BILL ANALYSIS Ó
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|SENATE RULES COMMITTEE | SB 287|
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THIRD READING
Bill No: SB 287
Author: Hueso (D)
Introduced:2/19/15
Vote: 21
SENATE HEALTH COMMITTEE: 9-0, 4/15/15
AYES: Hernandez, Nguyen, Hall, Mitchell, Monning, Nielsen,
Pan, Roth, Wolk
SENATE JUDICIARY COMMITTEE: 4-2, 5/12/15
AYES: Jackson, Hertzberg, Leno, Monning
NOES: Moorlach, Anderson
NO VOTE RECORDED: Wieckowski
SUBJECT: Automated external defibrillators
SOURCE: Author
DIGEST: This bill requires certain buildings with capacities of
200 persons or greater, as specified, constructed on or after
January 1, 2016, to have an automated external defibrillator
(AED) on the premises.
ANALYSIS:
Existing law:
1)Classifies, in the California Code of Regulations, all
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buildings and structures as to use and occupancy, and requires
a room or space that is intended to be occupied at different
times for different purposes to comply with all of the
requirements that are applicable to each of the purposes for
which the room or space will be occupied.
2)Provides, in the Civil Code, immunity from civil liability for
the acts or omissions of any person who, in good faith and not
for compensation, renders emergency care or treatment by the
use of an AED at the scene of an emergency.
3)Provides, in the Civil Code, immunity from civil liability for
any acts or omissions in the rendering of emergency care by
the use of an AED for a person or entity that acquires an AED
for emergency use, if that person or entity has complied with
certain specified requirements in the Health and Safety Code.
4)Provides, in the Health and Safety Code, immunity from civil
liability for a person or entity that acquires an AED for any
acts or omissions in the rendering of emergency care if that
person or entity meets various requirements, including:
a) Ensures that the AED is checked for readiness after each
use and at least once every 30 days;
b) Ensures that any person who renders emergency care or
treatment by using an AED activates the emergency medical
services system as soon as possible and reports the use to
the licensed physician and to the local EMS agency;
c) Ensures that for every AED unit acquired up to five
units, no less than one employee per AED unit, and one
employee for every additional five units, complete a
training course in cardiopulmonary resuscitation (CPR) and
AED use, as specified.
d) Ensure that tenants in a building where an AED is placed
receive a brochure describing the proper use of an AED and
are notified once a year of the location of AEDs.
This bill:
1)Requires the following structures that are constructed on or
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after January 1, 2016, to have an AED on the premises subject
to the existing requirements listed in the Health and Safety
Code related to training and maintenance:
a) Assembly buildings, as defined, with an occupancy of
greater than 300;
b) Business buildings, educational buildings, factory
buildings, high-hazard buildings, institutional buildings,
mercantile buildings, and storage buildings, as each of
these buildings are defined, and if they have occupancies
of 200 or more; and
c) Residential buildings with occupancy of 200 or more,
excluding single-family and multi-family dwelling units.
2)Provides immunity from civil liability for a person or entity
that supplies an AED pursuant to this bill, as specified in
existing provisions of law that condition immunity on meeting
certain requirements related to training and maintenance of
the AEDs.
3)Excludes structures owned or operated by the state or any
local entity from the provisions of this bill.
Comments
1)Author's statement. According to the author, "an estimated
350,000 individuals in the United States will suffer this year
from a Sudden Cardiac Arrest (SCA). For every minute an
individual goes without receiving defibrillation from an AED,
an individual's chances of surviving from SCA go down by 10
percent. Brain death and permanent death start to occur 4-6
minutes after someone experiences cardiac arrest. The use of
an AED in a timely manner can increase an individual's
probability of survival by 70 percent. By requiring AED
devices in newly constructed buildings with large occupancies,
we can ensure that more individuals will be located within 4
minutes of an AED, substantially increasing their chance of
survival. In my district, the City of San Diego has
implemented a similar ordinance, and has supported Project
Heartbeat, which provides AEDs and has saved 123 individuals."
2)According to the American Heart Association (AHA), an AED is a
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lightweight, portable device that delivers an electric shock
through the chest to the heart. The shock can stop an
irregular rhythm and allow a normal rhythm to resume in a
heart in SCA. SCA is an abrupt loss of heart function. If it
is not treated within minutes, it quickly leads to death. The
AED has a built-in computer which assesses the patient's heart
rhythm, determines whether the person is in cardiac arrest,
and signals whether to administer the shock. Audible cues
guide the user through the process.
According to the AHA, each year in the U.S., there are
approximately 359,400 Emergency Medical Services
(EMS)-assessed cardiac arrests outside of a hospital setting
and on average, less than 10% of victims survive. Early
defibrillation, along with CPR, is the only way to restore the
victim's heart rhythm to normal in a lot of cases of cardiac
arrest. For every minute that passes without CPR and
defibrillation, however, the chances of survival decrease by 7
to 10%. The 2013 Update of AHA's Heart Disease and Stroke
Statistics shows that 23% of out-of-hospital cardiac arrests
are "shockable" arrhythmias, or those that respond to a shock
from an AED, making AEDs in public places highly valuable.
