BILL ANALYSIS �
AB 633
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Date of Hearing: April 24, 2013
ASSEMBLY COMMITTEE ON LABOR AND EMPLOYMENT
Roger Hern�ndez, Chair
AB 633 (Salas) - As Amended: April 17, 2013
SUBJECT : Emergency medical services.
SUMMARY : Prohibits an employer from adopting a policy that
prohibits an employee from voluntarily providing emergency
medical services in response to a medical emergency.
Specifically, this bill :
1)Provides that an employer shall not adopt or enforce a policy
prohibiting an employee from voluntarily providing emergency
medical services, including, but not limited to,
cardiopulmonary resuscitation (CPR), in response to a medical
emergency.
2)Provides that specified provisions of existing law related to
civil liability would apply to an employee providing
resuscitation.
3)Provides that this prohibition shall not apply to a long-term
health care facility, a community care facility, adult day
health care centers, or residential care facility for the
elderly if there is a "do not resuscitate" or "Physician
Orders for Life Sustaining Treatment" forms or an advance
health care directive that prohibits resuscitation in effect
for the person upon whom the resuscitation would otherwise be
performed.
EXISTING LAW provides that no person who in good faith, and not
for compensation, renders emergency medical or nonmedical care
or assistance at the scene of an emergency shall be liable for
civil damages resulting from any act or omission other than an
act or omission constituting gross negligence or willful or
wanton misconduct.
FISCAL EFFECT : Unknown
COMMENTS : According to the author, this measure is in response
to a recent well-publicized incident at a retirement community
in Bakersfield. According to media reports, in February of this
year an 87-year-old resident of the Glenwood Gardens retirement
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community collapsed in the dining room of the facility. Media
reports showed that a 911 call revealed that an employee of
facility indicated that she would not perform CPR on the woman
due to a facility policy that prevented employees from
performing life-saving procedures. The woman subsequently
passed away before emergency services personnel could arrive.
According to news reports, the facility director later issued a
written statement asserting that the incident resulted from a
"complete misunderstanding" of the facility's practice with
regards to emergency medical care for its residents.
Existing state law (referred to generally as "Good Samaritan"
law) provides that no person who in good faith, and not for
compensation, renders emergency medical or nonmedical care or
assistance at the scene of an emergency shall be liable for
civil damages resulting from any act or omission other than an
act or omission constituting gross negligence or willful or
wanton misconduct. Existing law also contains other specific
liability provisions related to medical, law enforcement, and
emergency personnel, and other. [This bill has been
double-referred to the Assembly Judiciary Committee for a more
thorough discussion of the issues related to civil liability.]
According to the author, CPR is a series of life saving actions
that improve the chance of survival following cardiac arrest.
According to the American Heart Association, there are
approximately 360,000 out-of-hospital cardiac arrests in the
United States each year, accounting for 15 percent of all
deaths. On average, bystander CPR is provided in only
approximately one fourth of all out-of-hospital events in the
United States despite public education campaigns and promotion
of CPR as a best practice.
The author states that the question of whether employers have
policies that prevent employees from performing CPR is unclear,
which may cause confusion among Californians. The author argues
that any existing employer policies preventing employees from
performing CPR should be against public policy. Such employer
policies may discourage employees from performing CPR due to
fear of being disciplined or fired.
ARGUMENTS IN OPPOSITION :
The California Hospital Association (CHA) opposes this bill
unless amended. CHA states that the Good Samaritan provision of
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existing law exempts "emergency departments and other places
where medical care is usually offered" from the definition of a
"scene of an emergency." CHA states that this is in recognition
that hospitals and other places where medical care is usually
offered have a multitude of skilled individuals whose job it is
to render emergency medical care and assistance and that there
are specific protocols for doing so in those environments.
This bill would add an entirely new section to the Health and
Safety Code which would prohibit "employers" from having a
policy that precludes an employee from providing emergency
medical services. CHA states that as written, this bill would
prohibit hospitals and other employers licensed to provide
medical care from implementing such policies. However, as noted
above, hospitals and other medical providers are not similarly
situated to other employers.
RELATED LEGISLATION :
As introduced, AB 259 (Logue) would have made it unprofessional
conduct for a nurse to refuse to administer CPR in an emergency
situation, as specified. According to the analysis prepared by
the Assembly Health Committee, AB 259 was brought in response to
the same incident giving rise to this bill.
AB 259 was subsequently amended to provide that it is unlawful
for a long-term health care facility, a community care facility,
an adult day health care center, or residential care facility
for the elderly to have a policy that prohibits an employee from
administering CPR. AB 259 was also amended to include language
related to "do not resuscitate" orders or advanced health care
directives that mirrors the language contained in this bill.
AB 259 is currently pending before the Assembly Committee on
Business, Professions and Consumer Protection.
Therefore, this bill is broader than AB 259 in that in applies
to all employers, but contains specific exemption language
related to specified facilities to address the "do not
resuscitate" issue.
REGISTERED SUPPORT / OPPOSITION :
Support
AB 633
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California Advocates for Nursing Home Reform
California Professional Firefighters
Opposition
California Hospital Association (oppose unless amended)
Analysis Prepared by : Ben Ebbink / L. & E. / (916) 319-2091