to, an extracurricular 61
activity, organized physical activity courses, early 62
childhood education programs, or school district 63
administration; 64
(10) "School personnel", a school district or charter 65
school employee approved by the school board of the school 66
district or governing board of the charter school or a 67
contract employee of the school district or charter school 68
who is required to follow school policy a nd procedures; 69
(11) "School-sponsored event", any event or activity 70
sponsored by the public school or school district including, 71
but not limited to, athletic events, booster clubs, parent - 72
teacher organizations, or any activity designed to enhance 73
the school curriculum whether on the school campus or not; 74
(12) "Sudden cardiac arrest", a condition that occurs 75
when the heart malfunctions and stops beating unexpectedly, 76 SS SCS SBs 166 & 155 4
is due to abnormal heart rhythms called arrhythmias, and is 77
generally the result of some underlying form of heart 78
disease; 79
(13) "Ventricular fibrillation", the most common 80
arrhythmia that causes cardiac arrest and a condition in 81
which the heart's electrical impulses suddenly become 82
chaotic, often without warning, caus ing the heart's pumping 83
action to stop abruptly. 84
2. For the 2026-27 school year and all subsequent 85
school years, each public school shall develop and implement 86
a cardiac emergency response plan that addresses the 87
appropriate use of school personn el to respond to incidents 88
involving an individual experiencing sudden cardiac arrest 89
or a similar life-threatening emergency while on a school 90
campus. 91
3. Members of each public school's administration 92
shall coordinate directly with local emergen cy services 93
providers to integrate the public school's cardiac emergency 94
response plan into the local emergency services providers' 95
protocols. A cardiac emergency response plan shall 96
integrate evidence-based core elements, such as those 97
recommended by the American Heart Association guidelines, 98
Project ADAM, or another set of nationally recognized, 99
evidence-based standards or core elements. 100
4. The cardiac emergency response plan shall 101
integrate, at a minimum, the following core elements: 102
(1) Establishment of a cardiac emergency response team; 103
(2) Activation of the team in response to a sudden 104
cardiac arrest; 105
(3) Implementation of AED placement and routine 106
maintenance throughout the school campus; 107 SS SCS SBs 166 & 155 5
(4) Dissemination of the plan throughout the school 108
campus; 109
(5) Maintenance of ongoing staff training in CPR and 110
AED use; 111
(6) Practice of the cardiac emergency response plan 112
using drills annually; 113
(7) Integration of the plan into the local emergency 114
services providers' protocols; and 115
(8) Both annual and continuous reviews and evaluations 116
of the plan. 117
5. Appropriate AED placement shall be dictated by the 118
cardiac emergency response plan and in accordance with 119
guidelines set by the American Hear t Association or 120
nationally recognized guidelines focused on emergency 121
cardiovascular care. An AED should be identified with 122
appropriate signage and be on -site or placed and made 123
available in an unlocked location on school property. 124
6. For schools with an athletic department or 125
organized school athletic program, an automated external 126
defibrillator shall be clearly marked and easily accessible 127
in an unlocked location at each school athletic venue and 128
event. The AED shall be accessible during the school day 129
and any school-sponsored athletic event or team practice in 130
which pupils of the school are participating. It is 131
recommended, to the extent possible, that the governing body 132
of a public school shall make the best effort possible to 133
ensure that the AED placement as described in this 134
subsection is accessible within three minutes of cardiac 135
arrest. 136
7. Appropriate school personnel shall be certified in 137
first aid, CPR, and AED use following guidelines set forth 138
by the American Heart Association or nationally recognized 139 SS SCS SBs 166 & 155 6
guidelines focused on emergency cardiovascular care. The 140
school personnel required to be certified shall be 141
determined by the cardiac emergency response plan and shall 142
include, but shall not be limited to, athleti c coaches, 143
school nurses, and athletic trainers. 144
8. Nothing contained in this section shall be 145
construed to create a cause of action against a school 146
district, charter school, or any personnel of a school 147
district or charter school. 148