Draft language for consideration: State-specific modification may be required

Children's Cardiac Safety Act

AN ACT concerning the cardiac health of children and student athletes.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF ______:

NEW SECTION. Sec. 1. This act shall be known and may be cited as the “Children’s Cardiac Safety Act”.

NEW SECTION. Sec. 2. As used in this Act,

(1) “health care professional” means a physician, advanced practice nurse, or physician

assistant.

NEW SECTION. Sec. 3. A registered, licensed, and certified health care professional who performs an

annual physical examination of a child 19 years of age or younger shall include as part of that

examination questions that evaluate a child’s family history related to cardiac conditions contained in

the “Preparticipation Physical Evaluation” form developed jointly by the American Academy of Family

Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical

Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, American Osteopathic

Academy of Sports Medicine and the American Heart Association's 14 point screening for heart disease

in youth.

The evaluation shall include:

(1)A question regarding the biologic heart health history of the child, including any history of

sperm or egg donors and biological parents.

(2) Four specific questions regarding biologic heart health history during cardiac screening in

well-child visits and in preparticipation physical examinations, including:

(a) Have you ever fainted, passed out, or had an unexplained seizure suddenly and

without warning, especially during exercise or in response to sudden loud noises, such

as doorbells, alarm clocks, and ringing telephones?

(b) Have you ever had exercise related chest pain or shortness of breath?

(c) Has anyone in your immediate family (parents, grandparents, siblings) or other, more

distant relatives (aunts, uncles, cousins) died of heart problems or had an unexpected

sudden death before age 50? This would include unexpected drownings, unexplained

auto crashes in which the relative was driving, or SIDS.

(d) Are you related to anyone with hypertrophic cardiomyopathy or hypertrophic

obstructive cardiomyopathy, Marfan syndrome, arrhythmogenic cardiomyopathy, long

QT syndrome, short QT syndrome, Brugada syndrome, catecholaminergic polymorphic

ventricular tachycardia, Wolff-Parkinson-White syndrome or anyone younger than 50

years with a pacemaker or implantable defibrillator?

NEW SECTION. Sec. 4. The State Department of Education and the State Department of Health shall set

forth guidance to both public and private schools and require that prior to the participation of any

student enrolled in grades kindergarten to 12 on a school or community organization sponsored

interscholastic or intramural athletic team or squad, the student shall have a physical examination using

the “Preparticipation Physical Evaluation” form developed jointly by the American Academy of Family

Physicians, American Academy of Pediatrics, American College of Sports Medicine, American Medical

Society for Sports Medicine, American Orthopaedic Society for Sports Medicine, and American

Osteopathic Academy of Sports Medicine and the American Heart Association’s 14 point screening for

heart disease in the young. The Preparticipation Physical Evaluation form shall include the History and

Physical Examination components, and the additional questions required pursuant to Section 3 of this

act. The Preparticipation Physical Evaluation form shall also include a certification statement, to be

signed by the registered, licensed, and certified health care professional who performed the physical

examination, attesting to the completion of the current professional development module established

pursuant to this Act.

This physical examination shall be conducted within 6 weeks to the first day of official practice in an

athletic season and shall be conducted by a registered, licensed, and certified health care professional.

All preparticipation physical evaluations must be updated in accordance with the PPE Monograph

developed jointly by the American Academy of Family Physicians, American Academy of Pediatrics,

American College of Sports Medicine, American Medical Society for Sports Medicine, American

Orthopaedic Society for Sports Medicine, and American Osteopathic Academy of Sports Medicine and

the American Heart Association’s 14 point screening for heart disease in the young and ask if the

student has:

(1) been advised by a registered, licensed, and certified health care professional defined as

physician, advanced practice nurse, or physician assistant (MD, DO, PA, or APN/NP) not to

participate in a sport;

(2) sustained a concussion, been unconscious or lost memory from a blow to the head;

(3) broken a bone or sprained, strained, or dislocated any muscles or joints;

(4) fainted or blacked out;

(5) experienced chest pains, shortness of breath, or heart racing;

(6) had a recent history of fatigue and unusual tiredness;

(7) been hospitalized, visited an emergency room, or had a significant medical illness;

(8) started or stopped taking any over the counter or prescribed medications; or

(9) had a sudden death in the family, or whether any member of the student’s family under the

age of 50 has had a heart attack or heart trouble, and.

(10) asked specifically the new 4 questions listed in Section 3 (2) regarding the heart health

history during cardiac screening in well-child visit and/or PPE.

A board of education of a public school district and the governing board or chief school administrator of

a nonpublic school shall not permit a student enrolled in grades kindergarten to 12 to participate on a

school or community based organization sponsored interscholastic or intramural athletic team or squad

unless the student has a completed a Preparticipation Physical Evaluation form and, if applicable, a

completed health history update questionnaire as required under this Act.

NEW SECTION. Sec. 5. The state department of health shall create a single form, including the contents

in Section 3, to be utilized in all Preparticipation Physical Evaluations statewide.

