Chapter 23D. Public Access to Defibrillators and Epinephrine.

Subchapter I. Access to Defibrillator.

§ 7–2371.01. Definitions.

For the purposes of this subchapter, the term:

(1) “Automated external defibrillator” or “AED” or “defibrillator” means a medical device heart monitor and defibrillator that:

(A) Has received approval from the United States Food and Drug Administration of its premarket notification filed pursuant to section 510(k) of the Federal Food, Drug, and Cosmetic Act, approved October 10, 1962 (76 Stat. 794; 21 U.S.C. § 360(k));

(B) Is capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia, and determining, without intervention by an operator, whether defibrillation should be performed; and

(C) Upon determining that defibrillation should be performed, automatically charges and requests delivery of an electrical impulse to an individual’s heart.

(2) “Compensation” shall not include the salary of any person who registers an automated external defibrillator, trains the individuals who operate the registered automated external defibrillators, orders the automated external defibrillators which will subsequently be registered, or operates a registered automated external defibrillator at the scene of an emergency, excluding any professional medical emergency setting.

(2A) "CPR" means cardiopulmonary resuscitation.

(2B) "CPR and AED program" means a training course on CPR and the operation and use of an AED that has been approved by the Mayor pursuant to § 7-2371.02c.

(2C) "Facility AED Coordinator" means the person who acquires the AED for a facility, or his or her designee.

(3) “Recreation facility” means a Department of Parks and Recreation public facility that is regularly staffed by a paid District government employee.

(4) “Recreation facility certificate” means a certificate issued by the Mayor to authorize the installation and use of an AED at a recreation facility that has complied with the AED program requirements and guidelines established under § 7-2371.02a.

(5) "School" means a school in the District of Columbia Public Schools system, a public charter school, an independent school, a private school, or a parochial school.

(Apr. 27, 2001, D.C. Law 13-278, § 2, 48 DCR 1869; Mar. 6, 2007, D.C. Law 16-217, § 2(a), 53 DCR 10207; Mar. 25, 2009, D.C. Law 17-362, § 2(a), 56 DCR 1211; Oct. 8, 2016, D.C. Law 21-160, § 3144(a), 63 DCR 10775.)

Prior Codifications

2001 Ed., § 44-231

Effect of Amendments

D.C. Law 16-217 rewrote this section, which formerly read:

“For the purposes of this subchapter, the term ‘automated external defibrillator’ or ‘AED’ or ‘defibrillator’ means a medical device heart monitor and defibrillator that:

“(1) Has received approval from the United States Food and Drug Administration of its premarket notification filed pursuant to section 510(k) of the Federal Food, Drug, and Cosmetic Act, approved October 10, 1962 (76 Stat. 794; 21 U.S.C. 360(k));

“(2) Is capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia, and determining, without intervention by an operator, whether defibrillation should be performed; and

“(3) Upon determining that defibrillation should be performed, automatically charges and requests delivery of an electrical impulse to an individual’s heart.”

D.C. Law 17-362 added pars. (3) and (4).

§ 7–2371.02. Access by the public to defibrillation.

(a) A person who or entity that acquires an AED shall ensure that:

(1) The Facility AED Coordinator receives training from or is certified by the American Heart Association, the American Red Cross, or an equivalent state or nationally recognized course, such as the Heart Saver CPR AED course, in cardiopulmonary resuscitation (“CPR”) and in the use of an AED, and that the users maintain their certification in CPR and AED use;

(2) The defibrillator is maintained and tested according to the manufacturer’s operational guidelines, and written records of the maintenance and testing are maintained; and

(3) Repealed.

(4) Any person who uses an AED to provide emergency care or treatment on a person in cardiac arrest shall call 9-1-1 as soon as possible.

(b) Repealed.

(b-1) The Department shall:

(1) Oversee all efforts to improve and maintain access by the public to AEDs, including by setting AED deployment strategies and liaising with District government agencies; and

(2) Review each case in which an AED is used.

