Legislature(2023 - 2024)BELTZ 105 (TSBldg)
03/13/2024 03:30 PM Senate EDUCATION
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| Audio | Topic |
|---|---|
| Start | |
| SB158 | |
| SB221 | |
| Adjourn |
* first hearing in first committee of referral
+ teleconferenced
= bill was previously heard/scheduled
+ teleconferenced
= bill was previously heard/scheduled
| *+ | SB 158 | TELECONFERENCED | |
| *+ | SB 221 | TELECONFERENCED | |
| + | TELECONFERENCED | ||
SB 221-CPR CURRICULUM
4:11:00 PM
CHAIR TOBIN reconvened the meeting and announced the
consideration of SENATE BILL NO. 221 "An Act relating to
cardiopulmonary resuscitation education in public schools;
relating to the duties of the Department of Education and Early
Development; and providing for an effective date."
4:11:33 PM
SENATOR ELVI GRAY-JACKSON, District G, Alaska State Legislature,
Juneau, Alaska, speaking as sponsor of SB 221 provided the
following sponsor statement:
[Original punctuation provided.]
Sponsor Statement
Senate Bill 221
CPR CURRICULUM
Sudden Cardiac Arrest is a leading cause of death in
the USbut bystander CPR can double or triple the
survival rate.
Senate Bill 221 seeks to enhance the quality of health
education within our state's public school system.
This focuses on equipping our students with the
knowledge and skills necessary to increase the number
of CPR-trained bystanders.
By enacting this legislation, we prioritize the health
and well-being of our youth, empowering them with the
knowledge and skills to make informed decisions and
respond effectively in emergency situations,
potentially saving lives within their communities.
By integrating CPR education into the school
curriculum, we are promoting a culture of preparedness
and responsiveness to emergencies.
Requiring schools to teach CPR ensures that all
students, regardless of socioeconomic status or
geographic location, have access to this vital life-
saving skill.
4:13:19 PM
LUMA DIAZ, Staff, Senator Elvi Gray-Jackson, Alaska State
Legislature, Juneau, Alaska, gave a presentation on SB 221 to
discuss what the bill does. She moved to slide 2 and discussed
the following:
What is CPR? Importance of Early CPR
• Cardiopulmonary Resuscitation is a first aid
technique to help people who suffer a cardiac
arrest (their heart stops beating).
• It involves doing chest compressions.
• Aids in the circulation of oxygenated blood
around the body to maintain the brain and vital
organs until advance medical help arrives.
• If performed immediately, CPR can double or
triple a victim's chances of survival.
4:14:08 PM
MS. DIAZ moved to slide 3 and provided background on other
states that have passed bills similar to SB 221:
[Original punctuation provided.]
A little background
• Currently 40 states have a bill that requires
students to have CPR training before graduating high
school.
• Alabama passed a similar bill in 1984.
• Florida was the last state to adopt a similar bill
in 2021.
4:14:28 PM
MS. DIAZ moved to slide 4:
[Original punctuation provided.]
TRAINED STUDENTS SAVE LIVES
• Sudden Cardiac Arrest is a leading cause of death in the
USbut bystander CPR can double or triple the survival
rate.
• Training students in CPR requires minimal investment in
time and cost. According to the latest science, trainees
can achieve acceptable levels of CPR skills proficiency in
30 minutes or less.
• Pierson High School in Sag Harbor, NY began its CPR program
in 1994. Amazingly, at least 16 lives have been saved so
far because these students used their CPR skills in the
real world!
4:15:09 PM
MS. DIAZ moved to slide 5:
[Original punctuation provided.]
What does SB 221 do?
• It will require schools to develop and implement
curricula to instruct public school students on
hands-only cardiopulmonary resuscitation (CPR).
• The curricula must :
• Be based on current national, evidence-based
emergency cardiovascular care guidelines for
cardiopulmonary resuscitation.
• Incorporate hands-on practice in addition to
cognitive learning.
• Include instruction in the appropriate use of an AED
(automated external defibrillator), which may be
taught using video or other means if in-person
instruction is not available.
4:16:00 PM
MS. DIAZ provided the following sectional analysis for SB 221:
[Original punctuation provided.]
