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<subtitle num="06" heading="Public Access Automated External Defibrillator Program" title_num="30" title_heading="Maryland Institute for Emergency Medical Services Systems (MIEMSS)">
  <chapter num="01" heading="Definitions">
    <regulation prefix="Regulation" num=".01" heading="Definitions.">
      <paragraph num="A.">
        <text>In this subtitle, the following terms have the meanings indicated.</text>
      </paragraph>
      <paragraph num="B.">
        <text>Terms Defined.</text>
        <paragraph num="(1)">
          <text>“Automated external defibrillator (AED)” means a medical heart monitor and defibrillator device that:</text>
          <paragraph num="(a)">
            <text>Is cleared for market by the federal Food and Drug Administration;</text>
          </paragraph>
          <paragraph num="(b)">
            <text>Recognizes the presence or absence of ventricular fibrillation or rapid ventricular tachycardia;</text>
          </paragraph>
          <paragraph num="(c)">
            <text>Determines, without intervention by the operator, whether defibrillation should be performed;</text>
          </paragraph>
          <paragraph num="(d)">
            <text>On determining that defibrillation should be performed, automatically charges; and</text>
          </paragraph>
          <paragraph num="(e)">
            <text>Either:</text>
            <paragraph num="(i)">
              <text>Requires operator intervention to deliver the electrical impulse, or</text>
            </paragraph>
            <paragraph num="(ii)">
              <text>Automatically continues with delivery of electrical impulse.</text>
            </paragraph>
          </paragraph>
        </paragraph>
        <paragraph num="(2)">
          <text>“Event (code) summary” means the electronic report of an AED operation produced by an AED.</text>
        </paragraph>
        <paragraph num="(3)">
          <text>“Expected operator” means any individual identified by a registered facility to operate an AED at a registered facility</text>
        </paragraph>
        <paragraph num="(4)">
          <text>“Facility” means an agency, association, corporation, firm, partnership, or other entity.</text>
        </paragraph>
        <paragraph num="(5)">
          <text>“Operate” means to use or attempt to use an AED to defibrillate an individual whether or not any electrical impulse is delivered.</text>
        </paragraph>
        <paragraph num="(6)">
          <text>“Public safety answering point (PSAP)” has the meaning stated in Public Safety Article, §1-301(q), Annotated Code of Maryland.</text>
        </paragraph>
        <paragraph num="(7)">
          <text>Registered Facility.</text>
          <paragraph num="(a)">
            <text>“Registered facility” means an organization, business, association, or agency that meets the requirements of the EMS Board for providing automated external defibrillation.</text>
          </paragraph>
          <paragraph num="(b)">
            <text>“Registered facility” may include multiple sites.</text>
          </paragraph>
        </paragraph>
        <paragraph num="(8)">
          <text>“Response” means the removal of the AED from its storage location for the purposes of rendering care whether or not the care is actually rendered.</text>
        </paragraph>
        <paragraph num="(9)">
          <text>“Site” means a building, plant, unit, branch, vehicle, or other ancillary location that is part of or affiliated with a facility.</text>
        </paragraph>
      </paragraph>
    </regulation>
    <annotations>
      <annotation type="Authority">Education Article, §13-517, Annotated Code of Maryland</annotation>
      <annotation type="History" subtype="Administrative History">Effective date:</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .01 adopted as an emergency provision effective January 1, 2000 (27:2 Md. R. 142); adopted permanently effective April 17, 2000 (27:7 Md. R. 707)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .01B amended effective June 5, 2006 (33:11 Md. R. 952); May 4, 2009 (36:9 Md. R. 654); January 7, 2013 (39:26 Md. R. 1666)</annotation>
    </annotations>
  </chapter>
  <chapter num="02" heading="Approval of Facilities and Compliance">
    <regulation prefix="Regulation" num=".01" heading="Criteria for Registration of Facilities.">
