Wednesday, Aug. 23, 2006 | 7:44 a.m.
The Southern Nevada Health District is scrambling to find the almost $500,000 needed to fund its poison-control services after the Health Resources and Services Administration indicated it would no longer subsidize it.
Since 2004, the Health District has used part of a federal bioterrorism grant to fund basic services, but this year the health administration identified poison control as an essential service and therefore not an allowable expenditure.
In a July story, the Sun questioned federal officials and the Nevada State Health District on whether the grant money could be used for poison control.
Dr. Bradford Lee, the Nevada state health officer, acknowledged at the time that poison control is an essential service. He also pointed out, however, that the monitoring services performed by poison-control centers serve as an early-warning service for a disease outbreak, such as a pandemic.
The health administration has expanded the scope of its bioterrorism grants in recent years to allow for pandemic preparedness.
Agency officials said in July, however, that the grant money was not intended to be used for essential services that have a pandemic component. In a prepared statement Tuesday, spokesman David Bowman elaborated on this position:
"During a routine site visit earlier this year, HRSA staff discovered that state officials had been using (grant) funds improperly to fund the day-to-day operational costs of their Poison Control program. HRSA contacted state officials and advised them that this use of funds was unallowable."
Federal officials could not explain why this criterion had not been applied in the last two years and, county officials said, therein lies the rub. Because the use of the money for poison control has been allowed in the past, the Southern Nevada Health District had every reason to believe the expenditure was legitimate.
Dr. Don Kwalick, director of the Southern Nevada Health District, said losing almost $500,000 from the budget at any time would be a blow. The short time between the submission of grant requests and the dispersal of funds, however, makes the unexpected rejection even more difficult .
"That's the worst part," he said. "Had we known, we could have made alternate plans six or eight months ago."
Now the health department is forced to change plans on the fly.
Kwalick said the district has canceled its contract with the Rocky Mountain Poison and Drug Center and is negotiating a monthly rate with the center until a more permanent solution can be found.
The district had until July 31 to terminate its contract, or it would have been automatically renewed at a rate of $32,500 per month for 2007. With no assurances that money would be available, Kwalick said, he could not take chances: "I don't have money in the budget to fund it for the entire (fiscal) year."
Kwalick said there are contingency plans to maintain services at least through the end of 2006.
The Southern Nevada Health District's fiscal year began on July 1, but the federal grant money is dispersed in September, so the district will continue to fund the program with last year's grant money until then.
Kwalick said that he hopes federal officials will be sympathetic to the hardship created by the loss of funding and allow the county to use the grant funds until the end of the year. If not, he said, he will have to rely on funds created by salary vacancies to make up the deficit.
At its Board of Health meeting in July, district officials suggested the county ask the Nevada State Health Division to fund what it described as statewide services. But even if the state agrees, those dollars would cover less than 25 percent of the program's overall costs.
Officials said that charging hospitals a consultation fee for the almost 2,000 hospital-based calls each year could recoup some of the money. The elimination of drug identification calls, which represent about two-thirds of all calls, could further reduce the county's cost.
The poison-control program was started in the mid-1980s when Sunrise Hospital contracted with the Rocky Mountain Poison and Drug Center to handle the less than 1,000 poison-related calls from valley residents each year.
As Clark County has continued to grow, however, call volume and the costs associated with it have risen dramatically.
In 2001, the district took over the contract, and the poison center handled more than 15,000 Clark County calls, paid for with $159,000 in local funds. In 2006, the county estimates there will be 36,000 calls to the poison-control help line at a cost of $390,000.
Despite these escalating costs, county officials maintain that a regional approach to poison control is the most cost effective.
They estimate that the calls taken by Rocky Mountain Poison and Drug Center would cost more than $1 million if handled independently through a local call center.
Long-term solutions include a statewide poison-control line, and the state health department is lobbying to secure funding for the program in next year's budget. The county may look to local hospitals to help .
"The hospitals have all been supportive and recognize that if this were to go away it would be a big loss," Kwalick said. "Everybody is concerned, but nobody has stepped forward yet."
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