Sectional Analysis for SB 221
CPR Curriculum
Section 1: Amends AS 14.30.360(a) by deleting
Cardiopulmonary Resuscitation (CPR) from the program
curricula in this section.
Section 2: Amends AS 14.30 by adding a new section,
Sec. 14.30.363 Cardiopulmonary Resuscitation Education
to establish the curricula details and
responsibilities of the Department of Education and
Early Development.
Section 3: Sets an effective date of August 25, 2025.
4:16:51 PM
CHAIR TOBIN asked how many districts already offer CPR training
and whether they follow the proposed legislation. She also
inquired if there is any data on how many districts currently
provide this training in their schools.
4:17:16 PM
SENATOR GRAY-JACKSON stated that while current statute
encourages CPR training, SB 221 would make it a requirement. She
added that she would provide the committee with information on
how many districts teach CPR training to students.
4:17:29 PM
MS. DIAZ stated that many schools already encourage CPR and
similar trainings. She mentioned meeting a teacher in Juneau who
included CPR in a life skills program. However, she emphasized
the importance of having this requirement in statute to ensure
that every school can provide CPR training to all students.
4:18:05 PM
SENATOR KIEHL asked about the structure of the CPR requirement
in SB 221. He noted that while the numbered list [on slide 5]
requires the curriculum to follow current national evidence-
based guidelines, the paragraph specifies hands-only CPR. He
questioned why hands-only CPR is specified, given that the
guidelines changed only 10 to 15 years ago. He suggested it
might be better to align strictly with the best evidence-based
practices, allowing flexibility as guidelines evolve.
4:18:52 PM
SENATOR GRAY-JACKSON deferred the question, asking that Chief
Schrage answer it.
4:19:10 PM
CHAIR TOBIN referred to SB 221, page 2, line 5, which mentions a
person holding a current pulmonary resuscitation instructor
certificate. She asked if this section of the bill allows for
individuals with outside expertise to volunteer their time in
schools.
SENATOR GRAY-JACKSON deferred the question.
4:19:49 PM
MS. DIAZ clarified that the SB 221 allows anyone with a
certified qualification to train students in CPR, which could
include teachers, administrative staff, or certified volunteers.
She mentioned being in contact with fire department personnel,
paramedics, and Emergency Medical Services (EMS), who have
previously volunteered their time to teach hands-only CPR in
schools. She emphasized that the intent of SB 221 is to ensure
that anyone trained in CPR can provide this training to
students.
4:20:55 PM
CHAIR TOBIN announced invited testimony for SB 221.
4:21:15 PM
DOUGLAS SCHRAGE, Chief, Anchorage Fire Department, Anchorage,
Alaska, stated that he was present to provide information and
express strong support for SB 221, emphasizing the goal of
improving the survivability of sudden cardiac arrest. He
highlighted that sudden cardiac arrest is often a survivable
condition and noted that approximately 1,100 Alaskans die each
year from heart disease, with many deaths preventable through
early Cardiopulmonary Resuscitation (CPR). He explained that
hands-only CPR maintains oxygen flow to vital organs until
Emergency Medical Services (EMS) arrives and is most effective
when initiated immediately by a bystander.
4:22:11 PM
MR. SCHRAGE addressed questions about hands-only CPR, stating
that it is supported by scientific evidence, particularly in
situations where EMS response is within 15 minutes. He noted
that hands-only CPR is often more effective because people are
more willing to perform it and it better circulates oxygen
without the interruptions caused by mouth-to-mouth. He
acknowledged that for longer periods, additional oxygen would
eventually be needed but emphasized the effectiveness of hands-
only CPR in the critical early minutes.
MR. SCHRAGE stressed that improving survival from cardiac arrest
is a community-wide effort, not just the responsibility of
emergency services. He pointed out that the best emergency
systems still require time to arrive, while permanent brain
damage can occur within four minutes of a cardiac event. He
called for more community members to be trained in CPR and for
more automated external defibrillators (AEDs) to be available in
public spaces.
4:24:15 PM
MR. SCHRAGE argued that SB 221 could significantly improve
survival rates in Alaskan communities by equipping youth with
life-saving skills. He noted that current public education
efforts are insufficient, while hands-only CPR training is
straightforward, cost-effective, and can be implemented with
minimal resources. He provided an example of successfully
teaching CPR to a group of 40 people in 20 minutes. He added
that while certification through the American Heart Association
or American Red Cross is desirable, it is not required under SB
221. He concluded by urging support for SB 221, citing its
profound potential impact relative to its modest investment.