      <text>To be eligible for registration, or renewal of registration, to operate an AED under this subtitle, a registered facility shall:</text>
      <paragraph num="A.">
        <text>Designate an AED coordinator who shall:</text>
        <paragraph num="(1)">
          <text>Have successfully completed CPR and AED Training, and subsequent refresher training, in accordance with their training course requirements that at a minimum includes content consistent with the recommendations for layperson CPR and AED training in the most current publication of the American Heart Association Guidelines for CPR and ECC;</text>
        </paragraph>
        <paragraph num="(2)">
          <text>Be responsible for implementing and administering the AED program at the registered facility; and</text>
        </paragraph>
        <paragraph num="(3)">
          <text>Ensure that monthly safety inspections of all supplemental and AED equipment, including assurance of adequate battery charge, per the manufacturer’s guidelines are conducted and maintain written logs of the inspections.</text>
        </paragraph>
      </paragraph>
      <paragraph num="B.">
        <text>Provide information regarding the operation, maintenance, and location of the registered facility's AEDs to all individuals employed by or volunteering for the registered facility;</text>
      </paragraph>
      <paragraph num="C.">
        <text>Place all AEDs in locations which are visible and readily accessible to any person willing to operate the AED in the event of a cardiac arrest;</text>
      </paragraph>
      <paragraph num="D.">
        <text>Have a telephone or other communication service available at all times at each site at which an AED is operated, for the notification of the public safety answering point;</text>
      </paragraph>
      <paragraph num="E.">
        <text>Submit data or other information concerning the AED program which may be periodically requested by MIEMSS; and</text>
      </paragraph>
      <paragraph num="F.">
        <text>Ensure that expected operators have completed CPR and AED Training, and subsequent refresher training, in accordance with their training course requirements that at a minimum includes content consistent with the recommendations for layperson CPR and AED training in the most current publication of the American Heart Association Guidelines for CPR and ECC.</text>
      </paragraph>
    </regulation>
    <regulation prefix="Regulation" num=".02" heading="Protocol.">
      <text>All personnel who are expected to operate an AED at a registered facility shall utilize the AED in accordance with their training. When an individual's training conflicts with the auditory and visual prompts of the device, the individual shall follow the auditory and visual prompts.</text>
    </regulation>
    <regulation prefix="Regulation" num=".03" heading="Quality Assurance and Maintenance.">
      <text>Each registered facility shall:</text>
      <paragraph num="A.">
        <text>Comply the federal Safe Medical Devices Act of 1990 and the Medical Device Amendments of 1992;</text>
      </paragraph>
      <paragraph num="B.">
        <text>Maintain:</text>
        <paragraph num="(1)">
          <text>The certificate issued by MIEMSS in a place where it is readily available;</text>
        </paragraph>
        <paragraph num="(2)">
          <text>Each AED and all related equipment and supplies in accordance with the standards established by the device manufacturer and the federal Food and Drug Administration;</text>
        </paragraph>
        <paragraph num="(3)">
          <text>Supplemental equipment with the AED at all times as follows:</text>
          <paragraph num="(a)">
            <text>Two sets of defibrillator chest pads;</text>
          </paragraph>
          <paragraph num="(b)">
            <text>Disposable gloves; and</text>
          </paragraph>
          <paragraph num="(c)">
            <text>Maryland Facility AED Report Forms for Cardiac Arrest;</text>
          </paragraph>
        </paragraph>
      </paragraph>
      <paragraph num="C.">
        <text>Submit:</text>
        <paragraph num="(1)">
          <text>A report for each incident of suspected cardiac arrest at the facility on the Maryland Facility AED Report Form for Cardiac Arrests, including, when available, any event (code) summary, recording, or tape created by the AED to MIEMSS, and be available for follow up as necessary; and</text>
        </paragraph>
        <paragraph num="(2)">
