State could lose access to poison-control center

Rhode Island’s access to a regional center for poison control and prevention in Boston could end on July 1, if the state can’t come up with $200,000 needed annually to support it.
Dr. Michael Fine, director of the R.I. Department of Health, indicated in a May 12 letter to the Regional Center for Poison Control and Prevention that federal budget cuts had put Rhode Island in a position of having to replace money that used to come from Washington for poison control.
Fine said in the letter that the department has had discussions with various partners, including hospitals, insurance medical directors, the Rhode Island Medical Society, the Hospital Association of Rhode Island, and various state officials regarding alternative funding streams. He says that so far only about $50,000 in potential state funding has been identified.
“I have not had any indication that additional resources are forthcoming,” Fine wrote in the letter. “However, I am still hopeful that the importance of the service provided by the Poison Control and Prevention Regional Center to Rhode Island will provide the traction needed to secure additional funds.”
Dr. Marsha Ford, president of the American Association of Poison Control Centers, as well as a board-certified toxicologist, said the full $200,000 would be needed for the state to maintain access to the center, located within Boston’s Children’s Hospital. Otherwise, Rhode Islanders would immediately lose access to the center, which serves both Rhode Island and Massachusetts, as of July 1.
“It’s definitely a loss, because now you’ve got an entire state without services,” Ford said last week. “Anyone trying a national poison-control hotline provided by the Health Resources and Services Administration would hear a message saying, ‘Poison Center services are no longer available in your area. Please go to your nearest emergency department or health care facility for care.’ ”
Despite reliance on the Internet among some people in poison emergencies, the use of poison-control center hotlines has increased through the latest year of measurement, which was 2012, according to Ford.
Ford pointed out that past experience shows that when poison-control centers are closed, emergency department visits and in-patient admissions go up. That was the case when Louisiana shuttered its center in 1988, later reopening it in 1991 because the costs of not having a center were found to be greater than the savings.
Among the effects of the Louisiana Poison Control Center’s closing, according to AAPCC, were 15,000 more emergency-room visits for poisonings that cost an additional $1.4 million.
Michigan, too, briefly curtailed its poison-center service, dropping coverage in 1993 from two of the three area codes that the center served. During the next four months, according to AAPCC, a large insurance company counted a 35 percent increase in outpatient visits for suspected poisonings and a 16 percent increase in hospitalizations. Michigan, too, restored its coverage.
The United States’ 55 poison centers had their federal funding cut by 39 percent in 2011. The effects of the cuts have been palpable at centers all around the country, according to the AAPCC. And indeed Rhode Island is not the only state contemplating dropping funding for its poison-control center. Illinois is on the brink of closing its center as well.
On April 1, the Illinois Poison Center (which is the oldest in the United States) provided 90 days notice to the Illinois Department of Health that it would close on July 1 if funding for the center cannot be secured. The Illinois state Senate has approved a measure to continue funding.
Dr. Christopher Lehrach, a practicing emergency department physician at Westerly Hospital as well as chief transformation officer for L+M Healthcare, said that being the only state in the union without access to a poison-control center is not a good course for Ocean State.
“This is an important matter for Rhode Island’s population,” he said. “I know that every dollar is being looked at very carefully, and that’s the right way to approach a budget, but this would be a very short-sighted decision as we would see our Medicaid expenses rise dramatically without access to poison-center services.”
Mike Souza, acting president of the Hospital Association of Rhode Island, agreed that Rhode Islanders’ access to the center should be preserved.
“The Poison Control Center is important to the public health of our state,” Souza said. “We urge appropriate funding for this important resource.” •

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