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HomeMy WebLinkAbout2009-036THE CORPORATION OF THE MUNICIPALITY OF CLARINGTON BY-LAW 2009-036 Being a By-law to authorize the execution of an Agreement between the Corporation of the Municipality of Clarington and the Central East Prehospital Care Program at Lakeridge Health Corporation of the Collaborative Statements for the Semi Automatic External Defibrillation Program at Community Services Recreation Facilities, Orono Arena, Newcastle Arena and Newcastle Community Hall. THE CORPORATION OF THE MUNICIPALITY OF CLARINGTON HEREBY ENACTS AS FOLLOWS: 1. THAT the Mayor and Clerk are hereby authorized to execute, on behalf of the Corporation of the Municipality of Clarington and seal with the Corporation Seal, an Agreement between Central East Prehospital Care Program at Lakeridge Health Corporation, and said Corporation; and 2. THAT the agreement attached hereto as Schedule "A" form part of this By-law. By-law read a first and second time this 24th day of March, 2009. By-law read a third time and finally passed this 24th day of March, 2009. Abe Y, Mayor- - ~~ `- nicipal Clerk Central East Prehospital Care Program at Lakeridge Health Corporation and Municipality of Clarington Semi Automatic External Defibrillation Collaboration Statement For the Cardiac Safe Community Public Access Defibrillation Program for Durham Region 6 Principle Statement This agreement between the above parties will ensure that the Municipality of Clarington and Public Access Defibrillation (PAD) responders are working under the legal, medical oversight of the Central East Prehospital Care Program (CEPCP) Medical Advisory Board Physicians when providing semi automated external defibrillation (SAED) to a victim of sudden cardiac arrest (SCA). It also provides for the provision of medically current training services in SAED & CPR to those PAD Responders by and under the direction of the CEPCP Medical Advisory Board Physicians. These conjoint efforts are focused on the provision of medically appropriate care for the citizens in our community. Program Components and Recommendations The following items will be components of the annual program maintenance: • Provision of medical oversight by the Central East Prehospital Caze Program (CEPCP) for the Cardiac Safe Community Program for Durham Region. ^ Provision of initial certification training and testing for SAED for PAD responders. • Provision of recertification testing for SAED. • Provision of C.P.R. recertification testing and training of the PAD responder employees as required. • Development and provision of in-house reviews of SAED. • Provision of Biomedical Engineering by the Lakeridge Health Biomedical Engineering Program to ensure that the SAEDs aze maintained according to the manufacturer's standards, including biomedical direction for the replacement of batteries and pads when mandated by the manufacturer or the Biomedical Department (once per year or after each use). ^ Method design for the collection of patient care outcome data by the CEPCP to provide the basis for ongoing patient care quality assurance programs. ^ A formal meeting between the Municipality of Clarington and the CEPCP to review the program's goals, outcomes, and patient care protocols on an annual basis. Availability of the CEPCP staff and physician to consult on and review issues and procedures as required, or at least on a minimum of once per yeaz. • Dedication of a designated CEPCP PAD Coordinator as a prime contact for the PAD site. • CEPCP medical and logistical support for the development of Conjoint Public Access Defibrillation Programs in our Community. The CEPCP will provide instructors (Paramedics and Firefighters) to deliver SAED training, using the principles of Adult Learning. The scope of this training will include, but is not limited to the content of the Canadian Heart and Stroke Foundations CPR &SAED recommendations. All curriculum content and instructor training and qualifications will be approved by the Central East Prehospital Care Program Medical Advisory Board Physicians. • To identify placement of such AED throughout the site to ensure time to defibrillation can be achieved in 3 minutes or less from time of recognition of cardiac arrest; To recommend the AED be placed in an Emergency Response Case that will audibly and visually (flashing red light) alert staff that the emergency response case door has been opened. When the AED is removed from the Emergency Response Case, a call is automatically made to the alarm company who in turn will notify 911 to activate emergency services (Fire Service and Emergency Medical Service). • To establish an action plan in the case of an emergency and AED use. The action plan is to be reviewed every year. • To maintain quality assurance by establishing a collaborative environment between the rescuers, CEPCP, Fire Service, and Emergency Medical Services (EMS) Paramedics through training, feed-back, group sharing of knowledge and learning from experience, and to establish afollow-up support system for rescuers post-AED use (ie. critical incident stress intervention). Agreement Criteria for PAD Pro2rana It is clearly understood and agreed to by both parties that medical direction and oversight to the PAD Responder for the purpose of SAED is provided under the following conditions: A. Direction and oversight of the Cardiac Safe Community PAD program is provided under the auspices of the CEPCP Medical Advisory Boazd Physicians. B. Direction and oversight is valid when the PAD responder is acting in the best interest of a SCA victim. This may include the utilization of a SAED in another PAD site. Any one who has been taught PAD under our program can assist citizen responders in the use of a PAD response. The audio and text prompts from the SAED must be followed exactly. C. Non-targeted responders who use the AED in good faith and voluntarily are covered from liability by the Chase McEachern Act (Heart Defibrillator Civil Liability), 2007, 5.0.2007, c. 10, 5ch. N (Appendix B) and the Good Samaritan Act, 2001 5.0.2001, CHAPTER 2 (Appendix C). Training DevetoymentAcademic Goals and Standards A. All training materials and lesson plans in the initial and on-going program development process will be scrutinized by qualified adult educators. "Qualified Adult Educators" for the purpose of this agreement are prehospital care professionals with practice qualifications of at least the Advanced Care Paramedic Level and with formal certification in adult education from a recognized community college or university. B. All learning objectives and learning outcomes for this program will be approved by a physician who is qualified as a specialist in Emergency Medicine and has experience providing medical direction in the field ofout-of-hospital Emergency Care. Agreement Term This agreement is for a term of one year. By mutual agreement of the parties this agreement will automatically renew for further one year terms on January 1'` of each subsequent year. The agreement will be annually reviewed by both parties before the end of the first quarter of the calendar year. Changes to this agreement will be made by mutual consent. Program Fees and Services Provided Fees The program fees for the services described below are based on groups of 10 certified PAD Responders and one unit at one location: 1. Initial training and certification ofproviders-$700.00 2. Program Support - $1,400.00 for the initial and each subsequent year per unit. Additional units at the same location require an annual fee of $400.00 per unit. 3. Annual Recertification costs are $600.00 4. The support and training fees in this agreement will increase by 3% at the beginning of each calendar year, the first increase for this agreement will be applied in January of 2010. For PAD Responders requiring remedial continuing education from the CEPCP PAD Coordinator or the CEPCP Physician over and above the instruction detailed the CEPCP and the Municipality of Clarington will negotiate a fee for that service at that time. Fees for a class of 10 or fewer students will be $700.00 per day. Minimum fees for an instructor are $400.00 per half day. 6 Services 1. Emergency Action Plan Development: - site assessment - needs assessment to determine the number of SAED's required - direct best placement for access to SAED - medical emergency response plan implementation (site specific 2. CPR Education Review (Canadian Heart & Stroke Foundation Guidelines): - placing 911 call (role of police, fire, and ambulance) - risk factors of heart disease - recognition of heart attack - choking emergencies - patient assessment - artificial respiration (pocket mask) - one and two person adult CPR 3. Defibrillation Training - SAED shock & nonshockable protocols - scenarios (based on Emergency Action Plan) - trouble shooting - SAED weekly, monthly, and after use checks - communication/documentation 4. Advanced Care Paramedic makes presentation on: - concept of rapid defibrillation medical direction of defibrillation - medical legal liabilities and issues - questions and concerns - certification/evaluation 5. Physician Review and Medical Oversight of. - program design - medical legal responsibilities - operational critique for every event 6. Newsletter for Targeted Responder (continuing educational topics for medical emergencies) 7. Quality Assurance and Risk Management: - identify and provide ongoing training for site coordinators - practice scenarios and assignments - daily, monthly, and after use checks - Emergency Action Plan Audit - Begin development of local on site instructor/coordinators to enhance initial certification process for new employees 8. Six month reviews (site visits) to: - evaluate skills retention and - review emergency response plan awareness - continue development of loca] on site instructor /coordinators 9. Office Administration: - maintenance of certification records - updates of protocol changes - clinical co-ordinator dedicated to Targeted Responder Program 