2. P.L.2013, c.71: SCHOLASTIC STUDENT- ATHLETE SAFETY ACT WEBINAR September 2015 New Jersey Department of Education Office of Student Support Services Nancy Curry, Director Christene DeWitt-Parker, MSN, CSN, RN School Health Coordinator

4. Requirements of P.L. 2013, c.71 The Scholastic Student-Athlete Safety Act may be accessed at: http://www.njleg.state.nj.us/2012/Bills/PL13/71_. HTM. http://www.njleg.state.nj.us/2012/Bills/PL13/71_. HTM The first NJDOE Broadcast memo outlining the provisions of the law may be accessed at: http://education.state.nj.us/broadcasts http://education.state.nj.us/broadcasts by clicking on September 10, 2013 then scrolling down to Scholastic Student-Athlete Safety Act.

5. Purpose of the Webinar P.L. 2013, c. 71, was passed by the New Jersey Legislature and signed by Governor Christie on June 27, 2013. The law includes several new requirements regarding school-sponsored interscholastic sports and intramurals, as well as the development of new forms. Therefore, the purpose of this webinar is to assist school district and nonpublic school staff in implementing each of its requirements and corresponding materials.

6. Objectives Following participation in this webinar attendees should be able to: 1.Understand the intent of the legislation; 2.Recognize the regulatory requirements included in the law; and 3.Successfully implement the new forms.

7. 6 Sudden Cardiac Death in Young Athletes United States - approximately 100 deaths are reported each year. This is tragic for the family, fellow athletes, friends, coaches, and everyone in the school community. Causes: It is due, in most cases, to the sudden onset of ventricular tachycardia or ventricular fibrillation which is not compatible with the adequate pumping function of the heart and leads to sudden collapse and loss of consciousness, ultimately resulting in death unless normal heart rhythm is restored using an automated external defibrillator (AED).

8. Warning Signs Prodromal symptoms (warning signs) that precede cardiac death are documented in 36% of sudden cardiac deaths (Gomez, Lantry & Saathoff, 1999). These symptoms include chest pain; fatigue; syncope (fainting); indigestion or heartburn; excessive shortness of breath; ear or neck pain; upper respiratory infection; palpitations; and severe headaches. (Thompson, et al., 2007).

9. The Purpose of Screening Pre-participation physical examinations (PPE) were created to ensure that prospective athletes were healthy enough to safely participate in activity without significant risk of injury, illness or catastrophic outcomes due to existing detectable underlying medical conditions. It is important to note that some medical conditions do not develop until an individual is older.

10. Pre-Participation Physical Evaluation This PPE, released on April 29, 2014, is the form mandated by the New Jersey Legislature. Developed by sports medicine experts. The first component is the History Form (page 1).  Student medical history  Family medical history  To be completed by parent or guardian  The date of the EXAM is at the top of the page – not the date the parent completes the history  Signed at the bottom by both the student and the parent or guardian

11. Supplemental History for Athletes With Special Needs This is the second component of the PPE (page 2). It is for students with disabilities. This is to be completed by the parent or guardian of a student with disabilities.

12. The Physical Examination Form The third component of the PPE (page 3). The physician, advanced practice nurse(APN) or physician assistant (PA) who performs the actual medical examination must review the answers on the History Form and discuss the responses with the student and parent or guardian (if present) prior to beginning the examination. If there are any abnormal findings and a referral to a specialist is warranted, the appropriate box must be checked under “Not cleared” and the reason and recommendations must be provided. The physician, APN, or PA then signs and dates the page.

13. Clearance Form This is the fourth component of the PPE (page 4). It offers significantly more room for the physician, APN or PA to write their comments and recommendations. Many students will have an unremarkable examination and the space will not be needed, however, there will be students whose health care provider will need the room for documentation. NOTE: The last line on the Clearance Form is a statement for the physician, APN, or PA to attest to completion of the Student-Athlete Cardiac Assessment module.

