The Flagler County School Board Tuesday became only the sixth or seventh district out of 67 in Florida to make ECG screenings for student athletes mandatory at least once in their four years of high school.
The 3-2 vote followed 75 minutes of often heart-wrenching personal pleas from parents whose children suffered or died from heart defects, and the divided board’s at times contentious disagreements over whether to include an opt-out in the requirement, especially between Will Furry, the board chairman–and opponent of a mandate–and Colleen Conklin, its chief advocate.
“The bottom line is, Will, we’re just going to respectfully disagree completely on this. I still just feel very strongly that it should be mandated,” Conklin said.
“I have faith in parents that they can make the right decision for their children,” Furry said.
“It does not mean that I don’t have faith in parents, so I reject that statement,” Conklin said, as Furry called it co-parenting. “I’m not looking to co parent anybody. This is not a vaccine. This is not a mask. It’s not invasive.”
Conklin, Cheryl Massaro and Sally Hunt voted to make ECG screenings mandatory. Furry and Christy Chong voted against.
The vote was not a given, and was the result of a sharp switch by Hunt. Until last week, she was siding with Furry. “I agree with Will in a lot of ways about, you know, really liking the opt out, because I, you know, I have a daughter,” Hunt said at a workshop last week, the last of many times the board discussed the matter in workshop. “I’m responsible for her wellbeing. My husband and I make decisions about her and her health.” A the time, it looked like a mandatory requirement would fail.
Hunt acknowledged her witch and explained it on Tuesday. “This is not masks. This is not every day. This is a one time, minutes, completely unintrusive procedure that does, in fact, save lives,” she said. “I originally, I will say, I very much believe, typically in parent opt out, very much. So I just don’t think this is a time for that. I really see this as a time for it being mandatory, and that I will tell you at this time that is where my my vote is.”
Flagler County schools now join Seminole, Orange, Suwanee, Highlands, Volusia and Brevard counties in making ECGs mandatory, though Brevard still provides at least some opt-out. Conklin said it’s a matter of time before the Florida High School Athletic Association, the state agency that regulates high school sports in Florida, will make the requirement mandatory. Right now it only recommends it, without further explanation. That vagueness, among other issues, also reflected in local paperwork parents fill out when they prepare their children for physicals, caused many parents to implore the board to be more assertive with a mandate.
Physicals are a state requirement for all student athletes who participate in competitive middle and high school high school. ECGs are not. The Flagler County School Board has for the last several years provided voluntary ECGs through its partnership with AdventHealth. The hospital offers free physicals to student-athletes, and in its own partnership with the non-profit called Who We Play For, free voluntary ECGs. (The name of the organization refers to those students who died from heart complications, and do not get to play on.) Over 80 percent of parents sign up their children for ECGs.
“They are available, and as we’ve heard, they’ve saved lives, and I don’t think there’s any doubt that all five of us are in support of that,” Board member Christy Chong said. “So I just want to make that clear. But what we’re talking about tonight is, are we mandating it? Will we have an opt out, or just leave it optional?” (Massaro toward the end of the meeting decried “the press that was released was ridiculous about three board members not being supportive, and that was way wrong, way wrong, and shouldn’t happen.” But it is Massaro who was flatly wrong: press reports here and elsewhere made clear that all board members approved of ECGs, but that, as of last week, three were opposed to a mandate. Two still are.)
“It’s just giving them that choice in healthcare. We don’t force anything on anyone. We want the patient to make that decision. So just for me, I at the very least would like a parent opt out,” Chong said.
Furry supports the voluntary ECGs and encourages parents to take advantage of them for their student athletes, as he did for his own children. But he echoed concerns raised by others, such as the potential cost, if the partnership with AdventHealth did not continue, or follow-up costs if further tests were necessary. Chong was also concerned about false positives. And both opposed making the option mandatory. To Furry, the 80 percent of parents who are voluntarily participating means that “it is working,” and that a mandate is not necessary. He disputed Conklin’s claim that not having the mandate would expose the district to liability.
The school board attorney cautioned that just because the district did not mandate it doesn’t protect the district from a lawsuit if something went wrong. “If you have the ECG, and it may be prevents that tragedy from occurring, you might have one less lawsuit that gets filed in the first place,” he said. And superintendent LaShakia Moore said the rest of the school year will be spent educating families to prepare them about the requirement. She said she had no reason to think the partnership with AdventHealth will end.
It would have been difficult–but for this board, not surprising–had the mandate not carried the vote after the board heard from numerous people, all of whose children had heart issues that could, and in some cases were, detected by an ECG.