10. Critical Incident Stress management services. - demobilization education is provided for the Site Co-ordinator and staff that will be called in to talk with PAD responders immediately following a SCA - when Targeted Responder personnel involved in an event; the Cardiac Safe Community Program will ensure incident debriefings are facilitated - the Cardiac Safe Community Program is affiliated with and supports the Durham Region Critical Incident Stress Management Team Services 11. Biomedical Engineering Support and Operational Risk Management - check SAED once a year - change SAED battery as required - change SAED pads as required - ensure SAED meets operational needs - certification of machine safety and operation Invoicine: Each year the staffthat are trained and/or certified, the number of AED sites along with additional defibrillators will be adjusted and included as a component of the invoicing process. Appendix A attached to this agreement lists the initial sites and numbers of SAEDs covered by this agreement. Hold Harmless Clause The Municipality of Clarington agrees to indemnify and save the Central East Prehospital Care Program at Lakeridge Health Corporation harmless from any court cost, expense, judgement, loss damage, death or injury including court costs and legal fees in any way caused by the negligence or wrong-doing of the Municipality of Clarington related to or arising out of the PAD Program or other matters to which the agreement pertains. The Central East Prehospital Care Program agrees to indemnify and save the Municipality of Clarington from any court cost, expense, judgement, loss, damage, death or injury including court costs and legal fees in any way caused by the negligence or wrong-doing of the Central East Prehospital Care Program at Lakeridge Health Corporation related to or arising out of the PAD Program or other matters to which this agreement pertains. LETTER OF AGREEMENT THIS AGREEMENT made, this 24 day of October A.D. 2008 BETWEEN Central East Prehospital Care Program at Lakeridge Health Corporation and the Municipality of Clarington NOW THEREFORE THIS AGREEMENT WITNESSED that in consideration of the mutual covenants herein contained and subject to the terms and conditions hereinafter set forth the parties hereto agree to participate in the Central East Prehospital Care Program Cardiac Safe Community PAD Program in accordance with the terms outlined in The Lakeridge Health Central East Prehospital Care Program and the Municipality of Clarington collaboration statement. If either party is dissatisfied with the performance of the other party, the dissatisfied party may give written notice of the dissatisfaction to the other party and shall provide the other party with 30 days within which to rectify the matter of dissatisfaction. Where the matter is not corrected to the satisfaction of the party giving notice within the ninety (90) day period, the dissatisfied party may terminate this Agreement by giving the other party ninety (90) days written notice of the party's intention to terminate the Agreement. The ninety (90) day period of notice shall commence five (5) business days after the notice has been mailed to the other party or twenty-four (24) hours following delivery of the notice by hand or by facsimile transmission. 2. The parties mutually agree that this Agreement will be reviewed and renewed annually by the Central East Prehospital Care Program at Lakeridge Health Corporation and the Municipality of Clarington. Any such renewal shall be based upon such terms and conditions, including any or all of the provisions of this Agreement, as maybe mutually agreed to by the parties. Municipality of Clarington OD PC March 31, 2009 P tt rtrie;_Municipal Clerk MarchDate, 2009 Marty Epp ~~// ~ 7 ' ~/~ -Print Date 10 APPENDIX Prog • • • ram Support Providing: Medical Oversight PAD Co-ordinator Contact Quarterl Reviews • Yearly Site Audits • Biomedical Services • Event Reviews For the following sites: • Garnet B. Rickard Recreation Complex $1400.00 • Courtice Community Centre 1400.00 • South Courtice Arena 1400.00 • Bowmanville Indoor Soccer Facility 1400.00 • Clarington Fitness Centre 1400.00 • Newcastle Recreation Centre 1400.00 • Darlington Sports Centre 1400.00 Sub Total 9800.00 GST 490.00 Total $10290.00 This is NOT an invoice. Appendix B Chase McEachern Act (Heart Defibrillator Civil Liabilitx), 2007, S.O. 2007, c. 10, Sch. N Citation: Chase McEachern Act (Heart Defibrillator Civil Liability), 2007, S.O. 2007, c. 10, Sch. N Information about this text: Consolidation: No Amendments. URL: http:%/www.canlii.orgion/laws/sta/2007c.lOsch.n/2 00707 1 7/whole.html Version downloaded by CanLII on 2007-07-17 Chase McEachern Act (Heart Defibrillator Civil Liability), 2007 S.O. 2007, CHAPTER 10 Schedule N Definitions 1. In this Act, "defibrillator° means an automated external medical heart monitor and defibrillator that is capable of, (a) recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia, (b) determining, without intervention by an operator, whether defibrillation should be performed, (c) automatically charging and requesting delivery of an electrical impulse to an individual's heart as medically required, and (d) satisfying any other criteria that may be prescribed by regulation; ("defibrillateur") "emergency" means a situation during which the behaviour of an individual reasonably leads another individual to believe that the first individual is experiencing alife-threatening event that requires the provision of immediate care to assist the heart or other cardiopulmonary functioning of that person; ("situation d'urgence") "health care professional" means, (a) a member of a College of a health profession set out in Schedule 1 to the Regulated Health Professions Act, 1991, (b) such other persons or classes of persons as may be prescribed. ("professionnel de la saute") 2007, c. 10, Sched. N, s. 1. Protection from civil liability, user of defibrillator 2. (1) Despite the rules of common law, a person described in subsection (2) who, in good faith, voluntarily and without reasonable expectation of compensation or reward uses a defibrillator on a person experiencing an emergency is not liable for damages that result from the person's negligence in acting or failing to act while using the defibrillator, unless it is 12 established that the damages were caused by the gross negligence of the person. 2007, c. 10, Sched. N, s. 2 (1). Persons covered (2) Subsection (1) applies to, (a) a health care professional, if the health care professional does not use the defibrillator at a hospital or other place having appropriate health care facilities and equipment for the purpose of defibrillation; and (b) an individual, other than a health care professional described in clause (a), who uses a defibrillator at the immediate scene of an emergency. 2007, c. 1D, Sched. N, s. 2 (2). Reimbursement of expenses (3) Reasonable reimbursement that a person receives for expenses that the person reasonably incurs in using a defibrillator shall be deemed not to be compensation or reward for the purpose of subsection (1). 2007, c. 10, Sched. N, s. 2 (3). Protection from civil liability, owner or operator of premises 3. (1) Despite the Occupiers' Liability Act and the rules of common law, any person who owns or occupies premises where a defibrillator is made available for use and who acts in good faith with respect to the availability or use of the defibrillator is exempt from civil liability for any harm or damage that may occur from the use of the defibrillator. 2D07, c. 10, Sched. N, s. 3 (1). Exception (2) Subsection (1) does not exempt the person who owns or occupies the premises where a defibrillator is made available for use from civil liability if, (a) that person acts with gross negligence with respect to making the defibrillator available; (b) that person fails to properly maintain the defibrillator; or (c) the premises where the defibrillator is made available for use is a hospital or other premises used primarily for the purpose of providing health care to individuals. 2007, c. 10, Sched. N, s. 3 (2). Regulations 4. The Lieutenant Governor in Council may make regulations, (a) prescribing criteria for the purpose of the definition of "defibrillator" in section 1; (b) prescribing persons or classes of persons for the purposes of the definition of "health care professional" in section 1; (c) governing standards for the proper maintenance of defibrillators; (d) respecting any matter necessary or advisable to carry out effectively the purposes of this Act. 2007, c. 10, Sched. N, s. 4. Applies to the Crown 5. This Act applies to the Crown and any agency of the Crown. 2007, c. 10, Sched. N, s. 5. 6. Omitted (provides for coming into force of provisions of this Ad). 2007, c. 10, Sched. N, s. 6. 7. Omitted (enacts short title of this Act). 2007, c. 10, Sched. N, s. 7. Reference: chase McEachern Act (Heart Defibrillator Civil Liability), 2007, S.O. 2007, c. ] 0, Sch. N; http://www.canlii.org/on/laws/sta/2007c. l Osch.n/20070717/whole.html. 13 14 Appendix C Good Samaritan Act, 2001, S.O.2001, CHAPTER 2 No amendments. Definition 1. In this Act, "health care professional" means a member of a College of a health profession set out in Schedule 1 to the Regulated Health Professions Act, 199]. 2001, c. 2, s. 1. Protection from liability 2. (1) Despite the rules of common law, a person described in subsection (2) who voluntarily and without reasonable expectation of compensation or reward provides the services described in that subsection is not liable for damages that result from the person's negligence in acting or failing to act while providing the services, unless it is established that the damages were caused by the gross negligence of the person. 