14. Health History Update Questionnaire The requirement for a Health History Update is not new. However, this law changed the length of time from 60 days to 90 days. Includes the specific questions articulated in the legislation. These questions are recommended by the American Heart Association and the American Academy of Cardiology. Provides current information which may impact participation. Allows acquisition of necessary “return to practice” HCP orders.

15. Health History Update Questionnaire Must be signed by the parent or guardian. Review by school nurse is required. If the school has an athletic trainer, he/she shall also review the update. The update questionnaire must be maintained in the student’s health record in the school nurse’s office. N.J.A.C. 6A:16-2.2(h)1iii will be amended to include this change from 60 to 90 days www.state.nj.us/education/code/current/title6a/ chap16.pdf www.state.nj.us/education/code/current/title6a/ chap16.pdf

16. Cardiac Assessment Professional Development Module The law required the New Jersey Department of Education (NJDOE) and the New Jersey Department of Health (NJDOH), and 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 to develop the module “to increase the assessment skills of those health care practitioners who perform student-athlete physical examinations and screenings.”

17. PD Module A health care provider (i.e., physician, advanced practice nurse, or physician assistant) who performs a student-athlete’s annual physical examination prior to the student’s participation in a school-sponsored interscholastic or intramural athletic team or squad shall first complete the PD module. Upon performing the physical examination, a health care provider shall sign the certification statement on the Preparticipation Physical Evaluation form attesting to the completion of the PD module. Upon completion of the PD module, the physician, APN or PA will be able to download and print a Certificate of Completion of the PD module. The physician, APN or PA should retain the Certificate of Completion for his/her files, but is not required to submit a copy of his/her Certificate of Completion to any public school district or nonpublic school. 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 on the Preparticipation Physical Evaluation Form to attest to the qualification of the health care provider to perform the physical examination. http://www.state.nj.us/education/students/safety/health/athlete/PDModule.sht ml. http://www.state.nj.us/education/students/safety/health/athlete/PDModule.sht ml

18. Sudden Cardiac Death in Young Athletes Pamphlet (Brochure) The original pamphlet was developed by the members of the Student-Athlete Cardiac Screening Task Force between 2010 and 2011. Distributed by the NJDOE via broadcast memorandum in March 2011. The Scholastic Student-Athlete Safety Act legislation required the same criteria to be included but with updated information. The section regarding the use of automated external defibrillators (AED) was revised pursuant to P.L. 2013, c.71. The pamphlet may be accessed at http://www.state.nj.us/education/students/safety/he alth/services/cardiac.pdf http://www.state.nj.us/education/students/safety/he alth/services/cardiac.pdf

19. Pamphlet Sign-Off Sheet  A school district and nonpublic school shall distribute the pamphlet to each student-athlete and to the parents or guardian of the student-athlete as part of the student’s pre- participation physical examination and completion of athletic permission forms.  For the 2013-2014 school year and in each subsequent school year.  The student-athlete and the parent or guardian of the student-athlete shall certify in writing that they received and reviewed the pamphlet.  The Sign-Off sheet may be accessed at the link shown here http://www.state.nj.us/education/students/safety/health/ser vices/SuddenCardiacDeathSignOffSheet.pdf http://www.state.nj.us/education/students/safety/health/ser vices/SuddenCardiacDeathSignOffSheet.pdf ***The school district can choose to develop their own sign- off sheet as long as it collects the same information.

20. Webinar Recording This webinar has been recorded and may be accessed on the NJDOE website at: http://www.state.nj.us/education/students/safety/he alth/services/athlete/webinar.shtmlhttp://www.state.nj.us/education/students/safety/he alth/services/athlete/webinar.shtml. The Scholastic Student-Athlete Safety Act Frequently Asked Questions (FAQ) may be accessed at: http://www.state.nj.us/education/students/safety/he alth/services/athlete/faq.pdf. http://www.state.nj.us/education/students/safety/he alth/services/athlete/faq.pdf