Existing law provides for the regulation of private swimming pools. Existing law also provides for the regulation of public swimming pools by the State Department of Public Health. Existing law requires the provision of lifeguard services at any public swimming pool that is of wholly artificial construction and for the use of which a direct fee, as defined, is imposed. A violation of those provisions is a crime.

This bill would require those public swimming pools pools, as defined, that are required to provide lifeguard services and that charge a direct fee to additionally provide an Automated External Defibrillator (AED) during pool operations. The bill would also require every K-12 school with a swimming pool onsite to provide an AED during pool operations. Because the failure to comply with these provisions would be a crime, and by imposing additional duties on local entities, the bill would create a state-mandated local program. The bill would also require the State Department of Education, in consultation with the State Department of Public Health, to issue best practices guidelines related to pool safety at K12 schools.

Existing law provides for the regulation of private swimming pools. Existing law also provides for the regulation of public swimming pools by the State Department of Public Health. Existing law requires the provision of lifeguard services at any public swimming pool that is of wholly artificial construction and for the use of which a direct fee fee, as defined, is imposed. A violation of those provisions is a crime.

This bill would require those public swimming pools that are required to provide lifeguard services and that charge a direct fee to additionally provide an Automated External Defibrillator (AED) during pool operations. The bill would also require every K-12 school with a swimming pool onsite to provide an AED during pool operations. Because the failure to comply with these provisions would be a crime, and by imposing additional duties on local entities, the bill would create a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that with regard to certain mandates no reimbursement is required by this act for a specified reason.

With regard to any other mandates, this bill would provide that, if the Commission on State Mandates determines that the bill contains costs so mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.

Existing law provides for the regulation of private swimming pools. Existing law also provides for the regulation of public swimming pools by the State Department of Public Health. Existing law requires the provision of lifeguard services at any public swimming pool that is of wholly artificial construction and for the use of which a direct fee is imposed. A violation of those provisions is a crime.

This bill would require those public swimming pools to additionally provide an Automated External Defibrillator (AED) during pool operations. The bill would also require every K-12 school with a swimming pool onsite to provide an AED during pool operations. Because the failure to comply with these provisions would be a crime, and by imposing additional duties on local entities, the bill would create a state-mandated local program.

The California Constitution requires the state to reimburse local agencies and school districts for certain costs mandated by the state. Statutory provisions establish procedures for making that reimbursement.

This bill would provide that with regard to certain mandates no reimbursement is required by this act for a specified reason.

With regard to any other mandates, this bill would provide that, if the Commission on State Mandates determines that the bill contains costs so mandated by the state, reimbursement for those costs shall be made pursuant to the statutory provisions noted above.

SENATE COMMITTEE ON

Senator Ricardo Lara, Chair

2017 - 2018 Regular Session

AB 735 (Maienschein) - Swimming pools: public safety

This bill meets the criteria for referral to the Suspense File.

Bill Summary:

AB 735 would require every public swimming pool that charges a fee for use to have an automated external defibrillator unit on site.

Fiscal Impact:

• One-time costs of $60,000 for the Department of Education to develop best practice guidelines related to pool safety at K-12 schools (General Fund).
• No significant costs are anticipated by the Department of Public Health which has regulatory oversight of public swimming pools.
• No reimbursable state mandate claims from K-12 schools or other public agencies are anticipated due to the bill. The requirements of the bill would apply to any public swimming pool (not limited to those operated by local governments such as school districts) and would only apply to pools that charge a fee for use. Because the provisions of the bill are not limited to public agencies and because operators of public pools only need to comply with the requirements of the bill if they opt to charge a fee for using a pool, the bill is not anticipated to result in a reimbursable state mandate claim by local government agencies that operate swimming pools.

Background:

Under current law, any public pool that charges a fee for use must provide lifeguard service. Other swimming pools must either provide lifeguard service or post a sign indicating that lifeguard service is not provided.

Current law requires certain non-governmental buildings with capacities over 200 persons that are constructed after January 1, 2017 to have an automated external defibrillator on site.

An automated external defibrillator is a portable device that delivers an electric shock through the chest to restart a heart that is not beating or that is beating irregularly. Automatic external defibrillators contain a computer that determines whether a shock is needed and the necessary voltage. These devices are simple enough to use that untrained members of the public can use them to treat a person who is in cardiac arrest.

Proposed Law:

AB 735 would require every public swimming pool that charges a fee for use to have an automated external defibrillator unit on site.

The bill would require the Department of Education to develop best practice guidelines related to pool safety at K-12 schools.

