[House Report 113-321]
[From the U.S. Government Publishing Office]
113th Congress Report
HOUSE OF REPRESENTATIVES
2d Session 113-321
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POISON CENTER NETWORK ACT
_______
January 7, 2014.--Committed to the Committee of the Whole House on the
State of the Union and ordered to be printed
_______
Mr. Upton, from the Committee on Energy and Commerce, submitted the
following
R E P O R T
[To accompany H.R. 3527]
[Including cost estimate of the Congressional Budget Office]
The Committee on Energy and Commerce, to whom was referred
the bill (H.R. 3527) to amend the Public Health Service Act to
reauthorize the poison center national toll-free number,
national media campaign, and grant program, and for other
purposes, having considered the same, report favorably thereon
without amendment and recommend that the bill do pass.
CONTENTS
Page
Purpose and Summary.............................................. 1
Background and Need for Legislation.............................. 2
Hearings......................................................... 2
Committee Consideration.......................................... 3
Committee Votes.................................................. 3
Committee Oversight Findings..................................... 3
Statement of General Performance Goals and Objectives............ 3
New Budget Authority, Entitlement Authority, and Tax Expenditures 3
Earmark, Limited Tax Benefits, and Limited Tariff Benefits....... 3
Committee Cost Estimate.......................................... 3
Congressional Budget Office Estimate............................. 3
Federal Mandates Statement....................................... 5
Duplication of Federal Programs.................................. 5
Disclosure of Directed Rule Makings.............................. 5
Advisory Committee Statement..................................... 5
Applicability to Legislative Branch.............................. 5
Section-by-Section Analysis of the Legislation................... 6
Changes in Existing Law Made by the Bill, as Reported............ 6
Purpose and Summary
H.R. 3527, the ``Poison Center Network Act of 2013,'' was
introduced on November 18, 2013, by Rep. Lee Terry (R-NE) and
referred to the Committee on Energy and Commerce.
The legislation would amend the Public Health Service Act
(PHSA) to reauthorize the poison center national toll-free
number, a national media campaign to inform the public, and
grant programs to support the operation of poison control
centers.
Background and Need for Legislation
Mortality due to poisoning has increased in the United
States since the 1970s. The most significant increase was
reported in unintentional poisoning mortality rates, which more
than tripled from 1990 to 2002. Unintentional poisoning deaths
were most often a consequence of illicit drugs in prior
decades. However, since the latter half of the 1990s,
medications began to account for a greater number of fatal
poisonings. More recent data show that the national trend of
increased rates of overdose is continuing, and the rate has
accelerated in recent years.\1\
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\1\http://www.publichealthreports.org/issueopen.cfm?articleID=2463.
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Poison Control Centers (PCC) were first established to
provide immediate information on an exposure to poisonous or
hazardous substances to healthcare providers. The American
Association of PCC was then founded to promote cooperation
between existing centers, to establish standardization, and to
offer services to the general public.\2\ Legislation
establishing a Federal Poison Control Program (PCP) was enacted
in 2000, and later reauthorized in 2003 and 2008, and provided
a toll-free number to access regional poison control centers, a
media campaign to promote use of poison control centers, and
for grants to assist PCCs to set standards and improve
surveillance.
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\2\http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2663870/.
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In 2004, the Institute of Medicine considered the future of
poison prevention and found that the PPC played a key role in
injury prevention, public health, and safety. The report,
Forging a Poison Prevention and Control System, concluded that
``poison control centers must be more stable financially and
better integrated and coordinated for performance of their
public health roles.''\3\
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\3\http://www.iom.edu/Reports/2004/Forging-a-Poison-Prevention-and-
Control-System.aspx.
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A network of 57 PCCs currently operate across the 50
States, the District of Columbia, and the territories. Studies
show that these PCCs reduce the severity of illness and death
caused by poison exposure and save money by reducing the number
of unnecessary visits to the emergency room.\4\
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\4\www.hrsa.gov/about/budget/budgetjustification2014.pdf.
