Minnesota s Journey to a CPR in Schools Law

Minnesota s Journey to a CPR in Schools Law Summary The 2010 elections brought a wave of new, ultraconservative legislators to the capitol as Republicans took control of the House and Senate for the first time in over 30 years before legislators in Minnesota were party affiliated. Many of these legislators ran on a no new mandate message and many signed no new mandate pledges upon running for office. It seemed abundantly clear that a CPR training graduation requirement would not be possible with this legislature. However, using a series of circumstances to build momentum combined with a solid advocacy strategy, help from coalition partners and a robust grassroots effort, we were able to not only find Republican champions for the bill, but the legislation passed both the House and Senate on bipartisan votes and was ultimately signed into law by Governor Mark Dayton on April 23, 2012. The American Heart Association led the charge in creating the new generation of life-savers in Minnesota. The History An effort to require all students in to receive CPR and AED training prior to graduating high school is not a new concept in Minnesota it had been attempted at least six times in the last 20 years, mostly by the EMS community. Each time the measure was met with fierce opposition from the Minnesota School Boards Association (MSBA) and legislators opposed to any mandate, especially unfunded mandates on public schools. The 2010 elections brought a wave of new, ultra conservative legislators to the legislature as Republicans took control of the House and Senate for the first time in more than 30 years. Many of these new legislators ran on a no new mandate message and signed no new mandate pledges upon running for office. Pursuing CPR training as a graduation requirement would be difficult with this legislature. However, a series of opportunities presented themselves which were unlikely to repeat themselves in the future. Taking advantage of those opportunities required strategic advocacy planning. A Series of Opportunities The momentum began with Hanna s Law during the 2011 session. A 4-year- old girl named Hanna choked on a grape while in daycare. Once the grape was removed from her throat, she wasn t breathing and her heart had stopped. No one in the room knew CPR and Hanna died while they waited for an ambulance to arrive. Although Licensed Daycare Providers were required to be CPR certified under state law, the certification requirement did not extend to all employees in the setting. This was an unintended omission and a bill named Hanna s Law was drafted to correct the oversight and ensure anyone who would be alone with children in a childcare setting would be required to be trained in CPR. This was an unfunded mandate on private business and both the American Heart Association and the American Red Cross, who worked jointly on the legislation, anticipated a backlash from the new antimandate legislature - only the backlash never came. Legislators from both parties were eager to sign onto the bill, even legislators that opposed ANY mandates on anything said they weren t about to vote against such a common sense bill in front of a grieving grandfather who attended most of the hearings. In the most contentious legislative session in generations, Hanna s Law was the only piece of legislation to pass unanimously that session. In addition to the momentum of Hanna s Law, the American Heart Association also learned that the new class of freshman legislators included an unusually large number of Health and Physical Education Teachers, former EMTs and nurses; and even more surprising was that two of the new legislators had used CPR to save a life! Following the passage of Hanna s Law, the American Heart Association s policy to teach every student CPR before graduation was shopped around to a few of the most mandate sensitive legislators, who expressed an interest in helping with its passage. The third piece to the puzzle was the formation of the Minnesota Resuscitation Consortium (MRC) launched under a Heart Rescue Project Grant from Medtronic. Included in its grant terms, the MRC s goals included aiding the passage of legislation requiring CPR