2001, c. 2, s. 2 (1). Persons covered (2) Subsection (1) applies to, (a) a health care professional who provides emergency health care services or first aid assistance to a person who is ill, injured or unconscious as a result of an accident or other emergency, if the health care professional does not provide the services or assistance at a hospital or other place having appropriate health care facilities and equipment for that purpose; and (b) an individual, other than a health care professional described in clause (a), who provides emergency first aid assistance to a person who is ill, injured or unconscious as a result of an accident or other emergency, if the individual provides the assistance at the immediate scene ofthe accident or emergency. 2001, c. 2, s. 2 (2). Reimbursement of expenses (3) Reasonable reimbursement that a person receives for expenses that the person reasonably incurs in providing the services described in subsection (2) shall be deemed not to be compensation or reward for the purpose of subsection (1). 2001, c. 2, s. 2 (3). 3. Omitted (provides for coming into force of provisions of this Act). 2001, a 2, s. 3. 4. Omitted (enacts short title of this Act). 2001, c. 2, s. 4. Reference: Good Samaritan Act, 2001, S.O. 2001, CHAPTER 2; http://www.e- laws.gov.on.ca/html/statutes/english/elaws_statutes_O1 g02_e.htm. Central East Prehospital Care Program at Lakeridge Health Corporation and Newcastle Arena Semi Automatic External Defibrillation Collaboration Statement For the Cardiac Safe Community Public Access Defibrillation Program for Durham Region Principle Statement This agreement between the above parties will ensure that the Newcastle Arena and Public Access Defibrillation (PAD) responders are working under the legal, medical oversight of the Central East Prehospital Care Program (CEPCP) Medical Advisory Board Physicians when providing semi automated external defibrillation (SAED) to a victim of sudden cazdiac arrest (SCA). It also provides for the provision of medically current training services in SAED & CPR to those PAD Responders by and under the direction of the CEPCP Medical Advisory Board Physicians. These conjoint efforts are focused on the provision of medically appropriate care for the citizens in our community. Program Components and Recommendations The following items will be components of the annual program maintenance: • Provision of medical oversight by the Central East Prehospital Care Program (CEPCP) for the Cazdiac Safe Community Program for Durham Region. • Provision of initial certification training and testing for SAED for PAD responders. • Provision of recertification testing for SAED. • Provision of C.P.R. recertification testing and training of the PAD responder employees as required. • Development and provision of in-house reviews of SAED. • Provision of Biomedical Engineering by the Lakeridge Health Biomedical Engineering Program to ensure that the SAEDs are maintained according to the manufacturer's standards, including biomedical direction for the replacement of batteries and pads when mandated by the manufacturer or the Biomedical Deparhnent (once per year or afrer each use). • Method design for the collection of patient Gaze outcome data by the CEPCP to provide the basis for ongoing patient care quality assurance programs. A formal meeting between the Newcastle Arena and the CEPCP to review the program's goals, outcomes, and patient care protocols on an annual basis. • Availability of the CEPCP staff and physician to consult on and review issues and procedures as required, or at least on a minimum of once per year. • Dedication of a designated CEPCP PAD Coordinator as a prime contact for the PAD site. • CEPCP medical and logistical support for the development of Conjoint Public Access Defibrillation Programs in our Community. The CEPCP will provide instructors (Paramedics and Firefighters) to deliver SAED training, using the principles of Adult Learning. The scope of this training will include, but is not limited to the content of the Canadian Heart and Stroke Foundations CPR &SAED recommendations. All curriculum content and instructor training and qualifications will be approved by the Central East Prehospital Care Program Medical Advisory Board Physicians. • To identify placement of such AED throughout the site to ensure time to defibrillation can be achieved in 3 minutes or less from time of recognition of cardiac arrest; To recommend the AED be placed in an Emergency Response Case that will audibly and visually (flashing red light) alert staff that the emergency response case door has been opened. When the AED is removed from the Emergency Response Case, a call is automatically made to the alarm company who in turn will notify 911 to activate emergency services (Fire Service and Emergency Medical Service). To establish an action plan in the case of an emergency and AED use. The action plan is to be reviewed every year. • To maintain quality assurance by establishing a collaborative environment between the rescuers, CEPCP, Fire Service, and Emergency Medical Services (EMS) Paramedics through training, feed-back, group sharing of knowledge and learning from experience, and to establish afollow-up support system for rescuers post-AED use (ie. critical incident stress intervention). Agreement Criteria for PAD Program It is clearly understood and agreed to by both parties that medical direction and oversight to the PAD Responder for the purpose of SAED is provided under the following conditions: A. Direction and oversight of the Cardiac Safe Community PAD program is provided under the auspices of the CEPCP Medical Advisory Board Physicians. B. Direction and oversight is valid when the PAD responder is acting in the best interest of a SCA victim. This may include the utilization of a SAED in another PAD site. Any one ~vho has been taught PAD under our program can assist citizen responders in the use of a PAD response. The audio and text prompts from the SAED must be followed exactly. C. Non-targeted responders who use the AED in good faith and voluntarily are covered from liability by the Chase McEachern Act (Heart Defibrillator Civil Liability), 2007, S.O. 2007, c. 10, Sch. N (Appendix B) and the Good Samaritan Act, 2001 S.O.2001, CHAPTER 2 (Appendix C). TrainingDeveloUmentAcademic Goals and Standards A. All training materials and lesson plans in the initial and on-going program development process will be scrutinized by qualified adult educators. "Qualified Adult Educators" for the purpose of this agreement are prehospital care professionals with practice qualifications of at least the Advanced Care Paramedic Level and with formal certification in adult education from a recognized community college or university. B. All learning objectives and learning outcomes for this program will be approved by a physician who is qualified as a specialist in Emergency Medicine and has experience providing medical direction in the field ofout-of-hospital Emergency Care. Agreement Term This agreement is for a term of one year. By mutual agreement of the parties this agreement will automatically renew for further one year terms on January 1 s` of each subsequent year. The agreement will be annually reviewed by both parties before the end of the first quarter of the calendar year. Changes to this agreement will be made by mutual consent. Program Fees and Services Provided Fees The program fees for the services described below are based on groups of 10 certified PAD Responders and one unit at one location: 1. Initial training and certification ofproviders-$700.00 2. Program Support - $1,400.00 for the initial and each subsequent year per unit. Additional units at the same location require an annual fee of $400.00 per unit. 3. Annual Recertification costs are $600.00 4. The support and training fees in this agreement will increase by 3% at the beginning of each calendar year, the first increase for this agreement will be applied in January of 2010. For PAD Responders requiring remedial continuing education from the CEPCP PAD Coordinator or the CEPCP Physician over and above the instruction detailed the CEPCP and the Newcastle Arena will negotiate a fee for that service at that time. Fees for a class of I O or fewer students will be $700.00 per day. Minimum fees for an instructor are $400.00 per half day. 6 Services 1. Emergency Action Plan Development: - site assessment - needs assessment to determine the number of SAED's required - direct best placement for access to SAED - medical emergency response plan implementation (site specific 2. CPR Education Review (Canadian Hear[ & Stroke Foundation Guidelines): - placing 911 call (role ofpolice, fire, and ambulance) - risk factors of heart disease - recognition of heart attack - choking emergencies - patient assessment - artificial respiration (pocket mask) - one and two person adult CPR 3. Defibrillation Training - SAED shock & nonshockable protocols - scenarios (based on Emergency Action Plan) - trouble shooting - SAED weekly, monthly, and after use checks - communication/documentation 4. Advanced Care Paramedic makes presentation on: - concept of rapid defibrillation medical direction of defibrillation - medical legal liabilities and issues - questions and concerns - certification/evaluation 5. Physician Review and Medical Oversight of: - program design - medical legal responsibilities - operational critique for every event 6. Newsletter for Targeted Responder (continuing educational topics for medical emergencies) 7. Quality Assurance and Risk Management: - identify and provide ongoing training for site coordinators - practice scenarios and assignments - daily, monthly, and after use checks Emergency Action Plan Audit Begin development of local on site instructor/coordinators to enhance initial certification process for new employees 8. Six month reviews (site visits) to: - evaluate skills retention and - review emergency response plan awareness - continue development of local on site instructor /coordinators 9. Office Administration: - maintenance of certification records - updates of protocol changes - clinical co-ordinator dedicated to Targeted Responder Program 10. Critical Incident Stress management services. - demobilization education is provided