2025 -- H 5423

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LC001120

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     STATE OF RHODE ISLAND

IN GENERAL ASSEMBLY

JANUARY SESSION, A.D. 2025

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A N   A C T

RELATING TO EDUCATION -- HEALTH AND SAFETY OF PUPILS

     Introduced By: Representatives Noret, Casimiro, Read, Shallcross Smith, Serpa, O'Brien,
Biah, and Finkelman

     Date Introduced: February 12, 2025

     Referred To: House Education

     It is enacted by the General Assembly as follows:

     SECTION 1. Section 16-21-33.1 of the General Laws in Chapter 16-21 entitled "Health

and Safety of Pupils" is hereby amended to read as follows:

     16-21-33.1. Automatic external defibrillators Automated external defibrillators and

cardiac emergency response plans.

     (a) Legislative findings:

     (1) Approximately three hundred twenty-five thousand (325,000) Americans suffer sudden

cardiac arrest (“SCA”) each year and more than ninety-five percent (95%) of them die before

reaching the hospital;

     (2) In the population of Rhode Island, an estimated one thousand (1,000) residents will die

of cardiac arrest every year;

     (3) No official statistics have been gathered about SCA in children, however experts

estimate about three hundred (300) deaths because of SCA every year for people under the age of

twenty-one (21) or about one tenth of one percent (.001%);

     (4) This means that at least one person under the age of twenty-one (21) years, most likely

a student, will die due to athletics related SCA every year in Rhode Island;

     (5) If defibrillation is performed within five (5) to seven (7) minutes, chances of survival

are increased by forty-nine percent (49%). Every minute that goes by without defibrillation reduces

the chance of survival by seven percent (7%) to ten percent (10%);

     (6) Automated external defibrillators (AEDs) are extremely accurate computerized devices

that can be operated by the average person;

     (7) AEDs are inexpensive and grants for AEDs are mostly given to nonprofit organizations,

such as schools; and

     (8) AEDs can be acquired through grants from various organizations or through

government agencies.

     (a) Definitions. As used in this section, the following words shall have the following

meanings:

     (1) “Athletic emergency action plan (AEAP)” means written guidelines and templates for

documentation of emergency planning to help prepare individuals for a catastrophic injury situation

within sports.

     (2) “Automated external defibrillator (AED)” means a lightweight, portable device that

delivers an electric shock through the chest to the heart. The shock can potentially stop an irregular

heartbeat (arrhythmia) and allow a normal rhythm to resume following sudden cardiac arrest.

     (3) “Cardiac emergency response plan (CERP)” means a written document that establishes

the specific steps to reduce death from cardiac arrest in any setting – be it a school, community

organization, workplace, or sports facility.

     (4) “Sudden cardiac arrest (SCA)” means when the heart malfunctions and stops beating

unexpectedly. If not treated within minutes, it quickly leads to death.

     (b) All high schools, and middle schools, and elementary schools, whether they are public

or privately run, shall provide and maintain on-site functional automated external defibrillators

(AEDs) in quantities and types, deemed by the commissioner of education, in consultation with the

director of health, accordance with the guidelines set by the American Heart Association or an

organization focused on emergency cardiovascular care, and as outlined in subsections (c) and (d)

of this section, to be adequate to ensure ready and appropriate access for use during emergencies.

Whenever school facilities are used for school-sponsored or school-approved curricular or

extracurricular activities, and whenever a school-sponsored athletic contest is held at any location,

the school officials and administrators responsible for such school facility or athletic contest shall

ensure the presence of at least one person who is properly trained in CPR and the operation and use

of an AED. Such training may be conducted by qualified personnel, including, but not limited to,

municipal fire and police department employees.

     (c) Establishing cardiac emergency response plans in schools.

     (1) Beginning in the 2026-2027 school year for high schools and middle schools and in the

2027-2028 school year for elementary schools, each school shall develop a cardiac emergency

response plan (CERP) that addresses the appropriate use of school personnel to respond to incidents

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involving an individual experiencing sudden cardiac arrest or a similar life-threatening emergency

while on school grounds.

     (2) School officials shall work directly with local emergency medical service (EMS)

providers to integrate the CERP into the community’s EMS responder protocols. Each plan shall

integrate evidence-based core elements, such as those recommended by the American Heart

Association or other nationally recognized recommendations or core elements.