training of all high school students and helping to promote and pass legislation that increased the survival rate from Sudden Cardiac Arrest (SCA). The MRC committed to securing no cost or low cost resources for schools and were willing to take their model statewide to ensure that CPR and AED training could occur at no cost or low cost across the state of Minnesota. The MRC model was fairly unique in that it had a two-tier approach. The first tier was to connect a school with a local partner Police/Fire/EMS/Survivor Groups/etc. who could provide the resources. These are traditionally better trainings and more impactful for students, plus they had the added bonus of creating a community project. The second tier caters to schools who were not matched with a local partner. While an unlikely scenario, if it happened the MRC would grant a Take 10 Kit directly to that school. The kit includes 10 inflatable CPR anytime mannequins, multiple DVDs to use for instruction and printable materials to hand out to students. In addition, the MRC launched the Minnesota CPR Directory- a website that allows visitors to click on their county for a list of resources and contact information for no cost and low cost CPR training. While the resources provided by the MRC are ultimately crucial to the implementation of the CPR in Schools bill, the initial thought was that their largest asset would be removing the unfunded part of the unfunded mandate objections. Conversations with lawmakers revealed their real objection was not the unfunded part, it was the mandate part of the bill. Nevertheless, the cost to schools was always the first argument thrown up against the initiative, so thanks to the MRC, the real, larger objections could be addressed. Building Support: The Grassroots Movement Engaging and educating the You re the Cure online network of grassroots supporters on the CPR in Schools legislation through emails early-on was imperative to building statewide support for the issue. Advocacy staff took every opportunity to present information on the bill to staff and current volunteers while also engaging new volunteers in creating the next generation of life-savers. Gathering survivor stories and saves was also an important part of the initial grassroots plan. Working with American Heart Association integration partners, the advocacy team held a mass CPR training event at the Mall of America during American Heart Month. Volunteers and survivors trained anyone who was interested in Hands- Only CPR while additional volunteers collected petition cards in support of the legislation. The team was also able to educate and engage Go Red For Women luncheon attendees to sign petition cards in support of the legislation. At the same time, there were multiple media placements throughout the state drawing awareness for the bill. In mid-march, about halfway to the end of session, the Heart on the Hill day at the capitol took place. More than 60 advocates from across the state attended this event to learn about CPR in Schools and then meet with their lawmakers to urge support of this life-saving legislation. A Hands-Only CPR training was also held during the day at the capitol for attendees, the public and more importantly lawmakers and their staff. Advocates were able to learn Hands-Only CPR side-by-side with their lawmakers. As the lobbying team assessed the opposition, the supporters of the bill, both legislators and the public, began to grow in numbers. Assessing and Engaging the Opposition The MSBA was always historically the largest opponent to this legislation. Their job is to fight any mandate on schools. They came out in strong opposition to the bill, but were thrown slightly by the impressive list of bipartisan authors on the bill. When assessing the legislature, the first strategic move was to target one of the most mandate-opposed, powerful GOP House members the Chair of the Ways & Means committee. The Representative was also the author of Hanna s Law, simply because Hanna s grandfather lives in her district. Appealing to all the good press and recognition she received from Hanna s Law, the American Heart Association pitched her authorship of the proposed legislation. At first, she was very hesitant to author a mandate. To sway her decision, an American Heart Association staffer who lives in the member s district wrote her a note thanking her for authoring Hanna s Law and her efforts to make a difference during such a caustic political environment. The note also asked the Representative to consider authoring the CPR in Schools bill. The next day the Representative signed on as chief author. Simply having her name as the chief author of the bill

opened many doors that normally would have remained shut. For example, the Education Reform Committee chair strongly disliked the bill and all mandates, however was willing to give the bill a hearing out of respect for the chief author. Other House members who were reluctant to sign on as co-authors or publicly support the bill, were able to do so under the cover of the powerful name at the top of the bill. Just by securing the right chief author, this bill was already further along than any of the previous attempts to pass the legislation. Securing a hearing in the Senate had similar challenges. The Senate Education Committee chair would also not commit to a hearing for a mandate on schools. She also did not support mandates and remained allusive during the several attempts made to secure a hearing. Again, the grassroots network was tapped. An American Heart Association volunteer, whose son had a SCA at age 16 on the high school football field happened to live in the Senator s district. The volunteer s son was saved when his coach and teammates performed CPR and used an AED. The volunteer s first attempt at reaching out to the member and telling her his story did not work. That s when the volunteer engaged in some grassroots of his own and began making speeches to local rotary clubs, telling his son s story and demonstrating how CPR training saves lives. The local rotary members were so moved that they immediately wanted to help pass the bill. He asked them to all contact the Senate Chair, asking her to schedule a hearing for the bill. A week later the hearing was scheduled. The lobbying team continued to meet with every legislator on the committees in both the House and the Senate and eventually the entire membership. There were, of course, a handful of steadfast anti-mandate folks that were put in the solid NO category and not many solid YES votes. However, the team was consistently surprised at the amount of times they heard soft support or open mindedness to the idea of a school mandate. The House and Senate hearings were held on the same day. The House hearing was held in the morning and the Senate in the afternoon. The advocacy team assembled a diverse group of testifiers: a 20-year-old SCA survivor, the parent of a 16-year-old SCA survivor, two additional survivors that were only alive because someone knew CPR, including one that was saved by a 16-year-old, representatives from the American Red Cross, a local school board member and the head of the MRC. The House hearing went as well as expected. While the testifiers did a good job, there were hostile committee members and the MSBA and the Association of Rural Schools testified in opposition. Immediately following the hearing, the team regrouped and adapted for the Senate hearing that afternoon based on the questions and opposition testimony from the morning. The Senate hearing couldn t have gone any better and was the momentum that pushed everything forward to the next step. Refocusing Our Strategy Following the Senate hearing, the MSBA started treating the bill more seriously. At the same time, rumors began circling that legislators were looking for a way to move the CPR bill forward by combining it with a mandate reduction bill so the package bill could be considered mandate neutral. While frustrating to learn that these conversations were happening without the American Heart Association, it was encouraging to know that some legislators were working, on their own, to move the bill forward in an anti-mandate environment. Eventually, the plan became public. The CPR in Schools bill was to be packaged with a bill to remove a mandate on how school districts spent staff development money. Every school district in Minnesota is required by law to set aside 2% of their budget on staff revenue and current law was very proscriptive as to how it was spent. School districts wanted to determine for themselves how to spend the staff development money. The proposed legislation kept the budget dollars the same, and required them to still be spent on staff development, however it allowed districts to decide how to allocate it. To the American Heart Association, this seemed like a very reasonable approach, but the lobbying team immediately went to our DFL education leaders to ask their opinion. Both the House and Senate leads said it was a good bill and they supported it. The lobbying team was surprised to find out