Yet, AHA states there are not enough AEDs and persons trained
in using them and performing CPR to provide this life-saving
treatment, resulting in lost opportunities to save more lives.
Communities with comprehensive AED programs that include CPR
and AED training for rescuers have achieved survival rates of
nearly 40% for cardiac arrest victims. AHA states on its Web
site that it supports placing AEDs in targeted public areas
such as sports arenas, gated communities, office complexes,
doctor's offices, and shopping malls. When AEDs are placed in
the community or a business or facility, AHA strongly
encourages that they be part of a defibrillation program which
includes notification to the local EMS office when an AED is
acquired, that a licensed physician or medical authority
provides medical oversight to ensure quality control, and that
persons responsible for using the AED are trained in CPR and
how to use an AED.
3)California Code of Regulations. In California's Building
Standards Code, Part 2, Chapter 3, buildings and structures
are classified with respect to use and occupancy in each of
the groups as follows:
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a) Defines Assembly Group A occupancy as including,
among others, the use of a building or structure, or
portion thereof, for the gathering of persons for purposes
such as civic, social, or religious functions; recreation,
food, or drink consumption or motion picture and television
production sound stages, approved production facilities and
production locations.
b) Defines Business Group B occupancy as including, among
others, the use of a building or structure, or portion
thereof, for office, professional, or service-type
transactions, including storage of records and accounts.
c) Defines Educational Group E occupancy as including,
among others, the use of a building or structure, or
portion thereof, by more than six persons at any one time
for educational purposes through the 12th grade, except a
residence used as a home school for the children who
normally reside at the residence.
d) Defines Factory Industrial Group F occupancy as
including, among others, the use of a building or
structure, or portion thereof, for assembling,
disassembling, fabricating, finishing, manufacturing,
packaging, repair or processing operations that are not
classified as a Group H hazardous or Group S storage
occupancy.
e) Defines High-hazard Group H occupancy as including,
among others, the use of a building or structure, or
portion thereof, that involves the manufacturing
processing, generation or storage of materials that
constitute a physical or health hazard in quantities in
excess of those allowed in control areas, as further
defined.
f) Defines Institutional Group I occupancy as including,
among others, the use of a building or structure, or
portion thereof, in which care or supervision is provided
to persons who are or are not capable of self-preservation
without physical assistance or in which persons are
detained for penal or correctional purposes or in which the
liberty of the occupants is restricted.
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g) Defines Mercantile Group M occupancy as including, among
others, the use of a building or structure, or portion
thereof, for the display and sale of merchandise and
involves stocks of goods, wares or merchandise incidental
to such purposes and accessible to the public.
h) Defines Residential Group R occupancy as including,
among others, the use of a building or structure, or
portion thereof, for sleeping purposes when not classified
as Group I occupancy or when not regulated by the
California Residential Code.
i) Defines Storage Group S occupancy as including,
among others, the use of a building or structure, or
portion thereof, for storage that is not classified as a
hazardous occupancy.
4)Verdugo v. Target. On August 31, 2008, Mary Ann Verdugo was
shopping at a large Target store in Pico Rivera with her
mother and brother when she suffered a SCA and collapsed. In
response to a 911 call, paramedics were dispatched from a
nearby fire station. It took the paramedics several minutes to
reach the store and a few additional minutes to reach Verdugo
inside the store. The paramedics attempted to revive Verdugo
but were unable to do so; Verdugo was 49 years of age at the
time of her death. Target did not have an AED in its store.
The Verdugo family filed a lawsuit alleging Target breached
the duty of care that it owed to its business customers,
including Mary Ann, by failing to have an AED for use in a
medical emergency. After moving the case from the Los Angeles
County Superior Court to the federal district court, the
federal district court dismissed the case after concluding
Target had no duty to acquire and make available an AED for
the use of its customers. The plaintiffs appealed to the Ninth
Circuit Court of Appeals, at which point the panel turned to
the California Supreme Court "as better positioned to address
[this] major question of California tort law than this court."
The California Supreme Court construed the Ninth Circuit Court
of Appeals' question as "whether, under California law, the
common law duty of reasonable care that defendant Target
Corporation owes to its business customers includes an
obligation to obtain and make available on its business
premises an [AED] for use in a medical emergency." On June 23,
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2014, the California Supreme Court answered the question by
ruling that, "[U]nder California law, Target's common law duty
of care to its customers does not include a duty to acquire
and make available an AED for use in a medical emergency." On
October 28, 2014, the Ninth Circuit Court of Appeals,
following the guidance of the California Supreme Court,
affirmed the federal district court's ruling that Target had
no common law duty to provide an AED in its stores.
Judge Pregerson, a panelist of the Ninth Circuit Court of
Appeals, in a separate opinion, wrote:
"The California Supreme Court has spoken. This decision
holds that 'under California law, Target's common law duty
of care to its customers does not include a duty to acquire
and make available an AED for use in a medical emergency.'
