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Staff Report
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Report To: General Government Committee
Date of Meeting: March 20, 2023 Report Number: CSD-001-23
Submitted By: George Acorn, Director of Community Services
Reviewed By: Rob Maciver, Deputy CAO/Solicitor Resolution#: GG-077-23
File Number: By-law Number:
Report Subject: Lakeridge Health Public Access Defibrillator Program Agreement Renewal
Recommendations:
1. That Report CSD-001-23 be received;
2. That Council authorize the Director of Community Services to sign the agreement
provided by the Central East Prehospital Care Program (CEPCP), on behalf of
Lakeridge Health (Attachment #1), for the period April 1, 2023, to March 31, 2026;
and
3. That the CAO be authorized to approve subsequent renewals of agreements with
Lakeridge Health that pertain to the subject matter of Report CSD-001-23.
Municipality of Clarington
Report CSD-001-23
Report Overview
Page 2
This report seeks Council approval on a new three-year agreement with Lakeridge Health for
the Cardiac Safe Community Public Access Defibrillator Program in all municipal buildings.
The proposed agreement would also see the Municipality incorporating the library locations,
creating one operating agreement and streamlining the process.
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 As recommended in the 2020 Organizational Structure Review, responsibility for hall
boards and other non -municipally operated buildings transferred from Operations to
Community Services, including the administration of this program at all buildings,
excluding libraries. In 2021, operating budget changes
1.3 The current agreement is scheduled to expire on March 31, 2023.
2. Program Details
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 With the recent addition of Clarington Public Library units, the proposed agreement
totals 33 AED units. Community Services administer the program in all municipal
locations listed in the attachment.
2.4 The terms and conditions of the current agreement remain unchanged in the proposed
agreement attached. The term of this agreement is three years, effective April 1, 2023,
and expiring on March 31, 2026.
Municipality of Clarington
Report CSD-001-23
3. Financial Considerations
Page 3
3.1 The program fees and services proposed in this agreement remain unchanged from the
current agreement. All costs associated with this program, excluding libraries, are
included in the Community Services approved 2023 budget. The costs for administering
the program for library facilities have been approved in their 2023 budget and will be
invoiced to them by Financial Services.
4. Concurrence
This report has been reviewed by the Deputy CAO/Director of Legislative Services who
concurs with the recommendations.
5. Conclusion
It is respectfully recommended that the recommendation in the report be approved.
Staff Contact: George Acorn, Director of Community Services, 905-623-3379 ext. 2502 or
gacorn@clarignton.net.
Attachments:
Attachment 1 — Semi Automatic External Defibrillation Agreement
Interested Parties:
List of Interested Parties available from Department.
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
LH/The Municipality of Clarington Agreement
April 2023 - March 2026 Page 1 of 11
Princivle 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.
1. Program Components and Recommendations
(a) The following items will be components of 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 evaluation for SAED for PAD responders.
■ Provision of recertification evaluation for SAED.
■ Provision of C.P.R. recertification evaluation and training of the PADresponder employees
as required.
■ Development and provision of in-house reviews of SAED.
■ 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.
■ 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 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.
■ Availability of the CEPCP staff and physician to consult on and review issues and
procedures as required.
■ Dedication of a designated CEPCP PAD Coordinator as a prime contact for the PAD site.
LH/The Municipality of Clarington Agreement
April 2023 - March 2026 Page 2 of 11
■ 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 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:
■ To recommend the SAED be placed in an Emergency Response Case that will audiblyand
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).
■ To establish an action plan in the case of an emergency and AED use.
■ 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).
11. 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 Develovment 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 2023 - March 2026 Page 3 of 11
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 hasexperience
providing medical direction in the field of out -of -hospital Emergency Care.
This Agreement is for a term of three years, effective April 1, 2023, and expiring on March 31st
2026, or as terminated pursuant to Section VII: Dispute Resolution.
V. Program 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)
LH/The Municipality of Clarington Agreement
April 2023 - March 2026 Page 4 of 11
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 formedical
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
LH/The Municipality of Clarington Agreement
April 2023 - March 2026 Page 5 of 11
- 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
V/�i iLTft1E:7/ .R:Ca'iTi7f :i1C-1 OVUM
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.
V/1 ��7�:11 ita:Z�111 iit:7i1
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.
LH/The Municipality of Clarington Agreement
April 2023 - March 2026 Page 6 of 11
killfli • IVA
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 President Finance
and Information Management
Date
LH/The Municipality of Clarington Agreement
April 2023 - March 2026 Page 7 of 11
Appendix A
to Semi Automatic External Defibrillation Agreement
between Lakeridge Health and The Municipality of Clarington
April 1, 2023 to March 31, 2026
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: February 6. 2023
The Municipality of Clarington Site Locations
Address.-
120 Liberty Street South, Bowmanville
CR+
AED Serial #
43019129
BioMed
804486
2226 Golf Course Road, Newcastle
CR+
45529861
805094
26 Beech Ave., Bowmanville,
CR+
41899916
804390
26 Beech Ave., Bowmanville,
G3
4397960
803999
26 Beech Ave., Bowmanville,
CR+
45800313
805208
40 Temperance Street, Bowmanville
CR+
41899924
804450
132 Church Street, Bowmanville
CR+
41610234
804391
5360 Old Scugog Road, Hampton
CR+
45530053
805093
2320 Taunton Road, Hampton
CR+
41899917
804451
2503 Con Rd. 8, Haydon
CR+
42149184
804445
6742 Regional Rd 18, Kendal
CR+
41899925
804393
20 King Ave West, Newcastle
CR+
41899915
804392
103 Caroline Street West, Newcastle
CR+
41992471
804478
21 Church Lane, Newtonville, ON
CR+
42098646
804424
2 Princess Street, Orono
CR+
41992459
804850
3585 Taunton Road, Orono
CR+
41671451
804449
5315 Main Street, Orono
CR+
42241140
804474
178 Darlington Clark Townline Road
CR+
41899923
804453
62 Temperance Street, Bowmanville,
CR+
41899922
804452
1964 Concession Rd 6, Hampton
CR+
41227493
804322
1595 Prestonvale Road, Bowmanville
G3
4390766
803995
2716 Concession Road 7, Tyrone
CR+
42149185
804454
143 Simpson Ave, Bowmanville
CR+
41671450
804430
49 Liberty Street, Bowmanville
G3
4378809
804314
2375 Baseline Road, Bowmanville
G3
4369478
803997
2950 Courtice Road, Courtice
G3
4369864
803996
2440 Hwy # 2 Bowmanville
G3
4389100
803998
1780 Rudell Road, Newcastle
G3
4378757
804315
2276 Taunton Road, Hampton
G3
4378862
804316
163 Church Street, Bowmanville
On Site
A18G-01799
805204
150 King Avenue, East, Newcastle
On Site
A18G-01893
805206
127 Church Street, Orono
On Site
A18G-01776
805205
2950 Courtice Road, Courtice
G5
LH/The Municipality of Clarington Agreement
April 2023 - March 2026 Page 8 of 11
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 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,
LH/The Municipality of Clarington Agreement
April 2023 - March 2026 Page 9 of 11
(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 purposesof
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.
LH/The Municipality of Clarington Agreement
April 2023 - March 2026 Page 10 of 11
Annendix 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 bedeemed
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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