Education - Student Athletic Activities - Physical Examinations and Cardiovascular Prescreening

EXPLANATION: CAPITALS INDICATE MATTER ADDED TO EXISTING LAW.
[Brackets] indicate matter deleted from existing law.
*sb0593*

SENATE BILL 593
F1, J1 6lr1419
CF HB 837
By: Senator Brooks
Introduced and read first time: February 5, 2026
Assigned to: Education, Energy, and the Environment

A BILL ENTITLED

AN ACT concerning 1

Education – Student Athletic Activities – Physical Examinations and 2
Cardiovascular Prescreening 3

FOR the purpose of requiring a certain physical examination used to determine the physical 4
fitness of a student seeking to participate in interscholastic sports to include a 5
certain cardiovascular prescreening ; requiring certain health care providers who 6
perform certain physical examinations for student s participating in interscholastic 7
sports to include a cardiovascular prescreening as part of the examination; requiring 8
the State Department of Education, in consultation with the Maryland Department 9
of Health to develop certain guidelines; requiring certain nonpublic schools that offer 10
athletic activities for students to develop policies and programs to provide certain 11
information on sudden cardiac arrest to certain persons participating in the 12
nonpublic school’s athletic programs ; and generally relat ing to student athletic 13
activities, physical examinations, and cardiovascular prescreening. 14

BY adding to 15
Article – Education 16
Section 7–402.1 17
Annotated Code of Maryland 18
(2025 Replacement Volume and 2025 Supplement) 19

BY repealing and reenacting, with amendments, 20
Article – Education 21
Section 7–436 22
Annotated Code of Maryland 23
(2025 Replacement Volume and 2025 Supplement) 24

BY repealing and reenacting, without amendments, 25
Article – Health – General 26
Section 14–501(a)(1), (3), and (5) and (b) 27
Annotated Code of Maryland 28
2 SENATE BILL 593

(2023 Replacement Volume and 2025 Supplement) 1

BY repealing and reenacting, with amendments, 2
Article – Health – General 3
Section 14–501(a)(4) 4
Annotated Code of Maryland 5
(2023 Replacement Volume and 2025 Supplement) 6

SECTION 1. BE IT ENA CTED BY THE GENERAL ASSEMBLY OF MARYLAND, 7
That the Laws of Maryland read as follows: 8

Article – Education 9

7–402.1. 10

(A) IN THIS SECTION, “CARDIOVASCULAR PRESCREENING” MEANS A SET OF 11
TESTS AND EXAMINATIONS DESIGNED TO ASSESS AN INDIVIDUAL’S HEART HEALTH, 12
IDENTIFY RISK FACTOR S FOR HEART DISEASE , AND DETECT ANY UNDER LYING 13
CARDIOVASCULAR ABNORMALITIES BEFORE SYMPTOMS APPEAR, INCLUDING: 14

(1) A TARGETED PERSONAL AND FAMILY HISTORY; AND 15

(2) A PHYSICAL EXAMINATION BASED ON NATIONALLY RECOGNIZED, 16
EVIDENCE–BASED GUIDELINES RECOMM ENDED BY ORGANIZATIO NS FOCUSED ON 17
CARDIOVASCULAR CARE IN PEDIATRIC POPULATIONS. 18

(B) THIS SECTION APPLIES TO PUBLIC SCHOOLS AND NONPUBLIC SCHOOLS 19
THAT HOLD A CERTIFIC ATE OF APPROVAL ISSU ED BY THE STATE BOARD UNDER § 20
2–206 OF THIS ARTIC LE THAT REQUIRE S STUDENTS TO RECEIVE A PHYSICAL 21
EXAMINATION DETERMIN ING PHYSICAL FITNESS TO PARTICIPATE IN 22
INTERSCHOLASTIC SPORTS. 23

(C) A PHYSICAL EXAMINATION OF A STUDENT USED TO DETERMINE THE 24
STUDENT’S PHYSICAL FITNESS TO PARTICIPATE IN INTERSCHOLASTIC SPOR TS, 25
INCLUDING A TRY–OUT, PRACTICE, OR CONTEST OF A SCHO OL TEAM , SHALL 26
INCLUDE A CARDIOVASCULAR PRESCREENING IN ACCORDANCE WITH THIS SECTION 27
BEFORE THE STUDENT PARTICIPATES IN AN INTERSCHOLASTIC SPORT. 28

(D) (1) (I) BEGINNING IN THE 2026–2027 SCHOOL YEAR, A QUALIFIED 29
HEALTH CARE PROVIDER WHO PERFORMS PHYSICAL EXAMINATIONS UNDER § 7–402 30
OF THIS SUBTITLE FOR STUDENTS PARTICIPATING IN INTERSCHOLASTIC SPORTS OR 31
FOR A NONPUBLIC SCHO OL STUDENT , SHALL INCLUDE A CARD IOVASCULAR 32
PRESCREENING AS A PART OF THE EXAMINATION. 33

