BILL NUMBER: AB 1369 AMENDED
BILL TEXT
AMENDED IN SENATE JULY 1, 2003
AMENDED IN SENATE JUNE 12, 2003
AMENDED IN ASSEMBLY MAY 7, 2003
AMENDED IN ASSEMBLY APRIL 21, 2003
INTRODUCED BY Assembly Member Pavley
(Coauthors: Assembly Members Calderon, Hancock, Koretz, Maze,
Mullin, and Vargas)
(Coauthors: Senators Figueroa, Machado, Romero, and Soto)
FEBRUARY 21, 2003
An act to add Section 1569.6 to the Health and Safety Code,
relating to residential care facilities for the elderly.
LEGISLATIVE COUNSEL'S DIGEST
AB 1369, as amended, Pavley. Residential care facilities for the
elderly: automatic external defibrillators.
Existing law authorizes the Emergency Medical Services Authority
to establish minimum standards for the training and use of automatic
external defibrillators by individuals not otherwise licensed or
certified for the use of the device.
Under existing law, the State Department of Health Services
licenses and regulates skilled nursing and intermediate care
facilities.
Under existing law, the State Department of Social Services
licenses and regulates residential care facilities for the elderly.
A violation of provisions relating to residential care facilities
for the elderly is a crime.
This bill would, commencing January July
1, 2005, require every residential care facility for the
elderly, where the facility's licensed bed capacity exceeds 60
persons to purchase, use in accordance with law, and train
personnel in the use of, automatic external defibrillators. This
bill would also provide that, except as prescribed, when an employee
of a residential care facility for the elderly uses or attempts
to use an automatic external defibrillator to render emergency
care or treatment in a manner consistent with the bill, neither the
employee nor the board of directors of that facility is liable for
civil damages resulting from any acts or omissions in rendering the
emergency care or treatment.
This bill would provide that, if a residential care facility for
the elderly resident executes an advance health care directive,
including, but not limited to, a request to forego
resuscitative measures , an advanced directive, or
a do-not-resuscitate order, the resident shall indicate separately,
in writing by using a "Do Not AED" order , if he or she
does not want facility employees to use an automatic external
defibrillator if he or she needs emergency care or treatment.
The bill would also establish procedures to be used by facilities
with respect to the presentation and maintenance of "Do Not AED"
orders, and would require facilities to provide residents with
additional specified information.
Because this bill would create a new crime, it would impose new
duties upon local law enforcement agencies, thus constituting a
state-mandated local program.
The California Constitution requires the state to reimburse local
agencies and school districts for certain costs mandated by the
state. Statutory provisions establish procedures for making that
reimbursement.
This bill would provide that no reimbursement is required by this
act for a specified reason.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: yes.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1569.6 is added to the Health and Safety Code,
to read:
1569.6. (a) Commencing January July
1, 2005, every residential care facility for the elderly as defined
in Section 1569.2 with a licensed bed capacity that exceeds 60
persons shall purchase, use in accordance with law, and
train personnel in the use of, an automatic external defibrillator
pursuant to Section 1797.190 and paragraphs (1) and (2) of
subdivision (b) of Section 1797.196.
(b) An employee of a residential care facility for the elderly who
uses , or attempts to use, an automatic external
defibrillator consistent with the terms of this section to render
emergency care or treatment is not liable for civil damages resulting
from any acts or omissions in rendering the emergency care or
treatment, except as provided in subdivision (d).
(c) When an employee uses , or attempts to use, an
automatic external defibrillator consistent with the requirements of
this section to render emergency medical care or
treatment, the members of the board of directors of the facility
shall not be liable for civil damages resulting from any act or
omission in rendering the emergency care or treatment, except as
provided in subdivision (d).
(d) Subdivision (b) does not apply in the case of personal injury
or wrongful death that results from gross negligence or willful or
wanton misconduct on the part of the person who uses an automatic
external defibrillator to render emergency care or treatment.
