Flagler Schools' electrocardiogram requirement for high school athletes to begin ahead of next school year

The School Board voted 3-2 to mandate the screenings for participation in sports, marching band and JROTC.


Speakers at the Sept. 18 School Board meeting, including Who We Play For team members and Flagler County families, celebrate the board's approval of an ECG screening mandate for student athletes, marching band members and JROTC cadets. Courtesy photo
Speakers at the Sept. 18 School Board meeting, including Who We Play For team members and Flagler County families, celebrate the board's approval of an ECG screening mandate for student athletes, marching band members and JROTC cadets. Courtesy photo
  • Palm Coast Observer
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In May of 2023, April Adams opted to have an electrocardiogram screening for her son, Hayden, at AdventHealth’s annual event providing free sports physicals for Flagler County students. The screening detected an abnormality in Hayden’s heart.

Craig and Jennifer Cavaliere said an ECG screening at the free event in 2021 saved their son, Sam’s, life.

Lori Bosset’s daughter, Julia, a student at Seabreeze High School in Volusia County, didn’t have the screening four years ago. The Florida High School Athletic Association’s clearance form recommended the screening but didn’t require it or explain what it was, so the Bossets decided to forego it. Two months later, Julia suffered sudden cardiac arrest on the school gym floor while warming up for basketball. Julia, who like the Cavalieres’ son, has Long QT syndrome, a heart rhythm disorder, was lucky to survive, her mother said.

The three parents and others spoke eloquently and emotionally at the Sept. 18 Flagler County School Board meeting, urging board members to mandate ECG screenings in addition to the FHSAA’s required physicals to allow students to students to participate in school sports and other activities.

By a slim 3-2 margin, the board voted to require an ECG screening for all high school athletes before their first year of participation at a district school.

The mandate was one of three options board members had selected at a workshop to consider for a vote. Colleen Conklin made a motion for the the mandate, adding marching band and Junior ROTC participants be included along with participants in competitive sports and sideline cheer.

After a sometimes spirited discussion, Sally Hunt, Conklin and Cheryl Massaro voted in favor of the motion. All three board members will not be on the board in two months. Hunt resigned her seat two days later, while Conklin and Massaro’s terms end on Nov. 19 when new board members Janie Ruddy and Lauren Ramirez will be sworn in.

Board Chair Will Furry and Christy Chong voted against the mandate.

FOUR OTHER CENTRAL FLORIDA DISTRICTS REQUIRE SCREENINGS

Flagler County will join Brevard, Osceola, Seminole and Orange as counties in Central Florida that require ECG screenings — which monitors the heart's electrical activity — for athletic participation. Volusia County had a mandate, but the School Board later withdrew it.

The nonprofit organization, Who We Play For, has led the movement to bring awareness of the need for affordable heart screenings to eliminate preventable sudden cardiac death among young people. Four members of the organization spoke at the School Board meeting supporting the mandate. They noted that two high school football players in Florida have died of sudden cardiac arrest since August.

Superintendent LaShakia Moore said the district will spend the rest of the school year educating families and putting procedures in place before requiring ECG screenings beginning with the 2025-26 school year.

The other two options were to keep ECGs optional as they are now or require them with a parent’s right to opt out. Furry wanted to keep the screenings optional, noting that 80% of the students who participated in AdventHealth’s free physicals at Flagler Palm Coast High School this past May had the ECGs as part of the physical. The program is already successful without a mandate, he said. Approving a mandate without details being worked out is concerning, he added.

“I have faith in parents. I don’t believe it’s our role to co-parent,” Furry said.

Erik Nason, who is AdventHealth East Florida Division’s senior manager of sports medicine for partnerships, told the Observer that while about 80% of the 740 students who participated in the free physicals this year included the ECG screenings, that is only about 50% of the students who received athletic clearance. Because the ECGs weree not required, There is no record of students who had screenings elsewhere.

AdventHealth has a partnership with Flagler Schools in which the health-care system provides full-time athletic trainers to the two high schools and orthopedic physicians at football games as well as the free physicals.

Chong, who is a board certified family nurse practitioner, said during the workshops that she favored the one-time-per-student ECG requirement with a parent’s right to opt out. But before the vote on Conklin’s motion she said she had several questions such as what would happen if the partnership with AdventHealth would end and there would no longer be free ECG screenings and would a plan be needed to help families locate a pediatric cardiologist if an abnormality is found.

She said the screenings save lives, “but in healthcare we don’t force anything on anyone. At the very least, I would give parents the option (to opt out).”

‘NO MORE THAN ONE IN 300 RED-FLAGGED’

Moore said there is no reason to believe the partnership with AdventHealth will not continue but that board members should decide whether to require the screenings regardless if they are offered for free. 

Nason said there are several clinics in Central Florida including one in Daytona Beach that offer $15 ECG screenings for students.

No more than one in 300 students (receiving the screenings) are red-flagged. They are rescreened to make sure it’s not a false positive test. Then we discuss where do we go next, what do we need to know. We never scan children and leave them to stand alone.
— ERIK NASON, AdventHealth senior manager of sports medicine for partnerships

“The real value in Flagler County,” he said, “is the partnership with AdventHealth. We have the pathways, funding and commitment to make sure (the free screenings and physicals) can be provided to the students.

“No more than one in 300 students (receiving the screenings) are red-flagged,” he added. “They are rescreened to make sure it’s not a false positive test. Then we discuss where do we go next, what do we need to know. We never scan children and leave them to stand alone. We (AdventHealth with assistance from Who We Play For) find the right connection for them and the right providers.”

Adams said that because of the huge crowd, forgotten paperwork and trying to register on the new clearance app, she was not in the best of moods and almost skipped the last station, the optional ECG, at the free physical, but a volunteer told her it would not take much time. Hayden was able to continue playing soccer.

“I’m glad we had the opportunity to discover and fix the issue before it could affect him on the field,” she said.

Hunt said she is confident that AdventHealth will “continue to be a great partner.

“This is not masks, not everyday,” she added. “It’s a one-time, completely unobtrusive procedure that does save lives.”

 

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