          <text>If the AED fails when operated, in addition to submitting the required report to the federal Food and Drug Administration, a copy of the report to MIEMSS; and</text>
        </paragraph>
      </paragraph>
      <paragraph num="D.">
        <text>Ensure the confidentiality of any medical records maintained by the registered facility as required by law.</text>
      </paragraph>
    </regulation>
    <regulation prefix="Regulation" num=".04" heading="Application and Registration Process.">
      <paragraph num="A.">
        <text>A facility seeking registration or renewal of registration shall submit an application and all required documentation to MIEMSS on the form required by MIEMSS.</text>
      </paragraph>
      <paragraph num="B.">
        <text>MIEMSS may make the inspection and require the verification necessary to ensure that an applicant meets the requirements of this chapter, including an inspection of the facility, any sites, equipment, and records.</text>
      </paragraph>
      <paragraph num="C.">
        <text>MIEMSS shall issue a certificate of registration or renewal to a facility that meets the requirements of Regulation .01 of this chapter.</text>
      </paragraph>
      <paragraph num="D.">
        <text>The certificate of registration or renewal is valid for a period of 3 years.</text>
      </paragraph>
    </regulation>
    <regulation prefix="Regulation" num=".05" heading="Denial of Registration.">
      <paragraph num="A.">
        <text>MIEMSS may deny an application if it finds that the applicant fails to meet the requirements of this chapter.</text>
      </paragraph>
      <paragraph num="B.">
        <text>Notice of Denial.</text>
        <paragraph num="(1)">
          <text>MIEMSS shall issue a written notice of denial to an applicant that includes the reasons for denial.</text>
        </paragraph>
        <paragraph num="(2)">
          <text>The notice shall conform to the requirements of State Government Article, §10-207, Annotated Code of Maryland.</text>
        </paragraph>
      </paragraph>
      <paragraph num="C.">
        <text>An applicant denied approval may file an appeal with the EMS Board under Regulation .05 of this chapter.</text>
      </paragraph>
      <paragraph num="D.">
        <text>If an applicant does not file a timely appeal under Regulation .05 of this chapter, the decision is final.</text>
      </paragraph>
      <paragraph num="E.">
        <text>If an application is denied, the applicant may reapply under this chapter.</text>
      </paragraph>
    </regulation>
    <regulation prefix="Regulation" num=".06" heading="Compliance.">
      <paragraph num="A.">
        <text>MIEMSS may initiate a compliance review of a registered facility upon information that the registered facility has failed to comply with this subtitle.</text>
      </paragraph>
      <paragraph num="B.">
        <text>MIEMSS shall give written notice of the compliance review to the registered facility.</text>
      </paragraph>
      <paragraph num="C.">
        <text>In the course of its compliance review, MIEMSS may:</text>
        <paragraph num="(1)">
          <text>Inspect all:</text>
          <paragraph num="(a)">
            <text>Sites where the registered facility maintains an AED;</text>
          </paragraph>
          <paragraph num="(b)">
            <text>Records relating to the AED maintained by the facility; and</text>
          </paragraph>
          <paragraph num="(c)">
            <text>Equipment related to the AED; and</text>
          </paragraph>
        </paragraph>
        <paragraph num="(2)">
          <text>Interview employees of the registered facility regarding the AED program.</text>
        </paragraph>
      </paragraph>
      <paragraph num="D.">
        <text>If MIEMSS finds that a registered facility has failed to comply with this subtitle, MIEMSS may:</text>
        <paragraph num="(1)">
          <text>Suspend the facility's registration;</text>
        </paragraph>
        <paragraph num="(2)">
          <text>Revoke the facility's registration;</text>
        </paragraph>
        <paragraph num="(3)">
          <text>Refuse to renew a facility's registration; or</text>
        </paragraph>
        <paragraph num="(4)">
          <text>Take other action as appropriate.</text>
        </paragraph>
      </paragraph>
      <paragraph num="E.">
