[Congressional Record Volume 146, Number 10 (Tuesday, February 8, 2000)]
[House]
[Pages H230-H233]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              {time}  1430
          POISON CONTROL CENTER ENHANCEMENT AND AWARENESS ACT

  Mr. UPTON. Mr. Speaker, I move to suspend the rules and pass the 
Senate bill (S. 632) to provide assistance for poison prevention and to 
stabilize the funding of regional poison control centers.
  The Clerk read as follows:

                                 S. 632

       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 control centers are a valuable national resource 
     that provide 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 $32, 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. Within just the last year, 2 
     poison control centers have been forced to close because of 
     funding problems. A third poison control center is scheduled 
     to close in April 1999. Currently, there are 73 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) Rule of Construction.--Nothing in this section shall be 
     construed as prohibiting the establishment or continued 
     operation of any privately funded nationwide toll-free phone 
     number used to provide advice and other assistance for 
     poisonings or accidental exposures.
       (c) Authorization of Appropriations.--There is authorized 
     to be appropriated to carry out this section, $2,000,000 for 
     each of the fiscal years 2000 through 2004. Funds 
     appropriated under this subsection shall not be used to fund 
     any toll-free phone number described in subsection (b).

     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.

[[Page H231]]

       (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 2000 through 2004.

     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;
       (4) improve national toxic exposure surveillance; and
       (5) expand the physician/medical toxicologist supervision 
     of poison control centers.
       (c) Certification.--Except as provided in subsection (d), 
     the Secretary may make a grant to a center under subsection 
     (a) only if--
       (1) 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; or
       (2) the center has been certified by a State government, 
     and the Secretary has approved the State government 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 (c) with respect to a 
     noncertified poison control center or a newly established 
     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, or local 
     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 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 2000 through 2004.

  The SPEAKER pro tempore (Mr. Barrett of Nebraska). Pursuant to the 
rule, the gentleman from Michigan (Mr. Upton) and the gentleman from 
New York (Mr. Towns) each will control 20 minutes.
  The Chair recognizes the gentleman from Michigan (Mr. Upton).


                             General Leave

  Mr. UPTON. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days within which to revise and extend their remarks 
and to include extraneous material on S. 632.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from Michigan?
  There was no objection.
  Mr. UPTON. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today to ask my colleagues to approve S. 632, the 
Poison Control Center Enhancement and Awareness Act.
  This long-overdue legislation will provide a stable base of support 
for our Nation's threatened poison control centers and improve public 
education and awareness about these life-saving resources.
  This Senate bill is the companion measure to the legislation that I 
introduced with my colleague and friend, the gentleman from New York 
(Mr. Towns), in the last session of Congress. I am pleased to note that 
our bill enjoys strong bipartisan support, it has more than 130 
cosponsors; and that the Senate bill, this bill, was approved by 
unanimous consent under the leadership of our Ohio friend, Senator Mike 
DeWine.
  Poison control centers provide vital, very cost-effective services to 
the American public. Each year more than 2 million poisonings are 
reported to poison control centers throughout the United States. More 
than 90 percent of these poisonings occur in the home, and more than 50 
percent of poisoning victims are children under the age of 16.
  For every dollar spent on poison control center services, $7 in 
medical services are saved. But in spite of their obvious value, poison 
control centers are indeed in jeopardy.
  Historically, these centers were typically funded by the private and 
public sector hospitals where they were located. The transition to 
managed care, however, has resulted in a gradual erosion of the 
funding. As this funding source has been drying up, poison control 
centers have only partially been able to replace the support by 
cobbling together other State and local and private funding.
  The financial squeeze has forced many of the centers to curtail their 
poison prevention advisory services and their information and emergency 
activities and reduce the number of nurses, pharmacists, and physicians 
answering the emergency telephones. Currently, there are 73 centers. In 
1978 there were 661.
  The Poison Control Center Enhancement and Awareness Act will provide 
up to $28 million each year over the next 5 years to provide a stable 
source of funding for these centers, to establish a national toll-free 
poison control hotline, and to improve public education on poisoning 
prevention and poison center services.
  The legislation is designed to ensure that these funds supplement, 
not supplant, other funding that the centers may be receiving and 
provides the Secretary of Health and Human Services with the authority 
to impose a matching requirement.
  Further, to receive Federal funding, a center will have to be 
certified by the Secretary of Health and Human Services or an 
organizational expert in the field of poison control designated by the 
Secretary. I want to recognize especially Senator DeWine's contribution 
and his leadership.
  In addition to my colleague, the gentleman from New York (Mr. Towns), 
I would especially like to thank the gentleman from Virginia (Mr. 
Bliley), chairman of the Committee on Commerce; the gentleman from 
Michigan (Mr. Dingell), the ranking member; and the gentleman from 
Florida (Mr. Bilirakis), the chairman of the Subcommittee on Health and 
the Environment; and the gentleman from Ohio (Mr. Brown), his ranking 
member, for their interest and leadership on this issue.
  Mr. Speaker, there is no greater pain or nightmare to watch a loved 
one suffer for something that we could cure.
  I can remember, as a new dad, buying those little gadgets and putting 
them on my cupboards in my kitchen to make sure that my daughter and my 
son would not be able to open those up and find the detergent and 
bleach and other things that might be in those cabinets. But despite 
that foresight, it is not 100 percent foolproof. And when these things 
happen, we have to make sure that every family across this great 
country has access to an 800 number where they can immediately reach 
out to someone who knows what to do when that tragedy might strike.
  That is what this bill does, Mr. Speaker. It provides that access so 
our kids and our loved ones can live. I urge all of my colleagues to 
support this legislation. It is long overdue, and I look forward to its 
passage this evening.
  Mr. Speaker, I reserve the balance of my time.
  Mr. TOWNS. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I rise today to join my colleague and friend, the 
gentleman from Michigan (Mr. Upton), in supporting S. 632.
  I also would like to thank the gentleman from Michigan (Mr. Dingell), 
the ranking member of the full committee; and, of course, the gentleman 
from Florida (Mr. Bilirakis), the chairman of the subcommittee; and the 
gentleman from Virginia (Mr. Bliley), the chairman of the full 
committee; and the gentleman from Ohio (Mr. Brown),

