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Staff Report
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Report To: General Government Committee
Date of Meeting: January 27, 2020 Report Number: CSD-002-20
Submitted By: George Acorn, Acting Director of Community Services
Reviewed By:
File Number:
Report Subject:
Andrew C. Allison, CAO
Resolution#:
By-law Number:
Public Access Defibrillator Program L Lakeridge Health Agreement
Renewal
Recommendations:
1. That Report CSD-002-20 be received;
2. That Council authorize the Mayor and Clerk to sign the Agreement provided by the
Central East Prehospital Care Program (CEPCP), on behalf of Lakeridge Health;
and
3. That Central East Prehospital Care Program be advised of action taken.
Municipality of Clarington
Report CSD-002-20
Report Overview
Page 2
This report recommends approval of the renewal agreement with Central East Prehospital
Care Program for the Public Access Defibrillator program in municipal facilities and
buildings.
1. Background
1.1 The Municipality has been involved with the Cardiac Safe Community Public Access
Defibrillator Program, coordinated by the Central East Prehospital Care Program
(CEPCP) since 2005. The program began with the installation of our first automatic
external defibrillator (AED) unit at Courtice Community Complex that year.
1.2 In November 2012 Council approved the expansion of the defibrillator program to be
offered to all hall boards and other non -municipally operated buildings. Funding for the
additional AED units and program support was added to the operating budget in 2013
and has been administered by the Operations Department.
1.3 There are 28 AED units identified in the current agreement. An additional unit was
added at the Beech Centre part way through the term of this agreement. There are now
29 AED units under the new agreement.
1.4 The current agreement is scheduled to expire on March 31, 2020.
2. Proposal
2.1 By continuing to work with CEPCP under this agreement it is ensured that the
Municipality and the Public Access Defibrillator (PAD) responders are working under the
oversight of the CEPCP of Lakeridge Health when providing defibrillation to a victim of
sudden cardiac arrest.
2.2 The agreement includes medical oversight, annual certification training, biomedical
servicing of all AED units, and ongoing staff support of the program.
2.3 The agreement (Attachment 1) includes all AED locations. The Operations Department
will continue to administer the AED units located in board operated community halls and
buildings. The Community Services Department will continue to administer the AED
units located in municipally operated indoor recreation facilities.
2.4 The term of this agreement is for three years, effective April 1, 2020 and expiring on
March 31, 2023.
Municipality of Clarington
Report CSD-002-20
3. Financial Considerations
Page 3
3.1 The Program Fees listed in the attached agreement are consistent with the previous
agreement with no increase in fees. The required funds for the applicable fees have
EHH-i-GJ H-HWRCIT-iuiH-DSSJ; SID-H-G-ISDuP H-iIVRSH_D[LJ iEEGJ HAC
4. Concurrence
4.1 This report has been reviewed by the Acting Director of Operations who concurs with
the recommendations.
5. Conclusion
5.1 It is respectfully recommended that Council approve the renewal of this agreement and
the Municipality continues to partner with CEPCP for the provision of medically
appropriate care for our citizens and our visitors.
Staff Contact: George Acorn, Acting Director of Community Services, 905-623-3379 ext. 2502
or gacorn@clarington.net.
Attachments:
Attachment 1 -]Semi Automatic External Defibrillation Agreement
The following interested parties will be notified of Council's decision:
Sarah Vanderzee, Manager Office Operations, Central East Prehospital Care Program
Semi Automatic External
Defibrillation Agreement
For the Cardiac Safe
Community Public Access
Defibrillation Program for Durham Region
BETWEEN
Lakeridge Health
("The Hospital")
and
The Municipality of Clarington
Agreement
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April 2020 - March 2023 Page 1 of 253
Princiale Statement
This agreement between the above parties will ensure that the The Municipality of Clarington
and Public Access Defibrillation (PAD) responders are working under the oversight of the
Central East Prehospital Care Program (CEPCP) of Lakeridge Health 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.
THEREFORE in consideration of the mutual covenants contained herein 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 Agreement.