     (3) The CERP shall integrate, at a minimum, the following core elements:

     (i) Establishing a voluntary cardiac emergency response team;

     (ii) Activating the team in response to a SCA;

     (iii) Implementing AED placement and routine maintenance within the school according

to the manufacturer’s operational guidelines;

     (iv) Disseminating the plan throughout the school campus;

     (v) Maintaining training in CPR/AED use for the cardiac emergency response team;

     (vi) Practicing using drills annually;

     (vii) Integrating local EMS with the plan;

     (viii) Ongoing and annual review and evaluation of the plan.

     (4) Appropriate AED placement shall be determined by the CERP in accordance with

guidelines set by the American Heart Association or an organization focused on emergency

cardiovascular care. An AED should be identified with appropriate signage and be on-site and made

available in an unlocked location on school property that is able to be placed on a person

experiencing SCA within three (3) minutes.

     (5) Appropriate school staff shall be trained in first-aid, CPR, and AED use that follow

evidence-based guidelines set forth by the American Heart Association. Staff trained shall be

determined by the CERP including, but not limited to, licensed coaches, school nurses, and athletic

trainers.

     (d) Establishing cardiac emergency response plans or athletic emergency action plans for

high school and middle school athletic events and facilities.

     (1) Beginning in the 2026-2027 school year, each high school and middle school with an

athletic department or organized athletic program shall develop a cardiac emergency response plan

(CERP) in accordance with recommendations or core elements set forth by either the American

Heart Association or an athletic emergency action plan (AEAP) following nationally recognized

recommendations or core elements that address the appropriate use of school personnel to respond

to incidents involving an individual experiencing cardiac arrest or a similar life-threatening

emergency while attending or participating in an athletic practice or event while on school grounds

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that are venue specific and rehearsed annually.

     (2) An automated external defibrillator shall be clearly marked and easily accessible in an

unlocked location at each school athletic venue and event. The AED shall be accessible during the

school day and any school-sponsored athletic event or team practice in which pupils of the school

are participating. An AED should be placed on a person experiencing SCA within three (3) minutes.

     (3) AEDs shall be tested and maintained according to the manufacturer's operational

guidelines and notification is provided to the appropriate first aid, ambulance, or rescue squad or

other appropriate emergency medical services provider regarding the AED, the type acquired, and

its location.

     (4) All coaches shall obtain and maintain training in cardiopulmonary resuscitation, first

aid, and the use of the automated external defibrillator. Certification in CPR and AED use shall be

consistent with national evidence-based emergency cardiovascular care guidelines.

     (e) Funding for cardiac emergency response plans and athletic emergency action plans.

     (1) The state shall appropriate for the fiscal year 2026 the sum of two hundred thousand

dollars ($200,000) to the department of health to implement this section.

     (2) Funding shall be used for activities and equipment that further promote CERP/AEAP

preparedness in schools including, but not limited to, the purchase of AEDs and AED maintenance

(pads and battery replacement), the purchase of CPR training manikins, or CPR/AED training for

faculty and staff.

     (3) Funding priority shall be given to high-needs schools where at least fifty percent (50%)

of children are eligible to receive free and reduced priced meals or the school participates in the

community eligibility provision. High-needs schools may also be defined by Title 1 status.

     (4) A local and regional board of education may accept gifts, grants, and donations,

including in-kind donations designated for the purchase of an AED that meets the standards

established by the United States Food and Drug Administration and for the costs incurred to inspect

and maintain such device and train staff in the use of such device.

     (f) The commissioner of elementary and secondary education, in collaboration with the

director of the department of health, may adopt regulations to implement this chapter.

     (g) The commissioner of elementary and secondary education, in collaboration with the

director of the department of health, shall establish a process to monitor compliance with this

chapter.

     SECTION 2. This act shall take effect upon passage.

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EXPLANATION

BY THE LEGISLATIVE COUNCIL

OF

A N   A C T

RELATING TO EDUCATION -- HEALTH AND SAFETY OF PUPILS

***

     This act would repeal the legislative findings in this section. It would also require

elementary, middle and high schools to provide and maintain on-site functional automated external

defibrillators (AEDs) in accordance with guidelines by the American Heart Association or an

organization focused on emergency cardiovascular care.

     This act would take effect upon passage.

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