Title
a. Receive and approve the status report on Senate Bill (SB) 658, Automated External Defibrillators; and
b. Approve the acceptance of the Tyler Heart Institute Grant.
Report
RECOMMENDATION:
It is recommended that the Board of Supervisors:
a. Receive, review and approve the status report on Senate Bill (SB) 658, Automated External Defibrillators; and
b. Approve the acceptance of the Tyler Heart Institute Grant
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 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 employees 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.
DISCUSSION:
Monterey County does not have a formalized County AED/PAD program. Several departments own and maintain AEDs; however, there is not a standard practice to procure, install, maintain or report AED use.
The project team, consisting of representatives from CAO Contracts Purchasing and Intergovernmental & Legislative Affairs (IGLA), County Counsel Risk Management, Health Department, Resource Management Agency (RMA) and the Sheriff Office reviewed and analyzed a facility list (166) of County-owned and leased properties. The list was categorized by department/address. Health Clinic Services and NMC were not included in the analysis because they are licensed health facilities. Child Support Services, Emergency Communications, Information Technology, Parks, Probation and Sheriff have a combined total of 71 AEDs made by various manufacturers. On-going maintenance costs for the 71 existing AEDs have been absorbed by departments.
Community Hospital of the Monterey Peninsula (CHOMP) Tyler Heart Institute provides a full range of cardiac services, including management of community-based AED programs. The Tyler Heart Institute program supports non-profit organizations and schools with partial or complete grants to enhance and increase the survival chances of an individual who experiences cardiac arrest. The County of Monterey applied for a grant in June 2016 requesting three additional AEDs, and was approved for $1,700 per AED. The County of Monterey share is $300 per AED. The grant program provides the initial site visit, the AED itself, and off-site training for eighteen staff members. The three AEDs would be installed at the following locations:
• Government Center, Board Chambers, 168 W. Alisal Street, Salinas
• Schilling Place, 1441 Schilling Place, Salinas
• Department of Social Services, 1000 S. Main Street, Salinas
There is no annual cost for the maintenance support or enrollment in the Tyler Heart Institute AED Program for the three new AEDs. The only ongoing cost to the County after installation of the AED is to replace the battery/pads every 2.5 years which is approximately $125.00 per AED.
In standardizing and formalizing the Monterey County Public Access Defibrillation Program, staff recommends the creation of an oversight committee, consisting of the CAO - IGLA and the Health Department’s Emergency Medical Services (EMS) Agency. Staff also recommends that the EMS Agency, as the State-mandated agency that regulates PAD programs, provide regulatory oversight and technical consulting to support the County’s PAD program, and that the CAO-IGLA coordinate the interdepartmental management of the County PAD Program, including development of process and procedures for PAD Program procurement, installation, and maintenance and reporting.
The Budget Committee received and supported the Status Report on August 31, 2016. The committee also recommended the oversight committee evaluate options to make CPR/AED training available to staff countywide.
OTHER AGENCY INVOLVEMENT:
The CAO - IGLA Division, CAO - Budget & Analysis, County Counsel Risk Management, Health, Resource Management Agency, Social Services and Sheriff Office have been involved in project development, analysis, recommendations, and grant application.
FINANCING:
The project was led by County Administrative Office - Department 1050, Intergovernmental & Legislative Affairs Division - Unit 8054. Staff recommends that the Utilities budget under RMA, Fund 001-3000-8182, Appropriation Unit RMA098 be the source to pay for the AEDs installed at the Government Center, Board Chambers and Schilling Place as these facilities are occupied by multiple County Departments. Staff is recommending that Social Services Fund 001-5010-8262, Appropriation Unit SOC005 be the source to pay for the AED installed at the Social Services facility located at 1000 S. Main Street, Salinas as this facility is occupied by a single Department. The oversight committee will return to the Budget Committee at a future date to report on department maintenance costs.
Prepared by: Joann Iwamoto, Management Analyst, x3017
Approved by: Nicholas E. Chiulos, Assistant CAO, x5145