Chapter 3701-41 Poison Control, Prevention, and Treatment
As used in this chapter:
(A) "Director" means the director of health or an official or employee of the department of health who has been authorized by the director.
(B) "Entity" means an individual, hospital, institution of higher education, political subdivision, association, corporation, or public or private agency.
(C) "Poison prevention and treatment center" or "center" means an entity designated as a poison prevention and treatment center by the director under section 3701.20 of the Revised Code and rule 3701-41-02 of the Administrative Code. In the appropriate context,"poison prevention and treatment center" and "center" also mean an applicant for designation as a poison prevention and treatment center.
(A) For the purposes of this chapter, the director shall designate poison control network regions. In determining which geographic areas to designate as poison control network regions, the director shall consider:
(1) The groups of counties specified in paragraph (B) of this rule. The director may designate as regions areas larger or smaller than the groups of counties specified in paragraph (B) of this rule, but no region may have a population of less than one million;
(2) Which configuration of counties will minimize duplication and waste while assuring appropriate poison prevention and treatment services for the population of each region; and
(3) Any comments or suggestions provided by entities interested in poison prevention and treatment.
(B) For the purposes of designating poison control network regions under paragraph (A) of this rule, the director shall consider the following groups of counties:
(1) Allen, Hancock, Lucas, Sandusky, Auglaize, Hardin, Mercer, Seneca, Defiance, Henry, Ottawa, Van Wert, Erie, Huron, Paulding, Williams, Fulton, Logan, Putnam and Wood.
(2) Cuyahoga, Lorain, Geauga, Medina and Lake.
(3) Ashland, Crawford, Richland, Tuscarawas, Ashtabula, Holmes, Stark, Wayne, Carroll, Mahoning, Summit, Columbiana, Portage and Trumbull.
(4) Champaign, Miami, Clark, Montgomery, Darke, Preble, Greene and Shelby.
(5) Athens, Harrison, Meigs, Ross, Belmont, Hocking, Monroe, Scioto, Coshocton, Jackson, Morgan, Union, Delaware, Jefferson, Morrow, Vinton, Fairfield, Knox, Muskingum, Washington, Fayette, Lawrence, Noble, Wyandot, Franklin, Licking, Perry, Gallia, Madison, Pickaway, Guernsey, Marion and Pike.
(6) Adams, Clinton, Brown, Hamilton, Butler, Highland, Clermont and Warren.
(C) The director shall designate poison prevention and treatment centers within each region designated under paragraph (A) of this rule. The director may designate more than one center in a region.
(1) Any entity seeking designation as a poison prevention and treatment center shall apply in writing and shall provide the following information:
(a) The name and address of the applicant, its medical director and its project director;
(b) A description of the scope of poison prevention and treatment services provided by the applicant, directly and through contract;
(c) A description of the applicant's experience in providing poison prevention and treatment services;
(d) A description of the specific population and target area that the applicant intends to serve; and
(2) Applications for designation may be submitted at any time.
(3) The director may request additional information necessary to review an application for designation as a poison prevention and treatment center and the applicant shall provide the requested information within the time specified by the director.
(4) The director shall provide written notice of decisions concerning applications for designation by certified mail.
(D) To be eligible for designation as a poison prevention and treatment center and to retain designation, a center must maintain compliance with the standards established by this rule and rules 3701-41-03 and 3701-41-04 of the Administrative Code.
(1) Each applicant shall document compliance with the applicable standards. If the applicant proposes to provide poison prevention and treatment services by means of contracts with one or more other entities, the applicant shall document that the services provided through contract will comply with the standards established by rules 3701-41-03 and 3701-41-04 of the Administrative Code.
(2) Each applicant shall demonstrate that it has the capacity to provide poison prevention and treatment services to the entire region or that it has established or will establish arrangements to provide services to the entire region through collaborative efforts with other centers within or outside the region. An applicant may propose to provide services to areas not included within the region for which the applicant has requested designation.
