42 USC CHAPTER 6A, SUBCHAPTER X, Part G: Poison Control

From Title 42—THE PUBLIC HEALTH AND WELFARECHAPTER 6A—PUBLIC HEALTH SERVICESUBCHAPTER X—TRAUMA CARE

Part G—Poison Control

§300d–71. Maintenance of the national toll-free number and other communication capabilities

(a) In general

The Secretary—

(1) shall provide coordination and assistance to poison control centers for the establishment and maintenance of a nationwide toll-free phone number, to be used to access such centers; and

(2) may provide coordination and assistance to poison control centers and consult with professional organizations for the establishment, implementation, and maintenance of other communication technologies to be used to access such centers.

(b) Routing contacts with poison control centers

Not later than 18 months after December 20, 2019, the Secretary shall coordinate with the Chairman of the Federal Communications Commission, to the extent technically and economically feasible, to ensure that communications with the national toll-free number are routed to the appropriate poison control center based on the physical location of the contact rather than the area code of the contact device.

(c) Authorization of appropriations

There is authorized to be appropriated to carry out this section, $700,000 for each of fiscal years 2025 through 2029 for the establishment, implementation, and maintenance activities carried out under subsections (a) and (b).

(July 1, 1944, ch. 373, title XII, §1271, as added Pub. L. 108–194, §3, Dec. 19, 2003, 117 Stat. 2889; amended Pub. L. 110–377, §3, Oct. 8, 2008, 122 Stat. 4064; Pub. L. 113–77, §2, Jan. 24, 2014, 128 Stat. 644; Pub. L. 116–94, div. N, title I, §403(a), Dec. 20, 2019, 133 Stat. 3114; Pub. L. 118–86, §2(a), Sept. 26, 2024, 138 Stat. 1549.)

Editorial Notes

Amendments

2024—Subsec. (c). Pub. L. 118–86 substituted "fiscal years 2025 through 2029" for "fiscal years 2020 through 2024".

2019—Pub. L. 116–94, §403(a)(1), inserted "and other communication capabilities" after "toll-free number" in section catchline.

Subsec. (a). Pub. L. 116–94, §403(a)(2), added subsec. (a) and struck out former subsec. (a). Prior to amendment, text read as follows: "The Secretary shall provide coordination and assistance to poison control centers for the establishment of a nationwide toll-free phone number, and the maintenance of such number, to be used to access such centers."

Subsec. (b). Pub. L. 116–94, §403(a)(4), added subsec. (b). Former subsec. (b) redesignated (c).

Subsec. (c). Pub. L. 116–94, §403(a)(3), (5), redesignated subsec. (b) as (c) and substituted "2020 through 2024" for "2015 through 2019" and "establishment, implementation, and maintenance activities carried out under subsections (a) and (b)" for "maintenance of the nationwide toll free phone number under subsection (a)".

2014—Subsec. (b). Pub. L. 113–77 added subsec. (b) and struck out former subsec. (b). Prior to amendment, text read as follows: "There is authorized to be appropriated $2,000,000 for fiscal year 2009 to carry out this section, and $700,000 for each of fiscal years 2010 through 2014 for the maintenance of the nationwide toll free phone number under subsection (a)."

2008—Pub. L. 110–377 amended section generally. Prior to amendment, section required the Secretary to coordinate and assist in establishment of nationwide poison control center toll-free phone number, allowed for establishment and continued operation of privately funded nationwide toll-free numbers, and authorized appropriations for fiscal years 2000 through 2009.

Statutory Notes and Related Subsidiaries

Findings

Pub. L. 110–377, §2, Oct. 8, 2008, 122 Stat. 4063, provided that: "Congress makes the following findings:

"(1) Poison control centers are the primary defense of the United States against injury and deaths from poisoning. Twenty-four hours a day, the general public as well as health care practitioners contact their local poison control centers for help in diagnosing and treating victims of poisoning. In 2007, more than 4,000,000 calls were managed by poison control centers providing ready and direct access for all people of the United States, including many underserved populations in the United States, with vital emergency public health information and response.

"(2) Poisoning is the second most common form of unintentional death in the United States. In any given year, there will be between 3,000,000 and 5,000,000 poison exposures. Sixty percent of these exposures will involve children under the age of 6 who are exposed to toxins in their home. Poisoning accounts for 285,000 hospitalizations, 1,200,000 days of acute hospital care, and more than 26,000 fatalities in 2005.

