A BILL TO BE ENTITLED
AN ACT TO require use of automated external defibrillators AND BLEEDING CONTROL as part of required first aid training for PUBLIC school students, to require instruction in first aid and emergency care education in high school, to require THAT first aid training be offered to all school employees, TO REQUIRE THE PLACEMENT OF TRAUMA KITS IN public schools, TO REQUIRE A PRESENTATION ON THE USE AND LOCATION OF TRAUMA KITS DURING SCHOOL SAFETY EXERCISES, TO REQUIRE TRAINING OF SCHOOL PERSONNEL WHO ARE REASONABLY EXPECTED TO USE TRAUMA KITS, TO PROVIDE REQUIREMENTS CONCERNING THE MAINTENANCE OF TRAUMA KITS, AND TO PROVIDE CERTAIN IMMUNITY FROM CIVIL LIABILITY RELATED TO TRAUMA KITS.
The General Assembly of North Carolina enacts:

part i. first aid training for all students
SECTION 1.(a)  Article 8 of Chapter 115C of the General Statutes is amended by adding a new section to read:
"§ 115C‑81.22.  First aid and emergency care education.
(a)	Instruction shall be provided in first aid and emergency care education from kindergarten through grade 12. First aid and emergency care shall include, but is not limited to, the teaching of the following:
(1)	Cardiopulmonary resuscitation (CPR).
(2)	Heimlich maneuver.
(3)	Use of an automated external defibrillator, when equipment is available.
(4)	Beginning in grade six, bleeding control.
(b)	Instruction in cardiopulmonary resuscitation (CPR) and the Heimlich maneuver shall be given using hands‑on training with mannequins so that students pass a test approved by the American Heart Association or the American Red Cross. For the purposes of this subsection, schools shall do all of the following:
(1)	Use an instructional program developed by the American Heart Association, the American Red Cross, or other nationally recognized programs that is based on the most current national evidence‑based emergency cardiovascular care guidelines for CPR.
(2)	Maintain documentation in an electronic database that students have successfully completed CPR instruction to meet healthful living essential standards.
(3)	Require successful completion of instruction in CPR to be a requirement for high school graduation.
(c)	Instruction in the use of an automated external defibrillator shall provide training in the appropriate use of an automated external defibrillator in heart‑related emergencies, when equipment is available for training.
(d)	Instruction in bleeding control shall provide training on the immediate response to bleeding, how to recognize life‑threatening bleeding, and appropriate ways to stop the bleeding for immediate responders in trauma situations.
(e)	The State Board of Education shall develop and maintain a recommended list of first aid and emergency care materials that include components for teacher training and ongoing assessment and evaluation to verify success and ensure the use of up‑to‑date information and strategies.
(f)	The Department of Public Instruction shall do the following:
(1)	Work to strengthen instructional offerings in the content and skill areas in which first aid and emergency care education is addressed.
(2)	Develop curricular materials and resources that meet, extend, and supplement first aid and emergency care education as outlined in the standard course of study and the teacher handbook for the competency‑based curriculum.
(3)	Recommend to the State Board of Education any first aid and emergency care education support materials that should be removed from or added to the recommended list of curricular resources developed and maintained by the State Board of Education.
(g)	Local boards of education may select supplemental first aid and emergency care education materials from the list maintained by the State Board of Education or develop their own supplemental materials to be approved by the State Board of Education.
(h)	Local boards of education shall do the following:
(1)	Implement an approved first aid and emergency care education as a primary part of their comprehensive health education program.
(2)	Provide for ongoing evaluation of first aid and emergency care education resources to include participation in ongoing evaluations with the Department of Public Instruction.
(i)	The Department of Public Instruction, in conjunction with local school administrative units, shall provide for professional development to train educators and support personnel to implement a comprehensive first aid and emergency care education program.
(j)	Sequential, age‑appropriate instruction shall be provided that includes all of the following:
(1)	Reaches all students in all grades.
(2)	Utilizes information that is current and accurate.
(3)	Involves students in active "hands‑on" learning experiences.
(4)	Integrates first aid and emergency care education with other health and social issues and other subject and skill areas of the standard course of study.
(5)	Includes strategies to involve parents, family members, and the community.
(6)	Is continually open to revision, expansion, and improvement."
SECTION 1.(b)  G.S. 115C‑81.25(c)(10) reads as rewritten:
"(10)	First aid and emergency care.

	"
SECTION 1.(c)  G.S. 115C‑375.1 reads as rewritten:
"§ 115C‑375.1.  To provide some medical care to students.
(a)	It is within the scope of duty of teachers, including substitute teachers, teacher assistants, student teachers, or any other public school employee when authorized by the board of education or its designee to do any of the following:
(1)	Administer any drugs or medication prescribed by a doctor upon written request of the parents.
(2)	Give emergency health care when reasonably apparent circumstances indicate that any delay would seriously worsen the physical condition or endanger the life of the pupil.