Staff Comments:

The only costs that may be incurred by a local agency relate to crimes and infractions. Under the California Constitution, such costs are not reimbursable by the state.

-- END --

SENATE COMMITTEE ON HEALTH

Senator Ed Hernandez, O.D., Chair

BILL NO: AB 735

SUBJECT: Swimming pools: public safety

SUMMARY:

Requires every public swimming pool that charges a fee for the use of the pool to provide an Automated External Defibrillator unit, and requires the Department of Education, in consultation with Department of Public Health, to issue best practice guidelines related to pool safety at K-12 schools.

Existing law:

1. Requires the Department of Public Health (DPH) to have supervision of sanitation, healthfulness, and safety of public swimming pools.
2. Requires lifeguard service to be provided for any public swimming pool that is of wholly artificial construction and which charges a fee for use. For all other public swimming pools, requires lifeguard service to either be provided or to have signs clearly indicating that the service is not provided.
3. Requires persons providing aquatic instruction, including, but not limited to, swimming instruction, water safety instruction, water contact activities, and competitive aquatic sports, at a public swimming pool to possess current certificates from an American Red Cross or YMCA of the U.S.A. lifeguard training program, or have equivalent qualifications as determined by DPH. Additionally, requires these persons to be certified in standard first aid and cardiopulmonary resuscitation.
4. Provides immunity from civil liability for the acts or omissions of any person who, in good faith and not for compensation, renders emergency care or treatment by the use of an Automated External Defibrillator (AED) at the scene of an emergency.
5. Provides immunity from civil liability for any acts or omissions in the rendering of emergency care by the use of an AED for a person or entity that acquires an AED for emergency use, if that person or entity has complied with certain specified requirements.

This bill:

1. Requires every public swimming pool, as defined, that is required to provide lifeguard services and that charges a fee for the use of the pool, to provide an AED unit, and requires the AED unit to be readily available during pool operations.
2. Requires the Department of Education, in consultation with the DPH, to issue best practice guidelines related to pool safety at K-12 schools.

FISCAL EFFECT:

According to the Assembly Appropriations Committee:

1. Costs not likely to exceed $100,000 (General Fund) to Department of Education to research and publish guidelines. Consultation costs to DPH are expected to be minor.
2. Local environmental health agencies will incur minor costs for oversight of compliance with the new requirement, but any costs are recoverable through local permit fees.

PRIOR VOTES:

COMMENTS:

1. Author’s statement. According to the author, an AED unit is the only effective means of restoring a regular heart rhythm during sudden cardiac arrest, is relatively inexpensive, and is easy to operate for someone with no medical background to use. Drowning victims are often in cardiac arrest; they are not breathing and their hearts are not beating. Bystander cardio-pulmonary resuscitation (CPR) can address the respiration issue and sustain the victim’s life until emergency medical personnel arrive on scene, but it frequently requires an AED unit to get the victim’s heart restarted, and the sooner the drowning victim’s heart is restarted, the higher the chance of survival and the return to proper brain function. Clearly, making AED units available at public and school swimming pools is a reasonable, cost-effective way to help guard against unnecessary deaths by drowning. This bill will help provide this needed protection by requiring every public swimming pool that is required to provide lifeguard services and that charges a direct fee to provide on its premises to have an AED unit readily available during pool operations, and by requiring the Department of Education, in consultation with DPH, to issue best practices guidelines related to pool safety at K-12 schools.
2. Background on AEDs. According to the American Heart Association (AHA), an AED is a lightweight, portable device that delivers an electric shock through the chest to the heart. The shock can stop an irregular rhythm and allow a normal rhythm to resume in a heart in sudden cardiac arrest. Sudden cardiac arrest is an abrupt loss of heart function. If it is not treated within minutes, it quickly leads to death. The AED has a built-in computer which assesses the patient's heart rhythm, determines whether the person is in cardiac arrest, and signals whether to administer the shock. Audible cues guide the user through the process.

According to the AHA, each year in the U.S., there are approximately 359,400 Emergency Medical Services (EMS)-assessed cardiac arrests outside of a hospital setting and on average, less than 10% of victims survive. Early defibrillation, along with CPR, is the only way to restore the victim’s heart rhythm to normal in a lot of cases of cardiac arrest. For every minute that passes without CPR and defibrillation, however, the chances of survival decrease by 7 to 10%. The 2013 Update of AHA’s Heart Disease and Stroke Statistics shows that 23% of out-of-hospital cardiac arrests are "shockable" arrhythmias, or those that respond to a shock from an AED, making AEDs in public places highly valuable. Yet, AHA states there are not enough AEDs and persons trained in using them and performing CPR to provide this life-saving treatment, resulting in lost opportunities to save more lives. Communities with comprehensive AED programs that include CPR and AED training for rescuers have achieved survival rates of nearly 40% for cardiac arrest victims. AHA states on its website that it supports placing AEDs in targeted public areas such as sports arenas, gated communities, office complexes, doctor’s offices, and shopping malls. When AEDs are placed in the community or a business or facility, AHA strongly encourages that they be part of a defibrillation program which includes notification to the local EMS office when an AED is acquired, that a licensed physician or medical authority provides medical oversight to ensure quality control, and that persons responsible for using the AED are trained in CPR and how to use an AED.

