[Congressional Record Volume 146, Number 125 (Tuesday, October 10, 2000)]
[Senate]
[Pages S10160-S10161]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                 RURAL ACCESS TO EMERGENCY DEVICES ACT

  Mr. BROWNBACK. Mr. President, I ask unanimous consent that the HELP 
Committee be discharged from further consideration of S. 2528, and the 
Senate then proceed to its immediate consideration.
  The PRESIDING OFFICER. Without objection, it is so ordered. The clerk 
will report the bill by title.
  The legislative clerk read as follows:

       A bill (S. 2528) to provide funds for the purchase of 
     automatic external defibrillators and the training of 
     individuals in advanced cardiac life support.

  There being no objection, the Senate proceeded to consider the bill.
  Ms. COLLINS. Mr. President, I am pleased that the Senate is 
considering S. 2528, the Rural Access to Emergency Devices Act of 2000, 
which I introduced with my friend from Wisconsin, Senator Russ 
Feingold. Our bill is intended to improve access to automated external 
defibrillators in small communities and rural areas to boost the 
survival rates of individuals in those communities who suffer cardiac 
arrest. Joining us as cosponsors of the bill are Senators Jeffords, 
Murray, Abraham, Wellstone, Hutchinson, Dorgan, Grams, Bingaman, 
Chafee, Enzi, Snowe, Grassley, Biden, Leahy, Robb, Kerry,and Durbin. I 
particularly want to thank the distinguished Chairman of the Senate 
Health, Education, Labor and Pensions Committee, Senator Jeffords, for 
all of his assistance in helping us to expedite action on this 
important measure.
  Heart disease is the leading cause of death both in the state of 
Maine and in the United States. According to the American Heart 
Association, an estimated 250,000 Americans die each year from cardiac 
arrest. Many of these deaths could be prevented if automated external 
defibrillators--or AEDs--were more accessible. AEDs are computerized 
devices that can shock a heart back into normal rhythm and restore life 
to a cardiac arrest victim. They must, however, be used promptly. For 
every minute that passes before a victim's normal heart rhythm is 
restored, his or her chance of survival falls by as much as 10 percent.
  We have a number of new and improved technologies in our arsenal of 
weapons to fight heart disease, including a new generation of small, 
easy-to-use AEDs that can strengthen the chain of survival for cardiac 
arrest victims. These new devices make it possible for not only 
emergency medical personnel, but also trained lay rescuers, to deliver 
defibrillation safely and effectively. The new AEDs are safe, 
effective, lightweight, low maintenance, and relatively inexpensive. 
Moreover, they are specifically designed so that they can be used by 
non-medical personnel such as police, fire fighters, security guards 
and other lay rescuers, providing they have been properly trained. 
According to the American Heart Association, making AEDs standard 
equipment in police cars, fire trucks, ambulances and other emergency 
vehicles and getting these devices into more public places could save 
more than 50,000 lives a year.
  Last December, the Bangor Mall installed an AED that is one of the 
first of these devices in Maine to be placed in a public setting 
outside the direct control of emergency medical personnel and hospital 
staff. Both the AED and an oxygen tank are kept inside a customer 
service booth, which is in an area of the mall where there is a high 
concentration of traffic and where heart emergencies might occur. Mall 
personnel have also received special training and, during mall hours, 
there is always at least one person who has been certified in both CPR 
and defibrillator use.
  For at least one Bangor woman, this has been a lifesaver. On January 
12th, just weeks after the AED was installed, two shoppers at the Mall 
collapsed in a single day. One was given oxygen and quickly revived. 
But the other shopper was unconscious and had stopped breathing. The 
trained mall staff--Maintenance Supervisor Larry Lee, Security Chief 
Dusty Rhodes, and General Manager Roy Daigle-- were only able to detect 
a faint pulse. They quickly commenced CPR and attached the AED.
  It is important to note that defibrillation is intended to 
supplement, not replace standard CPR. These devices, which are almost 
completely automated, run frequent self-diagnostics and will not allow 
the administration of shock unless the victim's recorded heart pattern 
requires it. When the AED is attached, it automatically analyzes the 
victim's vital signs. One of two commands will then be voiced and 
displayed by the unit: ``Shock advised--charging''; or ``Shock not 
advised--continue CPR.''

