BILL ANALYSIS Ó
AB 1639
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Date of Hearing: March 16, 2016
ASSEMBLY COMMITTEE ON EDUCATION
Patrick O'Donnell, Chair
AB 1639
(Maienschein) - As Amended on March 9, 2016
[Note: This bill is double-referred to the Judiciary Committee
and will be heard by that Committee as it relates to issues
under its jurisdiction.]
SUBJECT: Pupil health: Sudden Cardiac Arrest Prevention Act
SUMMARY: Establishes the Sudden Cardiac Arrest Prevention Act;
requires the California Department of Education (CDE) to make
available specified guidelines and materials on sudden cardiac
arrest (SCA); requires pupils and parents to sign informational
materials before athletic participation; requires training of
coaches; and sets requirements for action in the event a pupil
experiences specified symptoms. Specifically, this bill:
1)Establishes the following definitions:
a) "Athletic activity" means the following:
i) Interscholastic athletics;
ii) An athletic contest or competition, other than
interscholastic athletics, sponsored by or associated
with a school, including cheerleading, club-sponsored
sport activities and sports activities sponsored by
school-affiliated organizations;
iii) Noncompetitive cheerleading sponsored by or
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associated with a school; and,
iv) Practices and scrimmages for activities listed under
i) through iii).
b) "School" means a public school, including a charter
school, or a private school with athletic activities.
2)Requires the CDE to develop and post on its Internet Web site
guidelines and an information sheet on specified SCA symptoms,
risks and warning signs.
3)Requires the materials to be developed using relevant
materials and training videos used by the Eric Paredes Save a
Live Foundation, the California Interscholastic Federation
(CIF) and the National Federation of High Schools (NFHS).
4)Encourages school districts and schools to post these
materials on their Internet Web sites.
5)Requires a pupil and the pupil's parent or guardian to sign an
acknowledgment of receipt and review of the information sheet
developed by the CDE every year before participation in an
athletic activity.
6)Authorizes schools to hold informational meetings on SCA
before each athletic season.
7)Requires removal from activity any pupil who passes out or
faints while participating in or immediately after athletic
activity, or who is known to have done so, by an athletic
trainer, coach or athletic director.
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8)Authorizes an athletic trainer to remove a pupil from
participation if the pupil experiences specified symptoms the
trainer reasonably believes are cardiac related. Requires, in
the absence of a trainer, a coach observing symptoms of SCA in
a pupil to notify a parent or guardian, so that that parent or
guardian can determine what treatment, if any, the pupil
should seek.
9)Prohibits a pupil who has been removed from activity for SCA
symptoms from returning to participation until evaluated and
cleared to participate in writing by an appropriate medical
professional.
10)Requires biennial SCA training for coaches.
11)Requires, beginning July 1, 2019, suspension of coaches for
not removing from activity a pupil who has fainted or passed
out, or for not undergoing the yearly training. Requires a
coach to be suspended for the remainder of a season, for a
first violation; for the remainder of the season and the next
season, for a second violation; and permanent suspension from
coaching any athletic activity, for a third violation.
12)Limits a coach's civil liability for his or her action or
inaction under the Act, other than acting in a grossly
negligent or reckless manner.
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13)Encourages the sponsors of youth athletic activities to
follow the guidelines in the Act.
14)Makes the Act operative on July 1, 2017.
EXISTING LAW:
1)Limits full-contact practices, as defined, for high school and
middle school football and urges CIF adoption of rules to
implement such guidelines. (Education Code (EC) Section
35179.5)
2)Requires an athlete suspected of sustaining a concussion or
head injury during athletic activity to be removed from that
activity and not be permitted to return until evaluated and
cleared by a licensed health care provider; urges the CIF to
develop rules and protocols to implement this; and requires
athletes and parents to receive, sign and return a head injury
information sheet annually before practice or competition.
Excludes the requirements from athletic activities during the
regular schoolday or as part of a physical education course.
(EC Section 49475)
3)Requires a high school sports coach to complete educational
programs developed by his or her school district and the CIF
that meet specified guidelines. (EC Section 49032)
4)Authorizes a school district or school to provide
comprehensive instruction in first aid or cardiopulmonary
resuscitation. (EC Section 49413)
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FISCAL EFFECT: Unknown
COMMENTS: This bill requires dispersion of informational
materials on SCA, and notification for student athletes and
their parents, in order to build awareness of the possible
precursors to SCA. This bill also requires training for coaches,
establishes procedures to be followed in the event of SCA
symptoms, and sets penalties for not following the procedures.
Existing law involving athletic activities. California has
established laws regulating athletic activities and requirements
for coaches, including limiting the number football full-contact
practices and requiring coaches to attend a coaching education
program. This bill is similar to requirements on concussions
among students in interscholastic sports, which were established
following increasing awareness of the dangers of head injuries.
Current law requires a graduated return-to-play protocol for
those pupils who have had a concussion or head injury diagnosed
by a licensed health care provider. These rules are for schools
with an interscholastic sports program and do not specify
penalties for violations.
Purpose of the bill. The author's office states that "Sudden
Cardiac Arrest (SCA) has emerged as a leading cause of death
among people under age 25. According to the American Heart
Association, SCA affects nearly 10,000 youth per year." The
author's office also states that 72 percent of those who have
suffered SCA experienced prior symptoms but did not recognize
them as warning signs. The sponsor of this bill, the Eric
Paredes Save a Life Foundation, seeks to make more people aware
of these warning signs, in the hopes that it will provide the
opportunity to prevent fatal cardiac events.