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H.R. 3527, the ``Poison Center Network Act of 2013,'' would
reauthorize the Poison Center Support, Enhancement, and
Awareness Act of 2008 and continue funding for the PCP. The
bill would continue to provide grants to States to establish
and operate poison centers and maintain a single, national
toll-free number that ensures access to poison center services
by connecting callers to the poison center serving their area.
In addition, the bill would provide for a national media
campaign to educate the public and health care providers about
poison prevention, poison center services, and the 800 number.
Hearings
The Subcommittee on Health held a hearing on Wednesday,
November 20, 2013, entitled ``Examining Public Health
Legislation to Help Local Communities.'' The Subcommittee
received testimony from: Dr. Marsha Ford of the American
Association of Poison Control Centers, Dr. Edward R.B. McCabe
of the March of Dimes Foundation, Ms. Laura Crandall of CJ
Foundation for SIDS, Mr. Robert Mt. Joy of Cornerstone Care
Inc., Dr. Drew Nagele from the Brain Injury Association of
America, Ms. Pat Smith, President of the Lyme Disease
Association Inc., and Dr. Steven Stack of the American Medical
Association. H.R. 3527, the ``Poison Center Network Act of
2013,'' was one of the bills discussed at the hearing.
Committee Consideration
On December 10, 2013, the Subcommittee on Health met in
open markup session and approved H.R. 3527 for full Committee
consideration by a voice vote. On December 10 and 11, 2013, the
Energy and Commerce Committee met in open markup session and
approved H.R. 3527 by a voice vote.
Committee Votes
Clause 3(b) of rule XIII of the Rules of the House of
Representatives requires the Committee to list the record votes
on the motion to report legislation and amendments thereto.
There were no record votes taken in connection with ordering
approved H.R. 3527. A motion by Mr. Upton to order H.R. 3527
reported to the House, without amendment, was agreed to by a
voice vote.
Committee Oversight Findings
Pursuant to clause 3(c)(1) of rule XIII of the Rules of the
House of Representatives, the Committee held a hearing on
November 20, 2013, and made findings that are reflected in this
report.
Statement of General Performance Goals and Objectives
Pursuant to clause 3(c)(1) of rule XIII of the House of
Representatives, the goal of the legislation is the
continuation of the poison center national toll-free number,
the national media campaign, and the grant program for poison
centers.
New Budget Authority, Entitlement Authority, and Tax Expenditures
In compliance with clause 3(c)(2) of rule XIII of the Rules
of the House of Representatives, the Committee finds that H.R.
3527 would result in no new or increased budget authority,
entitlement authority, or tax expenditures or revenues.
Earmark, Limited Tax Benefits, and Limited Tariff Benefits
In compliance with clause 9(e), 9(f), and 9(g) of rule XXI,
the Committee finds that H.R. 3527 contains no earmarks,
limited tax benefits, or limited tariff benefits.
Committee Cost Estimate
The Committee adopts as its own the cost estimate prepared
by the Director of the Congressional Budget Office pursuant to
section 402 of the Congressional Budget Act of 1974.
Congressional Budget Office Estimate
Pursuant to clause 3(c)(3) of rule XIII of the Rules of the
House of Representatives, the following is the cost estimate
provided by the Congressional Budget Office pursuant to section
402 of the Congressional Budget Act of 1974:
U.S. Congress,
Congressional Budget Office,
Washington, DC, January 7, 2014.
Hon. Fred Upton,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
Dear Mr. Chairman: The Congressional Budget Office has
prepared the enclosed cost estimate for H.R. 3527, the Poison
Center Network Act.
If you wish further details on this estimate, we will be
pleased to provide them. The CBO staff contact is Lisa Ramirez-
Branum.
Sincerely,
Douglas W. Elmendorf.
Enclosure.
H.R. 3527--Poison Center Network Act
Summary: H.R. 3527 would reauthorize the poison control
program, currently scheduled to expire in 2014, for the 2015-
2019 period. The program, which is administered by the Health
Resources and Services Administration (HRSA), provides grants
to poison centers and other organizations that focus on poison
control, funds a national media campaign, and maintains a
national toll-free number.