L Pro -gram Components and Recommendations
(a) The following items will be components of program maintenance:
f Provision of medical oversight by the Central East Prehospital Care Program (CEPCP) for
the Cardiac Safe Community Program for Durham Region.
f Provision of initial certification training and evaluation for SAED for PAD responders.
f Provision of recertification evaluation for SAED.
f Provision of C.P.R. recertification evaluation and training of the PAD responder employees
as required.
f Development and provision of in-house reviews of SAED.
f Provision of Biomedical Engineering by the Lakeridge Health Biomedical Engineering
Program, once per year or after each use, 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.
f Method design for the collection of patient care outcome data by the CEPCP to provide the
basis for ongoing patient care quality assurance programs.
f A Site Coordinator's Meeting will be organized by CEPCP on an annual basis to review the
program's goals, outcomes, and patient care protocols. Additional meetings between The
Municipality of Clarington and the CEPCP will be held at the request of either party.
f Availability of the CEPCP staff and physician to consult on and review issues and
procedures as required.
f Dedication of a designated CEPCP PAD Coordinator as a prime contact for the PAD site.
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April 2020 - March 2023 Page 2 of 253
f CEPCP medical and logistical support for the development of Conjoint Public Access
Defibrillation Programs in our Community.
f 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.
f To identify placement of such SAED throughout the site to ensure time to defibrillation can
be achieved in 3-5 minutes or less from time of recognition of cardiac arrest;
(b) The following items are recommendations of program maintenance:
f To recommend the SAED 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 SAED 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).
f To establish an action plan in the case of an emergency and AED use.
f 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 a follow-up support system for rescuers post-SAED use (ie. critical incident
stress intervention).
IL Agreement Criteria for PAD Program
It is clearly understood and agreed to by both parties that medical consultation to the PAD
Responder for the purpose of SAED is provided under the following conditions:
A. Consultation with respect to the Cardiac Safe Community PAD program is provided under
the auspices of the CEPCP Medical Advisory Board Physicians.
B. Consultation is available 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. Anyone 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 -trained responders who use the SAED in good faith and voluntarily are protected 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).
Ill. Training Development 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
LH/The Municipality of Clarington Agreement
April 2020 - March 2023 Page 3 of 253
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 of out -of -hospital Emergency Care.
IV. Agreement Term
This Agreement is for a term of three years, effective April 1, 2020, and expiring on March 31 sc
2023, or as terminated pursuant to Section VII: Dispute Resolution.
V. Pro -gram Fees and Services Provided
A. Fees:
1. Initial Site setup, including site assessment, signage, initial Biomed visit and PAD
awareness session is a one time fee of $600.00.
2. Annual training and certification of providers is at a fee of $750.00 for a class size
between 7 — 12 participants. Class duration will be 6'/2 — 7 hours which includes all
breaks. Classes must be cancelled no less than 2 business days prior to the scheduled
session, otherwise the usual charge applies.
3. Program Support is an annual fee of $1,000.00 for the initial unit at a site. Additional
units at the same location require an annual fee of $450.00 per unit.
HST is not included in the above fees. Program fees will be subject to review and increase on
renewal of this contract.
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 RMDSS will negotiate a fee for that service at that time.
B. Invoicing:
Training costs will be invoiced on a per course basis.
Program and Biomedical Engineering support costs will be invoiced quarterly starting in April of
each year. The number of sites to be billed is determined by the site list contained in Appendix
A. Sites that become active during the year will be billed when they become a live site. The
initial setup fee will apply in full and the support fees will be calculated on a prorated basis,
based on the number of whole months the site will be active in that calendar year.
C. Services:
Emergency Action Plan Development:
- site assessment to determine the number of SAED's required
- direct best placement for access to SAED
- medical emergency response plan implementation (site specific)
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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
- 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. PAD awareness session for Non -targeted Responders
concept of rapid defibrillation/medical direction of defibrillation
- medical legal liabilities and issues
- questions and concerns
5. Physician/Physician Review and Oversight of:
- program design
- 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
- daily, monthly, and after use checks
- Emergency Action Plan Audit
- Begin development of local on -site coordinators to enhance initial certification
process for new employees
8. Six month reviews (site visits) to:
- Ensure weekly and monthly checks are being completed
- Ensure adequate signage is placed to direct persons to the AED
- continue development of local on -site coordinators
9. Office Administration
- maintenance of certification records
- updates of protocol changes
- clinical co-ordinator dedicated to Targeted Responder Program
- Program representative on call 24/7 to respond to any issues/concerns or post-
SCA events
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 following a SCA
- when Targeted Responder personnel are involved in an event, the Cardiac Safe
Community Program will ensure incident debriefings are facilitated
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April 2020 - March 2023 Page 5 of 253
- 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
VI. Mutual Indemnification Clause
The Hospital agrees to indemnify and save the The Municipality of Clarington harmless from all
loss, cost, expense, judgment or damage on account of injury to persons including death or
damage to property, in any way caused by the negligence of the hospital, its servants, agents or
employees related to or arising out of programs or other matters to which this agreement
pertains, together with all legal expenses and costs incurred by the The Municipality of
Clarington in defending any legal action pertaining to the above.
