Learn About Lindsay’s Law: What You Should Know

Lindsay’s Law Explained

Lindsay’s Law is a piece of legislation that came into effect in January 2015. It was created in response to a series of cardiac deaths that occurred in young athletes over the course of several years. The National Center for Catastrophic Sport Injury Research at the University of North Carolina has recorded 35 cardiac deaths at the high school level from 1980 to 2012, and 19 of those were of individuals who had no symptoms of any heart disorders.
Lindsay’s Law requires all schools in California that serve grades seven to 12 to have an automated external defibrillator (AED) present at all athletic activities. Schools must comply in order to maintain eligibility for funding from the Interscholastic Federation to support its interscholastic athletic programs . An AED is an electronic device that can assess and treat life-threatening arrhythmias through analysis of heart rhythm and application of electric shock. It is used to restore a normal heart rhythm after someone has experienced a sudden cardiac arrest, which may occur due to an undetected heart condition.
Lindsay’s Law is named in honor of a 16-year-old athlete at El Dorado High School in Placentia, California. She collapsed instantly during a volleyball court drill in April 2006, and died several days later. Lindsay’s Law aims to at least remove the equipment barrier to youth sport athletes receiving adequate treatment in case of a cardiac incident. It may not be enough, however, to address the problems of youth sport safety.

The Requirements of Lindsay’s Law

As a consent requirement for Lindsay’s Law, each youth sports organization must adopt a policy requiring that each coach and volunteer, all parents of athletes, and each athlete periodically completes training on the nature and warning signs of sports-related concussions. Included in the training requirements are a requirement that each parental acknowledgement and consent form contain a related parent education component on the nature and warning signs of sports-related concussions. For this purpose, parent education materials are made available from the Department of Public Health’s website. It is not required that those materials be included with the stand-alone concussion acknowledgment form.
With regard to the stand-alone form, it must direct parents to the Department of Public Health’s website for a complete explanation of concussion signs, symptoms and prevention. The law provides no requirements on the specific format of the form. Console the most direct requirements of the law, naturally they are that the concussion form: While no specific penalties are outlined in the bill for non-compliance, under the penal code, an organization can be liable to the state for a fine of up-to $500 a day, every day it exists in violation of the law.

The Signs of Sudden Cardiac Arrest

Lindsay’s Law provides that all coaches, referees, umpires, and other game officials, as well as all coaches, administrators, volunteers, and employees of school districts and other specified youth programs, shall be required to complete educational training in the recognition of the signs and symptoms of sudden cardiac arrest. The training shall include:
Signs of sudden cardiac arrest can occur when an abnormal heart rhythm causes the heart to suddenly stop beating. It is vital for those monitoring athletes to recognize these critical symptoms, as 95% of youths who experience sudden cardiac arrest die on the field. The California Department of Public Health Research states that in most of these cases "an Athlete with a Cardiac Emergency", it could have been prevented by an automatic external defibrillator (AED). The National Collegiate Athletic Association (NCAA) has even gone on to say that the number one killer of student athletes is sudden cardiac arrest. To protect our children, Lindsay’s Law promotes the use of AEDs in youth sports. Schools that do not have AEDs are expected to have them available no later than July 1, 2017.
There is no single test that can definitively determine whether a youth has a possible underlying heart condition. Screening of youth athletes for risk of sudden cardiac death is therefore necessary and recommended by the American Heart Association, but even trained medical professionals have faced difficulties with recognizing these signs.

Implementation of Lindsay’s Law in Schools and Sports Organizations

Currently, California law mandates that all organizations and schools that offer youth sports leagues follow certain steps in order to adhere to the new rules and laws. The following steps are outlined in the new California Education Code Section 48853.71:

• Before any physical activity, all youth athletes and their parents must be provided a copy of both the educational materials prepared by the Department of Public Health as well as the cardiac arrest symptoms and warning signs.
• Organizations are required to receive confirmation in writing that the youth athlete and their parent or legal guardian received those materials.
• Every youth athlete who may have experienced a loss of consciousness due to a head injury, or who exhibits the symptoms of a head injury, may not resume playing until cleared by a healthcare provider that is trained in the management of youth concussion injuries. A youth athlete removed from a game for this reason will not face further penalties under existing law. Schools are, however, still encouraged to adopt policies that discourage return to play until cleared by a qualified healthcare professional who is oversees their care.
• Youth athletes who cough, wheeze, or have trouble breathing during practice or play must be removed from the game immediately and cannot return to participate unless there is medical authorization or a prescription that allows them to do so.

