[Congressional Record Volume 144, Number 35 (Wednesday, March 25, 1998)]
[Senate]
[Pages S2573-S2574]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DeWINE:
  S. 1862. A bill to provide assistance for poison prevention and to 
stabilize the funding of regional poison control centers; to the 
Committee on Labor and Human Resources.


        the poison control center enhancement and awareness act

  Mr. DeWINE. Mr. President, I rise today to introduce the Poison 
Control Center Enhancement and Awareness Act of 1998.

  Mr. President, America's poison control centers do important work--
and they need our help. The number of centers has been declining over 
the last several years. Their funding has been unstable--and this has 
resulted in the closing of many of them.
  Poison control centers manage poisonings over the telephone, direct 
those that cannot be managed at home to a local hospital for treatment, 
provide professional and public education and training, and collect 
data on poisoning exposures.
  Each year, more than 2 million poisonings are reported to poison 
control centers throughout the United States. More than 90% of these 
poisonings happen in the home--and over fifty percent of poisoning 
victims are children younger than 6 years of age.
  By providing expert telephone advice to distraught parents, poisoning 
victims, and health care professionals, poison control centers decrease 
the severity of illness and prevent deaths. Let me illustrate the value 
of poison control centers by telling you about two similar poisoning 
cases that had very different outcomes.
  In the first case, a 3 year old child swallowed several tablets of 
aspirin. His mother called the poison control center and was told to 
give the child syrup of Ipecac (pronounced ip-ah-kak) to make the child 
vomit before taking him to the emergency room. The boy was examined in 
the emergency room and sent home.
  In the second case, another toddler swallowed several aspirin while 
visiting her grandmother's house. Her family was unaware that aspirin 
can be very dangerous for children, and did not think to call the 
poison control center. Nine hours later, the child started to have a 
seizure. When she arrived at the hospital, she was severely ill and 
nearly died. She spent almost two weeks in the pediatric intensive care 
unit.
  Mr. President, I can tell you that even after eight children, it's 
often hard to know exactly what to do in these emergencies. In this 
kind of situation, poison control centers can save lives.
  They are life-saving--and they are truly cost-effective public health 
services. For every dollar spent on poison control center services, $7 
in medical costs are saved. The average cost from a poisoning exposure 
call is $31.28, while the average cost if other parts of the health 
care system are used is $932.
  In spite of their obvious value, poison control centers are seriously 
under-funded, and the funding situation threatens to get worse. These 
centers have so far been financed through unstable arrangements 
involving a variety of public and private sources.
  In Ohio, poison control centers are funded primarily by hospitals, 
with some funds coming from the State. Ohio's poison control centers 
are working together to coordinate services and consolidate resources, 
while they continue to look for stable funding sources.
  Currently, the Federal Government provides 5% of poison control 
center funding, but reaps most of the cost-savings benefits from poison 
control center services. It is only fair that the Federal Government 
pay for its share of the cost burden for poison control center 
services. This legislation provides Federal dollars to stabilize poison 
control center funding and improve poison control center services. I 
have

[[Page S2574]]

tried to write this legislation so that existing private and state 
dollars can be leveraged, rather than displaced, by Federal funds.
  Over the last two decades, the instability and lack of funding has 
resulted in a steady decline in the number of poison control centers in 
the United States. In 1978, there were over 600 poison control centers; 
now, there are 75. This trend has jeopardized the capacity of poison 
control centers to provide equitable services to all Americans. As a 
result, more people may die, more people may be injured and the costs 
for treating poisonings may increase.
  For example, in 1991, Louisiana closed its poison center and referred 
all calls to Alabama. After its closing, Louisiana found that ``the 
cost attributable to unnecessary emergency department visits was more 
than three times the amount allocated to operate the poison control 
center each year.'' Louisiana also found that medically treated 
poisonings, those treated in emergency rooms or by physicians, 
increased 42%. It reopened its poison control center.
  My office has consulted with a number of experts on how we can best 
improve poison control operations on a national scale, and my 
legislation contains a number of their suggestions.
  Here's what the bill does.
  It establishes a national toll-free number to ensure that all 
Americans have access to poison control center services. This number is 
then automatically routed to the center designated to cover the 
caller's region. This system will improve access to poison control 
center services for everyone. It will also simplify efforts to educate 
parents and the public about what to do in the event of a poisoning 
exposure and how to do it quickly.
  It begins a nationwide media campaign to educate the public and 
health care providers about poison prevention, and advertise the new, 
nationwide toll-free number. I've seen the great work done by some non-
profit groups, and how effective their public health campaigns have 
been. That's what I'd like to see here.
  It establishes a grant program to stabilize the funding mechanism and 
prevent certified regional poison control centers from closing. This 
program will support activities to prevent and treat poisonings; 
develop standard education programs; develop standard patient 
management protocols for commonly encountered toxic exposures; improve 
and expand the poison control data collection system; and improve 
national toxin exposure surveillance.
  Mr. President, I have always been a supporter of the prevention and 
treatment services provided by poison control centers. As a member of 
the Congressional Prevention Coalition, I hope to increase awareness of 
this very important issue. Federal support for poison control centers 
will help ensure that all Americans continue to have access to quality 
poison control center services.
  It will reduce the inappropriate use of emergency medical services 
and other costly health care services.
  And, most importantly, it will save lives.
  Mr. President, I ask unanimous consent that this statement and the 
text of the bill be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1862

