BILL ANALYSIS Ó
SB 287
Page 1
Date of Hearing: July 7, 2015
ASSEMBLY COMMITTEE ON BUSINESS AND PROFESSIONS
Susan Bonilla, Chair
SB 287(Hueso) - As Amended June 23, 2015
SENATE VOTE: 28-3
NOTE: This bill is double-referred, and if passed by this
Committee, it will be referred to the Assembly Judiciary
Committee.
SUBJECT: Automated external defibrillators (AEDs).
SUMMARY: 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.
EXISTING LAW:
1)Exempts from civil liability 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. (Civil Code (CIV)
Section 1714.21)
2)Exempts from civil liability a person or entity that provides
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CPR and AED training to a person who renders emergency care
pursuant to 1). (CIV Section 1714.21(c))
3)Exempts from civil liability a person or entity that acquires
an AED for emergency use pursuant to these provisions if that
person or entity has complied with the requirements in the
Health and Safety Code (HSC) pertaining to maintenance,
training, and use relating to AEDs, as specified. (CIV
Section 1714.21(d))
4)Exempts from civil liability a physician who is involved with
the placement of an AED and any person or entity responsible
for the site where an AED is located if that physician,
person, or entity has complied with the requirements in the
HSC pertaining to maintenance, training, and use relating to
AEDs, as specified, that apply to that physician, person, or
entity. (CIV Section 1714.21(e))
5)Provides that these protections do not apply in the case of
personal injury or wrongful death that result from the gross
negligence or willful or wanton misconduct of the person who
renders emergency care or treatment by the use of an AED.
(CIV Section 1714.21(f))
6)Provides that nothing in these provisions shall relieve a
manufacturer, designer, developer, distributor, installer, or
supplier of an AED or defibrillator of any liability under any
applicable statute or rule of law. (CIV Section 1714.21(g))
7)Authorizes the Emergency Medical Services Authority
(Authority) to establish minimum standards for the training
and use of AEDs. (Health and Safety Code (HSC) Section
1797.190)
8)To ensure public safety, exempts from civil liability any
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person or entity that acquires an AED if that person or entity
does all of the following:
a) Complies with all regulations governing the placement of
an AED. (HSC Section 1797.196(b)(1))
b) Ensures all of the following:
i) The AED is maintained and regularly tested according
to the operation and maintenance guidelines set forth by
the manufacturer, the American Heart Association (AHA),
and the American Red Cross, and according to any
applicable rules and regulations set forth by the
governmental authority under the federal Food and Drug
Administration and any other applicable state and federal
authority;
ii)The AED is checked for readiness after each use and at
least once every 30 days if the AED has not been used in
the preceding 30 days, and requires records of these
checks to be maintained;
iii)Any person who renders emergency care or treatment on a
person in cardiac arrest by using an AED activates the
emergency medical services system as soon as possible,
and reports any use of the AED to the licensed physician
and to the local EMS agency;
iv)For every AED unit acquired up to five units, no less
than one employee per AED unit complete a training course
in cardiopulmonary resuscitation (CPR) and AED use that
complies with the regulations adopted by the Authority
and the standards of the AHA or the American Red Cross,
and require an additional employee trained for each
additional five AED units acquired, as specified.
Requires those with AEDs to have trained employees who
should be available to respond to an emergency that may
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involve the use of an AED unit during normal operating
hours; and
v) There is a written plan that describes the
procedures to be followed in the event of an emergency
that may involve the use of an AED, to ensure compliance
with the requirements of provisions, and requires the
plan to include immediate notification of 911 and trained
office personnel at the start of AED procedures. (HSC
Section 1797.196(b)(2))
c) When an AED is placed in a building, requires building
owners to:
i) Ensure that tenants annually receive a brochure,
approved as to content and style by the American Heart
Association or American Red Cross, which describes the
proper use of an AED, and that similar information is
posted next to any installed AED; and
ii)Notify their tenants at least annually as to the
location of AED units in the building. (HSC Section
17971.196(b)(3),(4))
d) When an AED is placed in a public or private K-12
school, requires the principal to:
i) Ensure that the school administrators and staff
annually receive a brochure, approved as to content and
style by the American Heart Association or the American
Red Cross, that describes the proper use of an AED, and
that similar information is posted next to every AED;
ii)Notify school employees at least annually as to the
location of all AED units on the campus; and
iii)Designate the trained employees who shall be available
to respond to an emergency that may involve the use of an
AED during normal operating hours, as specified. (HSC
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Section 1797.196(b)(5))
9)Requires any person or entity that supplies an AED to do all
of the following: (HSC Section 17971.196(c))
a) Notify an agent of the local Emergency Medical Services
agency of the existence, location, and type of AED
acquired. (HSC Section 17971.196(c)(1))
b) Provide to the acquirer of the AED all information
governing the use, installation, operation, training, and
maintenance of the AED. (HSC Section 17971.196(c)(2))
10)Provides that a violation of this provision is not subject to
a misdemeanor, as specified. (HSC Section 17971.196(d))
11)Provides that these protections do not apply in the case of
personal injury or wrongful death that result from the gross
negligence or willful or wanton misconduct of the person who
renders emergency care or treatment by the use of an AED.
