BILL ANALYSIS Ó
SENATE COMMITTEE ON EDUCATION
Senator Carol Liu, Chair
2015 - 2016 Regular
Bill No: AB 1719
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|Author: |Rodriguez |
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|Version: |April 21, 2016 Hearing |
| |Date: June 15, 2016 |
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|Urgency: |No |Fiscal: |Yes |
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|Consultant:|Lenin DelCastillo |
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Subject: Pupil instruction: cardiopulmonary resuscitation
NOTE: This bill has been referred to the Committees on
Education and Judiciary. A "do pass" motion should include
referral to the Committee on Judiciary.
SUMMARY
This bill requires school districts and charter schools serving
students in grades 9-12 to offer instruction in compression-only
cardiopulmonary resuscitation (CPR) as part of a required
course, commencing in the 2018-19 school year.
BACKGROUND
Existing law:
1) Establishes high school graduation requirements,
including three years in English, two years in math, and
two years of physical education, and permits school
districts to establish graduation requirements which exceed
those required by the state. (Education Code § 51225.3)
2) Requires, through the adopted course of study, that
schools provide instruction at the appropriate grade levels
on personal and public safety and accident prevention,
including emergency first aid instruction, instruction in
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hemorrhage control, treatment for poisoning, resuscitation
techniques, and CPR when appropriate equipment is
available. (Education Code § 51202)
3) Provides that no person certified to teach CPR by the
American Red Cross or the American Heart Association, and
no local agency, entity of state or local government, or
other public or private organization which sponsors,
authorizes, supports, finances, or supervises the training
of citizens in cardiopulmonary resuscitation can be held
liable for any civil damages alleged to result from such
training programs. (Civil Code § 1714.2)
4) Provides that a person or entity who provides CPR
training to a person who renders emergency care is not
liable for any civil damages resulting from any acts or
omissions of the person rendering the emergency care.
(Civil Code § 1714.21)
ANALYSIS
This bill:
1) Requires, starting with the 2018-19 school year, school
districts and charter schools to provide instruction in
compression-only cardiopulmonary resuscitation (CPR) as
part of an existing course for grades 9-12. Specifically,
this bill:
2) Requires the instruction to include both of the
following:
a) An instructional program based on national
evidence-based emergency cardiovascular care
guidelines for the performance of compression-only
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CPR, such as those developed by the American Heart
Association or the American Red Cross.
b) Instruction to pupils relative to the
psychomotor skills necessary to perform
compression-only CPR. Defines "psychomotor skills" as
skills that pupils are required to perform as hands-on
practice to support cognitive learning.
1) Requires the California Department of Education (CDE),
prior to the beginning of the 2017-18 school year, to
provide guidance on how to implement the instructional
requirements of this bill, including, but not limited to,
who may provide instruction.
2) Encourages school districts and charter schools to
provide pupils general information on the use and
importance of an automated external defibrillator (AED).
Specifies that the physical presence of an AED in the
classroom is not required.
3) Provides that a school district or charter school may
adopt policies to implement the requirements of the bill.
4) Encourages a school district or charter school to use
the most cost-effective means possible to implement these
requirements.
5) Provides that a local agency, entity of state or local
government, or other public or private organization that
sponsors, authorizes, supports, finances, or supervises the
instruction of pupils, or an employee who provides or
facilitates instruction in compression-only CPR or the use
of an AED, shall not be held liable for any civil damages
alleged to result from the acts or omissions of an
individual who received such instruction.
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6) Specifies that this liability does not grant immunity
from civil damages to any person who provides or
facilitates the instruction of pupils in compression-only
CPR or the use of an AED in a manner that constitutes gross
negligence or willful or wanton misconduct.
STAFF COMMENTS
1) Need for the bill. The author's office indicates that
"sudden cardiac arrest is one of the most lethal public
health threats in the United States, and sadly only 10% of
people who suffer cardiac arrest outside the hospital
survive. If no cardiopulmonary resuscitation (CPR) is
provided or no defibrillation occurs within three to five
minutes of collapse, the chances of survival drop.
Effective bystander only CPR provided immediately after
sudden cardiac arrest can double or triple a victim's
chance of survival. Alarmingly, 70% of Americans may feel
helpless to act during a cardiac emergency because they do
not know how to perform only cardiopulmonary resuscitation
(CPR) and only 32% of cardiac arrest victims get CPR from a
bystander. CPR training is sensible and affordable and can
easily fit into existing classes. In fact, instruction in
CPR and automated external defibrillators (AED) is part of
the existing curriculum framework found in the Health
Education Content Standards for public schools. AB 1719
seeks to expand upon this current policy and ensure that
every high school student in California receives this
important, life-saving training."
