Should Poison Control Centers Be Reauthorized Through 2024? (H.R. 501)
Do you support or oppose this bill?
What is H.R. 501?
(Updated April 15, 2019)
This bill — the Poison Control Network Enhancement Act of 2019 — would reauthorize the U.S. poison control center program for another five years, from 2020-2024. The program would receive $700,000 each year.
This bill would also reauthorize the nationwide public awareness campaign program to promote poison control center utilization, directing the Dept. of Health and Human Services (HHS) Secretary to carry out and expand a national public awareness campaign to educate the public and health care providers about: 1) poisoning, toxic exposure, and drug misuse prevention, and 2) poison control center resources’ availability in local communities.
This bill would also reauthorize the poison control center grant program, giving the DHS Secretary discretion to award grants totalling up to $28.6 million a year to poison control centers and nationally recognized professional organizations in the field of poison control for the purposes of:
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Preventing, and providing treatment recommendations for, poisonings and toxic exposures, including opioid misuse;
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Assisting with public health emergencies, responses, and preparedness; and
- Complying with the operational requirements needed to sustain a poison control center’s accreditation.
Poison control centers or nationally recognized professional organizations in the field of poison control could also receive money to research poison prevention methods, improve toxic exposure and opioid misuse surveillance, develop communications and response between poison control centers, and a range of other initiatives that’d make poison control centers more effective.
There are 55 poison control centers across the U.S. that’d be affected by this bill.
Argument in favor
Poison control centers save lives, serve as an important line of defense against the opioid epidemic, help collect information about substance abuse, and disseminate important information about poison control. By preventing unnecessary ER visits, they help save the healthcare system — and individuals — $1.8 billion a year.
Argument opposed
There’s no need to maintain a nationwide network of over 50 poison control centers. Rather than paying over half a million dollars to maintain a poison control center in each state, it’d be better to consolidate all U.S. poison control centers into one large call center that serves the entire country.
Impact
Poison control centers; hospitals; 911 operators; professional organizations in the field of poison control; public awareness campaigns about poison control centers; and the DHS Secretary.
Cost of H.R. 501
When this bill was introduced in the 115th Congress, the CBO estimated that it’d cost $125 million over the 2019-2023 period.
Additional Info
In-Depth: Rep. Eliot Engel (D-NY) reintroduced this bill from the 115th Congress to reauthorize the national poison control program for another five years. When he and Rep. Susan Brooks (R-IN) introduced this bill last Congress, Rep. Engel said:
“Speedy access to poison centers through the national toll-free number – (800) 222-1222 – is an essential resource for all Americans, especially parents, who can take solace in the fact that there are 55 poison centers across the United States available 24 hours a day, 7 days a week, 365 days a year. Poison centers offer real-time, lifesaving assistance, while at the same time saving hundreds of millions in federal dollars. On top of that, these centers are playing a key role in the fight to end the opioid epidemic. I was proud to co-author the last poison center reauthorization in 2014, and I am proud to be a part of this bipartisan legislation.”
Original cosponsor Rep. Brooks added more information about poison control centers’ role in fighting the opioid epidemic:
“In one month alone, there were 9,039 opioid exposures reported to poison control centers nationwide. Since 2011, poison control centers have been working behind the scenes to fight against the opioid epidemic and have handled about 500,000 cases of opioid misuse and abuse – that’s approximately 192 cases per day, every day. Poison control centers save countless lives, prevent toxic exposure and poisoning injury, and reduce billions of dollars in unnecessary healthcare costs. The data poison centers collect can even be used to identify hotspots for opioid misuse and overdose. I am proud to introduce a bill with my colleagues on the Energy and Commerce Committee that will help those who find themselves in an emergency situation by enhancing the centers within the National Poison Data System that offer free, confidential, expert medical advice 24 hours a day, seven days a week.”
