Committee opposes use of defibrillators at assisted living sites

Posted March 24, 2009, at 7:24 p.m.

Despite their relative affordability and simplicity of use, defibrillators are not standard equipment in Maine assisted living and residential care facilities. On Tuesday, lawmakers on the Legislature’s Health and Human Services Committee gave thumbs down to a proposal to require the lifesaving devices in these settings.

LD 573, sponsored by Rep. Paul Davis, R-Sangerville, would require assisted living facilities and other residential care centers to purchase a defibrillator and to have working at all times at least one staff member trained in its use.

The measure would not affect nursing homes, which provide a higher level of care but also are not required to have defibrillators.

As any fan of television hospital dramas knows, defibrillators work by delivering an electrical jolt to jump-start a heart that has stopped beating. Recent advances in the technology have allowed the devices to be all but self-administering. One notebook-sized model, widely placed in schools and other public settings, uses a recording to “speak” the simple directions for attaching the electrode pads, tells the user to stand back and delivers the powerful shock that can revive a fallen victim.

For Cathy Cobb, a regulator with the state Department of Health and Human Services, the bill poses more problems than it solves. Because many of the elderly and disabled people who live in assisted living centers and nursing homes have requested that they not be resuscitated, Cobb said it would be inappropriate to reach for the defibrillator whenever a resident suffers a cardiac arrest.

The high rate of staff turnover in nursing homes and the need to keep them trained in the use of the defibrillator pose a cost burden, she said, as does the purchase price of the units, which typically run between $1,500 and $2,000. Cobb testified in opposition to the measure.

Rick Erb of the Maine Health Care Association, which represents nursing homes and other residential facilities, said Tuesday that placing defibrillators in a health care setting also poses certain liability issues. While the devices generally can be used by medical nonprofessionals without fear of legal ramifications, Erb said the issue of liability could become clouded when qualified health care staff members deliver the treatment.

With a vote of 11-2, committee members at Tuesday’s work session recommended the measure ought not to pass. The measure also was opposed by Tribal Representative Donald Soctomah, who sits on the committee but does not cast an official vote.

The bill now moves to the full Legislature for debate.

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