(c) Any person or entity who acquires an AED shall notify the Chief of the Department, or the Chief's designee, and the call center, as defined in § 1-327.51(2), of the AED and the location and type of the AED. If an AED is removed, the Chief of the Department shall be notified. The Chief of the Department may issue a citation if the requirements of this subsection are not followed; provided, that the Chief of the Department has adopted regulations governing the issuance of the citations.

§ 7–2371.02a. AED program for Department of Parks and Recreation facilities.

(a) The Mayor shall develop and implement an AED program for each recreation facility. The program shall meet the requirements of § 7-2371.02, and, in addition, ensure that:

(1) At least one AED is provided on-site at each recreation facility;

(2) An individual trained in the operation and use of an AED, pursuant to a training program approved under subsection (c) of this section, is present during the recreation facility’s hours of operation; and

(3) Each AED is maintained, operated, and tested according to the manufacturers’ guidelines by conducting periodic inspections and annual maintenance of each AED.

(b) The Mayor shall develop guidelines for the program, including requirements that written records be maintained documenting:

(1) The maintenance and testing of each AED; and

(2) That each Department of Parks and Recreation employee assigned to the recreation facility has successfully completed a training program approved under subsection (c) of this section.

(c)(1) The Mayor shall approve training programs required under this section in accordance with the requirements of § 7-2371.02. The training programs may be conducted by a private or public entity.

(2) The training programs shall be in conjunction with health training provided to Department of Parks and Recreation employees, as well as refresher training, as required.

(d) The Mayor shall comply with this section within 45 days of March 25, 2009. The Mayor shall expand the AED program to a new recreation facility within 45 days of its opening.

(Apr. 27, 2001, D.C. Law 13-278, § 3a; as added Mar. 25, 2009, D.C. Law 17-362, § 2(c), 56 DCR 1211.)

Prior Codifications

2001 Ed., § 44-232.01

Section References

This section is referenced in § 7-2371.01 and § 7-2371.02.

Emergency Legislation

For temporary (90 day) additions, see §§ 2 to 4 of AED Installation for Safe Recreation and Exercise Emergency Act of 2008 (D.C. Act 17-392, May 21, 2008, 55 DCR 6272).

For temporary (90 day) additions, see §§ 2 to 4 of AED Installation for Safe Recreation and Exercise Congressional Review Emergency Amendment Act of 2008 (D.C. Act 17-459, July 28, 2008, 55 DCR 8726).

Temporary Legislation

Sections 2 to 4 of D.C. Law 17-213 added sections to read as follows:

“Sec. 2. Definitions.

“For the purposes of this act, the term:

“(1) ‘Automated external defibrillator’ or ‘AED’ or ‘defibrillator’ means a medical device heart monitor and defibrillator that:

“(A) Has received approval from the United States Food and Drug Administration of its premarket notification filed pursuant to section 501(k) of the Federal Food, Drug, and Cosmetic Act, approved October 10, 1962 (76 Stat. 794; 21 U.S.C. § 360(k));

“(B) Is capable of recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia, and determining, without intervention by an operator, whether defibrillation should be performed; and

“(C) Upon determining that defibrillation should be performed, automatically charges and requests delivery of an electrical impulse to an individual’s heart.

“(2) ‘Certificate’ means a certificate issued by the Mayor to an authorized recreational facility.

“(3) ‘Recreation facility’ means staffed Department of Parks and Recreation facilities.

“Sec. 3. AED program.

“(a) The Mayor shall develop and implement an AED program for each recreation facility within 45 days of the effective date of this act.

“(b) The program required under subsection (a) of this section shall include provisions that:

“(1) Ensure that an AED is provided on-site; and

“(2) An individual trained in the operation and use of an AED is present during hours of operation.

“(c) The Mayor shall establish guidelines for periodic inspections and annual maintenance of the automated external defibrillators to ensure each AED is maintained, operated, and tested according to manufacturers’ guidelines, including:

“(1) Written records of the maintenance and testing of each AED are maintained, as required; and

“(2) Proof that each individual who operates an AED for the authorized recreational facility has successfully completed an educational training course in conjunction with health training already received by Department of Parks and Recreation employees and refresher training, as required.