for the Site Co-ordinator and staff that will be called in to talk with PAD responders immediately following a SCA - when Targeted Responder personnel involved in an event; the Cardiac Safe Community Program will ensure incident debriefings are facilitated - the Cardiac Safe Community Program is affiliated with and supports the Durham Region Critical Incident Stress Management Team Services 11. Biomedical Engineering Support and Operational Risk Management - check SAED once a year - change SAED battery as required - change SAED pads as required - ensure SAED meets operational needs - certification of machine safety and operation lnvoicina: Each year the staffthat are trained and/or certified, the number of AED sites along with additional defibrillators will be adjusted and included as a component of the invoicing process. Appendix A attached to this agreement lists the initial sites and numbers of SAEDs covered by this agreement. Hold Harmless Clause The Newcastle Arena agrees to indemnify and save the Central East Prehospital Care Program at Lakeridge Heath Corporation harmless from any court cost, expense, judgement, loss damage, death or injury including court costs and legal fees in any way caused by the negligence or wrong-doing of the Newcastle Arena related to or arising out of the PAD Program or other matters to which the agreement pertains. The Central East Prehospital Care Program agrees to indemnify and save the Newcastle Arena from any court cost, expense, judgement, loss, damage, death or injury including court costs and legal fees in any way caused by the negligence or wrong-doing of the Central East Prehospital Care Program at Lakeridge Health Corporation related to or arising out of the PAD Program or other matters to which this agreement pertains. LETTER OF AGREEMENT THIS AGREEMENT made, this 24 day of October A.D. 2008 BETWEEN Central East Prehospital Care Program at Lakeridge Health Corporation and the Newcastle Arena NOW THEREFORE THIS AGREEMENT WITNESSED that in consideration of the mutual covenants herein contained and subject to the terms and conditions hereinafter set forth the parties hereto agree to participate in the Central East Prehospital Care Program Cardiac Safe Community PAD Program in accordance with the terms outlined in The Lakeridge Health Central East Prehospital Care Program and the Newcastle Arena collaboration statement. 1. If either party is dissatisfied with the performance of the other party, the dissatisfied party may give written notice of the dissatisfaction to the other party and shall provide the other party with 30 days within which to rectify the matter of dissatisfaction. Where the matter is not corrected to the satisfaction of the party giving notice within the ninety (90) day period, the dissatisfied party may terminate this Agreement by giving the other party ninety (90) days written notice of the party's intention to terminate the Agreement. The ninety (90) day period of notice shall commence five (5) business days after the notice has been mailed to the other party or twenty-four (24) hours following delivery of the notice by hand or by facsimile transmission. 2. The parties mutually agree that this Agreement will be reviewed and renewed annually by the Central East Prehospital Care Program at Lakeridge Health Corporation and the Newcastle Arena. Any such renewal shall be based upon such terms and conditions, including any or all of the provisions of this Agreement, as may ~~utually agreed to by the parties. Jim Abernethy, Mayor March 31, 2009 _`~-- atti arrie, unicipal Cler arc , Nestle Arena Print Date ~ _ . d - ~ ~ ~ Marty Epp 9 0~9~~~ CEPC Print Date 10 APPENDIX A Program Support Providing: • Medical Oversight • PAD Co-ordinator Contact • Quarterl Reviews • Yearly Site Audits • Biomedical Services • Event Reviews For the following sites: • Newcastle Arena $1400.00 Sub Total ] 400.00 GST 70.00 Total $1470.00 This is NOT an invoice. ll Appendix B Chase McEachern Act (Heart Defibrillator Civil Liability) 2007, S.O. 2007, c. 10, Sch. N Citation: Chase McEachern Act (Heart Defibrillator Civil Liability), 2007, S.O. 2007, c. 10, Sch. N Information about this text: Consolidation: No Amendments. URL: httpJfwww.canlii.org/on/laws/stai2007c10sch.n/20070717/whole.html Version downloaded by CanLII on 2007-07-17 Chase McEachern Act (Heart Defibrillator Civil Liability), 2007 S.O. 2007, CHAPTER 10 Schedule N Definitions 1. In this Act, "defibrillator" means an automated external medical heart monitor and defibrillator that is capable of, (a) recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia, (b} determining, without intervention by an operator, whether defibrillation should be performed, (c) automatically charging and requesting delivery of an electrical impulse to an individual's heart as medically required, and (d) satisfying any other criteria that may be prescribed by regulation; ("defibrillateur") "emergency" means a situation during which the behaviour of an individual reasonably leads another individual to believe that the first individual is experiencing alife-threatening event that requires the provision of immediate care to assist the heart or other cardiopulmonary functioning of that person; ("situation d'urgence") "health care professional" means, (a) a member of a College of a health profession set out in Schedule 1 to the Regulated Health Professions Act, 1991, (b) such other persons or classes of persons as may be prescribed. ("professionnel de la saute") 2007, c. 10, Sched. N, s. 1. Protection from civil liability, user of defibrillator 2. (1) Despite the rules of common law, a person described in subsection (2) who, in good faith, voluntarily and without reasonable expectation of compensation or reward uses a defibrillator on a person experiencing an emergency is not liable for damages that result from the person's negligence in acting or failing to act while using the defibrillator, unless it is 12 established that the damages were caused by the gross negligence of the person. 2007, c. 10, Sched. N, s. 2 (1). Persons covered (2) Subsection (1) applies to, (a) a health care professional, if the health care professional does not use the defibrillator at a hospital or other place having appropriate health care facilities and equipment for the purpose of defibrillation; and (b) an individual, other than a health care professional described in clause (a), who uses a defibrillator at the immediate scene of an emergency. 2007, c. 10, Sched. N, s. 2 (2). Reimbursement of expenses (3) Reasonable reimbursement that a person receives for expenses that the person reasonably incurs in using a defibrillator shall be deemed not to be compensation or reward for the purpose of subsection (1). 2007, c. 10, Sched. N, s. 2 (3). Protection from civil liability, owner or operator of premises 3. (1) Despite the Occupiers'Liability Act and the rules of common law, any person who owns or occupies premises where a defibrillator is made available for use and who acts in good faith with respect to the availability or use of the defibrillator is exempt from civil liability for any harm or damage that may occur from the use of the defibrillator. 2007, c. 10, Sched. N, s. 3 (1). Exception (2) Subsection (1) does not exempt the person who owns or occupies the premises where a defibrillator is made available for use from civil liability if, (a) that person acts with gross negligence with respect to making the defibrillator available; (b) that person fails to properly maintain the defibrillator; or (c) the premises where the defibrillator is made available for use is a hospital or other premises used primarily for the purpose of providing health care to individuals. 2007, c. 10, Sched. N, s. 3 (2). Regulations 4. The Lieutenant Governor in Council may make regulations, (a) prescribing criteria for the purpose of the definition of "defibrillator" in section 1; (h) prescribing persons or classes of persons for the purposes of the definition of "health care professional"in section 1; (c) governing standards for the proper maintenance of defibrillators; (d) respecting any matter necessary or advisable to carry out effectively the purposes of this Act. 2007, c. 10, Sched. N, s. 4. Applies to the Crown 5. This Act applies to the Crown and any agency of the Crown. 2007, c. 10, Sched. N, s. 5. 13 6. Omitted (provides for coming into force of provisions of this Act). 2007, c. 10, Sched. N, s. 6. 7. Omitted (enacts short title of this Act). 2DD7, c. 10, Sched. N, s. 7. Reference: Chase McEachern Act (Heart Defibrillator Civil Liability), 2007, S.O. 2007, c. 10, Sch. N; http://www.canlii.org/on/laws/sta/2007c.] Osch.n/20070717/whole.html. 14 Appendix C Good Samaritan Act, 2001, S.O. 2001, CHAPTER 2 No amendments. Definition 1. In this Act, "health care professional" means a member of a College of a health profession set out in Schedule 1 to the Regulated Health Professions Act, 1991.2001, c. 2, s. 1. Protection from liability 2. (1) Despite the rules of common law, a person described in subsection (2) who voluntarily and without reasonable expectation of compensation or reward provides the services described in that subsection is not liable for damages that result from the person°s negligence in acting or failing to act while providing the services, unless it is established that the damages were caused by the gross negligence of the person. 2001, a 2, s. 2 (1). Persons covered (2) Subsection (1) applies to, (a) a health care professional who provides emergency health care services or first aid assistance to a person who is ill, injured or unconscious as a result of an accident or other emergency, if the health care professional does not provide the services or assistance at a hospital or other place having appropriate health care facilities and equipment for that purpose; and (b) an individual, other than a health care professional described in clause (a), who provides emergency first aid assistance to a person who is ill, injured or unconscious as a result of an accident or other emergency, if the individual provides the assistance at the immediate scene of the accident or emergency. 