Eric Paredes, for whom the sponsor organization was named, was a
young athlete who died from a sudden cardiac arrest while at
home. Eric's parents hope to use the story of their son's death,
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and those of other young athletes, to bring attention to heart
screening and possible warning signs they say could save the
lives of other children. The Foundation has worked extensively
to produce and distribute information on SCA, and to promote
training videos for coaches.
Supporters consider this bill a first effort in preventing
future deaths through information and risk assessment. One
supporter, Heartfelt Cardiac Projects, states, "This bill is an
inaugural step in educating youth, parents and coaches about the
potential warning signs and risk factors of sudden cardiac
arrest and about the cardiac chain of survival that could save a
life."
Similar requirements under CIF. The CIF, working with a panel
of medical professionals, established policies related to SCA
which went into effect in 2015. These policies cover most
students playing interscholastic sports, including 1,600 schools
with 1.8 million students. CIF added SCA information to their
existing training requirements for coaches. The CIF also added
protocols similar to those in this bill. They include removal
from athletic activity after a pupil passes out or faints during
or right after activity, with a medical clearance required to
return to activity. Similarly, pupils must be cleared if they
are held out for exhibiting signs or symptoms associated with
SCA. The policy requires a pupil and his or her parent or
guardian to receive and sign a Sudden Cardiac Information sheet
each year. The sponsors feel an information sheet serves the
purpose of educating pupils and parents regarding symptoms that
might otherwise be ignored.
Given that the CIF implemented coaching training rules and a
protocol for SCA in 2015, many of the informational and care
guidelines in this bill already apply to the great majority of
student athletes. To add another form for these same students
seems duplicative. The sponsor would like to extend these
guidelines to cover children in all grades and all
school-sponsored sports, with coach training required, including
at an elementary level, every two years. As written, the bill
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appears to include any athletic activity occurring at a school,
including independent club sports using school facilities and
elementary school "field day" type competitions. Ideally, the
sponsors have said, they would like every child screened, as SCA
does not affect only athletes.
Penalties. This bill's sponsors believe sanctions are needed to
provide an incentive for coaches to follow the guidelines when
they conflict with a desire to win. The CIF protocol on SCA
does not contain sanctions. According to the CIF, coaches are
employees of the school district, not the CIF. Existing law for
concussions also do not contain sanctions. While current law on
coaches speaks of the need for coaches to be trained in safety,
including cardiopulmonary resuscitation requirements, it is
silent on punishments for noncompliance in any area.
Unintended consequence? Cardiologists writing in the American
Heart Association publication, "Circulation", have noted that
the number of specifically athletic sudden cardiac deaths among
young people is "relatively small, with (about) 100 to 150
competitive deaths during sports in the United States annually."
These cardiologists also suggested that "significant gaps in
evidence exist related to effectiveness of preventing sudden
death in the athlete with preparticipation screening
strategies." The publication raised concern as to whether
screening could inappropriately lead to students becoming less
active - a known health risk.
Committee amendments:
1)Because the definition of athletic activity is broad and
somewhat unspecific, staff recommends that Section 33281(a)(2)
be amended to more narrowly define athletic activity. This
definition should include those activities sponsored by a
school, but exclude those activities "associated with a
school" or "sponsored by school-affiliated organizations." The
Committee may consider further focusing the bill's
requirements on schools with an athletic program.
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2)Staff recommends that Section 33482(a) be amended to delete
the requirement that the CDE be required to develop materials
and to clarify that CDE is simply required to post specified
informational material on its Web site.
3)To avoid duplication of notices, staff recommends that Section
33483 be amended to require, for athletic activities governed
by CIF, that schools retain a copy of each signed SCA
information sheet required by CIF; and that a pupil and parent
or guardian participating in a sport not governed by CIF be
required to sign and return to the school an acknowledgement
of receipt and review of the information material made
available on the CDE's website.
4)Staff recommends adding language consistent with that
currently applied to concussion protection, stating, "This
section does not apply to an athlete engaging in an athletic
activity during the regular schoolday or as part of a physical
education course required pursuant to subdivision (d) of
Section 51220." (Physical education requirements)
5)Staff recommends changing, in Section 33485, "appropriate
medical professional" to "licensed health care provider" to be
more specific and consistent with concussion protections.
6)Staff recommends amending Section 33487 to delete penalties
for violating Section 33485 and, for violations of Section
33486, to require suspension of a coach until completion of
required training. The Committee may also consider striking
Section 33487(b) with this amendment.
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Related legislation. AB 1719 (Rodriguez), pending in this
Committee, requires high school students to receive instruction
in cardiopulmonary resuscitation and the use of an automated
external defibrillator as part of a course required for
graduation. A similar bill by this author was held in the
Appropriations Committee suspense file in 2015.
AB 2182 (Mullin), pending in this Committee, requires
neurocognitive testing, as defined, for any pupil participating
in interscholastic athletics before competitions have taken
place and after any head injury. The bill also requires
collecting and maintaining data on injuries, with reporting to
the appropriate county office of education for compilation and
retention.
REGISTERED SUPPORT / OPPOSITION:
Support
Eric Paredes Save a Life Foundation (sponsor)
American Academy of Pediatrics, California
Children's Cardiomyopathy Foundation
Heartfelt Cardiac Projects
Mike Whitmarsh Memorial Foundation
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Olivia's Heart Project
San Diego City Councilmember Chris Cate
San Diego City Councilmember Mark Kersey
San Diego County Supervisor Ron Roberts
Travis R. Roy Sudden Cardiac Arrest Fund
Numerous individuals
Opposition
None on file
Analysis Prepared by:Carlos Alcala and Sophia Kwong Kim / ED. /
(916) 319-2087
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