After this bill’s passage through the House Energy and Commerce Committee in May 2018, Rep. Engel said:
“Most of us already know about much of the work poison centers do, but many may not know about the critical role poison centers are playing in the fight to end the opioid crisis. It is absolutely essential that this work continues. In Westchester County, 124 people died due to opioids in 2016. In the Bronx, more New Yorkers died of overdoses than in any other borough. We must do more to end this epidemic, and I am proud to see this important bill moving forward as part of that effort.”
In 2011, then-president of the American Association of Poison Control Centers Richard Dart MD, PhD, FACEP, FACMT defended poison control centers as “important partners in assuring the health of all Americans,” writing that:
“Every dollar spent on a poison center saves at least $7 in health care costs, and one study estimates that in 2007, every dollar of state funding the Banner Poison Center in Arizona received saved $36 in unnecessary health care costs. More than three-fourths of all poison exposure cases can be treated at home without the patient requiring a face to face health care visit. The cost savings are obvious: In 2005, the average cost of an emergency department visit was $745 while the average cost per call to a poison center was about $30… Our members’ call centers and data can help both governmental and non-governmental organizations fulfill their needs. It is not easy work, but it is rewarding work and it is necessary work to assure a successful future.”
Then-Rep. Denny Rehberg (D-MT) sponsored a bill that would’ve eliminated all but one of the U.S.’ poison control centers in 2011, arguing at the time that there was simply no need to maintain multiple poison control centers across the country:
"There's just no reason to maintain 57 separate call centers around the country when technology would enable us to get the job done with one. We can save millions simply by cutting out 56 duplicative locations and with record debt and deficits putting our future in jeopardy, it's worth looking under every rock for savings."
Mark Ryan, then-director of the Louisiana Poison Center, pushed back against Rep. Rehberg’s assertion, saying, “Local relationships are invaluable. There's no way a single center could get in there and provide for the wants and needs of every state. It's not possible." Ryan also warned against putting all resources into a single entity, asking, “What happens if the hypothetical 'single' center gets wiped out by a tornado and the infrastructure is destroyed? Where are those 12,000+ calls each day going to go?"
This bill has three bipartisan cosponsors, including two Republicans and one Democrat, in the current session of Congress. Last Congress, it passed the House by a voice vote with the support of 12 bipartisan cosponsors, including eight Republicans and four Democrats. However, it didn’t receive a vote in the Senate.
Of Note: Since 2011, U.S. poison centers have handed nearly 200 opioid misuse cases a day, helped detect trends in the opioid epidemic, and educated Americans about ways to potentially save their loved ones’ lives in the event of an overdose or other adverse event connected with opioid abuse. In its written Appropriations justification to Congress, HHS has acknowledged poison control centers’ critical role in combating opioid and synthetic drug (and heroin) abuse and misuse.
Private citizens aren’t the only people who rely on poison control centers. In 2009, 16 percent of the 4.2 million calls poison control centers answered came from hospitals seeking their expertise to verify that the treatment they’d administered to patients was correct. Additionally, when individuals call 911, the 911 operator also conferences in the poison control center for a three-way conversation. This is because the staff at poison control centers include nurses, physicians, and pharmacists with specialized poison center training and a toxicologist, who’s always on call.
In 2015, poison control centers managed 2.8 million calls — an average of 8,000 calls a day, or one every 11 seconds. Of the approximately 2.2 million poisonings reported in 2015, 67 percent were managed at the site of exposure, avoiding unnecessary ER visits. It’s estimated that every dollar invested in the poison center system saves $13.39 in medical costs and lost productivity, and poison control centers also reduce healthcare costs in the U.S. by more $1.8 billion annually.
Media:
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Sponsoring Rep. Eliot Engel (D-NY) Press Release (115th Congress)
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Sponsoring Rep. Eliot Engel (D-NY) Dear Colleague Letter (115th Congress)
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Original Cosponsoring Rep. Susan Brooks (R-IN) Press Release (115th Congress)
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CBO Cost Estimate (115th Congress)
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Ripon Advance
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CNN (Context)
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Illinois Poison Control Center Blog (Context)
Summary by Lorelei Yang
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