BILL NUMBER: AB 1369 AMENDED
BILL TEXT
AMENDED IN SENATE AUGUST 26, 2003
AMENDED IN SENATE AUGUST 18, 2003
AMENDED IN SENATE JULY 22, 2003
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 Machado, Romero, and Soto)
FEBRUARY 21, 2003
An act to add Section 1569.7 to and repeal
Section 1569.7 of 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 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 July 1, 2005,
and until January 1, 2010, would require every residential
care facility for the elderly, where the facility's licensed bed
capacity exceeds 60 persons, to acquire , and
maintain, and train personnel in the use of ,
automatic external defibrillators, as provided in the bill and
specified existing law. 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, the facility, 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 each resident, whether or
not he or she executes an advance health care directive, including,
but not limited to, a request to forego resuscitative measures or a
do-not-resuscitate order, shall indicate separately, in writing, if
he or she does not want facility employees to use an automatic
external defibrillator if he or she needs emergency care or treatment
prohibit a facility employee with the responsibility
to respond to emergencies from using an automatic external
defibrillator on a facility resident who has filed a Request to
Forego Resuscitative Measures or a Do Not Resuscitate (DNR) form
. The bill would also establish procedures to be used by
residential care facilities for the elderly with respect to the
presentation and maintenance of these written statements,
and would require facilities to provide residents with additional
specified information dissemination of specified
information regarding external automatic defibrillators and the
maintenance of lists of those residents who have filed a Request to
Forego Resuscitative Measures or a DNR form .
This bill would require the Emergency Medical Services Authority
to notify local EMS agencies of the provision
provisions of the bill, and to encourage the local agencies to
track the use of automatic external defibrillators in residential
care facilities for the elderly.
This bill would provide that, notwithstanding a specified
provision of existing law, violation of the bill shall not constitute
a misdemeanor.
This bill would also apply certain of its provisions
relating to liability to a residential care
facility for the elderly with a licensed capacity of 60 or fewer beds
that elects to acquire , and maintain,
and train personnel in the use of , an automatic external
defibrillator at the facility.
Vote: majority. Appropriation: no. Fiscal committee: yes.
State-mandated local program: no.
THE PEOPLE OF THE STATE OF CALIFORNIA DO ENACT AS FOLLOWS:
SECTION 1. Section 1569.7 is added to the Health and Safety Code,
to read:
1569.7. (a) Commencing 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 acquire,
acquire and maintain, and train personnel in the
use of , an automatic external defibrillator, pursuant to
Section 1797.190, subdivision (e)
subdivision (e), Section 1797.190 , and any relevant
regulations.
(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 (f).
(c) When an employee uses, or attempts to use, an automatic
external defibrillator consistent with the requirements of this
section to render emergency 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 (f).
(d) Except as provided in subdivision (f), when an employee uses,
or attempts to use an automatic external defibrillator in accordance
with this section to render emergency care or treatment, the facility
shall not be liable for civil damages resulting from any act or
omission in the course of rendering that emergency care or treatment,
provided that the facility fully complies with subdivision (e).
(e) In order to ensure public safety, a residential care facility
for the elderly shall do all of the following:
(1) Comply with all regulations governing the placement of an
automatic external defibrillator.
(2) Ensure all of the following:
(A) The automatic external defibrillator is maintained and
regularly tested according to the operation and maintenance
guidelines set forth by the manufacturer, the American Heart
Association, 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.
(B) The automatic external defibrillator is checked for readiness
after each use and at least once every 30 days if the automatic
external defibrillator has not been used in the preceding 30 days.
Records of these checks shall be maintained.
(C) Any person who renders emergency care or treatment on a person
in cardiac arrest by using an automatic external defibrillator
activates the emergency medical services system as soon as possible,
and reports any use of the automatic external defibrillator to the
licensed physician and to the local EMS agency.
(D) For every automatic external defibrillator unit acquired, up
to five units, no less than one employee per automatic external
defibrillator unit shall complete a training course in
cardiopulmonary resuscitation and automatic external defibrillator
use that complies with the regulations adopted by the Emergency
Medical Service Authority and the standards of the American Heart
Association or the American Red Cross. After the first five
automatic external defibrillator units are acquired, for each
additional five automatic external defibrillator units acquired, one
employee shall be trained beginning with the first automatic external
defibrillator unit acquired. Acquirers of automatic external
defibrillator units shall have trained employees available to respond
to an emergency that may involve the use of an automatic external
defibrillator unit during normal operating hours.