The The Municipality of Clarington agrees to indemnify and save the Hospital harmless from all
loss, cost, expense, judgment or damage on account of injury to persons including death or
damage to property, in any way caused by the negligence of the The Municipality of Clarington,
its servants, agents, or employees related to or arising out of programs or other matters to
which this agreement pertains, together with all legal expenses and costs incurred by the
Hospital in defending any legal action pertaining to the above.
VII. Dispute Resolution
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
thirty (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 thirty
(30) 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.
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April 2020 - March 2023 Page 6 of 253
Vlll. Review of Agreement
The parties mutually agree that this Agreement will be reviewed, prior to the end of its term, by
Lakeridge Health and the 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 may
be mutually agreed to by the parties.
The parties have caused this Agreement to be executed by their authorized representatives.
The Municipality of Clarington Print Date
Representative
Lakeridge Health Print
Vice Presient Finance
and Information Management
Date
LH/The Municipality of Clarington Agreement
April 2020 - March 2023 Page 7 of 253
Appendix A
to Semi Automatic External Defibrillation Agreement
between Lakeridge Health and The Municipality of Clarington
April 1, 2020 to March 31, 2023
This appendix maintains a complete list of all sites covered under this Agreement and will be
updated when sites become active or are deactivated.
Date of current Appendix A: November 28, 2019
The Municipality of Clarington Site Locations
•..
120[Liberty[Street[South,[Bowmanville0
.-
CR+
AED Serial #
43019129
BioMed
804486
2226 Golf Course Road, Newcastle, ON
CR+
45529861
805094
26 Beech Ave., Bowmanville, L1 C 3A2
CR+
41899916
804390
26 Beech Ave., Bowmanville, L1 C 3A2
G3
4397960
803999
26 Beech Ave., Bowmanville, L1 C 3A2
CR+
45800313
805208
40Qemperance[Street,Mowmanville,0I-XIBA617
CR+
41899924
804450
132[Ehurch[Street,[1Bowmanville,MNM
CR+
41610234
804391
5360 Old Scugog Road, Hampton, ON
CR+
45530053
805093
2320 Taunton Road, Hampton, LOB 1JO
CR+
41899917
804451
2503 Con Rd. 8, Haydon, ON
CR+
42149184
804445
6742 Regional Rd 18, Kendall
CR+
41899925
804393
20 King Ave West, Newcastle, L1 B 1 H1
CR+
41899915
804392
103 Caroline Street West, Newcastle, L1 B 1 H 1
CR+
41992471
804478
21 Church Street, Newtonville, ON, LOA 1JO
CR+
42098646
804424
2 Princess Street, Orono, LOB 1 MO
CR+
41992459
804850
3585Qaunton[toad,[Drono,[TOB[1Mold
CR+
41671451
804449
5315 Main Street, Orono, ON LOB 1 MO
CR+
42241140
804474
178Marlington[ElarkLfownline[Road0
CR+
41899923
804453
62 Temperance Street, Bowmanville, ON
CR+
41899922
804452
1964 Concession Rd 6, Hampton, ON LOB 1JO
CR+
41227493
804322
1595 Prestonvale Road, Bowmanville, L1 E 2P2
G3
4390766
803995
2716[EoncessionMoadE7,Mowmanville,ML1C[BK60
CR+
42149185
804454
143 Simpson Ave, Bowmanville, ON
CR+
41671450
804430
49 Liberty Street, Bowmanville
G3
4378809
804314
2375 Baseline Road, Bowmanville, L1C 3K3
G3
4369478
803997
2950 Courtice Road, Courtice, L1 E 2H8
G3
4369864
803996
2276 Taunton Road, Hampton
G3
4378809
804314
2440 Hwy # 2 Bowmanville, L1 C 1 K5
G3
4389100
803998
1780 Rudell Road, Newcastle,
G3
4378757
804315
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April 2020 - March 2023 Page 8 of 253
Appendix B
Chase McEachern Act (Heart Defibrillator Civil Liabilitv). 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 Consolidation: No Amendments.
text:
URL: http://www.canIii.org/on/laws/sta/2007c.10sch.n/20070717/whole.
html
Version downloaded by CanLll 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 a life -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
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,
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April 2020 - March 2023 Page 9 of 253
(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.
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/laws/sta/2007c.1 Osch.n/20070717/whole. html.
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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 (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/engIish/elaws_statutes_01 g02_e.htm
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