April Adams, a parent and for 19 years an educator in Flagler County told the board of how the ECG screening for her son, a student-athlete at Flagler Palm Coast High School, led to a diagnosis of Wolff-Parkinson-White syndrome, which causes irregular heartbeats. “His condition is rarely life threatening, but the episodes are alarming. Nonetheless, we scheduled a heart ablation for him several weeks later to correct his abnormal pathway,” Adams said. A little over a week later, he was back on the field.
“I don’t understand why we wouldn’t put safeguards in place to protect the lives of our children here in Flagler,” she said. “I’m here today to beg of you to make part make this part of our athletic clearance so that we can catch more students who may have issues like my son.”
Craig Cavalieri gave a similar account. His son, who’d been complaining of such things as blurred vision, lightheadedness or palpitations since he was in the running club at Rymfire Elementary. Two years ago he had an ECG at the AdventHealth clinic for student athletes. “He was diagnosed with type one Long QT syndrome, a heart rhythm disorder that causes fast, chaotic heartbeats, which can be life threatening.” It has restricted his activities and changed his and his family’s lives, “but this isn’t about feeling pity for him or for us. These changes are first-world problems. However, what doesn’t change is that is a free test and it is being provided. What a parent chooses to do with those results is their choice or their right.” As a teacher himself, he said, “our first obligation is the safety of our children. Please reconsider your position and opt for the ethical choice of safety and the ability for these students to reach their full potential. I’m sure you would rather choose to attend their graduation then possibly attend their funeral.” Jennifer Cavalieri, speaking through tears, put it bluntly: the ECG “saved our son’s life.”
Lori Bossett, a parent in Volusia County, explained why making an ECG optional defeats the purpose of the test’s intention, especially when many parents may not understand what the test is. “Since it doesn’t appear important enough to be mandated, they check the box, no. That is what we did as a parent of our 15 year old daughter, who was entering her sophomore year at sea breeze,” Bossett said. She had her physical without ECG. She was cleared for all sports. On Oct. 13, 2020, she collapsed on the gym flood at Seabreeze High School while warming up for basketball: sudden cardiac arrest. CPR and rescuers saved her life as she was airlifted to a children’s hospital, where she spent 10 days in intensive care. She had Long QT syndrome, a heart-rhythm disorder.
“The point here is that we really want this to be a mandatory vote to have these kids screened. I mean, we thought we were doing the right thing. We have physicals. We do everything that the school suggested. We’re the kind of parents who follow the rules. If they suggested an EKG, sure, we didn’t know anything about heart problems until this happened to us. So if people like me, who are educated and we’re good people and follow the rules, for someone, a family like us, to ignore that–I mean, if we were more educated on the purpose of these EKGs for school physicals, then, yes, we would have done it. My daughter is a unicorn. She’s lucky. She survived.”
Others spoke their grief: “My son Alexander died at the age of 21 from sudden cardiac arrest due to undetected hypertrophic cardiomyopathy,” Stacy Carter Cheney said. “Of all the conditions that can cause sudden cardiac arrest in youth, this is the number one killer. We know from top pediatric cardiologist across the nation and abroad that an ECG heart screening could have saved Alexander’s life about 95 percent of the time. As a mom, I would have never considered my rights infringed upon if the school, or literally anyone, would have suggested that my only son might die of sudden cardiac arrest if I didn’t get him a heart screening. I knew nothing about this possibility before he died. How could my perfectly handsome and healthy son just drop dead? Alex was just two months away from marrying his high school sweetheart. He was five days away from his birthday. He had Christmas gifts wrapped to give his sisters, but instead, he collapsed to his death when his heart stopped on a normal day as he was washing up for dinner with his grandparents. This is not rare, as you may have been told. In fact, at least one in 300 youth has an undetected heart condition.”
Shawn Sema, impact director with Who We Play For, had been conducting thousands of physicals as a sports medicine orthopedic physician’s assistant when he got a call in 2016 that his daughter had collapsed in a gym, undergoing emergency measures. “What I didn’t know as a PA doing thousands of physicals on kids is that that physical exam I was doing, that history I was taking, was going to miss most things that killed our kids, most things that are going to kill our kids. When we sign that piece of paper, we ain’t going to cover for it. Adding an EKG will catch anywhere from 90 to 95 percent of these conditions.”
To Conklin, it all added up to a simple choice. “Flagler has an opportunity to be Flagler forward and lead the way and adopt a policy that will mandate this screening,” Conklin said, emphasizing the board’s opportunity to make a local decision.
It was a rare victory for the more liberal side of the board–Conklin hugged Hunt afterward in just as rare a display of comity–if perhaps a fleeting one: this was also the penultimate board meeting for Conklin, nearing the end of her 24 years on the board.
