Minnesota's Journey to a CPR in Schools Law

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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 Ameri-
ca during American
Heart Month. Volunteers and survivors trained anyone who was interested in HandsOnly 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 7354, 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.
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