Title
a. Receive and consider approval of the County of Monterey Automatic External Defibrillator (AED) Policy and Procedure; and
b. Provide direction to staff as appropriate.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Receive and consider approval of the County of Monterey Automatic External Defibrillator (AED) Policy and Procedure; and
b. Provide direction to staff as appropriate.
SUMMARY:
SB 658 modifies existing regulation regarding the placement, training and use of Automatic External Defibrillators (AED), and the creation and operation of Public Access Defibrillation (PAD) programs. SB 658 removes requirements from California Code of Regulations, Title 22, Chapter 1.9, Sections 100031 through 100043. SB 658 was supported by a broad coalition of medical, emergency services, hospital, and cardiac care advocates because they considered the previous regulatory schema restrictive, complicated, and inhibiting to the creation and expansion of AED/PAD programs.
A Monterey County Automatic External Defibrillator (AED) Policy and Procedure has been developed to provide information on any and all use of the AED, training requirements, policies and procedures reviews, and post event reviews. The Policy and Procedure is limited to the AEDs enrolled in the Tyler Heart Institute (THI) Program and does not include County healthcare facilities or law enforcement safety offices. An Administrative Program Coordinator has been identified to be responsible for the overall coordination, implementation, and continued operation of the program.
The County has many AEDs installed at various County facilities. Seventy-five (75) of these AEDs are used at the Sheriff’s Office, Probation and Resource Management Agency (RMA) Parks Department. These AEDs follow standards pursuant to healthcare facilities or public safety law enforcement protocol. These offices should have an AED Policy and Procedure in their internal procedures and guidelines.
Monterey County was awarded a grant with the Community Hospital of Monterey Peninsula Tyler Heart Institute for three AEDs to be placed at the Government Center, Life Foundation Center and Schilling Place.
DISCUSSION:
A Public Access Defibrillation (PAD) Program is a program that places an AED, usually at a fixed location, such as a pool, health club, school or office building, with personnel trained in the use of the AED. PAD programs are typically operated by building owners, business organizations or government agencies. Effective January 1, 2016, SB 658 modifies existing law related to the placement, training, and use of an AED and operation of a PAD program. Three of the most significant changes resulting from SB 658 are:
• Any person trained in the use of an AED may use an AED during an emergency. Previous language restricted the use of the AED to persons that had been trained by that specific organization. Thus, under the previous language, a visitor to a business that had a PAD program could not use their AED to aid a cardiac arrest victim, even if that person was trained to use the device.
• A medical director or physician and surgeon is no longer required to be involved in the acquisition or placement of an AED. This significantly reduces the cost to start and maintain an AED program. The cost of and lack of availability of physician oversight was a significant barrier to starting and operating an AED program.
• There is no requirement that a minimum number of employee’s complete CPR and AED training to have an AED program. Responsible organizations will offer CPR/AED training to employees, but the previous regulatory language was viewed as inhibiting new AED programs.
The County has many AEDs installed at various County facilities including Natividad Medical Center, Health Department Clinics and Safety Departments. These departments maintain their AEDs under separate policies and are held to standards pursuant to subdivision (a), (b), (c), or (f) of Section 1250 or to public safety law enforcement personnel, firefighters, and lifeguards trained pursuant to California Code of Regulations, Title 22, Section 100014 through 100030.
Monterey County did not have a formalized Automatic External Defibrillator (AED) Policy and Procedure. Several departments own and maintain AEDs; however, there is not a standard practice to procure, install, maintain or report AED use. An Automatic External Defibrillator (AED) Policy and Procedure has been created to outline the following:
• Purpose
• Background
• Policy
• Procedure
• Review Date
• Board Action
The County of Monterey applied for the Community Hospital of Monterey Peninsula (CHOMP) Tyler Heart Institute grant and was awarded three AEDs and wall units for a total award of $6,000. The County of Monterey’s share was $900. The grant also includes three 45 minute trainings, compliance assistance with the requirements of the California Health and Safety Code, registration of AEDs, response/review of incident if AED is used, and maintenance oversight, including monthly check reminders, battery/pad replacement reminders and recall notifications. The grant also includes HeartSaver cardiopulmonary resuscitation (CPR) training for eighteen County staff. Six County staff will be trained in CPR from each location: Government Center, Schilling Place and Life Foundation Center.
The three AEDs awarded in the grant will be installed at the following locations:
• Government Center, Board Chambers, 168 W. Alisal Street, Salinas.
o Placement of AED on or around March 30, 2017
• Life Foundation Center, 1000 S. Main Street, Salinas
o Placement of AED on or around March 30, 2017
• Schilling Place, 1441 Schilling Place, Salinas
o Placement to be determined.
There is no annual cost for the maintenance support or enrollment in the Tyler Heart Institute (THI) AED Program for the three new AEDs. The on-going cost to the County after installation of the AED is to replace the battery/pads every 2.5 years which is approximately $125 per AED. The THI Program requires an AED Administrative Coordinator be assigned. The Administrator Coordinator’s role is to ensure that all issues related to training, such as scheduling of basic and periodic reviews, maintenance of training standards and AED Responder status, and record keeping is a continual management process. Staff recommends that the CAO-Intergovernmental & Legislative Affairs (IGLA) Division be identified as the Administrator Program Coordinator. Staff recommends that a Facility Program Coordinator be identified where a device has been installed. The Facility Program Coordinator works collaboratively with the Administrative Program Coordinator to coordinate compliance, maintenance and annual reporting. The Facility Coordinators are as follows:
Department: Facility Coordinator:
Child Support Services Daniel Gutierrez
Emergency Communications Cynthia Law
Government Center Maria Sandoval
Information Technology Michael Gross
Life Foundation Center Marcie Castro
Schilling Place Oscar Cervantes
The Budget Committee received and supported the Status Report on August 31, 2016. The committee recommended the project team evaluate options to make CPR/AED training available to staff countywide. Staff has researched the cost of CPR/First Aid training. The cost per participant is $50 with a bi-annual re-certification requirement to maintain the certificate. No further decision regarding a countywide training program has been determined.
OTHER AGENCY INVOLVEMENT:
The CAO - IGLA Division, County Counsel Risk Management, Child Support Services, Emergency Communications, Health Department, Information Technology, Resource Management Agency, Social Services, Sheriff’s Office, and EMS Agency have been involved in project development, analysis, recommendations, grant application, and implementation.
FINANCING:
Approval of this recommendation will have no impact on the County General Fund.
BOARD OF SUPERVISORS STRATEGIC INITIATIVES:
AEDs make it possible for more people to respond to a medical emergency where defibrillation is required. The addition of three AEDs will be installed in facilities where large numbers of people gather and supports the Board of Supervisors Strategic Initiatives:
X Administration
X Health & Human Services
X Infrastructure
X Public Safety
Prepared by: Joann Iwamoto, Management Analyst, x3017
Approved by: Nicholas E. Chiulos, Assistant CAO, x5145
Attachments: AED Policy and Procedure