(HSC Section 17971.196(e))
12)Provides that nothing in these provisions or Section 1714.21
of the CIV may be construed to require a building owner or a
building manager to acquire and have installed an AED in any
building. (HSC Section 17971.196(f))
THIS BILL:
13)Requires the following structures that are constructed on or
after January 1, 2016, as defined in the California Building
Standards Code, to have an AED on the premises subject to the
existing requirements listed in the HSC relating to
maintenance, training, and use:
a) Assembly buildings, as defined, with an occupancy of
greater than 300;
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b) Business buildings, educational buildings, factory
buildings, high-hazard buildings, institutional buildings,
mercantile buildings, and storage buildings, excluding
parking garages, as each of these buildings are defined,
and if they have occupancies of 200 or more; and,
c) Residential buildings, as defined, with occupancy of 200
or more, excluding single-family and multi-family dwelling
units.
14)Exempts from civil liability a person or entity that supplies
an AED pursuant to these provisions, as specified in existing
provisions of the CIV and the HSC that condition immunity on
meeting certain requirements related to maintenance, training,
and use of an AED, as specified.
15)Excludes structures owned or operated by any local entity
from the provisions of this bill.
FISCAL EFFECT: Unknown. This bill is keyed "fiscal" by the
Legislative Counsel.
COMMENTS:
Purpose. This bill is sponsored by the author. 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%. 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%. By requiring AED
devices in newly constructed buildings with large occupancies,
we can ensure that more individuals will be within 4 minutes of
an AED, substantially increasing their chance of survival. In
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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."
AEDs. An AED is a lightweight, battery-operated portable device
that checks the heart rhythm and can deliver an electric shock
through the chest to the heart to try to restore a normal heart
rhythm. AEDs are used to treat SCA. An SCA is a condition in
which the heart suddenly and unexpectedly stops beating, which
stops blood flowing to the brain and other vital organs.
According to the AHA most SCAs result from ventricular
fibrillation ("v-fib"). This is a rapid and unsynchronized
heart rhythm starting in the heart's lower pumping chambers, or
the ventricles, which is a type of arrhythmia. The heart must
be defibrillated quickly, because a victim's chance of surviving
drops by 10 percent for every minute a normal heartbeat is not
restored. According to the National Heart, Lung, and Blood
Institute of the National Institutes of Health (NHLBI), 95% of
people who have SCA die from it within minutes.
A built-in computer in the AED checks a victim's heart rhythm
through adhesive electrodes, and calculates whether
defibrillation is needed. If defibrillation is needed, a
recorded voice instructs the rescuer to press the shock button
on the AED. This shock momentarily stuns the heart and stops
all activity, giving the heart the chance to resume beating
effectively. Instructions guide the user through the process,
and the device prompts the user to let them know if and when
they should send a shock to the heart. AEDs advise a shock only
for ventricular fibrillation or another life-threatening
condition relating to the heart. According to the NHLBI,
"?learning how to use an AED and taking a CPR course are
helpful. However, if trained personnel aren't available,
untrained people can also use an AED to help save someone's
life."
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According to the AHA, AEDs are safe to use by anyone who's been
trained to use them, and studies have shown that 90 percent of
the time AEDs are able to detect a rhythm that should be
defibrillated, and 95 percent of the time, AEDs are able to
recommend not shocking when the computer shows defibrillation is
not indicated. According to the NHLBI, AEDs are "?safe to use.
There are no reports of AEDs harming bystanders or users. Also,
there are no reports of AEDs delivering inappropriate shocks."
According to the AHA, most AEDs are estimated to cost $1,500 to
$2,000.
Building Classifications. The California Building Standards
Code classifies buildings and structures by 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. This bill would
require specified private and state structures, as defined in
the California Building Standards Code, to have AEDs on
premises. These structures include the following:
1) Assembly Group A buildings with an occupancy of greater
than 300, including a building or structure, or portion
thereof, used 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 (e.g., theaters, banquet halls,
restaurants, bars, libraries, museums).