“(d) The Mayor shall issue and renew certificates to recreation facilities that meet the requirements of this section.

“(e) The Mayor shall approve educational and training programs required under this section that:

“(1) Are conducted by any private or public entity;

“(2) Include training in cardiopulmonary resuscitation; and

“(3) May include courses from nationally recognized entities, such as the American Heart Association, the American Red Cross, and the National Safety Council.

“(f) The Mayor shall make best efforts to use uniform equipment pursuant to this act.

“Sec. 4. Immunities.

“(a) In addition to any other immunities available under statutory or common law, an authorized recreation facility is not civilly liable for any act or omission in the provision of automated external defibrillation if the authorized facility:

“(1) Satisfied the requirements for making automated external defibrillation available under section 3; and

“(2) Possesses a valid certificate at the time of the act or omission.

“(b) The AED program established under this act shall include tort immunity pursuant to section 4 of the Public Access to Automated External Defibrillator Act of 2001, effective April 27, 2001 (D.C. Law 13-278; D.C. Official Code § 44-233).”

Section 6(b) of D.C. Law 17-213 provided that the act shall expire after 225 days of its having taken effect.

§ 7–2371.02b. Study to expand AED program throughout public facilities.

(a) The Mayor shall conduct a study examining the feasibility of installing AED devices in all District public facilities, including the District of Columbia Public Schools system and the Public Charter Schools. The study shall be submitted to the Council no later than 6 months following March 25, 2009.

(b) The study shall include:

(1) An evaluation of the available AED technologies, weighing advantages and disadvantages of these technologies, depending upon the characteristics of likely users within the public facility;

(2) An analysis of the optimum training program, to include cardiopulmonary resuscitation and AED operation, for obtaining maximum participation among potential rescuers;

(3) An analysis of the optimum program for maintenance and inspection of AEDs when placed throughout District of Columbia public facilities;

(4) A feasibility analysis for connecting AEDs, both those privately registered and those potentially placed throughout public facilities, to the District of Columbia emergency responder system;

(5) An examination of the AED programs in cities of comparable size or larger, including Baltimore, Philadelphia, and New York City;

(6) An analysis of the costs of different options for implementation, potential cost savings through training, and equipment alternatives; and

(7) An enumeration of the public facilities recommended for installation of AEDs.

§ 7–2371.02c. CPR and AED program.

(a) Within 120 days after October 8, 2016, each school shall meet the requirements of § 7-2371.02 and:

(1) Establish procedures for responding to a medical emergency involving cardiac arrest, including the appropriate use of CPR and an AED;

(2) Have at least one AED on-site at the school;

(3) Have, in coordination with the Department of General Services, a maintenance schedule established for each AED that is in accordance with the manufacturer's guidelines and includes:

(A) Periodic testing;

(B) Periodic inspection; and

(4) Ensure that each AED at the school is appropriate for use on children and adults;

(5) Have had the following individuals successfully complete a CPR and AED program; provided, that individuals newly hired for the following positions shall be required to successfully complete a CPR and AED program within 60 days after their hire date:

(A) Athletic coach, coaching assistant, and athletic trainer;

(B) Athletic director;

(D) School nurse; and

(E) Every anticipated AED user employed by the school, as designated by the school;

(6) Require that at least one individual trained in a CPR and AED program be present during the school's hours of operation and during any athletic activity; and

(7) Inform all school employees, at least annually, of the location of each AED in the school.

(b)(1) The Mayor shall:

(A) Establish baseline requirements and guidelines for a CPR and AED program;

(B) Approve each existing CPR and AED program that the Mayor determines meets or exceeds the baseline requirements and guidelines for a CPR and AED program, and any new CPR and AED programs established pursuant to this subchapter; provided, that the Mayor shall approve the existing programs listed in § 7-2371.02(a)(1) and the program offered by the Fire and Emergency Medical Services Department pursuant to § 5-401(b-1), as meeting the requirements of this section;

(C) Require each school to maintain a written record of the periodic testing, inspection, and maintenance of each AED; and

(D) Require the successful completion of a CPR and AED program by each employee in a position listed in subsection (a)(5) of this section.