SENATE BILL 593 3

(II) A CARDIOVASCULAR PRESC REENING MAY NOT BE 1
CONDUCTED EARLIER TH AN THE 90–DAY PERIOD BEFORE TH E FIRST DAY OF THE 2
SCHOOL YEAR IN WHICH THE STUDENT INTENDS TO PARTICIPATE IN 3
INTERSCHOLASTIC SPORTS. 4

(2) IF A HEALTH CARE PROV IDER DETERMINES THAT A STUDENT ’S 5
CARDIOVASCULAR PRESC REENING HAS A POSITI VE FINDING , THE HEALTH CARE 6
PROVIDER SHOULD DETE RMINE WHETHER A REFE RRAL TO A CARDIOLOGIST FOR 7
FURTHER EVALUATION AND TESTING IS NECESSARY. 8

(E) THE DEPARTMENT, IN CONSULTATION WITH THE MARYLAND 9
DEPARTMENT OF HEALTH, SHALL DEVELOP GUIDEL INES TO INCREASE HEA LTH 10
CARE PROVIDER KNOWLE DGE AND AWARENESS OF CARDIOVASCULAR 11
PRESCREENING FOR CHI LDREN PARTICIPATING IN YOUTH SPORTS , INCLUDING 12
POLICIES, PROGRAMS, TRAINING, AND CONTINUING EDUCATION ON: 13

(1) HOW TO COMPLETE A CAR DIOVASCULAR PRESCREE NING, 14
INCLUDING COLLECTING A FAMILY HISTORY AND PERSONAL REPORTS OF 15
SYMPTOMS; 16

(2) IDENTIFYING EARLY SIG NS OF CARDIAC ARREST THROUGH 17
PHYSICAL EXAMINATION; AND 18

(3) REFERRAL PROCEDURES FOR POSITIVE FINDINGS. 19

(F) (1) BEGINNING IN THE 2026–2027 SCHOOL YEAR , EACH PUBLIC 20
SCHOOL SHALL REPORT TO THE COUNTY BOARD OR COUNTY HEALTH DEPARTMENT 21
THE TOTAL NUMBER OF STUDENTS WHO: 22

(I) HAD A PHYSICAL EXAMIN ATION TO PARTICIPATE IN 23
INTERSCHOLASTIC SPORTS; 24

(II) HAD A PHYSICAL EXAMIN ATION THAT INCLUDED A 25
CARDIOVASCULAR PRESCREENING TO PARTICIPATE IN INTERSCHOLASTIC SPORTS; 26
AND 27

(III) WERE GIVEN A REFERRAL TO A CARDIOLOGIST FOR 28
FURTHER EVALUATION A ND TESTING RESULTING FROM A CARDIOVASCULA R 29
PRESCREENING. 30

(2) THE COUNTY BOARD OR C OUNTY HEALTH DEPARTM ENT SHALL 31
REPORT THE INFORMATION OBTAINED UNDER PARAGRAPH (1) OF THIS SUBSECTION 32
4 SENATE BILL 593

TO THE MARYLAND DEPARTMENT OF HEALTH BY THE DATE ESTABLIS HED THE 1
MARYLAND DEPARTMENT OF HEALTH. 2

(G) ON OR BEFORE JANUARY 31 EACH YEAR, THE MARYLAND DEPARTMENT 3
OF HEALTH SHALL PUBLISH A REPORT ON ITS WEBSITE: 4

(1) LISTING THE TOTAL NUMBER OF STUDENTS WHO: 5

(I) HAD A PHYSICAL EXAMIN ATION TO PARTICIPATE IN 6
INTERSCHOLASTIC SPORTS; 7

(II) HAD A PHYSICAL EXAMIN ATION THAT INCLUD ED A 8
CARDIOVASCULAR PRESCREENING TO PARTICIPATE IN INTERSCHOLASTIC SPORTS; 9
AND 10

(III) WERE GIVEN A REFERRAL TO A CARDIOLOGIST FO R 11
FURTHER EVALUATION A ND TESTING RESULTING FROM A CARDIOVASCULA R 12
PRESCREENING; AND 13

(2) ANALYZING THE OUTCOME S OF THE CARD IOVASCULAR 14
PRESCREENING REQUIRE MENTS, INCLUDING UTILIZATIO N AND UPTAKE BY 15
CLINICIANS, THE PROPORTION OF POSITIVE SCREENINGS, AND RECOMMENDATIONS 16
FOR ANY ADDITIONAL DIAGNOSTIC STUDIES. 17

(H) THE DEPARTMENT, IN CONSULTATION WITH THE MARYLAND 18
DEPARTMENT OF HEALTH, SHALL ADOPT REGULATI ONS TO IMPLEMENT THI S 19
SECTION. 20

7–436. 21

(a) (1) In this section the following words have the meanings indicated. 22

(2) (i) “Athletic activity” means: 23

1. Interscholastic athletics; 24

2. An athletic contest or competition that is sponsored by or 25
associated with a school; and 26

3. Practices and scrimmages. 27

(ii) “Athletic activity” includes cheerleading and sports sponsored by 28
school–affiliated organizations. 29

SENATE BILL 593 5

(3) “Sudden cardiac arrest” means a condition in which the heart suddenly 1
and unexpectedly stops beating. 2