        <text>Within 30 days after the conclusion of the compliance review, MIEMSS shall provide its findings, decision and any proposed action in writing to the:</text>
        <paragraph num="(1)">
          <text>Registered facility; and</text>
        </paragraph>
        <paragraph num="(2)">
          <text>EMS Board.</text>
        </paragraph>
      </paragraph>
      <paragraph num="F.">
        <text>The report shall:</text>
        <paragraph num="(1)">
          <text>Conform to the requirements of State Government Article, §10-207, Annotated Code of Maryland; and</text>
        </paragraph>
        <paragraph num="(2)">
          <text>Contain the reasons for the decision and the proposed action.</text>
        </paragraph>
      </paragraph>
      <paragraph num="G.">
        <text>Upon receipt of the report and proposed action, a registered facility may file an appeal with the EMS Board under Regulation .05 of this chapter.</text>
      </paragraph>
      <paragraph num="H.">
        <text>If an applicant does not file a timely appeal under Regulation .05 of this chapter, MIEMSS' proposed decision is final.</text>
      </paragraph>
    </regulation>
    <regulation prefix="Regulation" num=".07" heading="Procedure for Appeals.">
      <paragraph num="A.">
        <text>An applicant or registered facility may appeal a disputed decision by filing a notice of appeal to the EMS Board with the Executive Director of MIEMSS not later than 20 days after receipt of the decision.</text>
      </paragraph>
      <paragraph num="B.">
        <text>The appeal shall state with specificity the reasons why the disputed decision should be modified.</text>
      </paragraph>
      <paragraph num="C.">
        <text>An applicant or registered facility that files an appeal shall be granted a hearing before the:</text>
        <paragraph num="(1)">
          <text>EMS Board; or</text>
        </paragraph>
        <paragraph num="(2)">
          <text>Office of Administrative Hearings, if the Board so elects and notifies the applicant or registered facility.</text>
        </paragraph>
      </paragraph>
      <paragraph num="D.">
        <text>An appeal hearing shall be governed by COMAR 28.02.01.</text>
      </paragraph>
      <paragraph num="E.">
        <text>If the hearing is conducted by the Office of Administrative Hearings, COMAR 30.02.06.22 and .23 also apply.</text>
      </paragraph>
      <paragraph num="F.">
        <text>An applicant or registered facility which has participated in a hearing under this regulation may seek judicial review of the EMS Board's final action under State Government Article, §10-222, Annotated Code of Maryland. The EMS Board shall be party to the proceeding.</text>
      </paragraph>
    </regulation>
    <regulation prefix="Regulation" num=".08" heading="Confidentiality of Records.">
      <text>MIEMSS shall maintain the confidentiality of records referred to in this subtitle in accordance with:</text>
      <paragraph num="A.">
        <text>Health-General Article, Title 4, Subtitle 3, Annotated Code of Maryland;</text>
      </paragraph>
      <paragraph num="B.">
        <text>Health Occupations Article, Title 1, Subtitle 4, Annotated Code of Maryland; and</text>
      </paragraph>
      <paragraph num="C.">
        <text>General Provisions Article, Title 4, Subtitle 3, Annotated Code of Maryland.</text>
      </paragraph>
    </regulation>
    <annotations>
      <annotation type="Authority">Education Article, §13-517, Annotated Code of Maryland</annotation>
      <annotation type="History" subtype="Administrative History">Effective date:</annotation>
      <annotation type="History" subtype="Administrative History">Regulations .01—.06 adopted as an emergency provision effective January 1, 2000 (27:2 Md. R. 142); adopted permanently effective April 17, 2000 (27:7 Md. R. 707)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .01 amended effective June 5, 2006 (33:11 Md. R. 952); May 4, 2009 (36:9 Md. R. 654)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .01B amended effective October 15, 2004 (31:20 Md. R. 1486)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .01I amended and J adopted effective March 31, 2003 (30:6 Md. R. 423)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .02 amended effective May 4, 2009 (36:9 Md. R. 654)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .03 amended effective May 4, 2009 (36:9 Md. R. 654)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .04 amended effective May 4, 2009 (36:9 Md. R. 654)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .04C amended effective June 5, 2006 (33:11 Md. R. 952)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .05 amended effective May 4, 2009 (36:9 Md. R. 654)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .06B amended effective May 4, 2009 (36:9 Md. R. 654)</annotation>