(3) Allow the director access to its premises and records, including but not limited to the documentation prepared under rule 3701-41-04 of the Administrative Code, for the purpose of verifying compliance with section 3701.20 of the Revised Code and this chapter. The director shall make a site visit to each center at least annually and more often if the director considers it to be necessary.
(F) The director may revoke the designation of a poison prevention and treatment center or deny an application for designation if the center or applicant fails to comply with this rule or fails to meet or maintain compliance with the standards established by rules 3701-41-03 and 3701-41-04 of the Administrative Code. The notice of the denial or revocation provided under paragraph (C)(4) of this rule shall contain the reasons for the denial or revocation. The center may have the revocation or denial reconsidered in accordance with rule 3701-41-06 of the Administrative Code.
(A) To be designated as a poison prevention and treatment center under rule 3701-41-02 of the Administrative Code and to maintain the designation, a center shall conform to the standards of operation prescribed by this rule. A center may provide the services described in paragraphs (B) and (C) of this rule either directly or through contract with other entities, as the director considers appropriate.
(B) Each center shall maintain and staff a twenty-four-hour per day, toll-free telephone line to respond to inquiries and provide information about poison prevention and treatment and available services. A center may satisfy the requirement that the telephone line be toll-free either by maintaining a "1-800" number or accepting collect calls from within its region.
(C) Each center shall provide specialized treatment, consultation, information and educational programs to health care professionals and the public.
(D) Each center shall compile information on the types and frequency of treatment it provides.
(E) Each center shall have the following personnel, either on staff or by means of a contract with another entity:
(1) A medical director who:
(a) Is a physician licensed under Chapter 4731. of the Revised Code and board-certified in medical toxicology;
(b) Has ongoing interest and expertise in toxicology as evidenced by publications, research and meeting attendance;
(c) Has a medical staff appointment at a hospital providing poison treatment services;
(d) Is involved in the management of poisoned patients; and
(e) Assures that when he or she is not available to the center, qualified medical toxicology expertise is provided to the center by other physicians at all times.
(2) A managing director who :
(a) Has had substantial involvement in the operations of an entity providing services similar to those provided by poison prevention and treatment centers, including involvement in the areas of clinical toxicology, education and administration;
(b) Is licensed nurse, pharmacist, physician, or holds a degree in a life-science discipline if a diplomate of the American board of applied toxicology (ABAT);
(c) If responsible for toxicological supervision of providers of poison information for the center is board-certified or board-eligible for ABAT or American board of medical specialties (ABMS) certification.
(3) Providers of poison information who:
(a) Are registered nurses licensed to practice nursing as a registered nurse under Chapter 4723. of the Revised Code, pharmacists licensed under Chapter 4729. of the Revised Code, physicians licensed under Chapter 4731. of the Revised Code or individuals currently certified by the "American Association of Poison Control Centers" as specialists in poison information. The center may use other individuals as providers of poison information upon a determination by the director of health that the center has documented that the individual possesses appropriate equivalent qualifications and training and that the medical director has approved of the use of the individual as a provider of poison information;
(b) Are capable of comprehending and interpreting standard poison information resources and of transmitting that information in a logical, concise and understandable way to both health professionals and the public; and
(c) Either are dedicated fully to poison prevention and treatment center activities during periods when they are assigned to the center or perform only those other duties that do not interfere with center activities;
(4) Administrative personnel who are qualified by training or experience to supervise finances, operations, personnel, data analysis and other administrative functions of the center. The administrative personnel may be on the staff of a parent entity of which the center is a part;
(5) Education personnel who are qualified by training or experience to provide, under the supervision of the medical director, educational lectures or materials to health professionals; and
(6) Education personnel who are qualified by training or experience to provide public-oriented presentations on poison prevention and treatment center awareness, poison prevention and first aid for poisoning. These individuals shall be capable of providing verbal presentations to public audiences and shall have sufficient understanding of the material to answer questions from members of the public accurately.
Nothing in this paragraph precludes staff members of a poison prevention and treatment center from serving a center in more than one of the capacities listed by this paragraph.
