Current through Register Vol. 46, No. 39, September 25, 2024
(a) Services provided. A regional poison
control center shall receive or have a reasonable expectation of receiving not
less than 4,000 poison control calls per year and shall perform the following
functions:
(1) serve the population of the
designated service area;
(2)
provide expert information and consultation services to professional personnel
in the region on the diagnosis, treatment and management of any suspected or
actual poisoning(s);
(3) provide
information, emergency care, and referral services to the general
public;
(4) assure that tertiary
referral treatment centers willing to accept poison patients are identified for
the region;
(5) coordinate, develop
and monitor poison prevention and medical management programs for medical
professionals and the general public in the region;
(6) periodically report and/or conduct
investigations of new toxic risks and injuries, as indicated; and
(7) collect uniform data and engage in
research activity to enhance poison prevention and control
management.
(b)
Staffing. Regional poison control centers shall be staffed by a physician
medical director, qualified poison information specialists, an administrator or
administrative director, a health educator, and other personnel deemed
necessary to operate the poison control center within the requirements of this
Part. The following personnel standards and qualifications shall be met:
(1) The medical director shall have completed
sufficient training to qualify for certification in a medical primary care
specialty, have certification or appropriate experience in medical toxicology
and have a medical staff appointment at the hospital designated as the poison
control center.
(i) The medical director
shall provide training to and supervision of poison information specialists; be
responsible for medical decisions and treatment protocols: and provide direct
patient care, telephone supervision, or case consultation to the hospitalized
poison patient, either as the attending physician or as a consultant.
(ii) The medical director shall spend not
less than 20 hours per work week in poison control center activities.
(2) Poison information specialists
shall be qualified to read, understand and interpret standard poison
information resources and transmit that information in a logical, concise and
understandable way to both health care professionals and consumers and to
communicate information from standardized poison center treatment protocols
approved by the medical director.
(3) An administrator or administrative
director shall be employed who is qualified by training and experience to
supervise operations, finance, personnel, data collection and analysis and
other administrative functions of the poison control center.
(4) A health educator shall be employed who
is qualified by training and/or experience to conduct outreach and to develop
and provide training for both professional and public groups and organizations
in basic elements of poison prevention and treatment, especially to underserved
populations of the region.
(c) Operations.
(1) Poison control center services shall be
available to both the general public and health professionals 24 hours per day,
365 days per year.
(2) The center
shall be easily accessible by telephone at no charge to the public from all
areas within the designated region. The availability of poison control
information by telephone shall be widely publicized throughout the region to
both the public and health care providers.
(3) [Reserved]
(4) The following services shall be available
at the telephone answering site:
(i) current
toxicology information;
(ii) a
comprehensive set of current texts covering both general and specific aspects
of acute poisoning management;
(iii) primary information resources and
access to a major medical library or information system;
(iv) poison control center specialty
consultants available on an on-call basis; and
(v) a list of general hospitals in the region
capable of delivering comprehensive care for poison victims and willing to
accept such patients for care.
(5) The center shall develop and maintain
written policies and protocols for responding to calls from the public and
health professionals that provide consistent prehospital evaluation and
treatment of toxic exposures. The center shall also develop operational
guidelines prepared in conjunction with the medical director of the regional
emergency medical system. These policies, protocols and guidelines shall be
approved in writing by the medical director of the center and shall be
available at the central telephone answering site.
(6) The center shall function as a source of
comprehensive toxicology information and consultation to health professionals
in the region, and shall report and/or conduct investigations of new toxic
risks and injuries, as indicated.
(d) Regional coordination of poison control
activities. The designated regional poison control center shall function as the
focal point for the coordination of all poison control activities in a region.
(1) All medical care treatment facilities in
the region shall be evaluated by the center for participation in and
contribution to the regional poison control treatment program. This information
shall be available for the regional poison control center staff as a guide to
the facilities' capabilities in managing the poison patient.
(2) One or more tertiary treatment centers
for the management of pediatric, adolescent and adult poisoning victims shall
be identified for the region. A formal relationship shall be established
between such treatment centers and the regional poison control center for the
treatment of poison victims and to improve management of the poisoned
patient.
(3) Comprehensive
analytical toxicology services from laboratories approved as required by law
shall be identified and available within the region 24 hours a day, 365 days a
year so that required emergency analysis can be performed within a time frame
appropriate to the needs of patients. There shall be a written poison control
center protocol describing the available tests and the process for submission
of specimens and interpretation of results.
(4) The regional poison control center shall
have a protocol for interacting with the transport service(s) and communication
capability with the prehospital transport service(s) where this is available
and needed for acute management of patients. Such services shall be available
to all emergency patients.
(e) Health professional education, public
education and public outreach programs. The regional poison control center
shall provide the following educational services:
(1) instruction and programs in the
prevention, care and management of poisonings for health care professionals
involved directly in the regional treatment system, and to other professionals
with an interest or involvement in care of poison patients; and
(2) public and professional outreach programs
to promote or provide education on concepts related to poison prevention or
control.
(f) Regional
data collection system. Each regional program shall utilize a data collection
system that includes recording of all inquiries and cases handled or admitted
by the center. The center shall complete a record containing data elements
prescribed by the commissioner for all poison-related calls or admissions. Such
data elements shall include origin of call, type of call, substance involved,
description of the victim, designation as an accidental or intentional
incident, management and final disposition, and medical outcome, if any. The
center shall assure the confidentiality of such data as required by section
405.25(a)(9)
of this Title.
(g) Reporting and
evaluation.
(1) Regional poison control
centers shall submit semiannually to the department a report which shall
include, but not be limited to, a statement or regional program goals and
specific objectives for each year and progress toward meeting the stated goals
and objectives, and statistical data regarding the effectiveness of the
regional poison prevention and control activities.
(2) Regional poison control centers shall
submit to the department an annual report which shall include. but not be
limited to the number and percentage of total calls received from each county,
narrative information on program operations, the extent and type of targeted
outreach and education to professional and public groups in the region, the
relationship of center expenditures to program accomplishments, estimated cost
savings, if any, evaluation of poison patient outcomes, and other overall
findings and recommendations related to the program.
(3) The department shall conduct periodic
onsite program reviews to determine whether each regional poison control center
is in compliance with the standards set forth in this Part. A report
summarizing the findings of each review shall be made available in writing to
the center within 30 days of such review.
(i)
If the review report identifies areas in which the center is out of compliance
with the standards of this Part, the center shall submit to the commissioner,
within 30 days of issuance of the report, a plan detailing steps to be taken
for corrective action and a timetable for bringing the center into compliance
with the applicable standards.
(ii)
After receiving and accepting such a plan for corrective action, the department
may conduct a follow-up onsite review to determine whether the plan has been
implemented and whether the center has come into compliance with applicable
standards.
(iii) Failure to submit
an acceptable plan for corrective action shall constitute grounds for
revocation of poison control center designation.