(3)	Perform any other first aid or lifesaving techniques in which the employee has been trained in a program approved by the State Board of Education.
(b)	No employee, however, shall be required to administer drugs or medication or attend lifesaving techniques programs.
(c)	Each local board of education shall make available to employees annual instruction in first aid and lifesaving techniques. First aid and lifesaving techniques shall include, but are not limited to, the following:
(1)	Cardiopulmonary resuscitation (CPR).
(2)	Heimlich maneuver.
(3)	Use of an automated external defibrillator, when equipment is available.
(d)	Any public school employee, authorized by the board of education or its designee to act under subdivisions (1), (2), or (3) of subsection (a) of this section shall not be liable in civil damages for any authorized act or for any omission relating to that act unless the act or omission amounts to gross negligence, wanton conduct, or intentional wrongdoing. Any person, serving in a voluntary position at the request of or with the permission or consent of the board of education or its designee, who has been given the authority by the board of education or its designee to act under subdivision (2) of subsection (a) of this section shall not be liable in civil damages for any authorized act or for any omission relating to the act unless the act amounts to gross negligence, wanton conduct, or intentional wrongdoing.
(e)	At the commencement of each school year, but before the beginning of classes, and thereafter as circumstances require, the principal of each school shall determine which persons will participate in the medical care program."
SECTION 1.(d)  Subsections (a) and (b) of this section are effective July 1, 2020, and apply beginning with the 2020‑2021 school year.

part Ii. Trauma Kits in schools
SECTION 2.(a)  G.S. 115C‑47 is amended by adding a new subdivision to read:
"(64)	To Require Trauma Kits. – In accordance with G.S. 115C‑105.52A, each local board of education shall require the placement of at least one trauma kit in each classroom of every school under the authority of the local school administrative unit."
SECTION 2.(b)  G.S. 115C‑12 is amended by adding a new subdivision to read:
"(47)	Duty Regarding Trauma Kits. – In accordance with G.S. 115C‑105.52A, the State Board of Education shall require the placement of at least one trauma kit in each classroom of every school located in a public school unit, as defined by that section, operated under the control of the State Board of Education."
SECTION 2.(c)  G.S. 115C‑218.75 is amended by adding a new subsection to read:
"(e2)	Trauma Kits. – A charter school shall require the placement of at least one trauma kit in each classroom of the school in accordance with G.S. 115C‑105.52A."
SECTION 2.(d)  G.S. 115C‑238.66 is amended by adding a new subdivision to read:
"(7f)	Trauma Kits. – A regional school shall require the placement of at least one trauma kit in each classroom of the school in accordance with G.S. 115C‑105.52A."
SECTION 2.(e)  G.S. 116‑11 is amended by adding a new subdivision to read:
"(12f)	In accordance with G.S. 115C‑105.52A, the Board of Governors shall require the placement of at least one trauma kit in each classroom of every school located in a public school unit, as defined by that section, operated under the control of the Board of Governors."
SECTION 2.(f)  G.S. 115C‑105.49(a) reads as rewritten:
"(a)	At least once annually, each local school administrative unit shall require each school under its control to hold a full school‑wide tabletop exercise and drill based on the procedures documented in its School Risk Management Plan (SRMP), including a presentation on the location and use of any trauma kits placed in the school. The drill shall include a practice school lockdown due to an intruder on school grounds. Each school is encouraged to hold a tabletop exercise and drill for multiple hazards included in its SRMP. Schools are strongly encouraged to include local law enforcement agencies and emergency management agencies in their tabletop exercises and drills. The purpose of the tabletop exercises and drills shall be to permit participants to (i) discuss simulated emergency situations in a low‑stress environment, (ii) clarify their roles and responsibilities and the overall logistics of dealing with an emergency, and (iii) identify areas in which the SRMP needs to be modified."
SECTION 2.(g)  Article 8C of Chapter 115C of the General Statutes is amended by inserting a new section to read:
"§ 115C‑105.52A.  Trauma kits.
(a)	Definitions. – For purposes of this section, the following definitions shall apply:
(1)	Trauma kit. – A first aid response kit that is stored in a school in a public school unit and contains (i) at least all of the items listed in subsection (b) of this section and (ii) any, all, or none of the items listed in subsection (c) of this section.
(2)	Public school unit. – Any of the following:
a.	A local school administrative unit.
b.	A charter school.
c.	A regional school.
d.	A school providing elementary or secondary instruction operated by one of the following:
1.	The State Board of Education, including schools operated under Articles 7A and 9C of this Chapter.
2.	The University of North Carolina, including schools operated under Articles 4, 29, and 29A of Chapter 116 of the General Statutes.
(b)	Required contents. – A trauma kit shall contain at least all of the following items:
(1)	One combat application tourniquet.
(2)	One responder emergency trauma dressing at least 6 inches in length.
(3)	One compressed gauze.
(4)	Two pairs of nitrile gloves, size large.
(5)	One set of trauma shears, size 7 1/4 inch.