(F) Each center shall maintain a list of consultants who are qualified by training or experience to provide specialized toxicology or patient care information in their areas of expertise. The center shall document that these consultants have made an expressed commitment to provide consultation services on an on-call, as-needed basis. The list of consultants shall be consistent with the type of poisonings encountered in the area served by the center. Nothing in this paragraph shall be interpreted to prohibit consultants from charging fees to centers or callers for the provision of specialized expertise and consultation.
(G) Each center shall take measures to ensure the confidentiality of information about individuals to whom treatment or services are provided. These measures shall include but are not limited to:
(1) Assuring that only authorized persons are allowed in the area or room that is used to store records of persons receiving services from the center;
(2) Providing security measures to prevent inadvertent or unauthorized access to any case records containing sufficient information to identify the individual receiving services that are maintained in electronic or automated information systems; and
(3) Otherwise maintaining records according to procedures established by any applicable state or federal law.
(H) Each center shall develop and maintain on the premises of the center a written manual of policies and procedures that shall include, at a minimum, the following:
(1) A description of when the poison information providers are to contact the medical director or other on-call consultants;
(2) Descriptions of when first aid procedures are to be recommended to callers and of how the procedures are to be performed;
(3) A description of how callers are to be assigned priority for medical treatment or consultation, which may include a list, if applicable, of common substances with guidelines for when home and hospital management are appropriate;
(4) Guidelines for follow-up calls to patients managed at home or referred to a health care provider to determine case outcome;
(5) Procedure for handling information calls, animal exposure calls and human exposure calls;
(6) A schedule for reviewing and updating all protocols, policies and procedures; and
(7) A procedure for storing, processing, indexing, retrieving and destroying the center's medical and other case records.
(I) The center shall maintain on file a current table of organization that shall display, at a minimum, the following:
(1) All operating units of the entity involved in providing poison prevention and treatment services and all entities providing services for the center through contract and their interrelationships;
(2) Lines of responsibility and function for all administrative and service personnel of the center; and
(3) Any advisory boards, committees or similar bodies for the center.
(J) Each center shall maintain a written quality assurance plan which identifies an individual or individuals responsible for implementation of the plan and collection of necessary information. The center shall take and document corrective actions to improve service delivery as needed, based on its monitoring and evaluation under the quality assurance plan.
R.C. 119.032 review dates: 07/10/2014 and 07/01/2019
Promulgated Under: 119.03
Statutory Authority: 3701.20
Rule Amplifies: 3701.19, 3701.20, 3701.201
Prior Effective Dates: 3/29/1990 (Emer.), 9/16/90
(A) To be designated as a poison prevention and treatment center under rule 3701-41-02 of the Administrative Code and to retain the designation, a center or an applicant for designation as a center shall maintain and report data in accordance with this rule.
(B) Each center shall document poison prevention and control cases using nationally recognized standards for data elements and documenting procedures including the uniform "county of origin" system developed by the Ohio centers and the director. Nothing in this paragraph shall be construed to prohibit non-electronic data entry.
(C) Each center shall submit a report to the director on a form prescribed by the director no later than September first of each year for the previous calendar year. At a minimum, the annual report shall include:
(1) Data reported by county regarding the incidence of both human exposure to poison and other cases handled;
(2) The incidence of each reason for exposure in accordance with nationally recognized standards for data elements and documenting procedures;
(3) The percentage of accidental exposure cases managed over the telephone as compared to the percentage referred for medical treatment; and
(4) The percentage of intentional exposure cases managed over the telephone as compared to the percentage referred for medical, psychiatric or other treatment or management.
Five Year Review (FYR) Dates: 01/05/2015 and 07/01/2019
Promulgated Under: 119.03
Statutory Authority: 3701.20
Rule Amplifies: 3701.20
Prior Effective Dates: 3/29/1990 (Emer.), 9/16//90
(A) In accordance with this rule, the director shall make grants to poison prevention and treatment centers. Subject to the availability of an appropriation for grants, the director shall make grants annually on a fiscal year (July first to June thirtieth) basis.