  In the Bangor Mall case, the shock was not advised, so CPR was 
continued until the emergency medical personnel arrived. The EMT's told 
Mr. Daigle, the General Manager of the mall, that the woman--who had 
had a heart attack and subsequently required triple by-pass surgery--
simply would not have survived if they had not been so prepared. As Mr. 
Daigle observed, ``Twelve to fifteen minutes is just too long to wait 
for the emergency services to arrive.''
  Cities across America have begun to recognize the value of fast 
access to AEDs and are making them available to emergency responders. 
In many small and rural communities, however, limited budgets and the 
fact that so many rely on volunteer organizations for emergency 
services can make acquisition and appropriate training in the use of 
these life-saving devices problematic.
  The legislation we are considering today is intended to increase 
access to AEDs and trained local responders for smaller towns and rural 
areas in Maine and elsewhere where those first on the scene may not be 
paramedics or others who would normally have AEDs. Our bill provides 
$25 million over three years to be given as grants to community 
partnerships consisting of local emergency responders, police and fire 
departments, hospitals, and other community organizations. This money 
could then be used to help purchase AEDs and train potential responders 
in their use, as well as in basic CPR and first aid.
  The Rural Access to Emergency Devices Act has been endorsed by both 
the American Heart Association and the American Red Cross as a means of 
expanding access to these lifesaving devices across rural America, and 
I urge all of our colleagues to join us in supporting this important 
measure.
  Mr. BROWNBACK. Mr. President, I ask unanimous consent that the bill 
be read a third time and passed, the motion to reconsider be laid upon 
the table, and that any statements relating to the bill be printed in 
the Record.
  The PRESIDING OFFICER. Without objection, it is so ordered.
  The bill (S. 2528) was read the third time and passed, as follows:

                                S. 2528

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Rural Access to Emergency 
     Devices Act'' or the ``Rural AED Act''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) Heart disease is the leading cause of death in the 
     United States.
       (2) The American Heart Association estimates that 250,000 
     Americans die from sudden cardiac arrest each year.
       (3) A cardiac arrest victim's chance of survival drops 10 
     percent for every minute that passes before his or her heart 
     is returned to normal rhythm.
       (4) Because most cardiac arrest victims are initially in 
     ventricular fibrillation, and the

[[Page S10161]]

     only treatment for ventricular fibrillation is 
     defibrillation, prompt access to defibrillation to return the 
     heart to normal rhythm is essential.
       (5) Lifesaving technology, the automated external 
     defibrillator, has been developed to allow trained lay 
     rescuers to respond to cardiac arrest by using this simple 
     device to shock the heart into normal rhythm.
       (6) Those people who are likely to be first on the scene of 
     a cardiac arrest situation in many communities, particularly 
     smaller and rural communities, lack sufficient numbers of 
     automated external defibrillators to respond to cardiac 
     arrest in a timely manner.
       (7) The American Heart Association estimates that more than 
     50,000 deaths could be prevented each year if defibrillators 
     were more widely available to designated responders.
       (8) Legislation should be enacted to encourage greater 
     public access to automated external defibrillators in 
     communities across the United States.

     SEC. 3. GRANTS.

       (a) In General.--The Secretary of Health and Human 
     Services, acting through the Rural Health Outreach Office of 
     the Health Resources and Services Administration, shall award 
     grants to community partnerships that meet the requirements 
     of subsection (b) to enable such partnerships to purchase 
     equipment and provide training as provided for in subsection 
     (c).
       (b) Community Partnerships.--A community partnership meets 
     the requirements of this subsection if such partnership--
       (1) is composed of local emergency response entities such 
     as community training facilities, local emergency responders, 
     fire and rescue departments, police, community hospitals, and 
     local non-profit entities and for-profit entities concerned 
     about cardiac arrest survival rates;
       (2) evaluates the local community emergency response times 
     to assess whether they meet the standards established by 
     national public health organizations such as the American 
     Heart Association and the American Red Cross; and
       (3) submits to the Secretary of Health and Human Services 
     an application at such time, in such manner, and containing 
     such information as the Secretary may require.
       (c) Use of Funds.--Amounts provided under a grant under 
     this section shall be used--
       (1) to purchase automatic external defibrillators that have 
     been approved, or cleared for marketing, by the Food and Drug 
     Administration; and
       (2) to provide defibrillator and basic life support 
     training in automated external defibrillator usage through 
     the American Heart Association, the American Red Cross, or 
     other nationally recognized training courses.
       (d) Report.--Not later than 4 years after the date of 
     enactment of this Act, the Secretary of Health and Human 
     Services shall prepare and submit to the appropriate 
     committees of Congress a report containing data relating to 
     whether the increased availability of defibrillators has 
     affected survival rates in the communities in which grantees 
     under this section operated. The procedures under which the 
     Secretary obtains data and prepares the report under this 
     subsection shall not impose an undue burden on program 
     participants under this section.
       (e) Authorization of Appropriations.--There is authorized 
     to be appropriated $25,000,000 for fiscal years 2001 through 
     2003 to carry out this section.

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