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S. 1489 (is) To amend title 38, United States Code, to provide for the payment to States of plot allowances for certain veterans eligible for burial in a national cemetery who are buried in cemeteries of such States. [Introduced in Senate] ...

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  2d Session
                                S. 1488



                            January 27, 2000

                 Referred to the Committee on Commerce


                                 AN ACT

 To amend the Public Health Service Act to provide for recommendations 
 of the Secretary of Health and Human Services regarding the placement 
 of automatic external defibrillators in Federal buildings in order to 
improve survival rates of individuals who experience cardiac arrest in 
   such buildings, and to establish protections from civil liability 
             arising from the emergency use of the devices.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,


    This Act may be cited as the ``Cardiac Arrest Survival Act of 


    The Congress finds as follows:
            (1) Each year more than 250,000 adults suffer cardiac 
        arrest, usually away from a hospital. More than 95 percent of 
        them will die, in many cases because cardiopulmonary 
        resuscitation (``CPR''), defibrillation, and advanced life 
        support are provided too late to reverse the cardiac arrest. 
        These cardiac arrests occur primarily from occult underlying 
        heart disease and from drowning, allergic or sensitivity 
        reactions, or electrical shocks.
            (2) Every minute that passes before returning the heart to 
        a normal rhythm after a cardiac arrest causes the chance of 
        survival to fall by 10 percent.
            (3) In communities where strong public access to 
        defibrillation programs have been implemented, survival from 
        cardiac arrest has improved by as much as 20 percent.
            (4) Survival from cardiac arrest requires successful early 
        implementation of a chain of events, known as the chain of 
        survival, which must be initiated as soon as the person 
        sustains a cardiac arrest and must continue until the person 
        arrives at the hospital.
            (5) The chain of survival is the medical standard of care 
        for treatment of cardiac arrest.
            (6) A successful chain of survival requires the first 
        person on the scene to take rapid and simple initial steps to 
        care for the patient and to assure that the patient promptly 
        enters the emergency medical services system. These steps 
                    (A) recognizing an emergency and activating the 
                emergency medical services system;
                    (B) beginning CPR; and
                    (C) using an automated external defibrillator 
                (``AED'') if one is available at the scene.
            (7) The first persons at the scene of an arrest are 
        typically lay persons who are friends or family of the victim, 
        fire services, public safety personnel, basic life support 
        emergency medical services providers, teachers, coaches and 
        supervisors of sports or other extracurricular activities, 
        providers of day care, school bus drivers, lifeguards, 
        attendants at public gatherings, coworkers, and other leaders 
        within the community.
            (8) The Federal Government should facilitate programs for 
        the placement of AEDs in public buildings, including provisions 
        regarding the training of personnel in CPR and AED use, 
        integration with the emergency medical services system, and 
        maintenance of the devices.

              IN BUILDINGS.

    Part B of title II of the Public Health Service Act (42 U.S.C. 238 
et seq.) is amended by adding at the end the following section:

      ``recommendations regarding placement of automated external 
                      defibrillators in buildings

    ``Sec. 247. (a) Recommendation for Federal Buildings.--
            ``(1) In General.--Not later than 90 days after the date of 
        the enactment of the Cardiac Arrest Survival Act of 1999, the 
        Secretary shall assist in providing for an improvement in the 
        survival rates of individuals who experience cardiac arrest in 
        Federal buildings by publishing in the Federal Register for 
        public comment the recommendations of the Secretary with 
        respect to placing automatic external defibrillators in such 
        buildings. The Secretary shall in addition assist Federal 
        agencies in implementing programs for such placement.
            ``(2) Agency assessments.--Not later than 180 days after 
        the date on which the recommendations are published under 
        paragraph (1), the head of each Federal agency that occupies a 
        Federal building that meets the criteria described in 
        subsection (a)(1) shall submit to the Secretary an assessment 
        of the ability of each such agency to meet the goals described 
        in subsection (c).
    ``(b) Additional Recommendations.--The Secretary shall publish, as 
part of the recommendations referred to in subsection (a), 
recommendations with respect to the placement of automatic external 
defibrillators in buildings and facilities, or other appropriate 
venues, frequented by the public (other than the buildings referred to 
in subsection (a)). Such recommendations shall only be for information 
purposes for States and localities to consider in determining policy 
regarding the use or placement of such defibrillators in recommended 
buildings, facilities or venues.
    ``(c) Consideration of Certain Goals for Survival Rates.--In 
carrying out this section, the Secretary shall consider the goals 
established by national public-health organizations for improving the 
survival rates of individuals who experience cardiac arrest in 
nonhospital settings, including goals for minimizing the time elapsing 
between the onset of cardiac arrest and the initial medical response.
    ``(d) Certain Procedures.--The matters addressed by the Secretary 
in the recommendations under subsections (a) and (b) shall include the 
            ``(1) Procedures for implementing appropriate nationally 
        recognized training courses in performing cardiopulmonary 
        resuscitation and the use of automatic external defibrillators.
            ``(2) Procedures for proper maintenance and testing of such 
        devices, according to the guidelines of the manufacturer of the 
            ``(3) Procedures for ensuring direct involvement of a 
        licensed medical professional and coordination with local 
        emergency medical services in the oversight of training and 
        notification of incidents of the use of the devices.
            ``(4) Procedures for ensuring notification of an agent of 
        the local emergency medical system dispatch center of the 
        location and type of device.
    ``(e) Certain Criteria.--In making recommendations under 
subsections (a) and (b), the Secretary shall determine the following:
            ``(1) Criteria for selecting the public buildings, 
        facilities and other venues in which automatic external 
        defibrillators should be placed, taking into account--
                    ``(A) the typical number of employees and visitors 
                in the buildings, facilities or venues;
                    ``(B) the extent of the need for security measures 
                regarding the buildings, facilities or venues;
                    ``(C) buildings, facilities or other venues, or 
                portions thereof, in which there are special 
                circumstances such as high electrical voltage or 
                extreme heat or cold; and
                    ``(D) such other factors as the Secretary 
                determines to be appropriate.
            ``(2) Criteria regarding the maintenance of such devices 
        (consistent with the labeling for the devices).
            ``(3) Criteria for coordinating the use of the devices in 
        public buildings, facilities or other venues with providers of 
        emergency medical services for the geographic areas in which 
        the buildings, facilities or venues are located.''.