1. Prior legislation. SB 287 (Hueso, Chapter 449, Statutes of 2015) required certain buildings with capacities of 200 persons or greater, as specified, constructed on or after January 1, 2017, to have an AED on the premises.

SB 658 (Hill, Chapter 264, Statutes of 2015) repealed various requirements relating to persons or entities who acquire AEDs, including repealing requirements that employees complete training, and reducing the inspection requirements from once every 30 days to once every 90 days.

SB 1436 (Lowenthal, Chapter 71, Statutes of 2012) removed the sunset date, thereby making permanent, the existing protections that provide immunity from civil damages in connection with the use of AEDs.

SB 127 (Calderon, Chapter 500, Statutes of 2010) removed the July 1, 2012 sunset date for existing requirements that every health studio acquires and maintains an AED and trains personnel in its use thereby extending these requirements indefinitely.

SB 63 (Price of 2011) would have stated the intent of the Legislature that all public high schools acquire and maintain at least one AED and would require schools that decide to acquire and maintain an AED, or to continue to use and maintain an existing AED, to comply with specified requirements. SB 63 was held in the Senate Appropriations Committee.

AB 2083 (Vargas, Chapter 85, Statutes of 2006) extended the sunset date from 2008 to 2013 on the operative provisions of existing law which provide immunity from civil damages for persons or entities that acquire AEDs and comply with maintenance, testing, and training requirements.

AB 1507 (Pavley, Chapter 431, Statutes of 2005) required all health studios in the state to have AEDs available with properly trained personnel until July 1, 2012.

AB 2041 (Vargas, Chapter 718, Statutes of 2002) expanded the immunity protections for the use or purchase of an AED, and included a sunset date of 2008.

SB 911 (Figueroa, Chapter 163, Statutes of 1999) created qualified immunity from civil liability for trained persons who use in good faith and without compensation an AED in rendering emergency care or treatment at the scene of an emergency.

1. Support. This bill is sponsored by the Conference of California Bar Associations (CCBA), which states that this bill will help reduce the number of drowning-related incidents in public pools by requiring swimming pools that are open to the public and charge a fee to provide an AED unit for the use of lifeguards and the public. According to CCBA, death by drowning involves both cessation of respiration and of heart activity. While the cessation of respiration can by addressed through bystander CPR until emergency medical personnel arrive, it frequently requires an AED unit to get the victim’s heart restarted. CCBA states that the Model Aquatic Health Code published by the Center for Disease Control and Prevention recommends AED units as a component of the minimum safety equipment an aquatic facility should maintain. The League of California Cities states that it supports having AED units accessible for use by lifeguards at public swimming pools. The California State Alliance of YMCAs states that having an AED on hand for use by lifeguards or bystanders will increase the likelihood of survival of drowning victims who experience sudden cardiac arrest and will save lives. The American Red Cross states that AEDs are a user-friendly, lifesaving technology used to treat the effects of sudden cardiac arrest. According to the American Red Cross, only 12% of victims who suffer cardiac arrest outside of a hospital setting survive, largely because many victims do not receive timely CPR or AED application. The American Heart Association/American Stroke Association (AHA/ASA) states that it supports placing AEDs in targeted public areas where large numbers of people gather. The California Attractions and Parks Association states that all of their water parks have external defibrillators and supports

SUPPORT AND OPPOSITION:

Support: Conference of California Bar Associations (sponsor)

American Heart Association /American Stroke Association

American Red Cross

California Attractions and Parks Association

California Children’s Hospital Association

California State Alliance of YMCA’s

League of California Cities

One individual

Oppose: None received

-- END --

ASSEMBLY THIRD READING

ATR Bill Id:AB 735

Author:(Maienschein)

As Amended Ver:May 26, 2017

Majority vote

SUMMARY: Requires every public swimming pool that charges a direct fee and that is mandated to have lifeguard services to provide on its premises an Automated External Defibrillator (AED) unit that is readily available during pool operations. Requires the Department of Education (DoE), in consultation with the Department of Public Health (DPH), to issue best practices guidelines related to pool safety at K-12 schools.