2) Compression-only CPR training? Compression-only CPR is
conventional CPR without mouth-to-mouth resuscitation.
According to the American Heart Association,
compression-only CPR has been shown to be as effective as
conventional CPR for sudden cardiac arrest at home, at
work, or in public. Research indicates that this is due to
a better willingness to start CPR by bystanders, a low
quality of mouth-to-mouth ventilation and lengthy
interruptions of chest compressions during ventilation.
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Compression-only CPR involves two steps when a teen or
adult collapses: 1) calling 9-1-1, and 2) pushing hard on
the center of the person's chest at the rate of 100
compressions per minute. For infants, children, victims of
drowning or drug overdose, and people who collapse due to
breathing problems, the American Heart Association still
recommends CPR with compression and breaths.
3) CPR training in state health standards and curriculum
framework. CPR instruction is part of the state's health
content standards and corresponding curriculum framework.
The 2008 standards include: "Describing procedures for
emergency care and lifesaving, including CPR, first aid,
and control of bleeding." However, existing law does not
require a health course for graduation so not all students
receive instruction in CPR.
4) Impact on core academic courses? Notwithstanding the
benefits that may result, by requiring school districts and
charter schools to offer the instruction as part of a
required course, this bill could have the effect of taking
away valuable instructional time from a core academic
course and/or high school graduation requirement.
Additionally, the bill does not specify whether the
instruction would be offered annually for all students or
only on a one-time basis. However, the sponsors of this
measure, the American Red Cross and the American Heart
Association/American Stroke Association indicate that the
required instruction would only take approximately 30
minutes of class time. To help mitigate the potential
negative impact on the state required courses for
graduation and provide additional flexibility, staff
recommends an amendment that specifies that the instruction
could also be provided as part of a locally required course
and that a student only needs to receive the instruction
once during his or her tenure in high school.
5) Fiscal impact. According to the Assembly Appropriations
Committee, this bill would result in Proposition 98/GF
state mandated costs, potentially in the low millions,
starting in 2017-18, for school districts to provide
instruction in compression-only cardiopulmonary
resuscitation (CPR) to students in grades 9-12. Actual
costs will vary depending on how a district chooses to
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implement the provisions of the bill. Charter schools will
also incur costs to implement the requirements of the bill;
however, charter schools are not eligible for mandate
reimbursement.
School districts may have access to instruction through in-kind
donations from community partners, such as hospitals or fire
departments. Other districts may need to provide instruction
using existing district staff who will need time to review
online training videos and prepare lesson plans. San Francisco
Unified School District (SFUSD), for example, was able to
provide training through an in-kind donation from the local fire
department, however; according to SFUSD, the district dedicated
approximately $68,000 towards their hands-on CPR program. There
are 420 school districts that serve students in grades 9-12. If
one-fourth of these districts needed to make an investment
similar to SFUSD, statewide costs would be approximately $7.1
million.
There would also be General Fund administrative costs to
California Department of Education (CDE) of approximately
$32,000 to provide guidance documents and provide technical
assistance to districts and charter schools.
6) Related legislation.
AB 1639 (Maienschein, 2016) establishes the Sudden Cardiac
Arrest Prevention Act and requires the CDE to make
available specified guidelines and materials on sudden
cardiac arrest. This bill is scheduled to be heard by this
Committee on June 29, 2016.
AB 319 (Rodriguez, 2015) required school districts and
charter schools to provide instruction on performing CPR
and the use of an automated External Defibrillator (AED) to
students in grades 9-12 as part of a course required for
graduation. This measure failed passage in the Assembly
Appropriations Committee.
AB 2217 (Melendez, Chapter 812, Statutes of 2014)
authorizes a school to solicit and receive non-state funds
to acquire and maintain an AED, and provides that school
districts and their employees are not liable for civil
damages resulting from certain uses of an AED.
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SUPPORT
American Heart Association/American Stroke Association
American Red Cross
Association of California Healthcare Districts
California Association for Health, Physical Education,
Recreation and Dance
City of Los Angeles
Service Employees International Union
OPPOSITION
None received.
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