(4) “Youth sports program” means a program organized for recreational 3
athletic competition or instruction for participants who are under the age of 19 years. 4

(b) Nothing in this section may be construed to create, establish, expand, reduce, 5
contract, or eliminate any civil liability on the part of a county board employee, school 6
employee, or youth sports program volunteer. 7

(c) (1) The Department shall develop policies and implement a program to 8
provide awareness to coaches, school personnel, students, and the parents or guardians of 9
students, in collaboration with the Maryland Department of Health, each county board, the 10
Maryland Public Secondary Schools Athletic Association, the Maryland Athletic Trai ners’ 11
Association, Parent Heart Watch, and licensed health care providers who treat heart 12
issues, on: 13

(i) The nature and warning signs of sudden cardiac arrest, including 14
fainting, difficulty breathing, chest pains, dizziness, and abnormal heart rate; and 15

(ii) The risks associated with continuing to play or practice after 16
experiencing a symptom of sudden cardiac arrest. 17

(2) The program shall include a process to verify that a coach has received 18
information on the program developed under paragraph (1) of this subsection. 19

(3) (i) Before a student enrolled in a public school system in the State 20
may participate in an authorized athletic activity, the county board shall provide a sudden 21
cardiac arrest symptoms and warning signs information sheet to the student and a parent 22
or guardian of the student. 23

(ii) The student and the parent or guardian of the student shall sign 24
a statement acknowledging receipt of the information sheet. 25

(iii) The Department shall create the information sheet and 26
acknowledgment statement required under this paragraph. 27

(4) The Department may use materials available from the Centers for 28
Disease Control and Prevention, Parent Heart Watch, Sudden Arrhythmia Death 29
Syndromes Foundation, or any other appropriate entity to c arry out the requirements of 30
this subsection. 31

(d) A public school may hold an informational meeting before the start of each 32
athletic season regarding the symptoms and warning signs of sudden cardiac arrest. 33

(e) (1) Before an individual participates in an authorized athletic activity on 34
school property, the county board shall provide, or require that a third party provide: 35
6 SENATE BILL 593

(i) Information on sudden cardiac arrest to the individual and, if 1
applicable, a parent or guardian of the individual; and 2

(ii) Notice that acknowledgment of the receipt of the information by 3
the individual and, if applicable, the parent or guardian of the individual, is required. 4

(2) The information required under paragraph (1) of this subsection shall 5
be in the form of: 6

(i) A separate information sheet; or 7

(ii) A notice on the registration form for a youth sports program 8
stating that information on sudden cardiac arrest is available, including directions on how 9
to receive the information electronically. 10

(3) The i ndividual and, if applicable, the parent or guardian of the 11
individual shall: 12

(i) Acknowledge receipt of the information by: 13

1. Signature; 14

2. Checking an acknowledgment box on the registration 15
form; or 16

3. Another method of written or electronic acknowledgment; 17
and 18

(ii) Return the acknowledgment to the county board or third party. 19

(f) (1) A youth sports program that uses a public school facility shall provide 20
annually to the county board or the board’s agent a statement of intent to comply for all its 21
athletic activities with the requirements of subsection (e) of this section. 22

(2) A youth sports program that does not use a public school facility is 23
encouraged to follow the guidelines of this section. 24

(3) A NONPUBLIC SCHOOL THAT HOLDS A CERTIFICATE OF APPROVAL 25
ISSUED BY THE STATE BOARD UNDER § 2–206 OF THIS ARTICLE SHAL L DEVELOP 26
POLICIES AND PROGRAMS TO IMPLEMENT THE REQUIREMENTS OF THIS SECTION 27
FOR ITS STUDENT ATHLETIC ACTIVITIES. 28

Article – Health – General 29

14–501. 30

SENATE BILL 593 7

(a) (1) In this section the following words have the meanings indicated. 1

(3) “Sudden cardiac arrest” means a condition in which the heart suddenly 2
and unexpectedly stops beating. 3

(4) “Youth athlete” means an individual who participates in an athletic 4
activity in association with a youth sports program conducted: 5

(i) At a public school facility; [or] 6

(ii) AT A FACILITY OF A NONPUBLIC SCHOOL THA T HOLDS A 7
CERTIFICATE OF APPROVAL ISSUED BY THE STATE BOARD UNDER § 2–206 OF THE 8
EDUCATION ARTICLE; OR 9

(III) By a recreational athletic organization. 10

(5) “Youth sports program” means a program organized for recreational 11
athletic competition or instruction for participants who are under the age of 19 years. 12

(b) (1) A youth sports program shall make avai lable information on 13
concussions, head injuries, and sudden cardiac arrest developed by the State Department 14
of Education under §§ 7–433 and 7–436 of the Education Article to coaches, youth athletes, 15
and the parents or guardians of youth athletes. 16

(2) A coach of a youth sports program shall review the information provided 17
in paragraph (1) of this subsection. 18

SECTION 2. AND BE IT FURTHER ENACTED, That this Act shall take effect July 19
1, 2026. 20