BILL ANALYSIS                                                                                                                                                                                                    





                                                                AB 1312

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        GOVERNOR'S VETO
        AB 1312 (Swanson)
        As Amended  August 17, 2009
        2/3 vote

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        |ASSEMBLY:  |77-0 |(May 18, 2009)  |SENATE: |24-9 |(September 2,  |
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        |ASSEMBLY:  |76-2 |(September 9,   |        |     |               |
        |           |     |2009)           |        |     |               |
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         Original Committee Reference:    JUD.  

         SUMMARY  :  Seeks to extend the requirement that all health studios in  
        California have automatic external defibrillators (AEDs) available  
        with AED-trained personnel present to help save the lives of club  
        members who might experience cardiac arrest, and seeks to require  
        that golf clubs and amusement parks also provide visitors with AED  
        assistance in case of a cardiac arrest.  Specifically,  this bill   
        extends:

        1)By five years the sunset date of the requirement in Health and  
          Safety Code Section 104113, that every health studio, as defined  
          in Civil Code Section 1812.81, acquire AED devices, train  
          personnel in their proper use, and maintain AED-trained personnel  
          on site during all operating hours, such that the new sunset will  
          be July 1, 2014.  

        2)The requirement, to include golf courses and amusement parks,  
          requiring these facilities to acquire AED devices, train personnel  
          in their proper use, and maintain AED-trained personnel on site  
          during all operating hours.  
         
        The Senate amendments  require a record of a readiness check of an  
        AED be maintained for two years after the readiness check and  
        clarify that the qualified immunity continues after the sunset date.
         









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        EXISTING LAW  :  

        1)Provides immunity from civil liability to any person who, in good  
          faith and without compensation or the expectation of compensation,  
          renders emergency care at the scene of an emergency.  

        2)Provides immunity from civil liability to any person who completes  
          a designated CPR course and who, in good faith, renders emergency  
          cardiopulmonary resuscitation at the scene of an emergency,  
          without the expectation of receiving compensation for providing  
          the emergency care.  

        3)Exempts from civil liability any local agency, entity of state or  
          local government, or other public or private organization which  
          sponsors, authorizes, supports, finances, or supervises the  
          training of citizens in cardiopulmonary resuscitation (CPR).  

        4)Provides immunity from liability for certain trained persons who  
          in good faith and without compensation use an AED in rendering  
          emergency care or treatment at the scene of an emergency.  This  
          qualified immunity does not apply in the case of personal injury  
          or wrongful death resulting from the AED operator's gross  
          negligence or willful or wanton misconduct.  Nor does it apply to  
          the manufacturer, designer, developer, distributor, installer, or  
          supplier of an AED or defibrillator.  It only applies to:

           a)   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, when the person has completed a  
             specified training course within the preceding 12 months;

           b)   A person or entity who provides CPR and AED training to the  
             "Good Samaritan" rendering emergency care with the use of an  
             AED;

           c)   A physician who prescribes the AED and any person or entity  
             responsible for the site where an AED is located, for negligent  
             acts of the "Good Samaritan" in rendering emergency care with  
             an AED, if that physician, person, or entity has complied with  
             certain training and maintenance requirements.  

        5)Substantially relaxes the requirement that building owners and  









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          others who acquire AEDs must ensure that expected AED users  
          complete an accepted CPR and AED course as a condition of  
          immunizing that building owner from any liability arising from the  
          use of the acquired AED.  Maintained the requirement that any  
          immunities from civil liabilities in this context would not apply  
          in cases of gross negligence or willful or wanton misconduct.  

        6)Requires every health studio, as defined in Civil Code Section  
          1812.81, until July 1, 2012, to acquire an AED, and maintain and  
          train personnel in the use of the acquired AED.  
         
        AS PASSED BY THE ASSEMBLY  , this bill was substantially similar to  
        the version approved by the Senate.
         