2001, c. 2, s. 2 (2). Reimbursement of expenses (3) Reasonable reimbursement that a person receives for expenses that the person reasonably incurs in providing the services described in subsection (2) shall be deemed not to be compensation or reward for the purpose of subsection (1). 2001, c. 2, s. 2 (3). 3. Omitted (provides for coming into force of provisions of this Act). 2001, c. 2, s. 3. 4. Omitted (enacts short title of this Act). 2001, c. 2, s. 4. Reference: Good Samaritan Act, 2001, S.O. 2001, CHAPTER 2; http://www.e- laws.gov.on.ca/html/statutes/english/elaws_statutes_Ol g02_e.htm. Central East Prehospital Care Program at Lakeridge Health Corporation and Newcastle Town Hall Semi Automatic External Defibrillation Collaboration Statement For the Cardiac Safe Community Public Access Defibrillation Program for Durham Region Principle Statement This agreement between the above parties will ensure that the Newcastle Town Hall and Public Access Defibrillation (PAD) responders are working under the legal, medical oversight of the Central East Prehospital Care Program (CEPCP) Medical Advisory Board Physicians when providing semi automated external defibrillation (SAED) to a vicfim of sudden cardiac arrest (SCA). It also provides for the provision of medically current training services in SAED & CPR to those PAD Responders by and under the direction of the CEPCP Medical Advisory Board Physicians. These conjoint efforts are focused on the provision of medically appropriate care for the citizens in our community. Program Components and Recommendations The following items will be components of the annual program maintenance: • Provision of medica] oversight by the Central East Prehospital Care Program (CEPCP) for the Cardiac Safe Community Program for Durham Region. ^ Provision of initial certification training and testing for SAED for PAD responders. Provision of recertification testing for SAED. • Provision of C.P.R. recertification testing and training of the PAD responder employees as required. ^ Development and provision of in-house reviews of SAED. • Provision of Biomedical Engineering by the Lakeridge Health Biomedical Engineering Program to ensure that the SAEDs are maintained according to the manufacturer's standards, including biomedical direction for the replacement of batteries and pads when mandated by the manufacturer or the Biomedical Department (once per year or after each use). • Method design for the collection of patient care outcome data by the CEPCP to provide the basis for ongoing patient care quality assurance programs. A formal meeting between the Newcastle Town Hall and the CEPCP to review the program's goals, outcomes, and patient care protocols on an annual basis. Availability of the CEPCP staff and physician to consult on and review issues and procedures as required, or at least on a minimum of once per year. ^ Dedication of a designated CEPCP PAD Coordinator as a prime contact for the PAD site. • CEPCP medical and logistical support for the development of Conjoint Public Access Defibrillation Programs in our Community. The CEPCP will provide instructors (Pazamedics and Firefighters) to deliver SAED training, using the principles of Adult Learning. The scope of this training will include, but is not limited to the content of the Canadian Heart and Stroke Foundations CPR &SAED recommendations. All curriculum content and instructor training and qualifications will be approved by the Central East Prehospital Care Program Medical Advisory Board Physicians. To identify placement of such AED throughout the site to ensure time to defibrillation can be achieved in 3 minutes or less from time of recognition of cardiac arrest, To recommend the AED be placed in an Emergency Response Case that will audibly and visually (flashing red light) alert staff that the emergency response case door has been opened. When the AED is removed from the Emergency Response Case, a call is automatically made to the alarm company who in turn will notify 911 to activate emergency services (Fire Service and Emergency Medical Service). To establish an action plan in the case of an emergency and AED use. The action plan is to be reviewed every year. To maintain quality assurance by establishing a collaborative environment between the rescuers, CEPCP, Fire Service, and Emergency Medical Services (EMS) Paramedics through training, feed-back, group sharing of knowledge and learning from experience, and to establish afollow-up support system for rescuers post-AED use (ie. critical incident stress intervention). Agreement Criteria for PAD Program It is clearly understood and agreed to by both parties that medical direction and oversight to the PAD Responder for the purpose of SAED is provided under the following conditions: A. Direction and oversight of the Cardiac Safe Community PAD program is provided under the auspices of the CEPCP Medical Advisory Board Physicians. B. Direction and oversight is valid when the PAD responder is acting in the best interest of a SCA victim. This may include the utilization of a SAED in another PAD site. Any one who has been taught PAD under our program can assist citizen responders in the use of a PAD response. The audio and text prompts from the SAED must be followed exactly. C. Non-targeted responders who use the AED in good faith and voluntarily are covered from liability by the Chase McEachern Act (Heart De£brillator Civil Liability), 2007, 5.0.2007, c. 10, Sch. N (Appendix B) and the Good Samaritan Act, 2001 S.O.2001, CHAPTER 2 (Appendix C). TradndngDevelopmentAcademic Goals and Standards A. All training materials and lesson plans in the initial and on-going program development process will be scrutinized by qualified adult educators. "Qualified Adult Educators" for the purpose of this agreement are prehospital care professionals with practice qualifications of at least the Advanced Care Paramedic Level and with formal certification in adult education from a recognized community college or university. B. All learning objectives and learning outcomes for this program will be approved by a physician who is qualified as a specialist in Emergency Medicine and has experience providing medical direction in the field ofout-of-hospital Emergency Care. Agreement Term This agreement is for a term of one year. By mutual agreement of the parties this agreement will automatically renew for further one year terms on January 1 s` of each subsequent year. The agreement will be annually reviewed by both parties before the end of the first quarter of the calendar year. Changes to this agreement will be made by mutual consent. Program Fees and Services Provided Fees The program fees for the services described below are based on groups of 10 certified PAD Responders and one unit at one location: 1. Initial training and certification ofproviders-$700.00 2. Program Support - $1,400.00 for the initial and each subsequent year per unit. Additional units at the same location require an annual fee of $400.00 per unit. 3. Annual Recertification costs are $600.00 4. The support and training fees in this agreement will increase by 3% at the beginning of each calendar year, the first increase for this agreement will be applied in January of 2010. For PAD Responders requiring remedial continuing education from the CEPCP PAD Coordinator or the CEPCP Physician over and above the instruction detailed the CEPCP and the Newcastle Town Hall will negotiate a fee for that service at that time. Fees for a class of 10 or fewer students will be $700.00 per day. Minimum fees for an instructor are $400.00 per half day. 6 Services 1. Emergency Action Plan Development: - site assessment - needs assessment to determine the number of SAED's required - direct best placement for access to SAED - medical emergency response plan implementation (site specific 2. CPR Education Review (Canadian Heart & Stroke Foundation Guidelines): - placing 911 call (role of police, fire, and ambulance) - risk factors of heart disease - recognition of heart attack - choking emergencies - patient assessment - artificial respiration (pocket mask) - one and two person adult CPR 3. Defibrillation Training: - SAED shock & nonshockable protocols - scenarios (based on Emergency Action Plan) - trouble shooting - SAED weekly, monthly, and after use checks - communication/documentation 4. Advanced Care Paramedic makes presentation on: - concept of rapid defibrillation medical direction of defibrillation - medical legal liabilities and issues - questions and concerns - certification/evaluation 5. Physician Review and Medical Oversight of - program design - medical legal responsibilities - operational critique for every event 6. Newsletter for Targeted Responder (continuing educational topics for medical emergencies) 7. Quality Assurance and Risk Management: - identify and provide ongoing training for site coordinators - practice scenarios and assignments - daily, monthly, and after use checks Emergency Action Plan Audit Begin development of local on site instructor/coordinators to enhance initial certification process for new employees 8. Six month reviews (site visits) to: - evaluate skills retention and - review emergency response plan awareness - continue development of local on site instructor /coordinators 9. Office Administration: - maintenance of certification records - updates of protocol changes - clinical co-ordinator dedicated to Targeted Responder Program 10. Critical Incident Stress management services. - demobilization education is provided for the Site Co-ordinator and staff that will be called in to talk with PAD responders immediately following a SCA - when Targeted Responder personnel involved in an event; the Cardiac Safe Community Program will ensure incident debriefings are facilitated - the Cardiac Safe Community Program is affiliated with and supports the Durham Region Critical Incident Stress