2) Business Group B buildings with an occupancy of 200 or
more, including a building or structure, or portion
thereof, used for office, professional, or service-type
transactions, including storage of records and accounts
(e.g. banks, salons, professional services offices, some
colleges).
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3) Educational Group E buildings with an occupancy of 200
or more, including a building or structure, or portion
thereof, used 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, or specified day care
facilities.
4) Factory Industrial Group F buildings with an occupancy
of 200 or more, including a building or structure, or
portion thereof, used 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.
5) High-hazard Group H buildings with an occupancy of 200
or more, including 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.
6) Institutional Group I buildings with an occupancy of 200
or more, including 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 (e.g. custodial care
facilities, hospitals, jails, prisons, nursing homes).
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7) Mercantile Group M buildings with an occupancy of 200 or
more, including a building or structure, or portion
thereof, used for the display and sale of merchandise and
involving stocks of goods, wares or merchandise incidental
to such purposes and accessible to the public (e.g.
department stores, markets, retail stores).
8) Residential Group R buildings with an occupancy of 200
or more, including a building or structure, or portion
thereof, used for sleeping purposes when not classified as
Group I occupancy or when not regulated by the California
Residential Code (e.g. boarding houses, hotels, assisted
living facilities, social rehabilitation facilities, group
homes).
9) Storage Group S buildings with an occupancy of 200 or
more, including a building or structure, or portion
thereof, used for storage that is not classified as a
hazardous occupancy. The bill specifically exempts parking
garages.
Other AED programs. In 2013, Oregon passed a law that required
owners of a place of public assembly, defined as a single
building that has 50,000 square feet or more of indoor floor
space and where the public congregates for purposes such as
deliberation, shopping, entertainment, amusement or awaiting
transportation, or where business activities are conducted and
at least 50 individuals congregate on a normal business day, to
have on the premises at least one AED.
In 2008, the City of San Diego passed an ordinance, which this
bill is modeled after, in part, requiring the placement of AEDs
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in all newly constructed buildings in the same occupancy groups
with the same occupant loads as specified in this bill. This
ordinance also required AEDs to be located in a place to
optimally achieve a three minute response time to the person in
need of emergency care, and placed other requirements on
building owners relating to the maintenance, recordkeeping,
training, and use of the AED, as specified. According to the
San Diego Project Heart Beat, the City's Public Access
Defibrillation/CPR Program managed by the San Diego Fire-Rescue
Department operated jointly with Rural/Metro Ambulance, over 123
lives have been saved as a result of the program.
Current Related Legislation. SB 658 (Hill), revises the
maintenance, training, and use requirements for placement of
AEDs in commercial buildings and K-12 schools that are
conditions for obtaining qualified immunity from civil liability
for the selection, installation, placement, and use of AEDs in
those facilities. STATUS: This bill is pending on the Assembly
Floor.
AB 2217 (Melendez) Chapter 812, Statutes of 2014, authorized a
public school to solicit and receive nonstate funds to acquire
and maintain an AED; provided that the employees of the school
district are not liable for civil damages resulting from certain
uses, attempted uses, or nonuses of an AED, except as provided;
and provided that a public school or school district that
complies with certain requirements related to an AED is not
liable for any civil damages resulting from any act or omission
in the rendering of the emergency care or treatment, except as
specified.
Prior Related Legislation. SB 1436 (Lowenthal), Chapter 71,
Statutes of 2012, removed the sunset date for civil immunity in
connection with the use of AEDs, thereby making that immunity
permanent.
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SB 1281 (Padilla) of 2010, would have repealed provisions
relating to the maintenance, training, and use of AEDs. NOTE:
This bill was held in the Senate Judiciary Committee.
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) of 2011, would have authorized a public high
school to solicit and receive nonstate funds to acquire and
maintain an AED, and require a public high school that acquired
an AED, or continued to use an AED, to comply with specified
requirements. NOTE: This bill was held in the Senate
Appropriations Committee.
AB 1312 (Swanson) of 2009, would have made existing requirements
for health studios to purchase, maintain, and train staff in the
use of automatic external defibrillators applicable to amusement
parks and golf courses, and revised the sunset date on this
requirement from July 1, 2012 to July 1, 2014. NOTE: This bill
was vetoed by Governor Schwarzenegger due to the lack of a
"?compelling need to extend the 2012 sunset date at this time,
especially when a reasonable exemption for a particular type of
business model was sought and rejected."
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
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health studios in the state to have AEDs available with properly
trained personnel until July 1, 2012.
AB 1145 (Shirley Horton) Chapter 5, Statutes of 2004, required
the Department of General Services to apply for specified
federal funds for the purchase of automated external
defibrillators to be located within state-owned and leased
buildings, as specified.
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.
