Closing poison center costly, officials say

Friday, June 27, 2003 | 4:46 a.m.

PORTLAND, Ore. - For Oregon, Alaska and much of Nevada, the Oregon Poison Center is the first line of defense for accidental and intentional poisonings. It also provides invaluable, hard-to-find information and expertise for physicians and emergency workers treating poisoned patients, researchers and the public.

But the poison center is scheduled to shut its doors at the end of this month, following a national trend of centers crippled or closed by budget cuts. Oregon Health & Sciences University is cutting the program due to reduced state funding and Medicaid receipts.

Officials estimate closing the center could cost up to seven times more in unnecessary medical measures than it currently takes to run the $1.35 million operation.

Established in 1978, the Oregon Poison Center has a free 24-hour hot line staffed by seven toxicologists and 20 registered nurses from its Portland base at OHSU. The center fielded almost 70,000 calls in 2002.

About 14 percent of those calls came from Alaska and 11 counties in northern Nevada, where the center has contracts to provide poison help and education. Neither state has its own poison control center, as their small populations wouldn't justify a full-time, fully staffed operation, said Sandy Giffin, director of the Oregon Poison Center.

Dr. Guy Gansert, medical director of the Reno, Nev.-based Washoe Health System, said the health services network relies solely on the Oregon Poison Center for expert poison advice.

"They've done such a great job for us (that) we haven't gone out and explored other control centers for some time," Gansert said. "Most of the service could be provided anywhere, but it makes it a little nicer when the toxicologist can come down and visit."

The Oregon center began offering its services out of state in 1994 to maintain operations, Giffin said. Last year, it received $180,000 from the two states.

OHSU provides $1.28 million of the center's regular budget, the Legislature $90,000. A federal grant allocates further funds for poison prevention and education programs.

Now, the university is unable to support the poison center without sacrificing other programs, Giffin said.

Similar situations exist throughout the nation, said Rose Ann Soloway, associate director of the American Association of Poison Control Centers in Washington, D.C.

In Hershey, Pa., the Penn State Poison Center closed June 15 when its host institution, the Milton S. Hershey Medical Center, cut off funding.

That's a risky move, Soloway said. In 1988, the Louisiana Drug and Poison Information Center in Monroe, La., shut down for nine months due to budget worries. When it reopened, she said, the state found the cost of rerouting calls tripled that of operation.

Giffin estimated the Oregon Poison Center saves about $7 in unnecessary health care costs for every dollar spent. The center spends about $24 to handle a poison exposure call, compared to the national average of $44.84, and uses nurses instead of pharmacists to save money.

Because the Oregon Poison Center handles most of its calls entirely by telephone, Giffin said, it saves money that would otherwise be spent calling 9-1-1, dispatching an ambulance, transporting victims to the hospital and treating them in the emergency room.

To salvage the poison center, Rep. Rob Patridge, R-Medford, is sponsoring a bill that would appropriate 9-1-1 funds. Otherwise, Patridge said, "It's going to burden not only the 9-1-1 system but the emergency services and medical systems as well."

House Bill 2709 is currently before the Legislature's Ways and Means Committee.

Without the center and its toll-free number, poison victims would need to seek emergency services or physicians to handle those concerns. Most of those aren't readily equipped to answer toxicology questions.

"The most worrisome thing is, there are people (exposed to poison) who will say, 'I don't know. I'll just wait and see what happens,'" Giffin said. "But when symptoms occur, there's already a problem. The damage is being done."