4:25:44 PM
CHAIR TOBIN noted that many young students might babysit or care
for younger siblings. She asked whether the 20-minute CPR
training given to Rotary members included infant CPR and whether
this type of training might also be available to students in
schools.
4:26:06 PM
MR. SCHRAGE responded that he did not include infant
Cardiopulmonary Resuscitation (CPR) in the training. He
explained that infant CPR requires a different, more specialized
skill set, which is very valuable for people in environments
with infants and children, and he recommended certification for
those scenarios. However, he emphasized that the main focus is
on addressing sudden cardiac arrest in adults, where the
greatest number of lives can be saved. He noted that while
cardiac arrest in infants does occur, it is relatively rare, and
the strategy is to train as many people as possible to perform
CPR on adults.
4:27:43 PM
JAMIE MORGAN, Senior Region Lead, State Government Relations,
American Heart Association, Dallas, Texas, stated that each year
more than 350,000 people experience cardiac arrest outside of a
hospital, with only one in ten surviving due to receiving timely
Cardiopulmonary Resuscitation (CPR). She noted that in 2008, the
American Heart Association released a scientific advisory
promoting hands-only CPR as the standard response for adult
sudden cardiac arrest. She explained that cardiac arrest is
caused by an electrical malfunction in the heart, unlike a heart
attack, and nearly 90 percent of those who experience it outside
of a hospital do not survive.
MS. MORGAN emphasized the importance of training students in
hands-only CPR to improve survival rates, noting that 70 percent
of out-of-hospital cardiac arrests happen at home. Early
training could foster a culture of action and improve survival
rates. She explained that hands-only CPR instruction can be
delivered within a single class period, using resources such as
sample curricula, first aid e-books, streaming videos, and
mannequins for practice.
4:29:56 PM
MS. MORGAN shared a story highlighting the importance of
bystander CPR, involving J.R. Lewis of KTVF in Fairbanks, whose
15-year-old son suffered a cardiac arrest but survived because
bystanders knew CPR. This experience led Lewis to raise
awareness about CPR, which he promotes in his newscasts. She
also noted that since 2018, more than 40 states have passed laws
requiring CPR training before high school graduation, while
Alaska remains among the few without such a requirement.
MS. MORGAN urged support for SB 221, stating that teaching
students hands-only CPR could save thousands of lives by
equipping communities with lifesavers who can provide immediate
assistance until first responders arrive. She emphasized that
now is the time to act, with the American Heart Association
encouraging support for SB 221.
4:31:16 PM
KELLY MANNING, Deputy Director, Innovation and Education
Excellence, Department of Education and Early Development
(DEED), Juneau, Alaska, paraphrased DEED's fiscal note for SB
221, OMB component 2796, dated February 29, 2024:
[Original punctuation provided.]
This bill removes cardiopulmonary resuscitation (CPR)
from AS 14.30.360(a) as recommended content for
physical health and personal safety instruction and
adds a new section AS 14.30.363 that requires CPR be
provided in public schools using curricula developed
by the Department of Education and Early Development
(DEED) at grade levels determined by DEED. This fiscal
note assumes that DEED will create the CPR curriculum
and identify which grade levels are appropriate for
instruction.
This fiscal note contains the following one-time
expenses: 1) $400.0 for a facilitator to convene 20
qualified medical providers with educational expertise
for their participation in the development of a K-12
CPR curriculum, including stipends, travel, and
facilitation fees; 2) $100.0 First Year certification
training for certified trainers (includes cost for a
facilitator and travel for certified trainers); and 3)
$6.0 for legal fees to implement the necessary
regulation changes.
This fiscal note contains the following annual
expenses: 1) $30.0 for printed materials; 2) $10.0 for
supplies (cleaning supplies, gloves, etc. as
identified by the curriculum); 3) $35.0 CPR/AED kits
($55.50 (whole dollars) per kit - which supports 15
students, approximately 635 kits are needed); 4)
$375.0 Annual Curriculum training (2-3 staff per
district, depending on district size, up to 165 per
year this includes stipends, travel, materials and
supplies); 5) $75.0 annual certified trainer
certification training (facilitator, travel for
trainers, materials, and supplies.).