later that these two legislators were in the minority of the minority and most DFLers strongly opposed the staff development bill. The teachers union (EDMN) and the schools districts (MSBA) fought a turf war over who controlled this money. With about a month to go in the session, a Senate hearing to officially combine the bills into the package was held. Although EDMN repeatedly asked for the bill to be removed from the staff development bill, the committee vote to combine the bills passed unanimously with bipartisan support and added steam to EDMN s opposition to the CPR in Schools bill. Navigating the Floor Votes Following the bill combination, the lobbying team worked on whipping votes on the floor while the opponents worked focusing on the Governor s veto of the bill should it end up on his desk. The Governor s staff indicated he was unlikely to sign a bill over the objection of EDMN and the best strategy for a win were solid bipartisan floor votes, which would make it difficult for him to veto. There was solid Republican support of the bill in the Senate partly because of the staff development piece and partly because the mandate neutral approach made it acceptable for them to vote for the CPR bill. By the morning of the Senate floor vote, the whip count was very shy of bipartisan support with 12 DFLers claiming they couldn t vote in opposition to EDMN, even though they supported the CPR bill. On the floor, the CPR in Schools bill s Senate DFL champion stood up and railed against the staff development part of the bill calling it anti-teacher and shameful. Then he said that the CPR bill was too important to link to this terrible bill, and then proceeded to publicly thank the Republicans for supporting such an important mandate on public schools. Then he offered an amendment to separate the bills and sat down. The amendment to separate the bills failed on party lines and a vote was called on the package bill. This Senator had privately conferred with 12 other DFL senators and explained that if they could get on record as being steadfastly opposed to the staff development piece, but supportive of CPR and they tried to separate them, they had the political cover they needed to vote for the bill on the merits of CPR in Schools. The bill passed the senate floor 56-6 with great bipartisan support. This was a huge victory. On the heels of the Senate vote, the bill s opponents started riling up House members. Regardless of the Senate momentum, the House vote was a disaster. The House author moved to concur with the Senate language which was the combination package including the CPR bill. It lost both Republicans and Democrats for various of reasons. To make things even stranger an ultraconservative House member who was morally opposed to the bill earlier in session, stood up and gave a speech in support of the bill and how important it is for kids to learn life-skills in school, like CPR. The bill ultimately passed 73-54, but there was opposition on both sides. Go Time: Engaging Grassroots at Full-Force At this point it was clear the bill did not have the support it needed to withstand a veto by the Governor. EDMN had lobbied him hard against it. At this point, the only strategy that was left and had any hope was to engage the grassroots supporters collected throughout the campaign at full force. And the clock was ticking, the Governor had only three days to either sign or veto the bill. Both a phone and email campaign targeting the Governor were launched simultaneously. Anticipating the Governor as the campaign s ultimate target, newspaper ads were placed in papers throughout the state and advocates??? More than 400 emails, 75 phone calls and more than 1,400 petition cards collected from across the state filtered into the Governor s office urging him to sign the bill. On the day the bill was to be presented to his office, a drop-by visit campaign was launched. More than 15 people, representing different groups of supporters for the bill dropped by the Governor s office consistently throughout the day pledging their support in person. EMTs came to the capitol in uniform with notes of support for the bill from their Police and Fire Chiefs. Several survivors, young and old dropped by to tell how their lives would have already ended if someone near them didn t know CPR. There was even a celebrity showing of support for the bill when Prince s Drummer, Bobby Z, dropped by with a camera crew and demanded to explain to Governor s staff the importance of the bill. Board members from the American Heart Association, executive from businesses in the community and representatives from partner organizations all dropped by the Governor s office urging his support of the bill. Originally the lobbying team was unable to secure a meeting with the Governor s policy staff to talk about the bill that day. Halfway through the drop-by demonstration day however, the team was called into the Governor s office for the meeting. At the meeting, the team simply explained to the Governor s staff that this was the furthest this bill has ever come in the Minnesota legislature. And while, ideally

everyone would prefer it was a standalone bill, if the Governor does not sign it, there was a very real chance he would never see it again. The next morning Governor s legislative director called the lobbying team and said the bill had been discussed, the options weighed, and although the Governor hated the staff development piece and was going to take a shot from EDMN, he understood that the CPR in Schools bill will make Minnesota a safer and healthier place to live. She said he would sign the bill into law and then asked that the phone calls, emails and visits be stopped. On Monday, April 23, 2012, Governor Mark Dayton signed the CPR in Schools bill into law, making Minnesota the third state in the country to require all high school students to be trained in CPR prior to graduation. Final Thoughts In the end, this was a unique way to pass this bill. It was a lesson in extreme patience because every roadblock had to be addressed individually and it required looking for an immediately jump on EVERY opportunity that presented itself. Every angle, every opportunity to keep the bill alive was explored fully.