      <annotation type="History" subtype="Administrative History">Chapter revised effective January 7, 2013 (39:26 Md. R. 1666)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .08C amended effective October 12, 2015 (42:20 Md. R. 1265)</annotation>
    </annotations>
  </chapter>
  <chapter num="03" heading="Protocol">
    <regulation prefix="Regulation" num=".01" heading="Repealed." />
    <annotations>
      <annotation type="Authority">Education Article, §13-517, Annotated Code of Maryland</annotation>
      <annotation type="History" subtype="Administrative History">Effective date:</annotation>
      <annotation type="History" subtype="Administrative History">Regulations .01—.03 adopted as an emergency provision effective January 1, 2000 (27:2 Md. R. 142); adopted permanently effective April 17, 2000 (27:7 Md. R. 707)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .02 amended effective June 5, 2006 (33:11 Md. R. 952)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .03 amended effective March 31, 2003 (30:6 Md. R. 423); October 15, 2004 (31:20 Md. R. 1486); June 5, 2006 (33:11 Md. R. 952)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .03 repealed and new Regulation .03 adopted as an emergency provision effective December 15, 2006 (34:3 Md. R. 296); emergency status extended at 34:13 Md. R. 1150</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .03 repealed and new Regulation .03 adopted effective June 4, 2007 (34:11 Md. R. 972)</annotation>
      <annotation type="History" subtype="Administrative History">Chapter revised effective May 4, 2009 (36:9 Md. R. 654)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .01 amended effective November 28, 2011 (38:24 Md. R. 1503)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .01 repealed effective January 7, 2013 (39:26 Md. R. 1666)</annotation>
    </annotations>
  </chapter>
  <chapter num="04" heading="Quality Assurance and Maintenance" reason="Repealed">
    <annotations>
      <annotation type="History" subtype="Administrative History">Effective date:</annotation>
      <annotation type="History" subtype="Administrative History">Regulations .01—.02 adopted as an emergency provision effective January 1, 2000 (27:2 Md. R. 142); adopted permanently effective April 17, 2000 (27:7 Md. R. 707)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .01 amended effective May 4, 2009 (36:9 Md. R. 654)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .02 amended effective May 4, 2009 (36:9 Md. R. 654)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .02B, C amended effective June 5, 2006 (33:11 Md. R. 952)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .02D amended effective March 31, 2003 (30:6 Md. R. 423); June 5, 2006 (33:11 Md. R. 952)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .02E amended effective June 5, 2006 (33:11 Md. R. 952)</annotation>
      <annotation type="History" subtype="Administrative History">Regulations .01—.02 repealed effective January 7, 2013 (39:26 Md. R. 1666)</annotation>
    </annotations>
  </chapter>
  <chapter num="05" heading="Training Programs" reason="Repealed">
    <annotations>
      <annotation type="History" subtype="Administrative History">Effective date:</annotation>
      <annotation type="History" subtype="Administrative History">Regulations .01—.04 adopted as an emergency provision effective January 1, 2000 (27:2 Md. R. 142); adopted permanently effective April 17, 2000 (27:7 Md. R. 707)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .01 amended effective October 15, 2004 (31:20 Md. R. 1486); June 5, 2006 (33:11 Md. R. 952); May 4, 2009 (36:9 Md. R. 654)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .01C amended and D adopted effective March 31, 2003 (30:6 Md. R. 423)</annotation>
      <annotation type="History" subtype="Administrative History">Regulation .02A amended effective March 31, 2003 (30:6 Md. R. 423)</annotation>
      <annotation type="History" subtype="Administrative History">Regulations .01—.04 repealed effective January 7, 2013 (39:26 Md. R. 1666)</annotation>
    </annotations>
  </chapter>
</subtitle>