And so, in this diversity case, that holding controls. But
that decision troubles me. Therefore, I write separately
hoping that big box stores like Target will, at the very
least, recognize their moral obligation to make AEDs
available for use in a medical emergency. Should that not
come to pass, I hope that our California Legislature takes
a hard look at this issue and considers a statutory
standard of care that will protect consumers by requiring
big box stores to make life-saving AEDs available."
5)Other jurisdictions. In November 2008, the San Diego City
Council passed legislation with requirements nearly identical
to the provisions of this bill. Over the last six years, the
Oregon State Legislature has passed several pieces of
legislation relating to AEDs. In 2009, Oregon passed
legislation requiring certain places of public assembly,
defined as a facility of 50,000 square feet or more and at
least 50 individuals congregated on a normal business day, to
have AEDs. In 2010, Oregon also passed a law requiring each
school campus in a school district, private school campus and
public charter school campus to have at least one AED on
premises. Community colleges and public universities are also
required to have at least one AED on the campus in Oregon.
Related Legislation
SB 658 (Hill), as amended April 27, 2015, repeals and revises
various requirements relating to persons or entities who acquire
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AEDs and makes the civil liability immunity in existing law for
persons or entities who acquire an AED no longer conditional
upon meeting specified requirements.
Prior Legislation
SB 1436 (Lowenthal, Chapter 71, Statutes of 2012), removed the
sunset date, thereby making permanent, the existing protections
that provide immunity from civil damages in connection with the
use of AEDs.
SB 127 (Calderon, Chapter 500, Statutes of 2010) removed the
July 1, 2012 sunset date for existing requirements that every
health studio acquires and maintains an AED and trains personnel
in its use thereby extending these requirements indefinitely.
SB 63 (Price, 2011) would have stated the intent of the
Legislature that all public high schools acquire and maintain at
least one AED and would have require schools that decide to
acquire and maintain an AED, or to continue to use and maintain
an existing AED, to comply with specified requirements. SB 63
was held in the Senate Appropriations Committee.
AB 2083 (Vargas, Chapter 85, Statutes of 2006) extended the
sunset date from 2008 to 2013 on the operative provisions of
existing law which provide immunity from civil damages for
persons or entities that acquire AEDs and comply with
maintenance, testing, and training requirements.
AB 1507 (Pavley, Chapter 431, Statutes of 2005) required all
health studios in the state to have AEDs available with properly
trained personnel until July 1, 2012.
AB 2041 (Vargas, Chapter 718, Statutes of 2002) expanded the
immunity protections for the use or purchase of an AED, and
included a sunset date of 2008.
SB 911 (Figueroa, Chapter 163, Statutes of 1999) created
qualified immunity from civil liability for trained persons who
use in good faith and without compensation an AED in rendering
emergency care or treatment at the scene of an emergency.
FISCAL EFFECT: Appropriation: No Fiscal
Com.:NoLocal: No
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SUPPORT: (Verified5/14/15)
American Medical Response
California Professional Firefighters
California State Firefighters' Association
Madaffer Enterprises, Inc.
Paramedics Plus
San Diego City Fire Fighters Local 145
San Ysidro Health Center
Sudden Cardiac Arrest Foundation
OPPOSITION: (Verified5/14/15)
Building Owners and Managers Association of California
California Business Property Association
Commercial Real Estate Development Association, NAIOP of
California
International Council of Shopping Centers
ARGUMENTS IN SUPPORT: The California Professional
Firefighters supports this bill, stating that when an AED is
used to treat cardiac arrest, it serves as a life-saving device
given that cardiac arrest is a sudden condition that can be
fatal if not treated within a few minutes. Paramedics Plus,
Alameda's 911 EMS ambulance provider, also supports this bill,
stating that AEDs are inexpensive, easy to use, and save lives.
Paramedics Plus states that having access to an AED in a timely
manner can increase an individual's probability of a heart
attack by as much as 70%. Paramedics Plus also suggests an
amendment to this bill which would coordinate the location of
each AED in 911 EMS dispatch centers. By identifying the
location of AEDs, Paramedics Plus believes response times will
be cut in emergencies thus saving even more lives. The Sudden
Cardiac Arrest Foundation supports this bill by stating that by
requiring the deployment of AEDs as part of an emergency
response plan, there will be a more effective and efficient
emergency response system in California commercial properties.
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ARGUMENTS IN OPPOSITION: The California Business Properties
Association, Building Owners and Managers Association of
California, Commercial Real Estate Development Association, and
International Council of Shopping Centers all oppose this bill,
stating that advancements in technology in the use of AEDs has
made the existing standards for training and testing obsolete.
These opponents note that SB 648 (Hill, 2015) proposes to reform
these outdated requirements that have become barriers to
installation. Opponents state that mandating installation
before this reform has been enacted will put property owners and
tenants in an untenable position where they may be forced to
install a device but physically cannot comply with the training
requirements required by statute. Opponents also state that
building code has traditionally applied equally to all
structures based on occupancy, regardless of ownership.
Prepared by:Juan Reyes / HEALTH /
5/15/15 15:24:27
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