        FISCAL EFFECT  :  None


         COMMENTS  :  This bill is part of a continuing and laudable effort by  
        policymakers in California to encourage the proliferation and use of  
        automatic external defibrillators (AEDs) in easily accessible public  
        locations to save lives.  AEDs are portable medical devices used to  
        administer an electric shock through the chest wall to the heart  
        after someone suffers cardiac arrest.  They are reportedly  
        "fail-safe," and there apparently has been no successful lawsuit  
        brought against an individual for the use or misuse of these  
        devices.  The Judiciary Committee has, with the help of the American  
        Heart Association, the Consumer Attorneys of California, and other  
        interested parties, helped fashion several measures over the years  
        to help spur the availability and use of AEDs.  This measure,  
        following in those earlier bills' footsteps, seeks to extend the  
        sunset date by 5 years for the requirement that health studios  
        purchase and maintain AEDs for possible use by club personnel to  
        potentially save lives, train staff in their proper use, and  
        maintain staff on the premises during all operating hours, such that  
        the new sunset will be July 1, 2014.  The bill would also extend  
        these requirements to golf clubs and amusement parks.  


        According to the American Heart Association (AHA), cardiac arrest is  
        a life-or-death situation, and the patient has very little chance of  
        survival without defibrillation.  However, the window of opportunity  
        for saving lives through defibrillation is very small, being only  









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        10-13 minutes even if CPR is administered correctly.  According to  
        the AHA, in cases of sudden cardiac arrest, CPR is merely a  
        maintenance tool, and defibrillation must take place to "shock" the  
        patient's heart into a proper working rhythm.  Thus, the public  
        would be better served, and lives could be saved, if businesses and  
        offices across California are better encouraged to have AEDs on  
        site.  
        According to the AHA, AEDs contain microcomputers to accurately  
        identify sudden cardiac arrests and make extensive use of audible  
        prompting and signals to provide operators with clear and concise  
        instruction, making their use uncomplicated, intuitive, and nearly  
        foolproof.  Safeguards are built in to protect both operator and  
        victim and to ensure that the AED will only deliver a shock if, in  
        fact, the device affirmatively determines that a victim is in sudden  
        cardiac arrest.  Further, the device does not allow for manual  
        overrides, in the event a panicked operator tries to administer the  
        shock even when the device finds that the victim is not in cardiac  
        arrest.

        Several other states require AEDs (and trained staff) at health  
        studios, including Illinois, Indiana, Massachusetts, Michigan, New  
        Jersey, and New York.  None of these states' statutes have sunset  
        provisions, therefore it is reasonable for California to extend the  
        sunset provision in Health and Safety Code section 104113.

        Some states require AEDs at facilities other than health studios.   
        Illinois and New York require AEDs at certain school (fitness)  
        facilities and events.  New York state additionally requires AEDs at  
        "places of public assembly," defined as places with an occupancy  
        capacity of 1,000 or more, including stadiums, ballparks, and  
        similar sporting event facilities; as well as concert halls and  
        other facilities where musical concerts are given; but does not  
        include churches or libraries.  (NY Public Health Law section 225,  
        5-b(c)).  New York City has very broad AED requirements, mandating  
        that they be provided by operators of all "public places," "in  
        quantities and locations deemed adequate," in a manner such that the  
        AEDs be "readily accessible for use during medical emergencies."   
        (NY Administrative Code section 17-188.)  "Public places" include  
        public buildings, parks, nursing homes, ferry terminals, senior  
        centers, golf courses, and sports arenas.  Given that other states  
        have done so, it is reasonable for California to extend its AED  
        requirements to public places other than health studios.









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        According to the Golf Course Superintendents Association of  
        America's website, "Sudden cardiac arrest is the number one killer  
        on golf courses, and according to Golf Digest, golf courses rank  
        fifth in places where sudden cardiac arrest is most likely to  
        occur."  The Red Cross website states, "Golf courses and sports  
        stadiums are two of the top five most likely spots for cardiac  
        arrest" and that, "although sudden cardiac arrest can happen  
        anywhere, the odds skyrocket in busy locations such as airports and  
        train stations."  According to the International Association of  
        Amusement Parks and Attractions' website, "Most large amusement  
        parks and aquatic facilities already have AEDs on site in multiple  
        locations."  Neither the GCSAA nor the IAAPA recommends that their  
        respective facilities be required to maintain AEDs, but they do  
        recommend voluntary AED acquisition and training.  Therefore, given  
        the prevalence of cardiac arrest on golf courses, the busy nature of  
        amusement parks, and the fact that professional organizations for  
        both types of facilities are recommending AED acquisition and  
        training, it does seem reasonable to require AEDs in those places. 

         GOVERNOR'S VETO MESSAGE  :

        "There is no 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.  I am not willing to  
        extend this law to additional businesses until this problem is  
        addressed."
         


        Analysis Prepared by  :  Drew Liebert / JUD. / (916) 319-2334   FN:  
        0003307