FISCAL EFFECT: According to the Assembly Appropriations Committee:

1. Costs not likely to exceed $100,000 GF to DoE to research and publish guidelines. Consultation costs to DPH are expected to be minor.
2. Local environmental health agencies will incur minor costs for oversight of compliance with the new requirement, but any costs are recoverable through local permit fees.

COMMENTS: According to the author, drowning victims are often in cardiac arrest; they are not breathing and their hearts are not beating. Bystander cardio-pulmonary resuscitation can address the respiration issue and sustain the victim's life until emergency medical personnel arrive on scene. But it frequently requires an AED unit to get the victim's heart restarted, and the sooner the drowning victim's heart is restarted, the higher the chance of survival and the return to proper brain function. The author states that this bill solves this problem by requiring public swimming pools to have an AED available for the use of lifeguards. Because K-12 schools with pools are not required to provide lifeguards, the author argues that these schools should provide AED units for bystander rescuers. According to the author, three student deaths occurred at California K-12 schools between 2007 and 2010. If an AED unit had been available at the scene, bystanders could have attempted to save those students’ lives.

An AED is a portable device that checks the heart rhythm and can send an electric shock to the heart to try to restore a normal rhythm. AEDs are used to treat sudden cardiac arrest (SCA). SCA is a condition in which the heart suddenly and unexpectedly stops beating. When this happens, blood stops flowing to the brain and other vital organs. SCA usually causes death if it's not treated within minutes. According to the National Institutes of Health, each minute of SCA leads to a 10% reduction in survival. Ninety-five percent of people who have SCA die from it – most within minutes. Rapid treatment of SCA with an AED can be lifesaving. The list price of AEDs varies between approximately $1200 and $2500, with discounts available for schools and certain other organizations. The Assembly Health Committee received a school-based quotation of $1195 for a water resistant AED from one distributor.

Analysis Prepared by: John Gilman / HEALTH / (916) 319-2097 FN: 0000860

Date of Hearing: April 26, 2017

ASSEMBLY COMMITTEE ON APPROPRIATIONS

Lorena Gonzalez Fletcher, Chair

ABPCA Bill Id:AB 735

Author:(Maienschein) – As Amended Ver:March 30, 2017

Urgency: No State Mandated Local Program: Yes Reimbursable: Yes

SUMMARY:

This bill requires certain public swimming pools to provide on their premises an Automated External Defibrillator (AED) unit that is readily available during pool operations. Specifically, the bill applies to public pools that are currently required to have a lifeguard present, and that are "of wholly artificial construction and for the use of which a direct fee is charged."

It also applies the same requirement to K-12 schools with a swimming pool onsite.

FISCAL EFFECT:

This bill has three potential fiscal effects:

1. The mandate for K-12 facilities to provide for AEDs at swimming pools is potentially state-reimbursable, as it mandates a higher level of service than is currently required under law. The magnitude of the mandate is unknown, as the number of pools does not appear to be tracked on a statewide basis. Los Angeles Unified School District (LAUSD), for instance, maintains 37 pools.

Assuming the potentially reimbursable cost of purchasing and installing an AEDs is $1,300 and the total number of pools statewide is proportional to the number maintained by LAUSD, potential state-reimbursable mandate costs in the range of $475,000 (GF/Prop 98).

1. Potentially significant state-reimbursable mandate claims associated with the requirement for public swimming pools to provide AEDs. While mandate claims do not appear likely, the potential for state-reimbursable mandate costs cannot be ruled out, because "public swimming pool" is ill-defined and could be read to refer to publicly administered pools. It is unclear precisely how many pools are maintained by local public agencies in California, but every hundred pools, state-reimbursable costs of $130,000 GF. See "Staff Comments" below for additional discussion.
2. Local environmental health agencies will incur minor costs for oversight of compliance with the new requirement, but any costs are recoverable through local permit fees.

COMMENTS:

1. Purpose. According to the author, this bill will potentially save lives by requiring AEDs at certain pool sites. This bill is sponsored by the California Conference of Bar Associations and supported by the Red Cross.
2. Background. According to the Red Cross, an AED is the only effective treatment for restoring a regular heart rhythm during sudden cardiac arrest, and is easy to operate for someone with no medical background. Current law encourages K-12 schools to acquire and maintain an AED, and allows them to solicit funds to do so. Current law does not require K-12 schools to have a CPR/AED-trained lifeguard on-site, which means the AED could be available for bystander use.

