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SECOND REGULAR SESSION
HOUSE BILL NO. 2949
103RD GENERAL ASSEMBL Y
INTRODUCED BY REPRESENT A TIVE DOLL.
6629H.01I JOSEPH ENGLER, Chief Clerk
AN ACT
T o amend chapter 160, RSMo, by adding thereto one new section relating to sudden cardiac
arrest screening.
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
2 known as section 160.484, to read as follows:
160.484. 1. This section shall be known and may be cited as the "Sudden
2 Cardiac Arre st Scr eening Act".
3 2. As used in this section, the following terms mean:
4 (1) "Athletic activity" includes, but is not limited to, the following:
5 (a) Interscholastic athletics at a public or private school offering instruction to
6 students in kindergarten thr ough grade twelve;
7 (b) Any athletic contest or competition, other than interscholastic athletics, that
8 is sponsored by or associated with a school entity including, but not limited to, club-
9 sponsor ed sports activities;
10 (c) Competitive or noncompetitive cheerleading that is sponsor ed by or
11 associated with a school entity; and
12 (d) Any practice, scrimmage, or interschool practice relat ed to activities listed in
13 paragraphs (a) to (c) of this subdivision;
14 (2) "Department", the state department of elementary and secondary education;
15 (3) "MSHSAA", the Missouri State High School Activities Association;
EXPLANA TION — Matter enclosed in bold-faced brackets [thus] in the above bill is not enacted and is
intended to be omitted from the law . Matter in bold-face type in the above bill is proposed language.
16 (4) "Qualified medical profession al", a licensed physician, licensed physician
17 assistant, nurse practitioner , certified athletic trainer , or cardiologist trained in
18 r ecognizing and tr eating cardiac conditions in athletes;
19 (5) "Student athlete", a student who:
20 (a) Is enrol led in a public or private school offering instruction to students in
21 kindergarten thr ough grade twelve; and
22 (b) Participates in any athletic activity .
23 3. (1) For the 2027-28 school year and all subsequent school years, the
24 department, in collaboration with the state department of health and senior services and
25 MSHSAA, shall distribute educational materials that follow evidence-based science to
26 inform and educate student athletes, par ents and guardians, and coaches about the
27 diseases that can cause sudden cardiac arres t and the nature and warning signs of
28 sudden cardiac arr est including, but not limited to, the risks associated with continuing
29 to participate in or practice an athletic activity after experiencing symptoms. Such
30 educational materials shall be distributed annually in conjunction with a student
31 athlete's pr eparticipation physical examination and completion of the re quir ed
32 permission forms.
33 (2) (a) For the 2027-28 school year and all subsequent school years, befor e any
34 student athlete participates in any athletic activity , the student athlete and such student
35 athlete's par ent or guardian shall sign and ret urn to the student athlete's school the
36 r equire d acknowledgment form acknowledging the re ceipt and rev iew of such
37 educational materials.
38 (b) The state department of health and senior services, in collaboration with
39 MSHSAA, shall develop such acknowledgment form for MSHSAA's member schools.
40 As part of the student athlete's eligibility r equir ements, a new acknowledgment form
41 shall be signed and retu rned to the applicable school at the beginning of each school
42 year in which the student athlete intends to participate in an athletic activity . Each
43 acknowledgment form shall be stor ed in the school's online eligibility softwar e pr ogram.
44 (3) The department, the state department of health and senior services, and
45 MSHSAA shall post any educational materials distributed under this section on each
46 entity's publicly accessible website.
47 4. (1) For the 2027-28 school year and all subsequent school years, each coach of
48 an athletic activity shall annually complete a cardiac arr est training course pr ovided by
49 MSHSAA or a qualified pr ovider for its member schools. The training shall be
50 appr oved by the school board.
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51 (2) The training shall be in corr elation with any other training requ ired by the
52 r elevant school association rel ated to cardiopulmonary resusci tation (CPR) and
53 automated external defibrillators (AEDs).
54 (3) A coach of an athletic activity shall not be eligible to coach in a practice or
55 competition until such coach has completed the training course requ ired under this
56 section.
57 5. (1) For the 2027-28 school year and all subsequent school years, a qualified
58 medical pr ofessional who performs a physical examination for student athletes shall
59 include a cardiovascular prescr eening that follows nationally recogn ized, evidence-
60 based guidelines recomm ended by organizations focused on cardiovascular car e in
61 pediatric populations.
62 (2) Key pre scre ening elements shall include a targeted personal history , targeted
63 family history , and a focused physical examination to detect or raise suspicion for
64 cardiovascular disease and shall incorporate at least the following elements:
65 (a) For personal history , prior elevated systemic blood press ure, unexplained
66 exertional chest pain or syncope, palpitations, or decre ased exer cise tolerance;
67 (b) For family history , known cardiac conditions such as cardiomyopathy ,
68 arrhythmia syndr omes, pr ematur e sudden cardiac death, and unexplained dr owning or
69 seizur es; and
70 (c) For physical examination, detection of a pathologic heart murmur , irregu lar
71 rhythm, abnormal pulses, or other findings suggestive of structural or electrical heart
72 disease.
73 (3) Athletes with positive findings shall be referr ed to a cardiologist for further
74 evaluation and testing.
75 (4) Pr escr eening shall take place within the thr ee months before the first day of
76 the school year in which the athletic season takes place.
77 (5) (a) The state department of health and senior services shall compile and
78 publish on its website an annual report containing the total number of examinations
79 that were completed and the number of ref errals that were made to cardiology . The
80 r eport shall analyze the outcomes under this section and be made publicly available.
81 (b) Monitoring shall record the total number of scr eenings including, but not
82 limited to, utilization and uptake by clinicians, pro portion of positive scr eens and
83 follow-up, and, where possible, data rega rding the follow-up including, but not limited
84 to, false positive rates, and additional diagnostic studies.
85 6. Qualified medical profes sionals who perform a physical examination for
86 student athletes as req uired under this section shall incr ease knowledge of pr escr eening
87 guidelines thr ough policies, pro grams, training, and continuing education implemented
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88 by the state board of regi stration for the healing arts and the Missouri state board of
89 nursing. Such policies, pr ograms, training, and continuing education shall include, but
90 not be limited to:
91 (1) How to complete the cardiovascular risk assessment including, but not
92 limited to, collecting family history and personal rep orts of symptoms;
93 (2) Identifying early signs of cardiac arres t thr ough physical examination; and
94 (3) Referral pr ocedur es for positive findings.
95 7. The department shall promul gate all necessary rules and r egulations for the
96 administration of this section. Any rule or portion of a rule, as that term is defined in
97 section 536.010, that is crea ted under the authority delegated in this section shall
98 become effective only if it complies with and is subject to all of the provi sions of chapter
99 536 and, if applicable, section 536.028. This section and chapter 536 are nonseverable
100 and if any of the powers vested with the general assembly pursuant to chapter 536 to
101 r eview , to delay the effective date, or to disappr ove and annul a rule are subsequently
102 held unconstitutional, then the grant of rulemaking authority and any rule pr oposed or
103 adopted after the effective date of this section shall be invalid and void.
✔
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