Submission Date:
Question:
We are planning an emergency preparedness training for library staff to include CPR, First Aid, Stop the Bleed, and Narcan training. We have heard from librarians that some boards are concerned about the implications of having staff trained. We would like to have some commonly asked questions addressed so that we can answer them if they come up.
1. If staff are trained, do they incur a duty to act? Would they personally or the library as institution become liable should they freeze up and not intervene?
2. If staff are trained but inadvertently cause harm in the process of administering aid, are they covered by any kind of Good Samaritan law?
3. Can a library have a policy of requiring all staff to undergo these types of trainings?
4. Are there any other legal implications or obligations that should be considered that the average person may not think of?
Answer:
Because the training and resources described in the question can save lives, I will both a) quickly answer the questions and b) provide an answer in a format suitable to share with a library board.
Quick answers:
1. If staff are trained, do they incur a duty to act?
No, they will not incur a duty to act, unless the library adds that expectation to a job description, or adopts a policy requiring such action (which it should not do without careful planning).
1.5 Would they personally or the library as institution become liable should they freeze up and not intervene?
No, they will not incur liability for failure to provide first aid or emergency treatment, unless the library adds that expectation to a job description or adopts a policy requiring such action (which it should not do without careful planning).
2. If staff are trained but inadvertently cause harm in the process of administering aid, are they covered by any kind of Good Samaritan law?
Yes, except in cases of "gross negligence" (more on that below) they are shielded from liability by New York State's "Good Samaritan" law (Section 3000-a of the Public Health Law).
3. Can a library have a policy of requiring all staff to undergo these types of trainings?
Mandatory training, which could imply that providing first aid or emergency treatment is a job requirement (and thus outside the scope of the Good Samaritan protection), should not be required unless there is a careful program that considers the factors set forth in the guidance below.
Voluntary training, however—even on staff time—does not remove the Good Samaritan protection.
4. Are there any other legal implications or obligations that should be considered that the average person may not think of?
Yes (see below). But none that should get in the way of a library helping library employees and volunteers feel better prepared to provide first aid and emergency treatment!
Analysis
NOTE: This "Analysis" is composed in a format that could be presented to a board with concerns regarding this type of training or capability in their library.
First Aid at Your Public Library
A Guide for Public Library Boards in New York
Stephanie A. Adams, Esq.
The Law Office of Stephanie Adams, PLLC
Library trustees know that as free and open places of public accommodation, public libraries can often be the location of a medical emergency.
Because of this, many public libraries opt to prepare by:
- Having first aid kits on site
- Having Narcan on site (with or without staff training)
- Installing an AED[1] on site (to be used by EMS upon arrival after calling 911)
- Using posters in multiple languages to alert people to important considerations during a medical emergency
- Arranging training in first aid, CPR, and "Stop the Bleed" for staff and volunteers
- Implementing private security with some level of emergency response training
- Implementing policies for addressing medical emergencies in the library
Of course, a good board of trustees not only considers how to address potential medical emergencies in the library but also considers how the resources and tactics selected could put library employees, volunteers, the public, and the library itself at legal risk.
This guide addresses the fundamental considerations of such an analysis and provides three immediate assurances so long-range planning doesn't slow down steps that may be immediately implementable.
Immediate Assurance #1: New York Law's "Good Samaritan Law" protects those who voluntarily provide first aid and emergency treatment.
In New York, Public Health Law 3000-a provides that any person who "voluntarily and without expectation of monetary compensation renders first aid or emergency treatment at the scene of an accident or other emergency outside a hospital, doctor’s office or any other place having proper and necessary medical equipment, to a person who is unconscious, ill, or injured, shall not be liable for damages for injuries alleged to have been sustained by such person or for damages for the death of such person alleged to have occurred by reason of an act or omission in the rendering of such emergency treatment unless it is established that such injuries were or such death was caused by gross negligence[2] on the part of such person."
Immediate Assurance #2: New York Law Protects Libraries that enable access to and use of Narcan (naloxone).
2. In New York, Public Health Law Section 3309 provides that the "use of an opioid antagonist [such as Narcan] ... shall be considered first aid or emergency treatment for the purpose of any statute relating to liability...[and] an...entity, or any person employed by the person or entity, acting reasonably and in good faith in compliance with this section, shall not be subject to criminal, civil or administrative liability solely by reason of such action."
In 2016, this section of the Public Health Law was revised to specifically include a public library in the definition of a protected "entity." So, without a doubt, a library providing access to Narcan, or whose employees administer Narcan, are protected by the law (so long as they avoid "gross negligence" as required by the law).