    Part B of title II of the Public Health Service Act, as amended by 
section 3 of this Act, is amended by adding at the end the following 

       ``liability regarding emergency use of automated external 

    ``Sec. 248. (a) Persons Using AEDs.--Any person who provides 
emergency medical care through the use of an automated external 
defibrillator is immune from civil liability for any personal injury or 
wrongful death resulting from the provision of such care, except as 
provided in subsection (c).
    ``(b) Other Persons Involved With AEDs; Special Rules for 
            ``(1) In general.--With respect to a personal injury or 
        wrongful death to which subsection (a) applies, in addition to 
        the person who provided emergency medical care through the use 
        of the automated external defibrillator, the person described 
        in paragraph (2) is with respect to the device immune from 
        civil liability for the personal injury or wrongful death in 
        accordance with such paragraph, except as provided in 
        subsection (c).
            ``(2) Person described.--A person described in this 
        paragraph is the person who acquired the device for use at a 
        nonmedical facility (in this paragraph referred to as the 
        `acquirer'). Such person shall be immune from liability as 
        provided for in paragraph (1) if the following conditions are 
                    ``(A) The condition that the acquirer notified 
                local emergency response personnel of the most recent 
                placement of the device within a reasonable period of 
                time after the device was placed.
                    ``(B) The condition that, as of the date on which 
                the emergency occurred, the device had been maintained 
                and tested in accordance with the guidelines 
                established for the device by the manufacturer of the 
                    ``(C) In any case in which the person who provided 
                the emergency medical care through the use of the 
                device was an employee or agent of the acquirer, and 
                the employee or agent was within the class of persons 
                the acquirer expected would use the device in the event 
                of a relevant emergency, the condition that the 
                employee or agent received reasonable instruction in 
                the use of such devices through a course approved by 
                the Secretary or by the chief public health officer of 
                any of the States.
    ``(c) Inapplicability of Immunity.--Immunity under subsections (a) 
and (b) does not apply to a person if--
            ``(1) the person engaged in gross negligence or willful or 
        wanton misconduct in the circumstances described in such 
        subsections that apply to the person with respect to automated 
        external defibrillators; or
            ``(2) the person was a licensed or certified medical 
        professional who was using the automated external defibrillator 
        while acting within the scope of their license or 
        certification, and within the scope of their employment as a 
        medical professional.
    ``(d) Rules of Construction.--
            ``(1) In general.--The following applies with respect to 
        this section:
                    ``(A) This section is not applicable in any State 
                that (before, on, or after the date of the enactment of 
                the Cardiac Arrest Survival Act of 1999) provides 
                through statute or regulations any degree of immunity 
                for any class of persons for civil liability for 
                personal injury or wrongful death arising from the 
                provision of emergency medical care through the use of 
                an automated external defibrillator.
                    ``(B) This section does not waive any protection 
                from liability for Federal officers or employees 
                            ``(i) section 224; or
                            ``(ii) sections 1346(b), 2672 and 2679 of 
                        title 28, United States Code, or under 
                        alternative benefits provided by the United 
                        States where the availability of such benefits 
                        precludes a remedy under section 1346(b) of 
                        title 28.
                    ``(C) This section does not require that an 
                automated external defibrillator be placed at any 
                building or other location.
            ``(2) Civil actions under federal law.--
                    ``(A) In general.--The applicability of subsections 
                (a) through (c) includes applicability to any action 
                for civil liability described in subsection (a) that 
                arises under Federal law.
                    ``(B) Federal areas adopting state law.--If a 
                geographic area is under Federal jurisdiction and is 
                located within a State but out of the jurisdiction of 
                the State, and if, pursuant to Federal law, the law of 
                the State applies in such area regarding matters for 
                which there is no applicable Federal law, then an 
                action for civil liability described in subsection (a) 
                that in such area arises under the law of the State is 
                subject to subsections (a) through (c) in lieu of any 
                related State law that would apply in such area in the 
                absence of this subparagraph.''.

            Passed the Senate November 19, 1999.


                                                    GARY SISCO,


Pages: 1

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