BILL ANALYSIS                                                                                                                                                                                                    Ó



          SENATE COMMITTEE ON APPROPRIATIONS
                             Senator Ricardo Lara, Chair
                            2015 - 2016  Regular  Session

          AB 1719 (Rodriguez) - Pupil instruction:  cardiopulmonary  
          resuscitation
          
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          |Version: June 22, 2016          |Policy Vote: ED. 9 - 0, JUD. 7  |
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          |Urgency: No                     |Mandate: Yes                    |
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          |Hearing Date: August 1, 2016    |Consultant: Jillian Kissee      |
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          This bill meets the criteria for referral to the Suspense File.



          


          Bill  
          Summary:  This bill requires school districts and charter  
          schools serving students in grades 9 through 12 to offer  
          instruction in compression-only cardiopulmonary resuscitation  
          (CPR) as part of a required course, commencing in the 2018-19  
          school year.


          Fiscal  
          Impact:  
           Unknown costs, but potentially in the low millions for school  
            districts and charter schools to implement CPR instruction.   
            Costs will depend on how they choose to implement this  
            instruction.  School districts would be able to claim for  
            reimbursement of their costs as this instruction is likely to  







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            result in a state reimbursable mandate.  Whether or not school  
            districts already provide this instruction, all school  
            districts operating grades 9 through 12 will be eligible to  
            submit a claim for reimbursement.  Some school districts may  
            be able to secure private funding or equipment or materials  
            which would likely count as offsetting some or all of the  
            district's costs related to the new state mandate.  See staff  
            comments.  (Proposition 98)


           The California Department of Education (CDE) estimates  
            one-time costs of $32,000 General Fund related to a partial  
            position to provide the required guidance on the  
            implementation of CPR instruction.


          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 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  








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            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)




          Proposed Law:  
            This bill requires, beginning with the 2018-19 school year,  
          the governing board of a school district, and the governing  
          board of a charter school, offering instruction to students in  
          grades 9 through 12 to provide instruction in performing  
          compression-only CPR as part of a course offered in any of  
          grades 9 through 12 that is required for the course of study in  
          grades 7 through 12 or that is a local high school graduation  
          requirement.
          The instruction is required to be provided one time and include  
          the following:


           An instructional program based on national evidence-based  
            emergency cardiovascular care guidelines for the performance  
            of compression-only CPR, as specified.


           Instruction to students relative to psychomotor skills  
            necessary to perform compression-only CPR.


          The CDE is required to provide guidance on implementing this  
          instruction before the beginning of the 2017-18 school year.


          This bill authorizes the governing board of a school district or  
          the governing board of a charter school to provide to students  
          general information on the use and importance of an automated  
          external defibrillator (AED).  It also encourages the governing  
          board of a school district or governing board of a charter  
          school to provide information in performing compression-only CPR  
          or information on the use of an AED in the most cost-effective  
          means possible.


          This bill provides that a public employee that facilitates the  








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          instruction or the local agency, entity of state or local  
          government, or other public or private organization that  
          sponsors, authorizes, supports, finances, or supervises the  
          instruction of students in compression-only CPR or the use of an  
          AED is not liable for any civil damages alleged to result from  
          the acts or omissions of an individual who received such  
          instruction.  This immunity from civil damages exists except in  
          a manner that constitutes gross negligence or willful or wanton  
          misconduct.




          Related  
          Legislation:  AB 1748 (Mayes, 2016) authorizes LEAs to provide  
          an emergency opioid antagonist to school nurses or trained  
          personnel to administer an opioid antagonist to a person  
          suffering from an opioid overdose.  It also provides for various  
          legal immunities, as specified.  AB 1748 is pending in this  
          committee.


          Staff  
          Comments:  Though this bill states that it shall not be  
          construed to require the governing board of a school district or  
          the governing body of a charter school to make any purchases, it  
          would be very difficult for a school to implement new  
          instruction without purchasing instructional material and  
          equipment.  It would be especially difficult to satisfy the  
          requirement that the instruction include psychomotor skills  
          necessary to perform compression-only CPR.  Therefore school  
          districts and charter schools will likely have to purchase  
          instructional material and equipment to implement a meaningful  
          course.  It is unclear whether the Commission on State Mandates  
          would deem this activity reimbursable.
          Ultimately, costs to implement this bill will depend upon how  
          school districts and charter schools choose to implement this  
          new instruction.  Language in the bill suggests the use of  
          instructional programs based on certain guidelines, such as  
          those developed by the American Heart Association.  The American  
          Heart Association offers "CPR in Schools Training Kits" which  
          covers CPR, choking relief, and AED skills designed for about 15  
          students at once.  The kit includes such things as mini  
          inflatable manikins, "practice-while-watching" training DVDs, a  








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          facilitator guide, a lesson plan and pre- and post-tests, and  
          AED training simulators at a cost of $714. 


          According to CDE there are about 1.9 million students enrolled  
          in grades 9 through 12, which averages 487,439 per grade.   
          Assuming 30 students to a class, each class required two kits,  
          and each teacher taught five classes (total of 3,249 teachers),  
          statewide costs for the CPR kits would be about $4.6 million.   
          This estimate does not include any new staff a school might need  
          to hire as a result of this bill.  This estimate also assumes  
          that instruction could be completed in one class period.

          In addition school districts would likely be allowed to claim  
          for reimbursement related to prepping to teach CPR training and  
          actually delivering the instruction.  Assuming two hours to  
          prepare and one hour to administer the course, the cost would  
          exceed $1 million.

          Staff notes that with the funding enacted in the 2016-17 Budget  
          Act to pay down owed mandate claims the estimated outstanding  
          debt is estimated to be $1.6 billion by the end of the current  
          budget year.


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