       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 ``Poison Control Center 
     Enhancement and Awareness Act''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) Each year more than 2,000,000 poisonings are reported 
     to poison control centers throughout the United States. More 
     than 90 percent of these poisonings happen in the home. 53 
     percent of poisoning victims are children younger than 6 
     years of age.
       (2) Poison centers are life-saving and cost-effective 
     public health services. For every dollar spent on poison 
     control centers, $7 in medical costs are saved. The average 
     cost of a poisoning exposure call is $31.28, while the 
     average cost if other parts of the medical system are 
     involved is $932. Over the last 2 decades, the instability 
     and lack of funding has resulted in a steady decline in the 
     number of poison control centers in the United States. 
     Currently, there are 75 such centers.
       (3) Stabilizing the funding structure and increasing 
     accessibility to poison control centers will increase the 
     number of United States residents who have access to a 
     certified poison control center, and reduce the inappropriate 
     use of emergency medical services and other more costly 
     health care services.

     SEC. 3. DEFINITION.

       In this Act, the term ``Secretary'' means the Secretary of 
     Health and Human Services.

     SEC. 4. ESTABLISHMENT OF A NATIONAL TOLL-FREE NUMBER.

       (a) In General.--The Secretary shall provide coordination 
     and assistance to regional poison control centers for the 
     establishment of a nationwide toll-free phone number to be 
     used to access such centers.
       (b) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, $2,000,000 for 
     each of the fiscal years 1999 through 2001.

     SEC. 5. ESTABLISHMENT OF NATIONWIDE MEDIA CAMPAIGN.

       (a) In General.--The Secretary shall establish a national 
     media campaign to educate the public and health care 
     providers about poison prevention and the availability of 
     poison control resources in local communities and to conduct 
     advertising campaigns concerning the nationwide toll-free 
     number established under section 4.
       (b) Contract with Entity.--The Secretary may carry out 
     subsection (a) by entering into contracts with 1 or more 
     nationally recognized media firms for the development and 
     distribution of monthly television, radio, and newspaper 
     public service announcements.
       (c) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, $600,000 for 
     each of the fiscal years 1999 through 2003.

     SEC. 6. ESTABLISHMENT OF A GRANT PROGRAM.

       (a) Regional Poison Control Centers.--The Secretary shall 
     award grants to certified regional poison control centers for 
     the purposes of achieving the financial stability of such 
     centers, and for preventing and providing treatment 
     recommendations for poisonings.
       (b) Other Improvements.--The Secretary shall also use 
     amounts received under this section to--
       (1) develop standard education programs;
       (2) develop standard patient management protocols for 
     commonly encountered toxic exposures;
       (3) improve and expand the poison control data collection 
     systems; and
       (4) improve national toxic exposure surveillance.
       (c) Certification.--Except as provided in subsection (d), 
     the Secretary may make a grant to a center under subsection 
     (a) only if the center has been certified by a professional 
     organization in the field of poison control, and the 
     Secretary has approved the organization as having in effect 
     standards for certification that reasonably provide for the 
     protection of the public health with respect to poisoning.
       (d) Waiver of Certification Requirements.--
       (1) In general.--The Secretary may grant a waiver of the 
     certification requirement of subsection (a) with respect to a 
     noncertified poison control center that applies for a grant 
     under this section if such center can reasonably demonstrate 
     that the center will obtain such a certification within a 
     reasonable period of time as determined appropriate by the 
     Secretary.
       (2) Renewal.--The Secretary may only renew a waiver under 
     paragraph (1) for a period of 3 years.
       (e) Supplement not Supplant.--Amounts made available to a 
     poison control center under this section shall be used to 
     supplement and not supplant other Federal, State, local or 
     private funds provided for such center.
       (f) Maintenance of Effort.--A poison control center, in 
     utilizing the proceeds of a grant under this section, shall 
     maintain the expenditures of the center for activities of the 
     center at a level that is equal to not less than the level of 
     such expenditures maintained by the center for the fiscal 
     year preceding the fiscal year for which the grant is 
     received.
       (g) Matching Requirement.--The Secretary may impose a 
     matching requirement with respect to amounts provided under a 
     grant under this section if the Secretary determines 
     appropriate.
       (h) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, $25,000,000 for 
     each of the fiscal years 1999 through 2001.

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