(e) (1) This section may not be construed to permit the use of an
automatic external defibrillator contrary to an advance health
care directive, including, but not limited to, a request to
forego resuscitative measures , advance directives, or
a do-not-resuscitate orders
order .
(2) If a resident executes an advance health care directive,
including, but not limited to, a request to forego
resuscitative measures , an advance directive, or
a do-not-resuscitate order, the resident shall indicate separately,
in writing by executing a "Do Not AED" order , if he or
she does not want facility employees to use an automatic external
defibrillator if he or she needs emergency care or treatment.
Notwithstanding any advance health care directive to the contrary, if
a resident has executed a "Do Not AED" order, employees trained in
the use of automatic external defibrillators may withhold the use of
an automatic external defibrillator.
(f) For residents who have not completed an advance health care
directive, as specified in this section, a residential care facility
for the elderly shall present a "Do Not AED" order to residents or
their responsible parties, which will allow residents to document
their wishes on the use of the device.
(g) (1) In order to implement this section, residential care
facilities for the elderly shall establish policies or procedures, or
appropriately amend their current policies and procedures, to
address the presentation, processing, maintenance, revision, and
information-dissemination of "Do Not AED" orders, and to the extent
possible, make these processes consistent with current systems for
advance health care directives pursuant to Section 1569.156.
(2) Lists of those residents who have completed a "Do Not AED"
order shall be made available to employees trained in the use of the
automatic external defibrillator in the facility, and a copy of the
list shall be maintained with the automatic external defibrillator
unit, or units if more than one is maintained in the facility. "Do
Not AED" orders shall be maintained in the resident file, with copies
in other locations where advance health care directives are also
stored and maintained in the facility.
(3) "Do Not AED" orders for new residents shall be presented and
discussed upon admission. The presentation and discussion of these
orders may be conducted at the time that advance health care
directives would also be presented and discussed with the prospective
resident.
(4) Prior to implementing this section, the facility shall inform
current residents or their responsible parties about automatic
external defibrillators and "Do Not AED" orders. Information
provided to residents shall include information consistent with that
published and distributed by the American Heart Association and the
American Red Cross on automatic external defibrillators.
(5) The facilities shall provide information, when possible and
appropriate, to residents or their responsible parties asking if a
"Do Not AED" order should be readdressed or changed, at the wishes
and discretion of the resident or their responsible parties. This
shall be done in a method to be determined by the policies and
procedures and at a minimum of once every two years.
(6) Issues of implementation not addressed in this section shall
be subject to the policies and procedures of the facility, to the
extent that they are consistent with existing law and regulations.
(h) The department may adopt emergency regulations to implement
this section in accordance with the rulemaking provisions of the
Administrative Procedure Act (Chapter 3.5 (commencing with Section
11340) of Part 1 of Division 3 of Title 2 of the Government Code).
The initial adoption of emergency regulations and one readoption of
the initial regulations shall be deemed to be an emergency and
necessary for the immediate preservation of the public peace, health
and safety, or general welfare. Initial emergency regulations and
the first readoption of those regulations shall be exempt from review
by the Office of Administrative Law. The initial emergency
regulations and the first readoption of those regulations authorized
by this subdivision shall be submitted to the Office of
Administrative Law for filing with the Secretary of State and
publication in the California Code of Regulations and each shall
remain in effect for no more than 180 days.
(i) Nothing in this section shall apply to a resident receiving
hospice services from a licensed hospice, as defined in Section
1339.31, who has completed an advance health care directive, as
defined in Section 4605 of the Probate Code, or a request to forego
resuscitative measures, as defined in Section 4780 of the Probate
Code.
SEC. 2. No reimbursement is required by this act pursuant to
Section 6 of Article XIII B of the California Constitution because
the only costs that may be incurred by a local agency or school
district will be incurred because this act creates a new crime or
infraction, eliminates a crime or infraction, or changes the penalty
for a crime or infraction, within the meaning of Section 17556 of the
Government Code, or changes the definition of a crime within the
meaning of Section 6 of Article XIII B of the California
Constitution.