"(3) In 2008, the Harvard Injury Control Research Center reported that poisonings from accidents and unknown circumstances more than tripled in rate since 1990. In 2005, the last year for which data are available, 26,858 people died from accidental or unknown poisonings. This represents an increase of 20,000 since 1990 and an increase of 2,400 between 2004 and 2005. Fatalities from poisoning are increasing in the United States in near epidemic proportions. The funding of programs to reverse this trend is needed now more than ever.

"(4) In 2004, The Institute of Medicine of the National Academy of Sciences recommended that 'Congress should amend the current Poison Control Center Enhancement and Awareness Act Amendments of 2003 [Pub. L. 108–194, see Short Title of 2003 Amendments note set out under section 201 of this title] to provide sufficient funding to support the proposed Poison Prevention and Control System with its national network of poison centers. Support for the core activities at the current level of service is estimated to require more than $100 million annually.'.

"(5) Sustaining the funding structure and increasing accessibility to poison control centers will promote the utilization of poison control centers and reduce the inappropriate use of emergency medical services and other more costly health care services. The 2004 Institute of Medicine Report to Congress determined that for every $1 invested in the Nation's poison control centers $7 of health care costs are saved. In 2005, direct Federal health care program savings totaled in excess of $525,000,000 as the result of poison control center public health services.

"(6) More than 30 percent of the cost savings and financial benefits of the Nation's network of poison control centers are realized annually by Federal health care programs (estimated to be more than $1,000,000,000), yet Federal funding support (as demonstrated by the annual authorization of $30,100,000 in Public Law 108–194) comprises less than 11 percent of the annual network expenditures of poison centers.

"(7) Real-time data collected from the Nation's certified poison control centers can be an important source of information for the detection, monitoring, and response for contamination of the air, water, pharmaceutical, or food supply.

"(8) In the event of a terrorist event, poison control centers will be relied upon as a critical source for accurate medical information and public health emergency response concerning the treatment of patients who have had an exposure to a chemical, radiological, or biological agent."

Pub. L. 108–194, §2, Dec. 19, 2003, 117 Stat. 2888, provided that: "The Congress finds the following:

"(1) Poison control centers are our Nation's primary defense against injury and deaths from poisoning. Twenty-four hours a day, the general public as well as health care practitioners contact their local poison centers for help in diagnosing and treating victims of poisoning and other toxic exposures.

"(2) Poisoning is the third most common form of unintentional death in the United States. In any given year, there will be between 2,000,000 and 4,000,000 poison exposures. More than 50 percent of these exposures will involve children under the age of 6 who are exposed to toxic substances in their home. Poisoning accounts for 285,000 hospitalizations, 1,200,000 days of acute hospital care, and 13,000 fatalities annually.

"(3) Stabilizing the funding structure and increasing accessibility to poison control centers will promote the utilization of poison control centers, and reduce the inappropriate use of emergency medical services and other more costly health care services.

"(4) The tragic events of September 11, 2001, and the anthrax cases of October 2001, have dramatically changed our Nation. During this time period, poison centers in many areas of the country were answering thousands of additional calls from concerned residents. Many poison centers were relied upon as a source for accurate medical information about the disease and the complications resulting from prophylactic antibiotic therapy.

"(5) The 2001 Presidential Task Force on Citizen Preparedness in the War on Terrorism recommended that the Poison Control Centers be used as a source of public information and public education regarding potential biological, chemical, and nuclear domestic terrorism.

"(6) The increased demand placed upon poison centers to provide emergency information in the event of a terrorist event involving a biological, chemical, or nuclear toxin will dramatically increase call volume."

§300d–72. Promoting poison control center utilization

(a) In general

The Secretary shall carry out, and expand upon, a national media campaign to educate and support outreach to the public and health care providers about poisoning and toxic exposure prevention and the availability of poison control center resources in local communities and to conduct advertising campaigns concerning the nationwide toll-free number and other available communication technologies established, implemented, or maintained under section 300d–71(a) of this title.

(b) Contract with entity

The Secretary may carry out subsection (a) by entering into contracts with one or more public or private entities, including nationally recognized organizations in the field of poison control and national media firms, for the development and implementation of a nationwide poisoning and toxic exposure prevention and poison control center awareness campaign, which may include—

(1) the development and distribution of poisoning and toxic exposure prevention awareness materials, applicable public health emergency preparedness and response information, and poison control center awareness materials;

(2) television, radio, Internet, and newspaper public service announcements; and

(3) other activities to provide for public and professional awareness and education.

(c) Authorization of appropriations

There is authorized to be appropriated to carry out this section, $800,000 for each of fiscal years 2025 through 2029.