The bill would authorize the appropriation of about $30
million a year for each of fiscal years 2015 through 2019 for
the poison control program. CBO estimates that implementing the
bill would cost about $125 million over the 2015-2019 period,
assuming appropriation of the authorized amounts. Pay-as-you-go
procedures do not apply to this legislation because it would
not affect direct spending or revenues.
The bill contains no intergovernmental or private-sector
mandates as defined in the Unfunded Mandates Reform Act (UMRA).
Estimated cost to the Federal Government: The estimated
budgetary impact of H.R. 3527 is shown in the following table.
The costs of this legislation fall within budget function 550
(health).
----------------------------------------------------------------------------------------------------------------
By fiscal year, in millions of dollars--
------------------------------------------------------------
2015 2016 2017 2018 2019 2015-2019
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CHANGES IN SPENDING SUBJECT TO APPROPRIATION
Authorization Level................................ 30 30 30 30 30 151
Estimated Outlays.................................. 12 25 29 29 29 125
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Note: Numbers may not sum to totals because of rounding.
Basis of estimate: H.R. 3527 would authorize annual
appropriations of about $30 million for each of the fiscal
years 2015 through 2019 for HRSA to administer the poison
control program. The Congress appropriated about $19 million
for the program for fiscal year 2013. Sequestration under the
Budget Control Act of 2011 reduced the 2013 funding to about
$18 million. That reduced funding level has been continued in
fiscal year 2014 through January 15, 2014. For this estimate,
CBO assumes that the bill will be enacted by the end of fiscal
year 2014 and that the authorized amounts will be appropriated
for each year.
H.R. 3527 would authorize the appropriation of $28.6
million a year for 2015 through 2019 for grant assistance to
poison control centers that offer the public and health care
providers treatment advice on poisonings. The bill also would
authorize the appropriation of $1.5 million a year for 2015
through 2019 to maintain a national toll-free number that
assists poison control centers and to fund a national media
campaign to educate the public and health care providers about
poison prevention.
Based on historical patterns of spending for the program,
CBO estimates that implementing the bill would cost about $125
million over the 2015-2019 period, assuming appropriation of
the specified amounts.
Pay-As-You-Go considerations: None.
Intergovernmental and private-sector impact: H.R. 3527
contains no intergovernmental or private-sector mandates as
defined in UMRA. State, local, and tribal governments that
operate poison control centers could benefit from grant funds
authorized by the bill.
Estimate prepared by: Federal Costs: Lisa Ramirez-Branum;
Impact on State, Local, and Tribal Governments: Lisa Ramirez-
Branum; Impact on the Private Sector: Alexia Diorio.
Estimate approved by: Holly Harvey, Deputy Assistant
Director for Budget Analysis.
Federal Mandates Statement
The Committee adopts as its own the estimate of Federal
mandates prepared by the Director of the Congressional Budget
Office pursuant to section 423 of the Unfunded Mandates Reform
Act.
Duplication of Federal Programs
No provision of H.R. 3527 establishes or reauthorizes a
program of the Federal government known to be duplicative of
another Federal program, a program that was included in any
report from the Government Accountability Office to Congress
pursuant to section 21 of Public Law 111-139, or a program
related to a program identified in the most recent Catalog of
Federal Domestic Assistance.
Disclosure of Directed Rule Makings
The Committee estimates that enacting H.R. 3527 would not
specifically direct a rulemaking within the meaning of 5 U.S.C.
551.
Advisory Committee Statement
No advisory committees within the meaning of section 5(b)
of the Federal Advisory Committee Act were created by this
legislation.
Applicability to Legislative Branch
The Committee finds that the legislation does not relate to
the terms and conditions of employment or access to public
services or accommodations within the meaning of section
102(b)(3) of the Congressional Accountability Act.
Section-by-Section Analysis of the Legislation
Section 1. Short Title. Section 1 states the legislation
may be cited as the ``Poison Center Network Act of 2013.''
Section 2. Reauthorization of the Poison Control Centers
National Toll-Free Number. Section 2 would amend the
authorization of appropriations for section 1271 of the Public
Health Service Act.
Section 3. Reauthorization of Nationwide Media Campaign to
Promote Poison Control Center Utilization. Section 3 would
extend the authorization of appropriations for section 1272 of
the Public Health Service Act.
