State Bills Impacting EP
January 20, 2026 -- This month, 35 state legislatures across the country have convened and are introducing a range of proposals affecting cardiac emergency preparedness, health care workforce licensing, imaging standards, and patient safety. HRA is tracking these bills to support policies that protect patients in schools and clinical settings. Below, we detail a few of those bills and the ways you can get involved.
Indiana — Defending Cardiac Safety Laws (HB 1004)
Indiana lawmakers are considering House Bill 1004, which would repeal key school cardiac safety requirements enacted in 2025. Those provisions ensure AED placement and access at school-related events, tailored Emergency Action Plans, and CPR training for coaches — measures backed by evidence demonstrating improved survival when sudden cardiac arrest (SCA) occurs. HRA is actively engaging members and partners to oppose the repeal and urges constituents to contact legislators before the House Education Committee hearing. We’re encouraging advocates to oppose any changes that would reduce AED placement and access.
North Carolina — Smart Heart Act & Related Health Bills
North Carolina continues to advance policy proposals that intersect with both cardiac safety and broader health system issues.
North Carolina has introduced the Smart Heart Act (Senate Bill 278, which would require all public schools to develop comprehensive Cardiac Emergency Response Plans (CERPs) and make AEDs available on campus, paired with annual CPR/AED training for designated staff and coordination with local EMS. It represents a holistic approach to emergency preparedness in school settings.
The North Carolina legislature has also introduced legislation to establish a formal licensure framework for medical imaging and radiation therapy professionals. House Bill 590 (identical to Senate Bill 415) would require individuals who perform or offer radiologic imaging and therapeutic radiation procedures - including sonographers, magnetic resonance technologists, computed tomography (CT) technologists, nuclear medicine technologists, and specialists such as cardiac electrophysiology and cardiac invasive specialists - to hold state licenses and be overseen by a newly created Medical Imaging and Radiation Therapy Board of Examiners. The bill aims to enhance patient safety by ensuring that imaging and radiation procedures are performed by qualified, licensed practitioners.
This imaging bill reflects broader legislative attention to clinical competency and patient safety in diagnostic care - issues that matter to cardiac patients and those at risk of rhythm disorders. However, HRA has concerns about the bill’s potential impact on the EP workforce; additional licensing and oversight creates more bureaucratic red tape for a profession that is already seeing reduced numbers. We will continue to monitor the legislation as it moves through the legislature.
Nebraska — Cardiac Emergency Plans (LB 463)
Nebraska legislators have introduced Legislative Bill 463, which would require school districts to develop Cardiac Emergency Response Plans under the state’s School Safety and Security Reporting Act and explore grant support to implement them. The bill follows compelling local stories about lives saved when plans are in place.
Idaho — CPR & AED Training Statutes
Idaho maintains statewide requirements for high school CPR/AED education as part of graduation standards and includes statutory provisions for AED use and maintenance. These existing policies reflect an ongoing commitment to preparedness, though no major changes to AED law have been filed this session.
Other States — Emerging Efforts
Across the nation, states continue to introduce a variety of proposals tied to cardiac emergency preparedness, EMS coordination, and related health policies. Some states (such as Nevada) have already passed bills requiring cardiac emergency response plans, while others are refining CPR/AED training mandates for students, school staff, and community responders.
HRA will continue to advocate for public support of AEDs, training programs, and other ways to increase patient safety. To learn more about what’s happening in your area, get involved with your HRA Regional Section.