(E) There is a written plan that exists that describes the
procedures to be followed in the event of an emergency that may
involve the use of an automatic external defibrillator, to ensure
compliance with the requirements of this section. The written plan
shall include, but not be limited to, immediate notification of 911
and trained office personnel at the start of automatic external
defibrillator procedures.
(f) Subdivisions (b), (c), and (d) do 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.
(g) Each resident, whether or not he or she has executed an
advance health care directive, including, but not limited to, a
request to forego resuscitative measures or a do-not-resuscitate
order, shall indicate separately, in writing, if he or she does not
want facility employees to use an automatic external defibrillator.
If a resident has indicated in writing that he or she does not want
facility employees to use an automatic external defibrillator if he
or she needs emergency care or treatment, facility employees shall
withhold the use of an automatic external defibrillator.
(h) (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 statements indicating that a resident
does not want facility employees to use an automatic external
defibrillator if the resident needs emergency care or treatment, 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 indicated in writing that
they do not want facility employees to use an automatic external
defibrillator 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 each automatic external
defibrillator unit maintained in the facility. Statements indicating
that a resident does not want facility employees to use an automatic
external defibrillator 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) Prior to July 1, 2005, the facility shall inform current
residents or their responsible parties about automatic external
defibrillators and the resident's option to state in writing that he
or she does not want facility employees to use an automatic external
defibrillator if the resident needs emergency care or treatment. New
residents or their responsible parties shall be informed upon
admission about automatic external defibrillators and the resident's
option to state in writing that he or she does not want facility
employees to use an automatic external defibrillator if the resident
needs emergency care or treatment.
(4) Information about automatic external defibrillators 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 about
automatic external defibrillators and shall ask if a statement
indicating that the resident does not want facility employees to use
an automatic external defibrillator should be readdressed, changed,
or initiated, at the wishes and discretion of the resident or their
responsible parties. This shall be done at a minimum of once every
two years.
(6) If a resident of a residential care facility for the elderly
begins receiving hospice services from a licensed hospice, as defined
in Section 1339.31, the residential care facility for the elderly
shall provide information to that resident or their responsible party
about automatic external defibrillators and ask if a statement
indicating that the resident does not want facility employees to use
an automatic external defibrillator should be readdressed, changed,
or initiated at the wishes and discretion of the resident or their
responsible parties.
(g) Notwithstanding any other provision of law and for the sole
purpose of implementing this section, a facility employee having the
responsibility to respond to emergencies as provided in subparagraph
(D) of paragraph (2) of subdivision (e) shall observe any Request to
Forego Resuscitative Measures or any Do Not Resuscitate (DNR) form
filed by a facility resident, by not using an automatic external
defibrillator in an emergency case involving that resident.
(h) (1) In order to implement this section, residential care
facilities for the elderly shall establish policies and procedures,
or appropriately amend their current policies and procedures, to
provide for the dissemination of information regarding the
installation of an automatic external defibrillator in the facility
and its potential uses to current and prospective residents, or their
responsible parties. Information provided about automatic external
defibrillators shall include information consistent with that
published and distributed by the American Heart Association and the
American Red Cross on automatic external defibrillators.
(2) The facility shall maintain lists of those residents who have
filed a Request to Forego Resuscitative Measures or a DNR form. A
copy of the list shall be made available to employees trained in the
use of the automatic external defibrillator in the facility. A copy
of the list shall also be maintained with each automatic external
defibrillator maintained in the facility.
(i) 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.
(j) The Emergency Medical Service Authority shall notify local EMS
agencies of this section and shall encourage the local EMS agencies
to track the number of times automatic external defibrillators are
employed on residents at residential care facilities for the elderly.
(k) Notwithstanding Section 1569.40, violation of this section
shall not constitute a misdemeanor.
(l) Subdivisions (b), (c), and (d) (d),
(g), and (h) shall also apply to a residential care facility
for the elderly with a licensed bed capacity of 60 or fewer persons
that elects to acquire, acquire and
maintain, and train personnel in the use of , an automatic
external defibrillator at the facility.
(m) This section shall remain in effect only until January 1,
2010, and as of that date is repealed, unless a later enacted statute
that is enacted before January 1, 2010, deletes or extends that
date.