Section 4. Reauthorization of the Poison Control Center
Grant Program. Section 4 would extend authorization of
appropriations for section 1273 and modify certification of a
poison control center to ensure that accreditation be
consistent with standards and by extending the waiver period
for a nonaccredited PCC.
Changes in Existing Law Made by the Bill, as Reported
In compliance with clause 3(e) of rule XIII of the Rules of
the House of Representatives, changes in existing law made by
the bill, as reported, are shown as follows (existing law
proposed to be omitted is enclosed in black brackets, new
matter is printed in italic, existing law in which no change is
proposed is shown in roman):
PUBLIC HEALTH SERVICE ACT
* * * * * * *
TITLE XII--TRAUMA CARE
* * * * * * *
Part G--Poison Control
SEC. 1271. MAINTENANCE OF THE NATIONAL TOLL-FREE NUMBER.
(a) * * *
[(b) Authorization of Appropriations.--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).]
(b) Authorization of Appropriations.--There is authorized to
be appropriated to carry out this section, $700,000 for each of
fiscal years 2015 through 2019 for the maintenance of the
nationwide toll free phone number under subsection (a).
SEC. 1272. NATIONWIDE MEDIA CAMPAIGN TO PROMOTE POISON CONTROL CENTER
UTILIZATION.
(a) * * *
* * * * * * *
[(d) Authorization of Appropriations.--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.]
(d) Authorization of Appropriations.--There is authorized to
be appropriated to carry out this section, $800,000 for each of
fiscal years 2015 through 2019.
SEC. 1273. MAINTENANCE OF THE POISON CONTROL CENTER GRANT PROGRAM.
(a) Authorization of Program.--The Secretary shall award
grants to poison control centers [certified] 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 complying with the
operational requirements needed to sustain the [certification]
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 [establish] research, establish, implement and
evaluate best practices in the United States for poison
prevention, poison control center outreach, and
emergency and preparedness programs;
* * * * * * *
(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;
[(4)] (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;
[(5)] (6) to develop initiatives to foster the
enhanced public health utilization of national poison
data collected by organizations described in [paragraph
(4)] paragraph (5);
[(6)] (7) to support and expand the toxicologic
expertise within poison control centers; and
[(7)] (8) to improve the capacity of poison control
centers to answer high volumes of calls [and respond]
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) [Certification] 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 [certified] accredited by a
professional organization in the field of poison
control, and the Secretary has approved the
organization as having in effect standards for
[certification] accreditation that reasonably provide
for the protection of the public health with respect to
poisoning; or
(2) the center has been [certified] accredited by a
State government, and the Secretary has approved the
State government as having in effect standards for
[certification] accreditation that reasonably provide
for the protection of the public health with respect to
poisoning.
(d) Waiver of [Certification] Accreditation Requirements.--
(1) In general.--The Secretary may grant a waiver of
[the certification] the accreditation requirements of
subsection (c) with respect to [a noncertified] 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 [a
certification] an accreditation within a reasonable
period of time as determined appropriate by the
Secretary.
* * * * * * *
(3) Limitation.--In no case may the sum of the number
of years for a waiver under paragraph (1) and a renewal
under paragraph (2) [exceed 5 years. The preceding
sentence shall take effect as of the date of the
enactment of the Poison Center Support, Enhancement,
and Awareness Act of 2008.] 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.
* * * * * * *
(f) Maintenance of Effort.--A poison control center, in
utilizing the proceeds of a grant under this section, shall
maintain the expenditures of the center [for activities 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.
[(g) Authorization of Appropriations.--There is authorized to
be appropriated to carry out this section, $27,500,000 for
fiscal year 2009, and $28,600,000 for each of fiscal years 2010
through 2014. The Secretary may utilize not to exceed 8 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 that do not include grants,
contracts, or cooperative agreements under subsections (a) and
(b), which are determined by the Secretary to be appropriate
for carrying out the program under this section.]
(g) Authorization of Appropriations.--There is authorized to
be appropriated to carry out this section, $28,600,000 for each
of fiscal years 2015 through 2019. 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.
* * * * * * *