[[Page H232]]

who is the ranking member on the Subcommittee on Health and the 
Environment. I would like to thank all of them for their outstanding 
leadership, along with the gentleman from California (Mr. Waxman) and 
the gentleman from Illinois (Mr. Rush).
  The Poison Control Center Enhancement and Awareness Act, we 
introduced virtually identical legislation, H.R. 1221, in March of last 
year. The poison control centers provide cost savings, effective 
preventive services to the American public. For every dollar spent on a 
center's services, $7 in medical costs are saved.
  Yet, we have seen a dramatic decrease in the number of centers. They 
have actually decreased them by 588 from 1978 to 1999, when we 
introduced 1221. That is hard to understand.
  When we talk to the nurses, they want it. When we talk to the 
doctors, they want it. Anybody that is involved in health care is 
asking that we fund these poison control centers and that we do it now. 
Because they are so important in terms of saving the lives of so many 
people, especially our children.
  This legislation would authorize appropriations for $28 million over 
the next 5 years, which provides a stable source of funding. The 
Secretary of Health and Human Services is also directed under the 
legislation to improve public education about poisonings and to provide 
correlation and assistance to regional poison control centers for the 
establishment of a nationwide toll-free phone number to access these 
centers. This kind of effort is critical if centers are to provide the 
maximum level of service to our most vulnerable population, the 
Nation's children.
  Children are disproportionately impacted. For example, 60 percent of 
poisonings involved children under the age of 6.
  In hearings that we held during the 104th Congress, in the House 
Government Operations Subcommittee on Human Resources, suggested that 
the unintentional injuries and deaths that result from poisonings could 
be mitigated if we had a stable source of funding for poison control 
centers.
  In other words, if we would just say that we were going to be 
committed to it and put forth a certain amount rather than continuing 
to do a piecemeal kind of thing, we would be able to save a lot of 
lives because people would know where to turn.
  S. 632 provides us with the opportunity today to ensure a stable 
source of funding. I urge my colleagues, including the 130 cosponsors 
of our bill, H.R. 1221, to join me in voting for this measure. It 
passed the Senate by unanimous consent. We should do no less today to 
guarantee that poison control centers have the financial security they 
need to provide our citizens with life-saving information about these 
centers.
  Mr. Speaker, let me just again commend my colleague, the gentleman 
from Michigan (Mr. Upton), for the outstanding job that he has done. 
Because when we walk the streets and we talk to people that have 
children and they talk about some of the incidents that have occurred 
and that they do not know where to turn, when we talk to physicians who 
are actually in the emergency rooms of these various hospitals who say 
that they look to these poison control centers to get information to be 
able to deal with the mother, or for a mother to be able to pick up the 
phone and call a center and for the center to tell her what to do on 
the phone, we are talking about saving money.
  I cannot understand why we are so reluctant to do this in this day 
and age when we know that it is important that we cut costs. But we 
need to do it in a very reasonable fashion.
  So I want to once again thank my colleague for having the foresight 
to say that this should be done. I think that we have to continue to 
work to make certain that we have that central number so that everybody 
knows that, once an incident occurs, that a person right away will know 
what to call by saying 1-800 and that mother would be able to be 
relieved of some of that tension that she might have if otherwise that 
information was not available.
  Mr. Speaker, I yield back the balance of my time.
  Mr. UPTON. Mr. Speaker, I yield myself the balance of my time.
  Mr. Speaker, it is hard to think of an issue that the gentleman from 
New York (Mr. Towns) and I when we have tried to lead on an issue have 
not reached out to each other and sought some partisan support. And I 
again appreciate that friendship and hard work.
  At the end of the day, at the end of this day, this Congress is going 
to follow through with what the Senate did and make sure that, in fact, 
these poison control centers are in place and that they are going to be 
funded.
  There is an old movie that I remember, ``Ghostbusters.'' Remember 
that? ``Who are you going to call? Ghostbusters.'' I am not going to 
sing it. But when a parent has a problem, particularly a parent, but it 
could be anybody, there has got to be a number that they can call, 
whether it is their cell phone in their pocket or the phone in their 
kitchen. And this bill does that. Because they do not have time, they 
do not have a lot of time to react when someone might be writhing on 
the floor with some substance that they might have ingested and they 
have no idea what to do, particularly as a non-physician, as most of us 
in this body are.
  This bill is going to save lives; and at the end of the day, it is 
going to save money too. I cannot think of a better promise to the 
American taxpayer, to the folks that we serve, as we have visited our 
day-care centers and we see those wonderful little kids that are 
playing. They cannot distinguish between a box of detergent and a box 
of cereal. They just know that it usually has got a pretty color.
  We have got to make sure that, in fact, their lives are going to be 
saved when they do something that they really should not do if they had 
had some parental involvement during that tragic moment.
  So again, Mr. Speaker, I ask my colleagues to support this 
legislation. I would hope that we can pass it without any objections at 
all.
  Mr. DAVIS of Illinois. Mr. Speaker, I rise today to urge you to 
support S. 632, the Poison Center Enhancement and Awareness Act of 
1997. This important legislation authorizes Congress to provide 
assistance to poison control, information and treatment centers 
nationwide through a grant-funding program that would be administered 
by the Centers for Disease Control and Prevention. The funding will be 
used to educate the public about the benefits of poison prevention and 
treatment, primarily through the ``Mr. Yuk'' campaign.
  The federal government should support poison control and treatment 
centers because they provide immediate, around-the-clock toxicity 
assessments and treatment recommendations over the telephone for all 
types of poisoning, overdoses and drug interactions affecting people of 
all ages. On a daily basis, parents, grandparents, child-care 
providers, teachers and health care providers consult these centers. 
Most calls are safely managed over the phone and referrals are made to 
health care facilities as appropriate. More severe cases are followed 
up so progress can be assessed and additional recommendations provided 
as necessary.
  The Illinois Poison Center (IPC), which is located in my 
congressional district, is the nation's oldest and Illinois' only 
remaining poison control, information and treatment center. Since 1953, 
it was operated by a local Chicago hospital. By 1996, however, the 
hospital was no longer able to maintain the center's operation, largely 
because of a lack of funding. Also by that time, the four other poison 
centers located in Illinois had closed. Eventually, the IPC's 
operations were assumed by the Metropolitan Chicago Healthcare Council 
and, at the request of others around the state, the center was expanded 
to serve the entire state.
  Unfortunately, the IPC's existence, like that of other poison centers 
around the nation, is jeopardized because of a lack of stable funding. 
There remains, however, a great need to support these centers and their 
education and treatment efforts. Studies also show that 90 percent of 
all poisonings happen in the home, and 53 percent of these cases 
involve children under six years of age. Also, a study conducted by the 
U.S. Department of Health and Human Services found that for every 
dollar spent on a poison center saves $7 in unnecessary medical costs. 
In 1998 alone, more than 79 percent of all human exposures presented to 
the Illinois Poison Center were handled without a referral to a 
hospital emergency department or a private physician. This in turn 
saved more than $15 million in unnecessary emergency room and physician 
office visits.
  Mr. BLILEY. Mr. Speaker, I rise in support of S. 632, The Poison 
Control Center Enhancement and Awareness Act. I ask my colleagues to 
consider that poisoning is the third most common form of unintentional 
death in

