HOUSE BILL REPORT

SHB 1556

As Passed House:

March 8, 2013

Title: An act relating to initiatives in high schools to save lives in the event of cardiac arrest.

Brief Description: Creating initiatives in high schools to save lives in the event of cardiac arrest.

Sponsors: House Committee on Education (originally sponsored by Representatives Van De Wege, Dahlquist, Morrell, Hayes, Cody, Pettigrew, Habib, McCoy, Ryu, Angel, Hunt, Goodman, Pollet, Fitzgibbon, Stonier, Dunshee and Fey).

Brief History:

Committee Activity:

Education: 2/15/13, 2/21/13 [DPS];

Appropriations Subcommittee on Education: 2/25/13 [DPS(ED)].

Floor Activity:

Passed House: 3/8/13, 83-14.

Majority Report: The substitute bill be substituted therefor and the substitute bill do pass. Signed by 21 members: Representatives Santos, Chair; Stonier, Vice Chair; Dahlquist, Ranking Minority Member; Magendanz, Assistant Ranking Minority Member; Bergquist, Fagan, Haigh, Hargrove, Hawkins, Hayes, Hunt, Klippert, Lytton, Maxwell, McCoy, Orwall, Parker, Pike, Pollet, Seaquist and Warnick.

Staff: Luke Wickham (786-7146).

Majority Report: The substitute bill by Committee on Education be substituted therefor and the substitute bill do pass. Signed by 10 members: Representatives Haigh, Chair; Fagan, Ranking Minority Member; Carlyle, Dahlquist, Haler, Maxwell, Pettigrew, Seaquist, Sullivan and Wilcox.

Staff: Jessica Harrell (786-7349).

Background:

Cardiopulmonary Resuscitation.

Cardiac arrest is when the heart stops contracting effectively, leading to a loss of blood circulation. This results in loss of pulse and blood pressure. The body and brain are then deprived of oxygenated blood. Death will often occur quickly unless heart rhythm, an adequate pulse, and blood pressure can be re-established.

Cardiopulmonary resuscitation (CPR) is an emergency procedure performed to preserve brain function until further measures are taken to restore blood circulation and breathing in a person experiencing cardiac arrest. The CPR combines chest compressions and breathing into the nose or mouth with the goal of restoring a partial flow of oxygenated blood to the brain and heart. The objective is to delay tissue damage and other issues until defibrillation, an electric shock to the heart, can restore heart rhythm.

Credits Required for Graduation.

In order to graduate from high school, there are a number of requirements, including 20 credits in specified course areas. Two of those 20 credits must be health and fitness credits. In 2016 students must complete a half credit of health and 1.5 credits of fitness.

Summary of Substitute Bill:

The Office of the Superintendent of Public Instruction (OSPI), in consultation with school districts and stakeholder groups, shall develop guidance for a medical emergency response and automated external defibrillator (AED) program for high schools. This response and program must comply with current evidence-based guidance from the American Heart Association or another national science organization. The OSPI, in consultation with the Department of Health, will assist districts in carrying out these programs and provide guidelines and advice for seeking grants for the purchase of the AEDs. The OSPI may coordinate with local health districts or other organizations in seeking grants and donations for this purpose.

Every school district that operates a high school must offer instruction in CPR to students. Beginning in the 2013-14 school year, instruction in CPR must be included in at least one health class necessary for graduation.

The CPR instruction must:

• be an instructional program developed by the American Heart Association or the American Red Cross or be nationally recognized and based on the most current national evidence-based emergency cardiovascular care guidelines for CPR;

• include appropriate use of an AED; and

• incorporate hands-on practice in addition to cognitive learning.

School districts may offer the instruction in CPR directly or arrange for a community-based provider to deliver the instruction. The instruction is not required to be provided by a certificated teacher. Certificated teachers providing the instruction are not required to be certified trainers of CPR. Students are not required to earn CPR certification to complete this instruction.

Appropriation: None.

Fiscal Note: Available.

Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.

Staff Summary of Public Testimony (Education):

(In support) Many individuals experience cardiac arrest. It is the third largest cause of death in the United States. Only 40 percent of people are provided the CPR they need. More young people can be taught CPR so that it can be provided to more people. The only way that someone can survive a sudden cardiac arrest is with CPR and a defibrillator. A student recently was saved by CPR and an AED, where the school had provided CPR instruction. This is the first of a few students who have been saved by CPR in this school. Out of 209 schools surveyed, 59 percent provided some kind of training. People that have learned CPR 20 years ago will still remember how to do it. Hands-only CPR can be taught in 20 minutes and can be more effective than other forms of CPR. CPR is one of the few things that students remember from health classes. It would be wonderful to see every student get trained, but that should not be required. There was resistance to CPR training as a graduation requirement.

(With concerns) The districts should have the ability to do this on their own and do not want to see this as a graduation requirement. If certificated teachers teach the instruction, these teachers should receive instruction in CPR.

(Opposed) You heard it is 20 minutes of training, but it is not. The chest compressions cannot be completed in one class period. Many teachers said that this class would take three class periods. This bill would be better with an amendment that removes CPR instruction from being a graduation requirement.

Staff Summary of Public Testimony (Appropriations Subcommittee on Education):

(In support) Cardiac arrest is often the first sign of cardiac health problems. Cardiopulmonary Resuscitation (CPR) is critical to brain and body functionality during a cardiac emergency. Training time is minimal and can be as little as 20 or 30 minutes. School districts have been surveyed about their current CPR curriculum and 59 percent of respondents indicate that they are already providing CPR training to students. Automated external defibrillators are an important aspect in the CPR training and resources. There are several options for providing the CPR training and many are at a lower cost than what is indicated by the fiscal note.

(With concerns) Cardiopulmonary resuscitation is useful, but this is an unfunded mandate for school districts. If the bill were to be amended so that all the "must" language was replaced with "may" then this bill would be improved. The Legislature should encourage districts to provide CPR education, but it should not mandate school districts to provide it without providing adequate funding. Many students are taking health classes online. The requirement to provide CPR instruction would necessitate some classroom time for health classes that are otherwise only taught online.

(Opposed) None.

Persons Testifying (Education): (In support) Representative Van De Wege, prime sponsor; Graham Nichol, University of Washington and American Heart Association; Darla Varrenti, Nick of Time Foundation; Tori Sorenson, University of Washington; and Eric Rothenberg, American Heart Association.

(With concerns) Jerry Bender, Association of Washington School Principals; and Andrea Cobb, Office of the Superintendent of Public Instruction.

(Opposed) Marie Sullivan, Washington State School Directors' Association.

Persons Testifying (Appropriations Subcommittee on Education): (In support) Representative Van De Wege, prime sponsor; and Lucy Asdairian, American Heart Association.

(With concerns) Marie Sullivan, Washington State School Directors Association.

Persons Signed In To Testify But Not Testifying (Education): None.

Persons Signed In To Testify But Not Testifying (Appropriations Subcommittee on Education): None.