The California Department of Public Health actively oversees the monitoring and implementation of all youth sport organizations that are covered under the new law. If these organizations are found to be non-compliant with the law, they may face certain consequences, including:
In addition, organizations are required to demonstrate more proof that they are adhering to the rules and regulations of the new law. To do this, they must ensure that all coaches, referees, league administrators, and other officials who oversee youth sports activities have completed a continuing education course on how the heart functions and the associated risks that may be involved in youth sports. Parents should ask about the all required certifications that coaches and other related professionals must possess before they can be employed in their designated positions. They can also find out whether their state is part of the National Collegiate Athletic Association’s (NCAA) Coaching Excellence Program and whether they require a CPR or first aid certification.

Success Stories and Impact

Lindsay’s Law was enacted as a fitting tribute to Lindsay Bernstein of Tustin, CA, who tragically passed away in 2005. Playing defense on her high school’s freshman football team during practice, Lindsay collapsed due to sudden cardiac arrest. Although a gym teacher and other students attempted CPR, Lindsay died two days later at the hospital. She was eighteen years old.
Our nation has seen an increased awareness of heart-related issues in relation to youth athletes since 2005. Thankfully, Lindsay’s Law has helped to further that awareness. The law went into effect in 2014, and the percentage of sudden cardiac arrest related to youth athletes has significantly declined. The purpose of the section is to promote awareness of the effects and potential success of Lindsay’s Law.
In light of the law, public schools have been provided with automated external defibrillators (AEDs) for potential use when necessary. Schools must ensure that the AED is easily accessible and functional at all times. Each school must also have in place an emergency action plan that outlines how to utilize the AED . Staff members are required to be trained in the use of AEDs, and students are encouraged to voluntarily complete CPR and AED training. These measures are largely credited with the decrease in sudden cardiac arrest reported amongst youth athletes.
There is little data available to adequately prove the success of the law at this time; however, as of 2020 the California Department of Public Health website shows that there have been only three cases of youth deaths in relation to sudden cardiac arrest since 2015. It is estimated that there are 450 youth athletes who die each year ranging from ages ten to twenty-eight. Additionally, it is estimated that there are five thousand+ youth athletes with heart conditions who compete in athletics annually. This data demonstrates the profound effects of the bill and how much Lindsay’s Law can save lives.
Although we have not received many reports of these (very serious) cases, we have received some reports that this law has been successful in preventing sudden cardiac arrest among youth athletes. We expect to see more success reports in the future.

Penalty for Violation and Lasting Implications

The law applies to all youth sports organizations, which is defined as "any organization of any public or private entity that provides a program of organized athletic competition for that entity’s school-aged youth that is operated primarily for the purpose of athletics, which includes leagues, schools, clubs, associations, select or travel teams, or recreational programs." Coaches, referees, officials, trainers and other individuals also have legal obligations under the law. Any individual that provides services related to youth sports is a Mandatory Reporter.
Mandatory reporters include: (i) any employee or volunteer of a youth sports organization; (ii) any athletic coach, manager, trainer, referee, volunteer, official, or other contracted or unpaid individual who is involved in the provision of or authorized to provide athletic coaching services to participants in a youth sports organization; (iii) any athletic trainer, referee, official, or on-site medical personnel who is involved in the provision of or is authorized to provide athletic training or medical services related to youth sports competition; (iv) any athletics coach who is approved to coach or authorized to be present and interact with licensed child-care services entity that includes an athletic program for children over the age of 4; and (v) any individual who organizes games for a fantasy sports league or Internet Website and earns a profit from the league or Website from the participation of others.
Any individual that fails to report an allegation that he or she knows or has reasonable cause to suspect falls within one of these duties to report is guilty of a Class A misdemeanor.

The Future of Youth Sports Safety

The future of youth sports safety in California may well rest on the success or failure of Lindsay’s Law. A proposed amendment to SB 278 – the law that adopted Lindsay’s Law in June 2015 – is pending in the state legislature, and its passage could result in a significant expansion of the testing and reporting requirements currently imposed on youth sports organizations in California. New legislation is also in the works with a similar mandate. And in the wake of Lindsay’s Law, public agencies have adopted their own approaches to youth sports safety. Among them, the California Department of Public Health ("Public Health"), which spearheaded the mandate for concussion education and information in 2009, has plans to partner with CBS and N.C.A.A to produce a 30-second spot informing parents and coaches about Lindsay’s Law . Public Health is also working, with the California Department of Education, to develop standard guidelines for the concussion training provided to school coaches under Lindsay’s Law, which should resolve issues about the issue of over reaching by non-school sports organizations such as Golden Glove boxing and the Junior Olympics in which schools have no responsibility to train or select coaches. On December 1, 2015, Public Health issued proposed revisions to sections 3345.1(c) and 3345.2 of the California Code of Regulations to give effect to Lindsay’s Law. Public Health also is contemplating bolstering the list of organizations exempt from the law. Currently, youth sports organizations that sponsor programs for interscholastic sports involve in a athletic program certified by the California Interscholastic Federation (that is, schools) are exempt from SB 278. However, over 900 youth sports organizations that have received a grant from the California Department of Parks and Recreation might also be added to the exemption list.