NEW SECTION. Sec. 6. The state departments of education and health shall establish a Childhood

Cardiac Screening professional development module to increase the assessment skills of those health

care practitioners who perform well-child physical examinations and screenings. The departments shall

either develop a module adhering to requirements in this Act, or adopt the module created by the New

Jersey Commissioners of Education and Health in consultation with the New Jersey Chapter of the

American Academy of Pediatrics, the New Jersey Academy of Family Physicians, the American Heart

Association, and the New Jersey Chapter of the American College of Cardiology.

If the Commissioners of Education and Health choose to develop a new module they shall, in

consultation with the state chapter of the American Academy of Pediatrics, the state chapter of the

Academy of Family Physicians, the American Heart Association, and the state chapter of the American

College of Cardiology, develop, by the 2026-2027 school year, a Childhood Cardiac Screening

professional development module to increase the assessment skills of those health care practitioners

who perform well child physical examinations and screenings. The module shall include, but need not be

limited to, the following:

(1) how to complete and review a detailed medical history with an emphasis on cardiovascular

family history and personal reports of symptoms;

(2) identifying symptoms of sudden cardiac arrest that may require follow up with a cardiologist;

(3) recognizing normal structural changes of the athletic heart;

(4) recognizing prodromal symptoms that precede sudden cardiac arrest;

(5) performing the cardiovascular physical examination;

(6) reviewing the major etiologies of sudden unexplained cardiac death with an emphasis on

structural abnormalities and acquired conditions; and

(7) when to refer a student to a cardiologist for further assessment.

The module shall be posted on the websites of the state department of education and the department

of health and links shall be made available to the American Academy of Pediatrics, the Academy of

Family Physicians, the American Heart Association, the American College of Cardiology, the Athletic

Trainers’ Society, the State Board of Medical Examiners, Board of Nursing, and the Society of Physician

Assistants.

Providers completing the Childhood Cardiac Screening will be registered in a database to ensure all

providers have successfully completed the required modules. This data shall be held for 10 years.

The department of health shall compile and publish on its website an annual report containing the total

number of exams that were completed and the number of referrals that were made to cardiology . The

report shall also analyze the outcomes of this legislation.

NEW SECTION. Sec. 7. The Commissioner of Education, in consultation with the Commissioner of Health,

the American Heart Association, and the American Academy of Pediatrics, shall develop a pamphlet that

provides information about the disease that can cause sudden cardiac arrest to children and their

parents. The pamphlet shall include an explanation of sudden cardiac arrest, its incidence, a description

of early warning signs, and an overview of the options that are privately available to screen for cardiac

conditions that may lead to sudden cardiac arrest, including a statement about the limitations of these

options.

The commissioner shall distribute the pamphlet, at no charge, to all school districts in the State. The

commissioner shall update the pamphlet as necessary, and shall make additional copies available to

nonpublic schools upon request.

Beginning in the 2026-2027 school year, each school district shall annually distribute this pamphlet to

the parents or guardians of students participating in school sports as part of the student’s

preparticipation physical examination and completion of athletic permission forms. A student and their

parent or guardian shall certify in writing that they received and reviewed the pamphlet.

NEW SECTION. Sec. 8. A registered, licensed, and certified health care professional who performs annual

physical examinations of children 19 years of age or younger, including examinations prior to the

student’s participation in a school or community based organization sponsored interscholastic or

intramural athletic team or squad as required under this Act, shall complete the Childhood Cardiac

Screening professional development module established by the department of health under this Act and

read the associated pamphlet every four years.

A contract between a school district and a school physician shall include a statement of assurance that

the school physician has completed the Childhood Cardiac Screening professional development module

and associated pamphlet under this Act within the past four years.

A registered, licensed, and certified health care professional who completes the Childhood Cardiac

Screening professional development module as required pursuant to this Act shall retain on file at that

person’s professional office a hard copy of the certificate of completion of the module. The hard copy of

the certificate of completion of the module shall be made available upon request.

Upon every renewal of a certification, biennial registration, or renewal of a license by a health care

professional who performs annual physical examinations of children 19 years of age or younger, the

health care professional shall attest to the completion of the module within the past four years to the

Board of Medical Examiners or the Board of Nursing, as appropriate. An application for renewal of a

certification, biennial registration, or renewal of a license shall include a check box for attestation

regarding the health care professional’s compliance with this Act

Upon performing a pre-participation physical examination required under this Act, the physician,

advanced practice nurse, or physician assistant shall sign the certification statement on the

Preparticipation Physical Evaluation form required pursuant to this Act attesting to the completion of

the module. The board of education of a public school district and the governing board or chief school

administrator of a nonpublic school shall retain the original signed statement to attest to the

qualification of the health care practitioner to perform the physical examination required under this Act.

NEW SECTION. Sec. 9. The Director of the Division of Consumer Affairs in the Department of Law and

Public Safety and the State Board of Education, pursuant to the “Administrative Procedure Act” and in

consultation with the Commissioner of Health, shall adopt rules and regulations to effectuate the

purposes of this act.