ARGUMENTS IN SUPPORT:
According to the California Professional Firefighters , "When
lives are on the line, every second counts. And, 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. Because [this bill]
would enhance the likelihood of a cardiac arrest victim's
survival by making AEDs readily available in these instances, we
urge your support for SB 287."
According to the American Heart Association (AHA) and the
American Stroke Association , "Every year there are over 300,000
out-of-hospital cardiac arrests in the United States. Sadly,
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only 10 percent of victims who suffer a cardiac arrest outside
of a hospital setting survive, largle in part because many
victims do not receive timely CPR or AED application. We support
placing AEDs in targeted public areas such as sports arenas,
gated communities, office complexes, doctor's offices, shopping
malls and other public venues. When AEDs are placed in the
community or a business or facility, the AHA strongly encourages
that they be part of a public access to defibrillation program."
According to the Sudden Cardiac Arrest Foundation , "The
likelihood of survival from SCA decreases by about 10 percent
each minute from the time of collapse until the time of
treatment with a defibrillator. If the victim is not treated
with a defibrillator within 10 minutes of collapse, survival is
unlikely. Unfortunately, even the best emergency medical
services typically cannot arrive at the scene of an emergency
within 10 minutes of collapse?.AEDs are safe, effective, and
designed for use by laypersons. They provide simple audio and
visual instructions. They automatically diagnose potentially
life-threatening heart rhythms. If an AED detects a problem
that may respond positively to an electric shock, it permits a
shock to be delivered to restore a normal heart rhythm. Given
these facts and the fact that AEDs are increasing
affordable?[,b]y requiring AED deployment as part of an
emergency response plan, we can secure a more effective and
efficient emergency response system in California commercial
properties."
ARGUMENTS IN OPPOSITION:
The California Business Properties Association , Commercial Real
Estate Development Association , International Council of
Shopping Centers , and the Building Owners and Managers
Association of California , all write in opposition, "Because of
the life-saving potential of AEDs and their proven efficacy, we
too encourage accessibility of these devices in places where
cardiac arrest may be a significant risk. Many of our members
currently have them installed in their buildings today. As such
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we have support reform of the statute that would remove outdated
requirements which have become barriers to installation. This
year, those reform provisions are contained in SB 658
(Hill)?.Therefore, mandating installation of AEDs while ignoring
this reform 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. Additionally, SB 287 requires mandatory
installation on private property only as it exempts buildings
owned by state and local entities. Building code traditionally
applies equally to all structured based on occupancy regardless
of ownership. Such a parsing of ownership for these purposes
would set a bad precedent. People in public buildings should
have the same protections as people in private buildings."
POLICY ISSUES:
The author may wish to exempt storage and high-hazard building
and use occupancy classifications from this bill. While the
200 person or more occupancy would still apply, those building
classifications tend to be more associated with industrial
uses, rather than the types of public places in which the bill
seeks to increase the availability of AEDs. In addition,
because licensed health care facilities already employ the use
of AEDs and other similar lifesaving devices, the author may
wish to explicitly exempt these facilities from the
requirements of this bill.
The author may also wish to consider delaying the operative date
of this bill to ensure that property owners have sufficient
time to prepare to meet the requirements of this bill, and
that local jurisdictions that seek to make conforming changes
to local ordinances have ample time to do so. In addition,
while the bill only requires that these provisions apply to
newly constructed buildings, the author may wish to clarify
that these provision do not apply to unoccupied buildings.
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AMENDMENT(S):
1)On page 2, strike lines 21-22 and lines 29-30 from the bill,
to exempt Group H high-hazard buildings and storage buildings.
2)On page 3, strike lines 7-9 and insert former subdivision (c)
and new provisions as follows:
(c) This chapter does not apply to the following:
(1) A structure or subdivision in subdivision (a)
that is owned or operated by any local government
entity.
(2) A facility licensed pursuant to subdivision
(a), (b), (c), or (f) of Section 1250."
(3) Vacant or unoccupied buildings or buildings
under construction or renovation.
(d) This chapter shall become operative on January 1, 2017.
REGISTERED SUPPORT:
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American Heart Association
American Medical Response
American Stroke Association
California Professional Firefighters
California State Firefighters' Association
Madaffer Enterprises, Inc.
Paramedics Plus
San Diego Fire Fighters Local 145
San Ysidro Health Center
Sudden Cardiac Arrest Foundation
REGISTERED OPPOSITION:
California Business Properties Association
Building Owners and Managers Association of California
Commercial Real Estate Development Association, NAIOP of
California
International Council of Shopping Centers
Analysis Prepared by:Eunie Linden / B. & P. / (916) 319-3301