(2) Agree in writing that the level of the total funds, labor and services devoted by the entity to the center during the period of the grant will approximate, as determined by the director, the level of total funds, labor and services devoted by that entity in the fiscal year preceding the fiscal year in which the grant begins. The entity shall submit verifiable financial data demonstrating its compliance with this paragraph. In determining whether grant period funds, labor and services devoted by the entity approximate the previous level, the director shall consider, among other relevant matters, the degree to which the preceding fiscal year's funds resulted from irregular revenues such as donations, bequests, grants and contracts.
(C) An application for a grant shall be filed with the director no later than May first for the fiscal year beginning on the following July first. The applicant for a grant shall file an original and one copy of a completed application form prescribed by the director, which shall include:
(1) The name and address of the applicant, its project director and its fiscal contact person;
(2) A narrative description of:
(a) The scope of poison prevention and treatment services provided and proposed to be provided by the applicant, directly and through contract, and a description of the applicant's experience in providing poison prevention and treatment services;
(b) The effectiveness of poison prevention and treatment services for the applicant's target population, including an analysis of the extent of poisoning and past and present service and educational efforts; and
(c) The applicant's proposals to provide additional services or educational programs or, subject to paragraph (B)(2) of this rule, to pay for services or programs currently provided, including identification of the proposed target population, the high-risk behaviors to be addressed and the methods and anticipated results of intervention;
(3) An itemized budget for the center, with supporting narrative explanation, and descriptions of the center's accounting system, procurement practices and auditing arrangements;
(4) Information about the qualifications and responsibilities of personnel and letters of support and commitment from other entities;
(5) The written agreement required by paragraph (B)(2) of this rule; and
(6) Statements of the applicant's compliance with Title VI of the "Civil Rights Act of 1964," 78 Stat. 252 (1964), 42 U.S.C. 2000d, as amended, and section 504 of the "Rehabilitation Act of 1973," 84 Stat. 394 (1973), 29 U.S.C. 794, as amended.
(D) The director may request additional information necessary to review a grant application and the applicant shall provide the requested information within the time specified by the director.
(E) In determining the amount of money to award to each eligible grant applicant, the director shall consider:
(1) The amount of money available for grants for the fiscal year for which grants are being awarded;
(2) The percentage of the total state population that resides in the region served by the applicant;
(3) The anticipated effectiveness of the applicant's proposal to expand poison prevention and treatment services;
(4) The applicant's demonstrated ability to form collaborative relationships with other providers of poison prevention and treatment services in the region;
(5) The appropriateness of the budget for the proposed activities;
(6) The effect of the region's economic condition on the center's ability to generate other funding;
(7) The degree to which grant money will be spent to provide direct services to health care professionals and the general public; and
(F) The director shall provide written notice by certified mail of grants awarded under this rule. If the amount of money awarded is less than was requested, the notice shall contain an explanation of the reason for the reduction.
(A) An entity denied designation as a poison prevention and treatment center or a poison prevention and treatment center which has been notified that its designation has been revoked may request reconsideration of the decision in accordance with this rule. A request for reconsideration shall be in writing and shall be filed with the director no later than thirty days after the date of mailing of the notice of denial or revocation under paragraph (C)(4) of rule 3701-41-02 of the Administrative Code.
(B) Upon receipt of a request for reconsideration, the director shall forward the request to the chairman of the Ohio poison control network advisory committee established by section 3701.21 of the Revised Code.
(1) The chairman shall convene a committee meeting within thirty days after receiving the reconsideration request from the director for the purpose of selecting a subcommittee of no less than three individuals to review the matter. These individuals may be members of the committee or other individuals whom the committee considers appropriately qualified to participate in the review. None of the individuals selected shall have a conflict of interest.
(2) In conducting the review of a denial of designation, the subcommittee shall consider the application and any additional information evaluated by the director in making the initial decision. In conducting the review of a revocation of designation, the subcommittee shall consider the information that was available to the director in making the initial decision.
(3) The subcommittee shall complete its review and submit a written report containing its recommendation and the reasons for the recommendation to the director within thirty days of its appointment.
(4) After considering the subcommittee's report, the director shall notify the applicant or center of his or her final decision on the matter by certified mail.