(2) A CPR and AED program may be conducted by a private or public entity.

§ 7–2371.03. AED use and tort immunity.

(a) Any person or entity who, in good faith and without compensation, uses an AED to provide emergency care or treatment shall be immune from civil liability for any personal injury resulting from the care or treatment, or resulting from any act or failure to act in providing or arranging further medical treatment, if the person acts as an ordinary, reasonably prudent person would have acted under the same or similar circumstances.

(b) The immunity from civil liability provided under subsection (a) of this section shall extend to the licensed physician or medical authority involved in automated external defibrillator site placement, the person who provides training in CPR and the use of the automated external defibrillator, and the person or entity responsible for the site where the automated external defibrillator is located.

(c) The immunity from civil liability provided under this subchapter shall not apply if the personal injury results from the gross negligence or the willful or wanton misconduct of the person providing the emergency care.

(d) This section expressly excludes from the provision of immunity designers, manufacturers, or sellers of automated external defibrillators who have claims brought against them based upon current District of Columbia law.

(e) A person who, in good faith and without compensation, uses a defibrillator at the scene of an emergency, and all other persons and entities providing services without compensation under this section, shall be immune from civil liability for any personal injury that results from any act or omission in the use of the defibrillator in an emergency situation.

(f) The immunity from civil liability under this section shall not apply to a licensed or certified health professional who used the automated external defibrillator device while acting within the scope of the license or certification of the professional or within the scope of the employment or agency of the professional.

(g) In addition to any other immunities available under statutory or common law, the District is not civilly liable for any act or omission in the provision of automated external defibrillation if, at the time of the act or omission, the recreation facility possessed a valid recreation facility certificate.

§ 7–2371.04. Agency fund.

(a) There is established the Automated External Defibrillator Registration Fee Fund (“Fund”), as a non-lapsing, revolving fund, to be administered by the Mayor as an agency fund, as that term is defined in § 47-373(2)(I), and to be used exclusively for the purposes stated in § 7-2371.02.

(b) The Fund shall be financed through registration fees generated pursuant to § 7-2371.02 and regulations promulgated by the Mayor.

§ 7–2371.04a. Automated external defibrillator incentive program.

(a) The Mayor may issue rebates to a property owner or lessee of a building in the District who, after October 1, 2022:

(1) Purchases and installs an AED in a publicly accessible location in the interior of a building owned or leased by the property owner or lessee, respectively, within 150 feet from the building's entrance;

(2) Registers the AED with the Fire and Emergency Medical Services Department;

(3) Submits a rebate claim that includes such information and documentation as may be required by the Mayor; and

(4) Meets any additional requirements and criteria established by rules issued by the Mayor pursuant to § 7-2371.05.

(b)(1) The rebates issued pursuant to subsection (a) of this section shall not exceed $400 for each AED installed in a building, with a maximum rebate of up to $750 per building.

(2) Notwithstanding paragraph (1) of this subsection, the amount of a rebate shall not exceed the purchase price of the AED.

(1) Be contingent upon the availability of funds; and

(2) Not be considered income for purposes of District income tax.

§ 7–2371.05. Rules.

The Mayor, pursuant to subchapter I of Chapter 5 of Title 2 may issue rules to implement the provisions of this subchapter.

§ 7–2371.06. Appropriations. [Repealed]

Repealed.

Subchapter II. Access to Treatment for Anaphylaxis.

§ 7–2381.01. Definitions.

For the purposes of this subchapter, the term:

(1) "Administer" means the direct application of an epinephrine auto-injection to a human body.

(2) "Authorized entity" means any entity or organization other than a public school, including recreational camps, colleges, universities, day care facilities, youth sports leagues, restaurants, places of employment, and sports arenas.

(3) "Department" means the Department of Health.

(4) "Epinephrine auto-injector" means a disposable drug delivery system with a spring-activated needle that is designed for the emergency administration of epinephrine to a person suffering an episode of anaphylaxis.

(5) "Health care professional" means a physician, physician assistant, or advanced practice registered nurse licensed under Chapter 12 of Title 3.