Management Team Services 11. Biomedical Engineering Support and Operational Risk Management - check SAED once a year - change SAED battery as required - change SAED pads as required - ensure SAED meets operational needs - certification of machine safety and operation Invoicine: Each year the staff that are trained and/or certified, the number of AED sites along with additional defibrillators will be adjusted and included as a component of the invoicing process. Appendix A attached to this agreement lists the initial sites and numbers of SAEDs covered by this agreement. Hold Harmless Clause The Newcastle Town Hall agrees to indemnify and save the Central East Prehospital Care Program at Lakeridge Health Corporation harmless from any court cost, expense, judgement, loss damage. death or injury including court costs and legal fees in any way caused by the negligence or wrong-doing of the Newcastle Town Hall related to or arising out of the PAD Program or other matters to which the agreement pertains. The Central East Prehospital Care Program agrees to indemnify and save the Newcastle Town Hall from any court cost, expense, judgement, loss, damage, death or injury including court costs and legal fees in any way caused by the negligence or wrong-doing of the Central East Prehospital Care Program at Lakeridge Health Corporation related to or arising out of the PAD Program or other matters to which this agreement pertains. LETTER OF AGREEMENT THIS AGREEMENT made, this 24 day of October A.D. 2008 BETWEEN Central East Prehospital Care Program at Lakeridge Health Corporation and the Newcastle Town Hall NOW THEREFORE THIS AGREEMENT WITNESSED that in consideration of the mutual covenants herein contained and subject to the terms and conditions hereinafter set forth the parties hereto agree to participate in the Central East Prehospital Care Program Cardiac Safe Community PAD Program in accordance with the terms outlined in The Lakeridge Health Central East Prehospital Care Program and the Newcastle Town Hall collaboration statement. If either party is dissatisfied with the performance of the other party, the dissatisfied party may give written notice of the dissatisfaction to the other party and shall provide the other party with 30 days within which to rectify the matter of dissatisfaction. Where the matter is not corrected to the satisfaction of the party giving notice within the ninety (90) day period, the dissatisfied party may terminate this Agreement by giving the other party ninety (90) days written notice of the party's intention to terminate the Agreement. The ninety (90) day period of notice shall commence five (5) business days after the notice has been mailed to the other party or twenty-four (24) hours following delivery of the notice by hand or by facsimile transmission. 2. The parties mutually agree that this Agreement will be reviewed and renewed annually by the Central East Prehospital Care Program at Lakeridge Health Corporation and the Newcastle Town Hall. Any such renewal shall be based upon such terms and conditions, including any or all of the provisions of this Agreement, as Abe mutually agreed to by the parties. Jim Abernethy, Mayor March 31, 2009 Patti L. Barrie, Municipal Clerk March 31, 2009 - _ iale~tle T~+n Hall Print Date - _ _ L~~ Marty Epp ~.~~~-o~ EP P Print Date 10 APPENDIX A Proeram Support Providing: • Medical Oversight • PAD Co-ordinator Contact • uarterl Reviews Yearly Site Audits • Biomedical Services • Event Reviews For the following sites: • Newcastle Town Hall $1400.00 Sub Total 1400.00 GST 70.00 Total $1470.00 This is NOT an invoice. I1 Appendix B Chase McEachern Act (Heart Defibrillator Civil Liabilitx , 2007, S.O. 2007, c. 10, Sch. N Citation: Chase McEachern Act (Heart Defibrillator Civil Liability), 2007, S.O. 2007, c. 10, Sch. N Information about this text: Consolidation: No Amendments. URL: http://www.canlii.org/on/laws/sta/2007c. t Osch.n/20070717/whole.html Version downloaded by CanLII on 2007-07-17 Chase McEachern Act (Heart Defibrillator Civil Liability), 2007 S.O. 2007, CHAPTER 10 Schedule N Definitions 1. In this Act, °defibrillator" means an automated external medical heart monitor and defibrillator that is capable of, (a) recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia, (b) determining, without intervention by an operator, whether defibrillation should be performed, (c) automatically charging and requesting delivery of an electrical impulse to an individual's heart as medically required, and (d) satisfying any other criteria that may be prescribed by regulation; ("defibrillateur") "emergency" means a situation during which the behaviour of an individual reasonably leads another individual to believe that the first individual is experiencing alife-threatening event that requires the provision of immediate care to assist the heart or other cardiopulmonary functioning of that person; ("situation d'urgence") "health care professional" means, (a) a member of a College of a health profession set out in Schedule 1 to the Regulated Health Professions Act, 1991, (b) such other persons or classes of persons as may be prescribed. ("professionnel de la sante") 2007, c. 10, Sched. N, s. 1. Protection from civil liability, user of defibrillator 2. (1) Despite the rules of common law, a person described in subsection (2) who, in good faith, voluntarily and without reasonable expectation of compensation or reward uses a defibrillator on a person experiencing an emergency is not liable for damages that result from the person's negligence in acting or failing to act while using the defibrillator, unless it is 12 established that the damages were caused by the gross negligence of the person. 2007, c. 10, Sched. N, s. 2 (1). Persons covered (2) Subsection (1) applies to, (a) a health care professional, if the health care professional does not use the defibrillator at a hospital or other place having appropriate health care facilities and equipment for the purpose of defibrillation; and (b) an individual, other than a health care professional described in clause (a), who uses a defibrillator at the immediate scene of an emergency. 2007, c. 10, Sched. N, s. 2 (2). Reimbursement of expenses (3) Reasonable reimbursement that a person receives for expenses that the person reasonably incurs in using a defibrillator shall be deemed not to be compensation or reward for the purpose of subsection (1). 2007, c. 10, Sched. N, s. 2 (3). Protection from civil liability, owner or operator of premises 3. (1) Despite the Occupiers'Llability Act and the rules of common law, any person who owns or occupies premises where a defibrillator is made available for use and who acts in good faith with respect to the availability or use of the defibrillator is exempt from civil liability for any harm or damage that may occur from the use of the defibrillator. 2007, c. 10, Sched. N, s. 3 (1). Exception (2) Subsection (1) does not exempt the person who owns or occupies the premises where a defibrillator is made available for use from civil liability if, (a) that person acts with gross negligence with respect to making the defibrillator available; (b) that person fails to properly maintain the defibrillator; or (c) the premises where the defibrillator is made available for use is a hospital or other premises used primarily for the purpose of providing health care to individuals. 2007, c. 10, Sched. N, s. 3 (2). Regulations 4. The Lieutenant Governor in Council may make regulations, (a) prescribing criteria for the purpose of the definition of "defibrillator" in section 1; (b) prescribing persons or classes of persons for the purposes of the definition of "health care professional" in section 1; (c) governing standards for the proper maintenance of defibrillators; (d) respecting any matter necessary or advisable to carry out effec[ively the purposes of this Act. 2007, c. 10, Sched. N, s. 4. Applies to the Crown 5. This Act applies to the Crown and any agency of the Crown. 2007, c. 10, Sched. N, s. 5. 13 6. Omitted (provides for coming into force of provisions of this Act). 2007, c. 10, Sched. N, s. 6. 7. Omitted (enacts short title of this Act). 2007, c. 10, Sched. N, s. 7. Reference: Chase McEachern Act (Heart DeSbrillator Civil Liability), 2007, S.O.2007, c. 10, Sch. N; http://www.canlii.org/on/laws/sta/2007c.1 Osch.n/20070717/whole.html. 14 Appendix C Good Samaritan Act, 2001, S.O. 2001, CHAPTER 2 No amendments. Definition 1. In this Act, "health care professional" means a member of a College of a health profession set out in Schedule 1 to the Regulated Health Professions Act, 1991. 2001, c. 2, s. 1. Protection from liability 2. (1) Despite the rules of common law, a person described in subsection (2) who voluntarily and without reasonable expectation of compensation or reward provides the services described in that subsection is not liable for damages that result from the person's negligence in acting or failing to act while providing the services, unless it is established that the damages were caused by the gross negligence of the person. 2001; c. 2, s. 2 (l). Persons covered (2) Subsection (1) applies to, (a) a health care professional who provides emergency health care services or first aid assistance to a person who is ill, injured or unconscious as a result of an accident or other emergency, if the health care professional does not provide the services or assistance at a hospital or other place having appropriate health care facilities and equipment for that purpose; and (b) an individual, other than a health care professional described in clause (a), who provides emergency first aid assistance to a person who is ill, injured or unconscious as a result of an accident or other emergency, if the individual provides the assistance at the immediate scene of the accident or emergency. 2001, o. 2, s. 2 (2). Reimbursement of expenses (3) Reasonable reimbursement that a person receives for expenses that the person reasonably incurs in providing the services described in subsection (2) shall be deemed not to be compensation or reward for the purpose of subsection (1).2001, c. 2, s. 2 (3). 