(July 1, 1944, ch. 373, title XII, §1272, as added Pub. L. 108–194, §3, Dec. 19, 2003, 117 Stat. 2889; amended Pub. L. 110–377, §4(a), Oct. 8, 2008, 122 Stat. 4064; Pub. L. 113–77, §3, Jan. 24, 2014, 128 Stat. 644; Pub. L. 116–94, div. N, title I, §403(b), Dec. 20, 2019, 133 Stat. 3114; Pub. L. 118–86, §2(b), Sept. 26, 2024, 138 Stat. 1549.)

Editorial Notes

Amendments

2024—Subsec. (c). Pub. L. 118–86 substituted "fiscal years 2025 through 2029" for "fiscal years 2020 through 2024".

2019—Pub. L. 116–94, §403(b)(1), substituted "Promoting" for "Nationwide media campaign to promote" in section catchline.

Subsec. (a). Pub. L. 116–94, §403(b)(2), inserted "and support outreach to" after "educate", and substituted "poisoning and toxic exposure prevention" for "poison prevention" and "and other available communication technologies established, implemented, or maintained under" for "established under".

Subsec. (b). Pub. L. 116–94, §403(b)(3)(A), substituted "nationwide poisoning and toxic exposure prevention" for "nationwide poison prevention" in introductory provisions.

Subsec. (b)(1). Pub. L. 116–94, §403(b)(3)(B), substituted "poisoning and toxic exposure prevention awareness materials, applicable public health emergency preparedness and response information, and poison control center" for "poison prevention and poison control center".

Subsecs. (c), (d). Pub. L. 116–94, §403(b)(4)–(6), redesignated subsec. (d) as (c), substituted "2020 through 2024" for "2015 through 2019", and struck out former subsec. (c). Prior to amendment, text of subsec. (c) read as follows: "The Secretary shall—

"(1) establish baseline measures and benchmarks to quantitatively evaluate the impact of the nationwide media campaign carried out under this section; and

"(2) on an annual basis, prepare and submit to the appropriate committees of Congress an evaluation of the nationwide media campaign."

2014—Subsec. (c)(2). Pub. L. 113–77, §3(1), struck out comma after "Congress".

Subsec. (d). Pub. L. 113–77, §3(2), added subsec. (d) and struck out former subsec. (d). Prior to amendment, text read as follows: "There is authorized to be appropriated to carry out this section, such sums as may be necessary for fiscal year 2009, and $800,000 for each of fiscal years 2010 through 2014."

2008—Pub. L. 110–377 amended section generally. Prior to amendment, section required the Secretary to establish a national media campaign to educate the public and health care providers about poison control and prevention and authorized appropriations for fiscal years 2000 through 2009.

Statutory Notes and Related Subsidiaries

Effective Date of 2008 Amendment

Pub. L. 110–377, §4(b), Oct. 8, 2008, 122 Stat. 4065, provided that: "The amendment made by this section [amending this section] shall be effective on the date of the enactment of this Act [Oct. 8, 2008] and shall apply to contracts entered into on or after January 1, 2009."

§300d–73. Maintenance of the poison control center grant program

(a) Authorization of program

The Secretary shall award grants to poison control centers accredited under subsection (c) (or granted a waiver under subsection (d)) and professional organizations in the field of poison control for the purposes of preventing, and providing treatment recommendations for, poisonings and toxic exposures and complying with the operational requirements needed to sustain the accreditation of the center under subsection (c).

(b) Additional uses of funds

In addition to the purposes described in subsection (a), a poison center or professional organization awarded a grant, contract, or cooperative agreement under such subsection may also use amounts received under such grant, contract, or cooperative agreement—

(1) to research, establish, implement, and evaluate best practices in the United States for poisoning and toxic exposure prevention, poison control center outreach, and emergency preparedness and response programs;

(2) to research, develop, implement, revise, and communicate standard patient management guidelines for commonly encountered toxic exposures;

(3) to improve national toxic exposure surveillance by enhancing cooperative activities between poison control centers in the United States, the Centers for Disease Control and Prevention, and other government agencies as determined to be appropriate and nonduplicative by the Secretary;

(4) to research, improve, and enhance the communications and response capability and capacity of the nation's network of poison control centers to facilitate increased access to the centers through the integration and modernization of the current poison control centers communications and data system, including enhancing the network's telephony, Internet, data and social networking technologies;

(5) to develop, support, and enhance technology and capabilities of professional organizations in the field of poison control to collect national poisoning, toxic occurrence, and related public health data;

(6) to develop initiatives to foster the enhanced public health utilization of national poison data collected by organizations described in paragraph (5);

(7) to support and expand the toxicologic expertise within poison control centers; and

(8) to improve the capacity of poison control centers to answer high volumes of contacts and Internet communications, and to sustain and enhance the poison control center's network capability to respond during times of national crisis or other public health emergencies.

