California Poison Control System Faces Layoffs, Closure

The California Poison Control System is the largest single provider of poison control services in the country. The system handles more than 900 calls daily. Now the program is bracing for layoffs and possible elimination – another victim of the current state budget crisis.

The system employs more than 75 pharmacists, nurses, physician-toxicologists and poison information providers who undergo intensive and highly specialized training and certification.

If the service is dismantled, there’s no easy way to put it back together, warns Iana Simeonov, director of program development. “If the state cannot pass a budget soon, we are going to have to issue layoff notices, probably by the middle of July.”

Analysis indicates that cutting the service may cost more money than its saves. “We estimate that the California Poison Control System saves at least $70 million per year in health care costs, with over 60,000 visits to emergency departments and health care providers avoided,” Simeonov says. Emergency room professionals and 911 dispatchers rely on the service.

“Before the system was centralized, there was a San Francisco regional poison control system,” says Simeonov. “At one point, Contra Costa County decided that it could not pay for the service. Then they saw how the decision led to an increase in emergency room visits and calls to 911.” The county soon returned to the fold.

At about $40 per call, the California Poison Control System is one of the most efficient nationwide, according to Simeonov.

Children age 5 and under are the group that suffers the most from unintentional exposure to poisons, and as the birthrate in California continues to rise, demand for poison control services is not likely to decline, Simeonov says.

Since 1997, the UCSF School of Pharmacy’s Department of Clinical Pharmacy has operated the system as a centralized service, with four call centers distributed throughout the state. The operating cost now is about $12.8 million. The state funding for this year was to be $5.9 million.

Governor Arnold Schwarzenegger earlier eliminated the funds from the budget. The Budget Conference Committee of the California Assembly and Senate added back half of the state funds. Even if the budget reemerges from legislative huddles with these funds restored, the governor may use his line-item veto to again remove funding. Nonstate funding sources for the program are contingent on state support.

Nationwide, there is a common toll-free number for poison control: 800/222-1222. But there is no nationwide program. All calls from California are routed within the state, for instance. If California drops out, don’t expect other states to pick up the slack, Simeonov says. They are faring little better than California. Without reimbursement, states that maintain programs are unlikely to pick up hotline callers from other states that end their programs.