4:34:50 PM
MS. MANNING continued her overview of fiscal note OMB component
2796:
It should be noted, after consultation with the
Division of Risk Management, there is concern
regarding the high liability exposure for DEED
developing the CPR curriculum for Alaskan School
districts. CPR curriculum should be developed and
taught by CPR certified instructors. If CPR is taught
to school students by non-certified parties and
something goes terribly wrong during the course of one
of those students' providing CPR, the school district,
or DEED, may be held liable for negligent and improper
instruction.
This fiscal note contains the following bi-annual
expenses: 1) $150.00 for a facilitator to convene 15
qualified medical providers with educational expertise
for their participation in a review of curriculum
against CDC guidelines every two years, including
stipends and facilitation fees.
(Can be conducted virtually)
4:35:59 PM
SENATOR KIEHL stated that he understood Ms. Manning was not part
of Risk Management but asked if she could clarify their
perspective on the potential liability. He noted that this
situation seems to align with the definition of discretionary
function immunity for a sovereign and inquired what possible
liabilities might be involved.
4:36:17 PM
MS. MANNING explained that Risk Management highlighted concerns
related to the department developing medical instruction. As
noted in the fiscal note, the potential liability stems not from
the inherent nature of CPR instruction itself, but from the
department developing a unique curriculum. The concern is that
if any issues arose with the department-developed curriculum,
liability could be a factor. She noted that existing curricula,
which have already undergone extensive vetting processes, might
mitigate such concerns better than a newly developed one. She
added that this was not her area of expertise.
4:37:03 PM
SENATOR KIEHL expressed skepticism about the liability concern,
noting that the State of Alaska regularly develops curricula and
standards across various domains. He pointed out that the
department also establishes standards for building safety,
despite the existence of codes, and could provide numerous
similar examples. He argued that this situation falls under
discretionary function immunity as defined by the Federal Tort
Claims Act and Alaska Supreme Court [Tort Claims Act]
4:37:37 PM
SENATOR GRAY-JACKSON thanked Senator Kiehl for his knowledge and
stated her staff would share who will develop the curriculum.
4:38:11 PM
MS. DIAZ stated Senator Gray-Jackson's office was in contact
with DEED regarding the fiscal note. She said there are many
fire departments, EMS, and paramedics, ready to volunteer and
eager to collaborate in developing the curriculum. This means
that the responsibility for creating the curriculum would not
fall entirely on the department. She emphasized that there are
already numerous resources available for building the
curriculum, which should be straightforward since SB 221 focuses
only on hands-only CPR. She mentioned a meeting with DEED and
expressed hope in finding ways to adjust the fiscal note to
reflect potential cost savings.
4:39:09 PM
SENATOR BJORKMAN inquired how educators or school personnel
would put SB 221 into practice and what it would look like in a
school environment.
4:39:41 PM
MS. MANNING replied that SB 221, as structured, leaves the
implementation largely at the discretion of each district. The
department is tasked with identifying the grades where CPR
training will occur and setting standards. If the curriculum
development changes, the department would adjust accordingly,
but districts would retain autonomy in deciding how to implement
it. She noted that districts have various options for employing
CPR training, and some already do so. The department would
provide support and technical assistance to help districts
explore different approaches, recognizing that there are
multiple ways to incorporate CPR training effectively.
4:41:02 PM
SENATOR BJORKMAN expressed appreciation for the potential range
and variety in implementation approaches. He referenced Chief
Schrage's comment that it took only 30 minutes to teach CPR to
the Rotary Club. However, he noted that the fiscal note, which
involves convening large groups, implies that the Department of
Education and Early Development (DEED) has a more expansive
vision for this program. He asked specifically what DEED
envisions teachers will be instructing students regarding CPR.
4:41:44 PM
MS. MANNING explained that the fiscal note is based on the
language in SB 221, Section 2, which states that the department
shall develop the curriculum. If the language changes, as
Senator Gray-Jackson suggested, the department would reconsider
its approach to the curriculum. The fiscal note reflects the
requirement for DEED to develop the curriculum, which accounts
for much of the projected cost. If DEED is not responsible for
developing it, a different approach could be adopted.