(c) Accreditation

Except as provided in subsection (d), the Secretary may award a grant to a poison control center under subsection (a) only if—

(1) the center has been accredited by a professional organization in the field of poison control, and the Secretary has approved the organization as having in effect standards for accreditation that reasonably provide for the protection of the public health with respect to poisoning; or

(2) the center has been accredited by a State government, and the Secretary has approved the State government as having in effect standards for accreditation that reasonably provide for the protection of the public health with respect to poisoning.

(d) Waiver of accreditation requirements

(1) In general

The Secretary may grant a waiver of the accreditation requirements of subsection (c) with respect to a nonaccredited poison control center that applies for a grant under this section if such center can reasonably demonstrate that the center will obtain such an accreditation within a reasonable period of time as determined appropriate by the Secretary.

(2) Renewal

The Secretary may renew a waiver under paragraph (1).

(3) Limitation

(A) In general

The sum of the number of years for a waiver under paragraph (1) and a renewal under paragraph (2) may not exceed 5 years.

(B) Public health emergency

Notwithstanding any previous waivers, in the case of a poison control center whose accreditation is affected by a public health emergency declared pursuant to section 247d of this title, the Secretary may, as the circumstances of the emergency reasonably require, provide a waiver under paragraph (1) or a renewal under paragraph (2), not to exceed 2 years. The Secretary may require quarterly reports and other information related to such a waiver or renewal under this paragraph.

(e) Supplement not supplant

Amounts made available to a poison control center under this section shall be used to supplement and not supplant other Federal, State or local funds provided for such center.

(f) Maintenance of effort

With respect to activities for which a grant is awarded under this section, the Secretary may require that poison control centers agree to maintain the expenditures of the center for such activities at a level that is not less than the level of expenditures maintained by the center for the fiscal year preceding the fiscal year for which the grant is received.

(g) Authorization of appropriations

There is authorized to be appropriated to carry out this section, $28,600,000 for each of fiscal years 2025 through 2029. The Secretary may utilize an amount not to exceed 6 percent of the amount appropriated under this preceding sentence in each fiscal year for coordination, dissemination, technical assistance, program evaluation, data activities, and other program administration functions, which are determined by the Secretary to be appropriate for carrying out the program under this section.

(h) Biennial report to Congress

Not later than 2 years after December 20, 2019, and every 2 years thereafter, the Secretary shall submit to the Committee on Health, Education, Labor, and Pensions of the Senate and Committee on Energy and Commerce of the House of Representatives a report concerning the operations of, and trends identified by, the Poison Control Network. Such report shall include—

(1) descriptions of the activities carried out pursuant to sections 300d–71, 300d–72, and 300d–73 of this title, and the alignment of such activities with the purposes provided under subsection (a);

(2) a description of trends in volume of contacts to poison control centers;

(3) a description of trends in poisonings and toxic exposures reported to poison control centers, as applicable and appropriate;

(4) an assessment of the impact of the public awareness campaign, including any geographic variations;

(5) a description of barriers, if any, preventing poison control centers from achieving the purposes and programs under this section and sections 300d–71 and 300d–72 of this title;

(6) a description of the standards for accreditation described in subsection (c), including any variations in those standards, and any efforts to create and maintain consistent standards across organizations that accredit poison control centers; and

(7) the number of and reason for any waivers provided under subsection (d).

(July 1, 1944, ch. 373, title XII, §1273, as added Pub. L. 108–194, §3, Dec. 19, 2003, 117 Stat. 2889; amended Pub. L. 110–377, §5(a), Oct. 8, 2008, 122 Stat. 4065; Pub. L. 113–77, §4(a), Jan. 24, 2014, 128 Stat. 644; Pub. L. 116–94, div. N, title I, §403(c), Dec. 20, 2019, 133 Stat. 3115; Pub. L. 118–86, §2(c), Sept. 26, 2024, 138 Stat. 1549.)

Editorial Notes

Amendments

2024—Subsec. (g). Pub. L. 118–86 substituted "fiscal years 2025 through 2029" for "fiscal years 2020 through 2024".

2019—Subsec. (a). Pub. L. 116–94, §403(c)(1), inserted "and toxic exposures" after "poisonings".

Subsec. (b)(1). Pub. L. 116–94, §403(c)(2)(A), substituted "for poisoning and toxic exposure" for "for poison" and "preparedness and response" for "and preparedness".

Subsec. (b)(3). Pub. L. 116–94, §403(c)(2)(B), substituted "United States," for "United States and" and inserted ", and other government agencies as determined to be appropriate and nonduplicative by the Secretary" before semicolon at end.

