Florida school districts considering heart exams for student athletes
School board sees need for tests, but worries about liability, cost
BREVARD COUNTY, Fla. – While playing football at Bayside High School in Palm Bay, former wide receiver and quarterback Xavier Hendrix was unaware he had a potentially life-threatening heart condition.
"I didn't have any shortness of breath or fainting or dizziness or anything like that," Hendrix. "I've been in 98 degree Florida weather (wearing) full pads, running up and down the field."
Just before Hendrix was set to begin playing football for Southeastern University in 2017, the teen underwent an electrocardiogram screening, or EKG, arranged by the school's athletic department.
That's when Hendrix discovered he had Wolff-Parkinson-White syndrome, a condition that can cause an abnormally rapid heartbeat due to an extra electrical pathway between his heart's upper and lower chambers.
"I could have just fallen down and died one day at practice," said Hendrix, who has since undergone three surgeries to correct the issue. "They would have found out after I was gone that it was due to a heart complication that could have been detected from an EKG screening."
Discoveries like the one that likely saved Hendrix's life are prompting Florida school districts to consider administering heart screenings to student athletes, either on a voluntary basis or as a required addition to mandatory physical exams.
Even though 11 of 15 public high schools in Brevard County have voluntarily offered cardiac screenings through their athletic programs, Brevard Public Schools does not currently have a policy endorsing or requiring heart exams on a district-wide basis.
"We want to protect our student athletes, but there are certain situations that we as a district need to work through to get there," Assistant Superintendent Christine Moore said.
During a recent school board workshop, Brevard Public Schools administrators and school board members examined what other districts are doing to address cardiac screenings.
Calhoun County School District in Florida's Panhandle is the only one that currently requires all student athletes to undergo an EKG.
According to Brevard school officials, at least 20 school districts do not offer any cardiac screenings, including Marion, Polk, Seminole and Volusia counties.
Brevard administrators found that at least nine other school districts, including Lake and Orange counties, do not mandate cardiac exams, but have allowed their high schools to independently arrange the tests.
Who We Play For, a nonprofit that provides low-cost EKG screenings, has worked with many of those schools to administer the exams.
The organization was created in memory of Rafe Maccarone, a Cocoa Beach High School soccer player who died from heart complications following practice in 2007.
"Sudden cardiac arrest is the leading cause of death in sports and on school campuses," said Evan Ernst, a co-founder of Who We Play For. "We've screened over 100,000 athletes and we've identified over 90 kids with life-threatening heart conditions."
Hendrix was one of those kids.
"(Screenings) should absolutely be mandatory at all schools," said Hendrix, who is studying to become a heart specialist. "It's mandatory that we make sure our kids are capable of doing the sport they play."
Officials with Brevard Public Schools said there are several issues that must be considered before requiring EKG screenings, including the potential liability to the school district if the test results are inaccurate.
"There's a case in Escambia County, where a student was screened and no abnormality was found, and later that student did have a cardiac issue," Moore said. "We might be holding kids out of (playing sports) who were a false positive. We might be putting kids into play where it was a false negative. So there are real concerns there and where that liability falls."
That liability might increase if the school district pays for the tests instead of requiring students to cover the cost, according to district officials.
School board member Misty Belford believes the district is being put at risk legally if it fails to mandate heart exams.
"I think we have equal liability allowing our athletes to go out on the field without having that screening," Belford said.
Risk management experts within Brevard County schools are reviewing a proposed parental consent form to find ways of limiting the district's liability.
Before requiring EKG screenings, school officials said the district must also ensure that anyone who handles the students' paperwork is trained in medical privacy laws, such as HIPPA, the Health Insurance Portability and Accountability Act.
Another concern is cost, particularly for students from lower income households who cannot afford the test.
Primary care physicians may charge as much as $150 for an EKG, according to Who We Play For.
The organization typically conducts heart screenings for $20, although it occasionally provides free exams subsidized by donations.
Brevard County school officials estimate it could cost approximately $80,000 to provide EKG screenings for student athletes who currently qualify for free or reduced-cost lunches.
"Is this a good idea? Absolutely," school board member Cheryl McDougall said. "But I am concerned about the cost for our students who can't (afford it), and I'm concerned about our budget's bottom line."
As Brevard County school officials evaluate potential legal and funding concerns, the district is strongly recommending that student athletes receive an EKG prior to participating in school sports.
"We're in a very precarious zone right now of protecting our kids, making sure the school board isn't at risk, but wanting to do the right thing," Moore said. "And the right thing is for our kids to get screened."
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