BILL ANALYSIS
AB 1369
Page 1
ASSEMBLY THIRD READING
AB 1369 (Pavley)
As Amended May 7, 2003
Majority vote
HUMAN SERVICES 5-0 APPROPRIATIONS 19-2
-----------------------------------------------------------------
|Ayes:|Wolk, Dutra, Lieber, |Ayes:|Steinberg, Berg, |
| |Ridley-Thomas, Mullin | |Calderon, Lowenthal, |
| | | |Laird, Diaz, Firebaugh, |
| | | |Goldberg, Leno, |
| | | |Maldonado, Nation, |
| | | |Negrete McLeod, Nunez, |
| | | |Pavley, Ridley-Thomas, |
| | | |Simitian, Wiggins, Yee, |
| | | |Chu |
| | | | |
|-----+--------------------------+-----+--------------------------|
| | |Nays:|Haynes, Runner |
| | | | |
-----------------------------------------------------------------
SUMMARY : Requires residential care facilities for the elderly
(RCFEs) with more than 60 beds, commencing January 1, 2005, to
purchase automatic external defibrillators (AEDs) and train
their staff in their use. Specifically, this bill :
1)Provides that the training of RCFE personnel and use of AEDs
must meet any minimum standards established by the Emergency
Medical Services Authority (EMSA).
2)Consistent with existing statutes regarding individuals or
entities who acquire AEDs, requires all RCFEs to comply with
all regulations governing the placement of an AED, to ensure
that the AED is maintained and regularly tested according to
operation and maintenance guidelines, to ensure that the AED
is checked for readiness after each use or at least once every
30 days, whichever is sooner, and to have a written plan that
describes the procedures to be followed in the event of an
emergency that may involve the use of an AED.
3)Requires at least one employee per AED unit in the RCFE to
complete a training course in CPR and AED use that complies
with regulations adopted by EMSA and the standards of the
American Heart Association or the Red Cross.
AB 1369
Page 2
4)Requires the RCFE to have trained employees who should be
available to respond to an emergency that may involve the use
of an AED unit during normal operating hours.
5)Extends the protections of the Good Samaritan law to employees
of the RCFE, providing immunity from liability to an employee
of the RCFE for civil damages resulting from an acts or
omissions in rendering the emergency care or treatment of a
resident by use of an AED, except in the case of personal
injury or wrongful death that results from gross negligence or
willful or wanton misconduct.
6)Clarifies that the requirement to render emergency treatment
by use of an AED does not authorize its use contrary to a
request to forego resuscitative measures, an advance
directive, or do-not resuscitate order.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, this bill has no impact on state or local government
costs.
COMMENTS : According to the author, "[a]t least 450,000 cases of
unexpected cardiac arrest occur annually in the United States,
and the majority of these cases occur in places other than
hospitals. Studies have shown that when defibrillators are used
immediately on cardiac arrest victims, the survival rate is
almost 100 percent. But because traditional emergency medical
services take 8 to 15 minutes to respond, the overall survival
rates for cardiac arrest victims in most U.S. communities are
only 5 to 10 percent." The author further notes that "[d]espite
the proven success of quick defibrillation, and the availability
of . . . AEDs that can be easily placed in a variety of
locations and used by non-medical personnel, facilities that
house and care for senior citizens oftentimes do not have AEDs
on the facilities' premises."
This bill mandates that large RCFEs (with a bed capacity
exceeding 60 persons) maintain and operate AEDs. As part of
this requirement, training of personnel must be consistent with
any minimum standards established by the Emergency Medical
Services Authority. RCFEs must ensure that the AED is
maintained and regularly tested, periodically checked for
readiness, and that records of those checks are maintained.
Additionally, at least one employee per AED unit in the RCFE is
AB 1369
Page 3
required to complete a training course in CPR and AED use that
complies with regulations adopted by EMSA and the standards of
the American Heart Association or the Red Cross. Furthermore,
the RCFE is required to have trained employees who "should be"
available to respond to an emergency that may involve the use of
an AED unit during normal operating hours.
Although state regulations do permit RCFEs to maintain and
operate AEDs, it appears few currently do so. This bill would
turn the permissive regulation into a mandate for the larger
RCFEs. In exchange for imposing this mandate, this bill extends
the good samaritan protections that exist for those who render
aid "in good faith" and "not for compensation" to employees of
the RCFE who render treatment by the use of an AED. The
immunity from liability does not exist to the extent that the
injury or death that resulted was due to an employee's gross
negligence or willful or wanton misconduct.
According to the author, the approximate cost of an AED is
$3,000. Additionally, standard CPR training by the American Red
Cross, which includes training on AED use, costs $45 per case.
The author comments that "this cost . . . is negligible when
compared with the cost the state and the counties incur when
having to care for patients that sustain major medical injuries
and disabilities as a result of tardy resuscitation." The
actual cost to the RCFE is unknown, depending on the number of
staff that must be trained and how often such training must be
repeated.
As noted above, this bill would require RCFEs to have trained
employees who should be available to respond to an emergency
that may involve the use of an AED unit during normal operating
hours. The normal operating hours for RCFEs are 24 hours a day.
This requirement likely means, therefore, that there needs to
be trained personnel available on every shift, at least one per
AED, who could respond in case of an emergency.
Analysis Prepared by : Donna S. Hershkowitz / HUM. S. / (916)
319-2089
FN: 0001150