She stated that if DEED develops the curriculum, it will need to
be created effectively according to national standards for CPR
instruction, which drives the majority of the expenses.
Additionally, DEED would need to train individuals on how to use
the new curriculum, which is what the fiscal note is focused on.
Once districts are trained, DEED would prepare a certified
facilitator who could then meet district needs according to the
curriculum developed by the group of experts.
4:42:54 PM
SENATOR GRAY-JACKSON commented that she would have SB 221
amended once it is determined who will be responsible for
developing the curriculum if it is not the department.
4:43:23 PM
SENATOR TOBIN opened public testimony on SB 221.
4:43:39 PM
JAMES WHITE, representing self, Juneau, Alaska, testified in
support of SB 221. He shared his experiences teaching
Cardiopulmonary Resuscitation (CPR) to students and emphasized
the importance of having an educated population ready to respond
to cardiac emergencies. He spoke about losing his father-in-law
to an asthma-induced cardiac arrest in 2018, which taught him
that every second is crucial in such situations. He noted that
70 percent of Americans are still hesitant to perform CPR due to
lack of training and pointed out that for every minute without
chest compressions, a person can lose up to 10 percent of brain
function. Immediate CPR more than doubles survival odds and
greatly reduces the risk of brain damage or lasting harm.
MR. WHITE incorporated the American Heart Association's hands-
only CPR curriculum into the life skills course he was teaching,
and for the past five years, he has used this curriculum to
teach students how to respond to cardiac arrest by performing
CPR and using an Automated External Defibrillator (AED) when
available. He described his experiences as both engaging and
rewarding.
4:45:06 PM
MR. WHITE shared specific success stories, including one in
December 2021 where a student saved his father's life by
performing hands-only CPR after a cardiac arrest. The student
credited his quick and effective response to the training he
received in class just weeks prior. Another similar incident
occurred in February 2023, when a student saved her mother's
life after a cardiac arrest at their Juneau home, again
attributing her successful response to the CPR lessons learned
in class.
4:45:55 PM
MR. WHITE highlighted the value of empowering students with
practical, life-saving skills like CPR, which benefit both the
students and the broader community. He expressed regret that in
December 2023, the life skills course was cut due to lack of
funding, eliminating CPR training opportunities for students in
his district. He urged support for increased Base Student
Allocation (BSA) funding to ensure teachers can continue
providing CPR education in schools, emphasizing that the
decision to empower students to save lives is now in the hands
of the policymakers.
4:46:42 PM
SCOTT WELLMAN, M.D., representing self, Anchorage, Alaska,
testified in support of SB 221 and is the medical director at
Providence Alaska Children's Hospital. He shared a story about a
patient he met last August, a generally healthy and active 15-
year-old from western Alaska. While playing basketball, the
teenager suddenly felt strange and collapsed. A bystander
provided Cardiopulmonary Resuscitation (CPR) until medics
arrived five minutes later and found an unstable heart rhythm. A
defibrillator was used to restore the normal rhythm. The
teenager took some time to recover but ultimately had an
excellent outcome, thanks to the bystander who knew CPR. He
noted that the patient's mother wanted this story shared, and he
emphasized its importance. Although remarkable, he said the
story was not unique, as he has seen other patients with similar
experiences.
4:47:57 PM
DR. WELLMAN noted that while students can potentially save
peers, CPR is more often used to save adults in their homes or
communities, where 70 to 75 percent of cardiac arrests occur. He
highlighted that having someone at home capable of responding to
an emergency can make all the difference. He also mentioned that
CPR has financial benefits, as survivors who receive CPR early
tend to recover faster, leave the hospital sooner, and return to
the workforce. He acknowledged that he did not have the exact
figures but believed this factor was crucial for consideration.
DR. WELLMAN emphasized that CPR is an essential life skill,
expressing happiness at hearing that it was taught in middle
schools earlier. He noted that the benefits extend beyond saving
lives, including building self-confidence among students. Given
that over 40 other states have already implemented CPR training
in schools, he urged that Alaska make CPR training a part of
school curricula across the state.