Provision of an AED at pool sites appears to be an industry best practice, and many public pools and schools already provide them. According to the Model Aquatic Health Code published by the Centers for Disease Control and Prevention, AEDs are recommended as a component of the minimum safety equipment an aquatic facility should maintain.

1. Staff Comments. The current-law definition (Health and Safety Code (HSC) 116045) of the subset of pools required to have lifeguards, to which this bill also applies, is unclear. The only definition for public swimming pool applicable to the section is in HSC 116025, which states, " “Public swimming pool,” as used in this article, means any public swimming pool, bathhouse, public swimming and bathing place and all related appurtenances." It is assumed, though it is not clearly stated, that the word public for purposes of section 116045 implies "open to the public" and not necessarily publicly administered, such as by a city or county. To eliminate the possibility of a mandate claim by cities, counties, or special districts based on this lack of clarity, staff suggests an amendment defining "public swimming pool" for purposes of HSC 116045 to ensure it clearly applies both to publicly and privately administered pools that meet the other applicable requirements.

Analysis Prepared by: Lisa Murawski / APPR. / (916) 319-2081

Date of Hearing: March 21, 2017

ASSEMBLY COMMITTEE ON HEALTH

Jim Wood, Chair

ABPCA Bill Id:AB 735

Author:(Maienschein) – As Introduced Ver:February 15, 2017

SUBJECT: Swimming pools: Automated External Defibrillators.

SUMMARY: Requires every public swimming pool that is mandated to have lifeguard services and every K-12 school with a swimming pool onsite to provide on its premises an Automated External Defibrillator (AED) unit that is readily available during pool operations.

EXISTING LAW:

1. Requires the Department of Public Health to regulate private and public swimming pools.
   
2. Requires the provision of lifeguard services at any public swimming pool that is of wholly artificial construction and for the use of which a direct fee is imposed.
   
3. Requires, by regulation, specified safety and first aid equipment at public swimming pools.
4. Permits a public school to solicit and receive nonstate funds to acquire and maintain an AED.
5. Immunizes from liability 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 certain conditions are met. Provides similar immunity from liability for school districts and their employees.
   

FISCAL EFFECT: This bill has not yet been analyzed by a fiscal committee.

COMMENTS:

1. PURPOSE OF THIS BILL. According to the author, drowning victims are often in cardiac arrest; they are not breathing and their hearts are not beating. Bystander cardio-pulmonary resuscitation (CPR) can address the respiration issue and sustain the victim’s life until emergency medical personnel arrive on scene. But it frequently requires an AED unit to get the victim’s heart restarted, and the sooner the drowning victim’s heart is restarted, the higher the chance of survival and the return to proper brain function. The author states that this bill solves this problem by requiring public swimming pools to have an AED available for the use of lifeguards. Because K-12 schools with pools are not required to provide lifeguards, the author argues that these schools should provide AED units for bystander rescuers. According to the author, three student deaths occurred at California K-12 schools between 2007 and 2010. If an AED unit had been available at the scene, bystanders could have attempted to save those students’ lives.
2. BACKGROUND. An AED is a portable device that checks the heart rhythm and can send an electric shock to the heart to try to restore a normal rhythm. AEDs are used to treat sudden cardiac arrest (SCA). SCA is a condition in which the heart suddenly and unexpectedly stops beating. When this happens, blood stops flowing to the brain and other vital organs. SCA usually causes death if it's not treated within minutes. According to the National Institutes of Health, each minute of SCA leads to a 10% reduction in survival. Ninety-five percent of people who have SCA die from it—most within minutes. Rapid treatment of SCA with an AED can be lifesaving. The list price of AEDs varies between approximately $1200 and $2500, with discounts available for schools and certain other organizations. The committee received a school-based quotation of $1195 for a water resistant AED from one distributor.
3. SUPPORT. The American Red Cross states that it supports the widespread placement and availability of AEDs, which this bill would accomplish. The Red Cross notes that only 12% of victims who suffer cardiac arrest outside of a hospital setting survive, largely in part because many victims do not receive timely CPR or AED application. One individual associated with the founding of the San Diego Project Heart Beat argues that this bill will help potential victims of SCA get a second chance at life.
4. PREVIOUS LEGISLATION. SB 287 (Hueso), Chapter 449, Statutes of 2015, requires certain buildings with capacities of 200 persons or greater constructed on or after January 1, 2017, to have an AED on the premises.

REGISTERED SUPPORT / OPPOSITION:

Support

American Red Cross

One individual

Opposition

None on file.

Analysis Prepared by: John Gilman / HEALTH / (916) 319-2097