Subsec. (b)(8). Pub. L. 116–94, §403(c)(2)(C), substituted "contacts" for "calls".

Subsec. (d)(3). Pub. L. 116–94, §403(c)(3), added par. (3) and struck out former par. (3). Prior to amendment, text read as follows: "In no case may the sum of the number of years for a waiver under paragraph (1) and a renewal under paragraph (2) exceed—

"(A) 5 years; or

"(B) in the case of a nonaccredited poison control center operating pursuant to a waiver under this subsection as of October 1, 2014, 6 years."

Subsec. (f). Pub. L. 116–94, §403(c)(4), added subsec. (f) and struck out former subsec. (f). Prior to amendment, text read as follows: "A poison control center, in utilizing the proceeds of a grant under this section, shall maintain the expenditures of the center for its activities at a level that is not less than the level of expenditures maintained by the center for the fiscal year preceding the fiscal year for which the grant is received."

Subsec. (g). Pub. L. 116–94, §403(c)(5), substituted "2020 through 2024" for "2015 through 2019".

Subsec. (h). Pub. L. 116–94, §403(c)(6), added subsec. (h).

2014—Subsec. (a). Pub. L. 113–77, §4(a)(1), substituted "accredited" for "certified" and "accreditation" for "certification".

Subsec. (b)(1). Pub. L. 113–77, §4(a)(2)(A), substituted "research, establish, implement," for "establish".

Subsec. (b)(4). Pub. L. 113–77, §4(a)(2)(C), added par. (4). Former par. (4) redesignated (5).

Subsec. (b)(5). Pub. L. 113–77, §4(a)(2)(B), redesignated par. (4) as (5). Former par. (5) redesignated (6).

Subsec. (b)(6). Pub. L. 113–77, §4(a)(2)(B), (D), redesignated par. (5) as (6) and substituted "paragraph (5)" for "paragraph (4)". Former par. (6) redesignated (7).

Subsec. (b)(7). Pub. L. 113–77, §4(a)(2)(B), redesignated par. (6) as (7). Former par. (7) redesignated (8).

Subsec. (b)(8). Pub. L. 113–77, §4(a)(2)(B), (E), redesignated par. (7) as (8) and substituted "and Internet communications, and to sustain and enhance the poison control center's network capability to respond" for "and respond".

Subsec. (c). Pub. L. 113–77, §4(a)(3), substituted "Accreditation" for "Certification" in heading and "accredited" for "certified" and "accreditation" for "certification" in pars. (1) and (2).

Subsec. (d). Pub. L. 113–77, §4(a)(4)(A), substituted "accreditation" for "certification" in heading.

Subsec. (d)(1). Pub. L. 113–77, §4(a)(4)(B), substituted "the accreditation" for "the certification", "a nonaccredited" for "a noncertified", and "an accreditation" for "a certification".

Subsec. (d)(3). Pub. L. 113–77, §4(a)(4)(C), substituted "exceed—" for "exceed 5 years. The preceding sentence shall take effect as of October 8, 2008." and added subpars. (A) and (B).

Subsec. (f). Pub. L. 113–77, §4(a)(5), substituted "for its activities" for "for activities of the center".

Subsec. (g). Pub. L. 113–77, §4(a)(6), added subsec. (g) and struck out former subsec. (g) which authorized appropriations for fiscal years 2009 through 2014 and limited the amount allowed to be spent on certain administrative functions.

2008—Pub. L. 110–377 amended section generally. Prior to amendment, section related to awarding of grants to certified regional poison control centers and additional uses of appropriated funds by Secretary and authorized appropriations for fiscal years 2000 through 2009.

Statutory Notes and Related Subsidiaries

Effective Date of 2014 Amendment

Pub. L. 113–77, §4(b), Jan. 24, 2014, 128 Stat. 646, provided that: "The amendments made by subsection (a) [amending this section] shall take effect on the date of the enactment of this Act [Jan. 24, 2014] and shall apply to grants made on or after October 1, 2014."

Effective Date of 2008 Amendment

Pub. L. 110–377, §5(b), Oct. 8, 2008, 122 Stat. 4067, provided that: "The amendment made by this section [amending this section] shall be effective as of the date of the enactment of this Act [Oct. 8, 2008] and shall apply to grants made on or after January 1, 2009."

§300d–74. Rule of construction

Nothing in this part may be construed to ease any restriction in Federal law applicable to the amount or percentage of funds appropriated to carry out this part that may be used to prepare or submit a report.

(July 1, 1944, ch. 373, title XII, §1274, as added Pub. L. 108–194, §3, Dec. 19, 2003, 117 Stat. 2891.)