4:49:23 PM
LINDA IRELAND, D.O., representing self, Anchorage, Alaska,
testified in support of SB 221. She said she is a practicing
cardiologist and president of the Alaska Heart and Vascular
Institute in Anchorage, as well as the current governor of the
Alaska Chapter of the American College of Cardiology, She
emphasized that requiring the Department of Education to
implement CPR education statewide is crucial for student and
community safety. She noted that cardiac arrest can happen
anywhere, with 70 percent of cases occurring at home, and
stressed that knowing CPR can mean the difference between life
and death. Drawing from her 20 years of cardiology experience in
Alaska, she shared that she has seen many instances where
delayed CPR led to severe incapacity or death, cases that could
have been prevented if CPR had been administered immediately.
She argued that educating students is a powerful way to save
lives, as empowering youth with CPR skills will have long-
lasting benefits for individuals and communities. She added that
the resources and training for hands-only CPR are widely
available and cost-effective.
4:50:38 PM
DR. IRELAND also shared her recent partnership with the Boys and
Girls Club, where she has begun teaching hands-only CPR, with
plans to continue these efforts in remote areas of Alaska this
summer, funded by a grant from the American College of
Cardiology. She urged that with the support of SB 221, every
student could graduate with the ability to respond effectively
in an emergency. In conclusion, she encouraged the committee to
pass SB 221, highlighting that over 40 states have already
integrated CPR training into school curricula. She stressed that
advancing this legislation will allow Alaska to join those
states in equipping students to act decisively in emergencies,
thereby saving lives and strengthening communities.
4:51:40 PM
BRIAN WEBB, representing self, Anchorage, Alaska, testified in
support of SB 221. He said he has been an Alaskan EMS professional
since 1978 and educator since 1984. He stressed that delayed EMS
response times and lack of bystander CPR are major challenges,
with each minute of cardiac arrest reducing survival chances by
10 percent. He noted Alaska remains among the few states without
mandatory school CPR training, despite past attempts since 2005.
4:52:25 PM
MR. WEBB emphasized that CPR certification isn't required
gaining skills is key, and effective training can be done in 30
minutes or less using low-cost programs and available
mannequins. He highlighted community support efforts from
Ketchikan, Kodiak, and Prince of Wales Island, and shared a
success story from Juneau where a student saved his father's
life using school CPR training and noted over 15 instances in
the lower forty-eight states where students saved lives. He
urged support for SB 221 to save lives across Alaska.
4:53:51 PM
TYLER BELK, representing self, Anchorage, Alaska, testified in
support of SB 221. He said he is a firefighter paramedic with
the Anchorage Fire Department and Executive Board member of the
International Association of Firefighters Local 1264. He stated
that CPR is a life-saving skill anyone can learn and has
witnessed its impact firsthand through community members
performing CPR before paramedics arrive. He emphasized that SB
221 provides a valuable opportunity to educate young people in
the community in this critical skill. He shared personal
stories, including finding a seven-year-old performing CPR on
their father, underscoring the importance of this training. He
expressed his full support for SB 221 and opined that his union
members also support SB 221.
4:55:41 PM
FORREST KUIPER, representing self, Fairbanks, Alaska, testified
in support of SB 221 and is the President of the Alaska Fire
Chiefs Association. He said he is the president of the Alaska
Fire Chiefs Association and emphasized the importance of
incorporating CPR training into high school curricula statewide.
He noted that Alaska's vast landscape creates unique emergency
response challenges, where seconds can determine life or death,
particularly in remote areas. He highlighted that CPR empowers
individuals to provide life-saving interventions until
professional help arrives. He cited three incidents in the last
60 days in the University Fire Service area where bystander CPR,
combined with early advanced interventions, led to successful
resuscitations. He credited these outcomes to quick bystander
actions. He urged support for SB 221, stressing that integrating
CPR training in schools would empower youth, improve emergency
response across Alaska, and ensure a safer future.
4:58:11 PM
GERALD VOSS, representing self, Juneau, Alaska, testified in
support of SB 221. He expressed strong support for teaching CPR
at a young age, noting that he has used CPR to save lives while
working in the airlines. He questioned why the resources and
expertise of fire departments couldn't be leveraged to train
both teachers and students, potentially reducing costs. He also
asked if defibrillators are available in high schools and
whether teachers would be trained to use them if needed. He
reiterated his support for teaching CPR to children.
4:59:08 PM
CHAIR TOBIN closed public testimony on SB 221.
4:59:18 PM
CHAIR TOBIN held SB 221 in committee.