(6) "Standing order" means a prescriptive order written by a health care professional that is not specific to and does not identify a particular patient.

§ 7–2381.02. Epinephrine prescriptions.

(a) A health care professional acting in good faith may directly or by standing order prescribe an epinephrine auto-injector to an authorized entity that has an employee or agent who has completed the training program described in § 7-2381.04.

(b) A pharmacist, in accordance with a health care professional's prescription or standing order, may dispense and distribute an epinephrine auto-injector to an authorized entity to whom an epinephrine auto-injector has been prescribed.

§ 7–2381.03. Authorized use.

An employee or agent of an authorized entity who has completed the training program described in § 7-2381.04 may use an epinephrine auto-injector prescribed pursuant to § 7-2381.02 to:

(1) Provide an epinephrine auto-injector to any individual who the employee or agent believes in good faith is experiencing anaphylaxis, for immediate administration;

(2) Provide an epinephrine auto-injector to the parent, guardian, or caregiver of an individual who the employee or agent believes in good faith is experiencing anaphylaxis, for immediate administration; or

(3) Administer an epinephrine auto-injector to any individual who the employee or agent believes in good faith is experiencing anaphylaxis.

§ 7–2381.04. Training required.

(a) An employee or agent of an authorized entity may not provide or administer an epinephrine auto-injector under this subchapter unless he or she completes an anaphylaxis training program. The training program shall be conducted by:

(1) A nationally recognized organization experienced in training laypersons in emergency health treatment; or

(2) An entity or individual approved by the Department.

(b) The training program may be conducted online or in person and shall include instruction on:

(1) The recognition of signs and symptoms of severe allergic reactions, including anaphylaxis;

(2) Standards and procedures for the storage and administration of an epinephrine auto-injector; and

(3) Post-administration emergency medical follow-up procedures.

(c) An organization, individual, or entity that conducts the training program shall issue a certificate, on a form developed by the Department, to each person who successfully completes the training program.

§ 7–2381.05. Storing and maintaining epinephrine.

(a) An authorized entity may acquire and maintain epinephrine auto-injectors obtained in accordance with § 7-2381.02. Once acquired, the epinephrine auto-injectors shall be maintained:

(1) In a location readily accessible in an emergency situation;

(2) In accordance with the manufacturer's instructions for storage; and

(3) In accordance with any additional requirements that may be established by the Department.

(b) An authorized entity shall designate employees or agents who have completed the training described in § 7-2381.04 to be responsible for the storage and maintenance of epinephrine auto-injectors acquired by the authorized entity.

§ 7–2381.06. Limitations on liability.

(a) The following shall be immune from civil or criminal liability for the performance of actions authorized by this subchapter; provided, that no immunity shall extend to gross negligence, recklessness, or intentional misconduct:

(1) An authorized entity and its employees or agents; and

(2) A third party that facilitates the availability of epinephrine auto-injectors to an authorized entity.

(b) The following shall be immune from civil or criminal liability for the performance of actions authorized by this subchapter; provided, that no immunity shall extend to gross negligence, recklessness, intentional misconduct, or a willful or wanton disregard for the health or safety of others:

(1) A health care professional that prescribes epinephrine auto-injectors to an authorized entity;

(2) A pharmacist that dispenses or distributes epinephrine auto-injectors to an authorized entity; and

(3) An organization, individual, or entity that conducts the training described in § 7-2381.04.

§ 7–2381.07. Incident reports.

(a) An authorized entity that acquires and provides or administers epinephrine auto-injectors shall submit to the Department, on a form developed by the Department, a report of each incident on the authorized entity's premises that involves the provision or administration of an epinephrine auto-injector pursuant to § 7-2381.03.

(b) By January 1, 2020, and annually thereafter, the Department shall publish a report summarizing and analyzing the reports submitted pursuant to subsection (a) of this section during the previous fiscal year.

§ 7–2381.08. Rules.

The Mayor, pursuant to subchapter I of Chapter 5 of Title 2, shall issue rules to implement the provisions of this subchapter.

§ 7–2381.09. Applicability. [Repealed]

Repealed.