Poison control centers in peril
10/3/2002The wallets of taxpayers and state policy makers have been locked up tighter than a tamper-proof pill bottle, which is putting pressure on the poison control center that serves 20 northwest Ohio counties.
Dr. David Grossman, health commissioner for the Toledo-Lucas County health department, said he thinks the center - which is based in Cincinnati - provides valuable information. He said he's even used it for drug overdose questions about his own patients. He thinks the funding situation is grim.
“I think it's relatively dire,” he said. “If we don't get some funding, they could stop” offering services in northwest Ohio.
Funding shortfalls aren't just a problem in northwest Ohio. Poison control centers nationwide have struggled for years and it's only getting worse in many cases, according to Rose Ann Soloway, associate director at the American Association of Poison Control Centers.
Ohio and Michigan are particularly hard hit.
Dr. Marcel Casavant, medical director of the Central Ohio Poison Center at Children's Hospital in Columbus, said his center, which covers 45 counties, struggles like the Cincinnati center that covers northwest Ohio. Dr. Casavant's center almost closed in 1997 and last year had a $600,000 deficit that was picked up by the hospital.
“My [staff] come in and they're never really quite sure if their job will be here tomorrow,” Dr. Casavant said.
Dr. Susan Smolinske, managing director of the poison control center at Children's Hospital in Detroit, said her organization fights for survival. Her center covers 18 counties, including Hillsdale, Lenawee, and Monroe counties, and had a deficit of $457,000 last year that had to be covered by the hospital.
Northwest Ohio isn't in danger of losing poison control services - yet - said Cincinnati center officials, but “we need to find some financial support,” said Dr. Earl Siegel, co-director of the Drug and Poison Information Center at Cincinnati Children's Medical Center.
The center picked up coverage of northwest Ohio last year after Medical College of Ohio Hospitals ended its 38-year program. Pharmacists and nurses at the Cincinnati center field lots of nervous calls; questions ranging from a child swallowing half a bottle of aspirin to a toddler sipping some cleaning fluid to a teenager overdosing on drugs.
Adding the northwest Ohio counties meant an extra 1,000 calls a month, half of them from Lucas County, without a stable way to cover the cost, Dr. Siegel said.
The center had been counting on passage of the Lucas County Alcohol and Drug Addiction Services tax levy, which would have brought in about $100,000 annually. The levy was defeated in May.
Covering northwest Ohio costs about $270,000. Currently, the center is absorbing most of that. The Hospital Council of Northwest Ohio, a professional organization representing hospitals, has kicked in $50,000 and the Toledo Community Foundation has given $12,000.
Paul Samenuk, director of pharmacy at MCO Hospitals, used to oversee MCO's poison control efforts. He said MCO had to stop offering the service because it received no outside financial help, and the thousands of calls were making it tough to handle other pharmacy duties.
“I think what will eventually happen if there is not funding in the near future is northwest Ohio might not have poison information services,” he said.
Ms. Soloway said there are 65 poison control centers nationwide and several have closed in the last 10 years for financial reasons. There are now three centers covering Ohio - Cincinnati, Columbus, and Cleveland - and two for Michigan - Detroit and Grand Rapids.
Drs. Siegel and Casavant said federal and state funding accounts for less than 10 percent of their budgets. Many states contribute more than Ohio does for poison control. Ohio's three poison control centers will receive about $323,980 collectively this fiscal year from the Ohio Department of Health, which doesn't go far, Dr. Siegel said.
“The support from the state has been very poor,” he said.
The centers' directors said poison control is a cost-effective way to deal with poisonings. 911 operators aren't trained to handle poison cases and usually refer patients to physicians or emergency rooms, Dr. Siegel said.
That can cost hundreds of dollars a case vs. the average $22.60 cost for one poison control call. Dr. Siegel said his staff is able to deal with 80 percent of the calls by talking through the problem with callers, saving many visits to the emergency room.
Dr. Casavant said some states, realizing the savings, have forced health insurance companies to kick in some money to fund poison control centers. Dr. Smolinske said centers in Michigan asked insurance companies there for help, “and we got a resounding `no way.'”