Immediate Assurance #3: Neither staff training nor on-site equipment creates an obligation to provide first aid or emergency treatment.
This is true even if the location is required by law to have an AED and a person trained to use it.[3]
So long as the first aid or emergency treatment is provided "voluntarily and without expectation of monetary compensation" (and without gross negligence) the person is protected by Public Health Law 3000-a.
First Legal Consideration: Voluntary Training, Voluntary Action
While the protection of the Good Samaritan law is clear, it is also clear that the help being provided must be "voluntary."
Because of that, unless a library has a) a carefully planned first aid/medical event program with b) well-developed policy, and c) language in job descriptions, all d) coordinated with the right insurance coverage, and the e) written plan for implementing that program has been f) reviewed by a lawyer issuing a g) written opinion as to how liability is mitigated, the training provided to staff should be documented as voluntary, with no express or implied requirement that an employee attend.
Second Legal Consideration: Alternate or Added Medical Event Planning
In a medical emergency, quick response time is key. So, in addition to or in lieu of training staff, some libraries may benefit from better contracts, Memoranda of Understanding, or other connections with local first responders.
If your library has first responders stationed or residing nearby, it may be better to train staff on recognizing different signs of medical distress and to practice calling 911. Then work with the local first responders on what type of training could be useful when even a quick response time might not be quick enough.
Third Legal Consideration: Insurance
Every board should review, on an annual basis, its library's coverage for personal injury, and be aware of the different protections the library has for on-site injury, which should include:
- Workers’ Compensation Insurance
- General Premises Liability
- Coverage as an "additional insured" (if there is a contractor or other professional physically working on site)
As part of this assessment, the board should be confident that the library has a clear process for 1) documenting on-site injury; 2) promptly alerting relevant insurance carriers about on-site injury; and 3) following up with carriers to ensure the library is making maximum use of the coverage it pays for.
Fourth Legal Consideration: Commitment to Continuous Improvement
In addition to assessing what equipment and training the library may need for first aid and emergency treatment, a board may also want to consider the results of a medical incident. While this goes beyond just considering the "legal" aspects, whenever there is a serious medical event in the library, the board should ensure the library has the resources to:
- Consider if the situation warrants improvements to on-site safety[4];
- Consider if there is a need to address employee well-being and morale; and
- Consider if the incident can have an impact on reputation.
With these assurances and considerations in mind, library leadership can effectuate immediate steps to address medical events in the library and initiate an overall plan for mitigating and managing associated risks. This is good for your community, good for your mission, and good for your workers... and consistent with the fiduciary duties of a library board.
[1] "Automatic Electronic Defibrillator". Good starter information on installing an AED at your library can be found at https://www.health.ny.gov/professionals/ems/pdf/07-04.pdf. Another resource is your county health department.
[2] Gross negligence "differs in kind, not only degree, from claims of ordinary negligence" (Colnaghi, U.S.A. v. Jewelers Protection Servs., 81 N.Y.2d 821, 823, 595 N.Y.S.2d 381, 611 N.E.2d 282; see Goldstein v. Carnell Assoc., Inc., 74 A.D.3d 745, 746, 906 N.Y.S.2d 905). "To constitute gross negligence, a party's conduct must smack of intentional wrongdoing or evince a reckless indifference to the rights of others" (Ryan v. IM Kapco, Inc., 88 A.D.3d 682, 683, 930 N.Y.S.2d 627 [internal quotation marks and brackets omitted] ). "Stated differently, a party is grossly negligent when it fails to exercise even slight care or slight diligence" (id. at 683, 930 N.Y.S.2d 627 [internal quotation marks omitted]; see Goldstein v. Carnell Assoc., Inc., 74 A.D.3d at 747, 906 N.Y.S.2d 905). Ordinarily, the question of gross negligence is a matter to be determined by the trier of fact (see Food Pageant v. Consolidated Edison Co., 54 N.Y.2d 167, 172-173, 445 N.Y.S.2d 60, 429 N.E.2d 738).
[3] Miglino v Bally Total Fitness of Greater NY, Inc., 20 NY3d 342 (2013)
[4] Many places worry that making improvements after an on-site injury can contribute to a finding of liability. Such a concern should never get in the way of making safety improvements; if that is a concern, it should be promptly addressed with your library's lawyer, who will research the latest case law on this issue and—unless there is a radical change in the law—advise that any potential hazards be mitigated.
Tag:
Emergency Response, Policy, Training, Templates, Employee Rights