(6)	One small, permanent marker.
(7)	One tourniquet application instruction card.
(8)	One polyvinyl chloride bleeding control patch.
(9)	One nylon bag with the following minimum dimensions:
a.	A height of 7 inches.
b.	A width of 5 inches.
c.	A depth of 2 3/4 inches.
(10)	Instructional documents developed by the Department of Public Instruction based on the Stop the Bleed national awareness campaign of the United States Department of Homeland Security.
(c)	Optional contents. – A trauma kit may contain, in the discretion of the principal or equivalent administrator of the school, any of the following items:
(1)	One bleeding control dressing.
(2)	Two compact chest seals.
(3)	Other medical materials and equipment that meet all of the following requirements:
a.	Can adequately treat a traumatic injury.
b.	Can be stored in a readily available trauma kit.
c.	Are approved by the Federal Commission on School Safety, the Combat Casualty Care Research Program of the United States Army Medical Research and Materiel Command, and the American College of Surgeons.
(d)	Location. – The governing body of each public school unit, in coordination with (i) the superintendent or equivalent administrator of that unit, (ii) the principal or equivalent administrator of each school within that unit, and (iii) local law enforcement and emergency management agencies with jurisdiction, shall place at least one trauma kit at an appropriate and easily accessible location in each classroom of every school within the unit.
(e)	Training. – All school personnel who are reasonably expected to use a trauma kit, as determined by the superintendent or equivalent administrator of the public school unit, shall complete training biannually on the appropriate use of a trauma kit. The Department of Public Instruction and the Center for Safer Schools, in consultation with the Department of Public Safety, shall provide or contract for adequate training on the use of trauma kits. At a minimum, the training shall meet all of the following requirements:
(1)	Include an online learning management system, operated on a secure platform, that contains, at a minimum, all of the following information:
a.	Instructor‑led videos provided by nationally certified tactical medical instructors. For purposes of this section, the term "tactical medical instructor" includes licensed emergency medical physicians and trauma surgeons.
b.	Instructor‑led video instruction slides with options for multi-language captions in at least English, Spanish, German, French, Italian, Portuguese, and Chinese.
c.	Multiple and varied video playback options.
d.	Quiz material with performance tracking capability.
e.	Individual certification and credentialing numbers for each participant.
f.	A comment forum with 24‑hour discussion monitoring in which instructors participate.
(2)	Curriculum shall adhere to best practices for active shooter preparedness and response as provided by the Federal Bureau of Investigation, the Federal Commission on School Safety, and the United States Department of Homeland Security.
(3)	Address the proper application of pressure to stop bleeding, the proper application of dressings and bandages, additional pressure techniques to control bleeding, and the proper application of tourniquets.
(4)	Incorporate any training modules for active shooter preparedness and response recommended by the Federal Bureau of Investigation, the Federal Commission on School Safety, and the United States Department of Homeland Security. Training modules for active shooter preparedness and response shall be led by persons who have completed the Active Shooter Threat Instructor Training Program provided by the United States Department of Homeland Security.
(f)	Inventory. – The principal or equivalent administrator of each school within a public school unit shall inspect every trauma kit in the school each year to ensure that materials, supplies, and equipment are not expired. The principal or equivalent administrator shall replace any expired materials, supplies, or equipment, as necessary.
(g)	Online usage tool; restocking. – No later than January 1, 2020, the Department of Public Instruction shall create an online usage tool to permit principals or equivalent administrators within public school units to provide information on the use and contents of all trauma kits located in a school. After each use of a trauma kit, the principal or equivalent administrator shall replace any used materials, supplies, or equipment, as necessary, and inform the Department via the online usage tool of the date of the use, the reason for the use, and any components of the trauma kit that were replaced as a result. No later than August 1, 2021, and each year thereafter, the Department shall report the most up‑to‑date information provided via the online usage tool to the Joint Legislative Education Oversight Committee and the Fiscal Research Division.
(h)	Liability. – No public school unit, nor its members, employees, designees, agents, or volunteers shall be liable in civil damages to any party for any act or omission related to the use of a trauma kit placed in a school in accordance with this section, unless that act or omission amounts to gross negligence, wanton conduct, or intentional wrongdoing."
SECTION 2.(h)  There is appropriated from the General Fund to the Department of Public Instruction for the 2019‑2020 fiscal year the sum of ten million dollars ($10,000,000) in nonrecurring funds to provide, in accordance with this section, (i) at least one trauma kit in each classroom of every school located in a public school unit, as defined in G.S. 115C‑105.52A(a)(2), as enacted by this section, (ii) training in the use of trauma kits, and (iii) an online usage tool to track use of trauma kits in public schools.
SECTION 2.(i)  This section becomes effective July 1, 2019, and applies beginning with the 2019‑2020 school year.

Part iii. effective date
SECTION 3.  Except as otherwise provided, this act is effective when it becomes law and applies beginning with the 2019‑2020 school year.