BILL ANALYSIS Ó
-----------------------------------------------------------------
|SENATE RULES COMMITTEE | SB 287|
|Office of Senate Floor Analyses | |
|(916) 651-1520 Fax: (916) | |
|327-4478 | |
-----------------------------------------------------------------
UNFINISHED BUSINESS
Bill No: SB 287
Author: Hueso (D)
Amended: 7/16/15
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
SENATE FLOOR: 28-3, 5/26/15
AYES: Allen, Beall, Block, Cannella, De León, Galgiani,
Hancock, Hernandez, Hertzberg, Hill, Hueso, Huff, Jackson,
Lara, Leno, Leyva, Liu, McGuire, Mendoza, Mitchell, Monning,
Nguyen, Pan, Pavley, Roth, Runner, Stone, Wolk
NOES: Anderson, Moorlach, Morrell
NO VOTE RECORDED: Bates, Berryhill, Fuller, Gaines, Hall,
Nielsen, Vidak, Wieckowski
ASSEMBLY FLOOR: 75-1, 8/27/15 - See last page for vote
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, 2017, to have an automated external defibrillator
(AED) on the premises.
SB 287
Page 2
Assembly Amendments 1) delay the operative date of this bill to
January 1, 2017; 2) clarify that the provisions of the bill
apply only to occupied buildings and not to structures that are
vacant or under construction or renovation; 3) remove storage
buildings and high-hazard buildings, and exempt licensed health
facilities, as specified, from the requirements of this bill; 4)
delete the state-owned or -operated exemption from the bill; and
5) conform the qualifications for immunity from civil liability
to those qualifications in existing law.
ANALYSIS:
Existing law:
1)Classifies, in the California Code of Regulations, all
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
SB 287
Page 3
services (EMS) 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 occupied structures that are
constructed on or after January 1, 2017, 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, institutional buildings, and mercantile
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 acquires 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 any local government
entity, storage buildings, as defined, high-hazard buildings,
as defined, and health facilities, as specified, from the
provisions of this bill.
SB 287
Page 4
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
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 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
SB 287
Page 5
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:
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
SB 287
Page 6
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.
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
SB 287
Page 7
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,
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
SB 287
Page 8
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."
FISCAL EFFECT: Appropriation: No Fiscal
Com.:YesLocal: No
According to the Assembly Appropriations Committee, likely minor
annual state costs, related to the purchase, installation, and
maintenance of AEDs and training on their use. These costs would
be from the General Fund and various special funds and would
depend on the number of applicable state buildings constructed
each year. At the state level, this bill mainly impacts the
Department of General Services (DGS), the Department of
Corrections and Rehabilitation, the University of California,
and the California State University. According to DGS, the cost
of an AED unit is about $2,000. In addition, DGS provides
training on AED operations through a contract costing $5,000
annually. Pending legislation would reduce training
requirements, however.
DGS notes that best practice is to have one AED on each floor,
or if a building is single-story, to have an AED within
one-minute walk of where any emergency could occur within the
building. While meeting these practices would increase costs,
this bill does not contain such requirements.
SUPPORT: (Verified8/28/15)
American Heart Association
American Medical Response
American Stroke Association
California Business Properties Association
California Professional Firefighters
SB 287
Page 9
California State Firefighters Association
City of Rancho Mirage
Madaffer Enterprises
Paramedics Plus
San Diego City Firefighters Local 145
San Diego Project Heart Beat
San Ysidro Health Center
Sudden Cardiac Arrest Foundation
OPPOSITION: (Verified8/28/15)
None received
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.
ASSEMBLY FLOOR: 75-1, 8/27/15
AYES: Achadjian, Alejo, Baker, Bigelow, Bloom, Bonilla, Bonta,
Brough, Brown, Calderon, Campos, Chang, Chau, Chávez, Chiu,
Chu, Cooley, Cooper, Dababneh, Dahle, Daly, Dodd, Eggman, Beth
Gaines, Gallagher, Cristina Garcia, Eduardo Garcia, Gatto,
Gipson, Gomez, Gonzalez, Gordon, Gray, Grove, Hadley, Roger
SB 287
Page 10
Hernández, Holden, Irwin, Jones, Jones-Sawyer, Kim, Lackey,
Levine, Linder, Lopez, Low, Maienschein, Mathis, Mayes,
McCarty, Medina, Melendez, Mullin, Nazarian, O'Donnell, Olsen,
Patterson, Perea, Quirk, Rendon, Ridley-Thomas, Rodriguez,
Salas, Santiago, Steinorth, Mark Stone, Thurmond, Ting,
Wagner, Waldron, Weber, Wilk, Williams, Wood, Atkins
NOES: Travis Allen
NO VOTE RECORDED: Burke, Frazier, Harper, Obernolte
Prepared by:Juan Reyes / HEALTH /
8/28/15 17:11:17
**** END ****