3. Omitted (provides for coming into force of provisions of this Act). 2001, c. 2, s. 3. 4. Omitted (enacts short title ofthis Act). 2001, c. 2, s. 4. Reference: Good Samaritan Act, 2001, S.O. 2001, CHAPTER 2; http://www.e- laws.gov.on.ca/html/statutes/english/elaws statutes O1g02_e.htm. i Central East Prehospital Care Program at Lakeridge Health Corporation and Orono Arena Semi Automatic External Defibrillation Collaboration Statement For the Cardiac Safe Community Public Access Defibrillation Program for Durham Region ' ~ Principle Statement This agreement between the above parties will ensure that the Orono Arena and Public Access Defibrillation (PAD) responders are working under the legal, medical oversight of the Central East Prehospital Care Program (CEPCP) Medical Advisory Board Physicians when providing semi automated external defibrillation (SAED) to a victim of sudden cardiac arrest (SCA). It also provides for the provision of medically current training services in SAED & CPR to those PAD Responders by and under the direction of the CEPCP Medical Advisory Board Physicians. These conjoint efforts are focused on the provision of medically appropriate care for the citizens in our community. Program Components and Recommendations The following items will be components of the annual program maintenance: Provision of medical oversight by the Central East Prehospital Care Program (CEPCP) for the Cardiac Safe Community Program for Durham Region. Provision of initial certification training and testing for SAED for PAD responders. Provision of recertification testing for SAED. • Provision of C.P.R. recertification testing and training of the PAD responder employees as required. • Development and provision of in-house reviews of SAED. ^ Provision of Biomedical Engineering by the Lakeridge Health Biomedical Engineering Program to ensure that the SAEDs are maintained according to the manufacturer's standards, including biomedical direction for the replacement of batteries and pads when mandated by the manufacturer or the Biomedical Department (once per year or after each use). Method design for the collection of patient care outcome data by the CEPCP to provide the basis for ongoing patient care quality assurance programs. ^ A formal meeting between the Orono Arena and the CEPCP to review the program's goals, outcomes, and patient care protocols on an annual basis. Availability of the CEPCP staff and physician to consult on and review issues and procedures as required, or at least on a minimum of once per year. Dedication of a designated CEPCP PAD Coordinator as a prime contact for the PAD site. CEPCP medical and logistical support for the development of Conjoint Public Access Defibrillation Programs in our Community. The CEPCP will provide instructors (Paramedics and Firefighters) to deliver SAED training, using the principles of Adult Learning. The scope of this training will include, but is not limited to the content of the Canadian Heart and Stroke Foundations CPR &SAED recommendations. All curriculum content and instructor training and qualifications will be approved by the Central East Prehospital Care Program Medical Advisory Board Physicians. • To identify placement of such AED throughout the site to ensure time to defibrillation can be achieved in 3 minutes or less from time of recognition of cardiac arrest; • To recommend the AED be placed in an Emergency Response Case that will audibly and visually (flashing red light) alert staff that the emergency response case door has been opened. When the AED is removed from the Emergency Response Case, a call is automatically made to the alarm company who in turn will notify 911 to activate emergency services (Fire Service and Emergency Medical Service). To establish an action plan in the case of an emergency and AED use. The action plan is to be reviewed every year. To maintain quality assurance by establishing a collaborative environment between the rescuers, CEPCP, Fire Service, and Emergency Medical Services (EMS) Paramedics through training, feed-back, group sharing of knowledge and Teaming from experience, and to establish afollow-up support system for rescuers post-AED use (ie. critical incident stress intervention). Agreement Criteria (or PAD Program It is clearly understood and agreed to by both parties that medical direction and oversight to the PAD Responder for the purpose of SAED is provided under the following conditions: A. Direction and oversight of the Cardiac Safe Community PAD program is provided under the auspices of the CEPCP Medical Advisory Board Physicians. B. Direction and oversight is valid when the PAD responder is acting in the best interest of a SCA victim. This may include the utilization of a SAED in another PAD site. Any one who has been taught PAD under our program can assist citizen responders in the use of a PAD response. The audio and text prompts from the SAED must be followed exactly. C. Non-targeted responders who use the AED in good faith and voluntarily are covered from liability by the Chase McEachern Act (Heart Defibrillator Civil Liability), 2007, S.O.2007, c. 10, Sch. N (Appendix B) and the Good Samaritan Act, 2001 5.0.2001, CHAPTER 2 (Appendix C). Training Develonment Academic Goals and Standards A. All training materials and lesson plans in the initial and on-going program development process will be scrutinized by qualified adult educators. "Qualified Adult Educators" for the purpose of this agreement are prehospital care professionals with practice qualifications of at least the Advanced Care Paramedic Level and with formal certification in adult education from a recognized community college or university. B. All learning objectives and learning outcomes for this program will be approved by a physician who is qualified as a specialist in Emergency Medicine and has experience providing medical direction in the field ofout-of-hospital Emergency Care. Agreement Tertn This agreement is for a term of one year. By mutual ageement of the parties this agreement will automatically renew for further one year terms on January 1" of each subsequent year. The agreement will be annually reviewed by both parties before the end of the first quarter of the calendar year. Changes to this agreement will be made by mutual consent. Program Fees and Services Provided Fees The program fees for the services described below are based on groups of 10 certified PAD Responders and one unit at one location: 1. Initial training and certification ofproviders-$700.00 2. Program Support - $1,400.00 for the initial and each subsequent year per unit. Additional units at the same location require an annual fee of $400.00 per unit. 3. Annua) Recertification costs are $600.00 4. The support and training fees in this ageement will increase by 3% at the beginning of each calendar year, the first increase for this agreement will be applied in January of 2010. For PAD Responders requiring remedial continuing education from the CEPCP PAD Coordinator or the CEPCP Physician over and above the instruction detailed the CEPCP and the Orono Arena will negotiate a fee for that service at that time. Fees for a class of 10 or fewer students will be $700.00 per day. Minimum fees for an instructor are $400.00 per half day. 6 Services 1. Emergency Action Plan Development: - site assessment - needs assessment to determine the number of SAED's required - direct best placement for access to SAED - medical emergency response plan implementation (site specific 2. CPR Education Review (Canadian Heart & Stroke Foundation Guidelines): - placing 911 call (role of police, fire, and ambulance) - risk factors of heart disease - recognition of heart attack - choking emergencies - patient assessment - artificial respiration (pocket mask) - one and two person adult CPR 3. Defibrillation Training - SAED shock & nonshockable protocols - scenarios (based on Emergency Action Plan) - trouble shooting - SAED weekly, monthly, and after use checks - communication documentation 4. Advanced Care Paramedic makes presentation on: - concept of rapid defibrillation medical direction of defibrillation - medical legal liabilities and issues - questions and concerns - certification evaluation 5. Physician Review and Medical Oversight of: - program design - medical legal responsibilities - operational critique for every event 6. Newsletter for Targeted Responder (continuing educational topics for medical emergencies) 7. Quality Assurance and Risk Management: - identify and provide ongoing training for site coordinators - practice scenarios and assignments - daily, monthly, and after use checks Emergency Action Plan Audit Begin development of local on site instructor/coordinators to enhance initial certification process for new employees 8. Six month reviews (site visits) to: - evaluate skills retention and - review emergency response plan awareness - continue development of local on site instructor /coordinators 9. Office Administration: - maintenance of certification records - updates of protocol changes - clinical co-ordinator dedicated to Targeted Responder Program 10. Critical Incident Stress management services. - demobilization education is provided for the Site Co-ordinator and staff that will be called in to talk with PAD responders immediately following a SCA - when Targeted Responder personnel involved in an event; the Cardiac Safe Community Program will ensure incident debriefings are facilitated - the Cardiac Safe Community Program is affiliated with and supports the Durham Region Critical Incident Stress Management Team Services 11. Biomedical Engineering Support and Operational Risk Management - check SAED once a year - change SAED battery as required - change SAED pads as required - ensure SAED meets operational needs - certification of machine safety and operation Invoicin~• Each year the staff that are trained and/or certified, the number of AED sites along