[[Page H233]]

the United States. Every year, poisoning accounts for 13,000 deaths. It 
also leads to 285,000 hospitalizations and 1 million days of acute 
hospital care. The direct costs of poisoning are estimated at over $3 
billion per year, which is more than our annual expenditures on gunshot 
wounds, burns and drownings combined.
  S. 632 will provide a stable source of funding for poison control 
centers, establish a national toll-free poison control hotline, and 
improve public education on poisoning prevention and services. This 
assistance is needed because poison control centers have experienced a 
gradual erosion of funding as payments to hospitals (where they have 
typically been located) have been reduced. This financial squeeze has 
forced many centers to curtail their poison prevention advisory 
services and their information and emergency activities, and to reduce 
the number of nurses, pharmacists, and physicians answering the 
emergency telephones. Currently, there are 73 centers. In 1978, there 
were 661. And yet, such centers are very cost-effective. For every 
dollar spent on poison control center services, seven dollars in 
medical costs are saved.
  Therefore, I encourage my colleagues to pass this bill, S. 632, which 
is being considered today under suspension of House rules. I join my 
Commerce Committee colleagues-- Representatives Upton, Bilirakis, and 
Towns--who are the original cosponsors of a very similar House Bill, in 
supporting its passage.
  Mr. UPTON. Mr. Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from Michigan (Mr. Upton) that the House suspend the rules 
and pass the Senate bill, S. 632.
  The question was taken.
  Mr. UPTON. Mr. Speaker, on that I demand the yeas and nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.

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