with additional defibrillators will be adjusted and included as a component of the invoicing process. Appendix A attached to this agreement lists the initial sites and numbers of SAEDs covered by this agreement. Hold Harmless Clause The Orono Arena agrees to indemnify and save the Central East Prehospital Care Program at Lakeridge Health Corporation harmless from any court cost, expense, judgement, loss damage, death or injury including court costs and legal fees in any way caused by the negligence or wrong-doing of the Orono Arena related to or arising out of the PAD Program or other matters to which the agreement pertains. The Central East Prehospital Care Program agrees to indemnify and save the Orono Arena from any court cost, expense, judgement, loss, damage, death or injury including court costs and legal fees in any way caused by the negligence or wrong-doing of the Central East Prehospital Care Program at Lakeridge Health Corporation related to or arising out of the PAD Program or other matters to which this agreement pertains. LETTER OF AGREEMENT THIS AGREEMENT made, this 24 day of October A.D. 2008 BETWEEN Central East Prehospital Care Program at Lakeridge Health Corporation and the Orono Arena NOW THEREFORE THIS AGREEMENT WITNESSED that in consideration of the mutual covenants herein contained and subject to the terms and conditions hereinafter set forth the parties hereto agree to participate in the Central East Prehospital Caze Program Cazdiac Safe Community PAD Program in accordance with the terms outlined in The Lakeridge Health Central East Prehospital Care Program and the Municipality of Clarington collaboration statement. If either party is dissatisfied with the performance of the other party, the dissatisfied party may give written notice of the dissatisfaction to the other party and shall provide the other party with 30 days within which to rectify the matter of dissatisfaction. 2. Where the matter is not corrected to the satisfaction of the party giving notice within the ninety (90) day period, the dissatisfied party may terminate this Agreement by giving the other party ninety (90) days written notice of the party's intention to terminate the Agreement. The ninety (90) day period of notice shall commence five (5) business days after the notice has been mailed to the other party or twenty-four (24) hours following delivery of the notice by hand or by facsimile transmission. The parties mutually agree that this Agreement will be reviewed and renewed annually by the Central East Prehospital Care Program at Lakeridge Health Corporation and the Municipality of Clarington. Any such renewal shall be based upon such terms and conditions, including any or all of the provisions of this &gree~ment, as may be mutually agreed to by the parties. EP P" Jim Abernethy, Mayor March 31, 2009 rrie, unit pal Cler arc , Print Date Marty Epp Print ~Q Date 10 APPENDIX A Program Support Providing: • Medical Oversight • PAD Co-ordinator Contact • Quarterly Reviews • Yearly Site Audits • Biomedical Services • Event Reviews For the following sites: • Orono Arena $1400.00 Sub Tota] 1400.00 GST 70.00 Total $1470.00 This is NOT an invoice. II Appendix B Chase McEachern Act (Heart Defibrillator Civil Liability,) 2007, S.O. 2007, c. 10, Sch. N Citation: Chase McEachern Act (Heart Defibrillator Civil Liability), 2007, S.O. 2007, c. ]Q Sch. N Infottnation about this text: Consolidation: No Amendments. URL: http://www.canliS.org/on/laws/sta/2007c.1 Osch.n/20070717/whole.html Version downloaded by CanLII on 2007-07-17 Chase McEachern Act (Heart Defibrillator Civil Liability), 2007 5.0..2007, CHAPTER 10 Schedule N Definitions 1. In this Act, "defibrillator" means an automated external medical heart monitor and defibrillator that is capable of, (a) recognizing the presence or absence of ventricular fibrillation or rapid ventricular tachycardia, (b) determining, without intervention by an operator, whether defibrillation should be performed, (c) automatically charging and requesting delivery of an electrical impulse to an individual's heart as medically required, and (d) satisfying any other criteria that may be prescribed by regulation; ("defibrillateur") "emergency" means a situation during which the behaviour of an individual reasonably leads another individual to believe that the first individual is experiencing alife-threatening event that requires the provision of immediate care to assist the heart or other cardiopulmonary functioning of that person; ("situation d'urgence") "health care professional" means, (a) a member of a College of a health profession set out in Schedule 1 to the Regulated Health Professions Act, 1991, (b) such other persons or classes of persons as may be prescribed. ("professionnel de la saute") 2007, c. 10, Sched. N, s. 1. Protection from civil liability, user of defibrillator 2. (1) Despite the rules of common law, a person described in subsection (2} who, in good faith, voluntarily and without reasonable expectation of compensation or reward uses a defibrillator on a person experiencing an emergency is not liable for damages that result from the person's negligence in acting or failing to act while using the defibrillator, unless it is 12 established that the damages were caused by the gross negligence of the person. 2007, c. 10, Sched. N, s. 2 (1). Persons covered (2) Subsection (1) applies to, (a) a health care professional, if the health care professional does not use the defibrillator at a hospital or other place having appropriate health care facilities and equipment for the purpose of defibrillation; and (b) an individual, other than a health care professional described in clause (a), who uses a defibrillator at the immediate scene of an emergency. 2007, c. 10, Sched. N, s. 2 (2). Reimbursement of expenses (3) Reasonable reimbursement that a person receives for expenses that the person reasonably incurs in using a defibrillator shall be deemed not to be compensation or reward for the purpose of subsection (1). 2007, c. 10, Sched. N, s. 2 (3). Protection from civil liability, owner or operator of premises 3. (1) Despite the Occupiers'Liability Act and the rules of common law, any person who owns or occupies premises where a defibrillator is made available for use and who acts in good faith with respect to the availability or use of the defibrillator is exempt from civil liability for any harm or damage that may occur from the use of the defibrillator. 2007, c. 10, Sched. N, s. 3 (1). Exception (2) Subsection (1) does not exempt the person who owns or occupies the premises where a defibrillator is made available for use from civil liability if, (a) that person acts with gross negligence with respect to making the defibrillator available; (b) that person fails to properly maintain the defibrillator; or (c) the premises where the defibrillator is made available for use is a hospital or other premises used primarily for the purpose of providing health care to individuals. 2007, c. 10, Sched. N, s. 3 (2). Regulations 4. The Lieutenant Governor in Council may make regulations, (a) prescribing criteria for the purpose of the definition of °defibrillator" in section 1; (b) prescribing persons or classes of persons for the purposes of the definition of "health care professional" in section 1; (c) governing standards for the proper maintenance of defibrillators; (d) respecting any matter necessary or advisable to carry out effectively the purposes of this Act. 2007, c. 10, Sched. N, s. 4. Applies to the Crown 5. This Act applies to the Crown and any agency of the Crown. 2007, c. 10, Sched. N, s. 5. ~. 13 6. Omitted (provides for coming into force of provisions of this Act). 2007, c. 10, Sched. N, s. 6. 7. Omitted (enacts short title of this Act). 2007, c. 10, Sched. N, s. 7. Reference: Chase McEachern Act (Heart Defibrillator Civil Liability), 2007, S.O. 2007, c. 10, Sch. N; http: //www. canlii. org/on/Iaws/sta/2007c. l Osch.n/20070717/whole.html . 14 ~ Appendix C Good Samaritan Act, 2001, S.O. 2001, CHAPTER 2 No amendments. Definition 1. In this Act, `health care professional" means a member of a College of a health profession set out in Schedule 1 to the Regulated Health Professions Act, 1991. 2001, c. 2, s. 1. Protection from liability 2. (1) Despite the rules of common law, a person described in subsection (2) who voluntarily and without reasonable expectation of compensation or reward provides the services described in that subsection is not liable for damages that result from the person's negligence in acting or failing to act while providing the services, unless it is established that the damages were caused by the gross negligence of the person. 2001, c. 2, s. 2 (1). Persons covered (2) Subsection (I) applies to, (a) a health care professional who provides emergency health care services or first aid assistance to a person who is ill, injured or unconscious as a result of an accident or other emergency, if the health care professional does not provide the services or assistance at a hospital or other place having appropriate health care facilities and equipment for that purpose; and (b) an individual, other than a health care professional described in clause (a), who provides emergency first aid assistance to a person who is ill, injured or unconscious as a result of an accident or other emergency, if the individual provides the assistance at the immediate scene of the accident or emergency. 2001, a 2, s. 2 (2). Reimbursement of expenses (3) Reasonable reimbursement that a person receives for expenses that the person reasonably incurs in providing the services described in subsection (2) shall be deemed not to be compensation or reward for the purpose of subsection (1). 2001, c. 2, s. 2 (3). 3. Omitted (provides for coming into force of provisions of this Act). 2001, a 2, s. 3. 4. Omitted (enacts short title of this Act). 2001, a 2, s. 4. Reference: Good Samaritan Act, 2001, S.O. 2001, CHAPTER 2; http://www.e- laws.gov.on.calhtml/statutes/english/elaws_statutes_O1 g02_e.htm.