ADMINISTRATIVE CODE

TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER f: EMERGENCY MEDICAL SERVICES AND HIGHWAY SAFETY
PART 215 REGIONAL POISON CONTROL CENTER CODE

Section 215.100 Definitions

Section 215.150 Incorporated and Referenced Material

Section 215.200 Rights and Obligations of Regional Poison Control Centers

Section 215.300 Application for Designation as a Regional Poison Control Center

Section 215.400 Operation of a Regional Poison Control Center

Section 215.500 Staffing

Section 215.600 Quarterly Data Submission

Section 215.700 Misrepresentation

Section 215.800 Advisory Committee

Section 215.APPENDIX A American Association of Poison Control Centers' Criteria for Certification as a Regional Poison Center (Repealed)

TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER f: EMERGENCY MEDICAL SERVICES AND HIGHWAY SAFETY
PART 215 REGIONAL POISON CONTROL CENTER CODE
SECTION 215.100 DEFINITIONS

Section 215.100 Definitions

The following terms shall have the meanings ascribed to them here whenever the term is used in this Part.

Act – the Poison Control System Act [410 ILCS 47].

Advanced Life Support (ALS) Services – an advanced level of pre-hospital and inter-hospital emergency care and non-emergency medical care that includes basic life support care, cardiac monitoring, cardiac defibrillation, electrocardiography, intravenous therapy, administration of medications, drugs and solutions, use of adjunctive medical devices, trauma care, and other authorized techniques and procedures as outlined in the Advanced Life Support National Curriculum of the United States Department of Transportation and any modifications to that curriculum specified in rules adopted by the Department pursuant to the Emergency Medical Services Systems Act. (Section 3.10(a) of the Emergency Medical Services Systems Act [210 ILCS 50])

Advanced Life Support Vehicles – vehicles licensed by the Department to provide services at the ALS level.

Basic Life Support (BLS) Services – a basic level of pre-hospital and inter-hospital emergency care and non-emergency medical care that includes airway management, cardiopulmonary resuscitation (CPR), control of shock and bleeding and splinting of fractures, as outlined in the Basic Life Support National Curriculum of the United States Department of Transportation and any modifications to that curriculum specified in rules adopted by the Department pursuant to the Emergency Medical Services Systems Act. (Section 3.10(c) of the Emergency Medical Services Systems Act)

Basic Life Support Vehicles – vehicles licensed by the Department to provide services at the BLS level.

Department – the Illinois Department of Public Health.

Director – the Director of the Illinois Department of Public Health or his designee.

EMS Medical Director – the physician appointed by the Resource Hospital who has the responsibility and authority for total management of the EMS System.

Emergency Medical Services (EMS) System – an organization of hospitals, vehicle service providers and personnel approved by the Department in a specific geographic area, which coordinates and provides pre-hospital and inter-hospital emergency care and non-emergency medical transports at a BLS, ILS and/or ALS level pursuant to a system program plan submitted to and approved by the Department, and pursuant to the EMS Region Plan adopted for the EMS Region in which the System is located. (Section 3.20(a) of the Emergency Medical Services Systems Act)

Emergency Medical Technician (EMT) – a person who has successfully completed a course of instruction as prescribed by the Department, is licensed by the Department in accordance with standards prescribed by the Emergency Medical Services (EMS) Systems Act and the Emergency Medical Services and Trauma Center Code (77 Ill. Adm. Code 515) and practices within an EMS System.

Full-Time Equivalent (FTE) – the number of days routinely worked by a full-time hospital employee in one year. This shall not be less than 240 days.

Hospital – a facility licensed pursuant to the Hospital Licensing Act [210 ILCS 85].

Human Poison Control Center – an emergency public health service providing toxicity, hazard, and treatment information, case documentation, and follow-up calls. A Human Poison Control Center is staffed, in part, by professionals dedicated solely to the operation of the Center while staffing the Center, provides 24 hour a day toll-free telephone access, and provides the public and health professionals with educational programs on poison prevention and treatment. (Section 10 of the Act)

Managing Director – the person who is responsible on a full-time basis for operations, personnel, data analysis and other administrative duties in a Regional Poison Control Center.

Medical Director – the physician appointed by the Center who has responsibility and authority for total management of the Regional Poison Control Center.

Pharmacist – a person licensed as a registered pharmacist under the Pharmacy Practice Act of 1987 [225 ILCS 85].

Physician – a person licensed to practice medicine in all its branches as provided in the Medical Practice Act of 1987 [225 ILCS 60].

Poison Information Specialist or Specialist in Poison Information – a pharmacist, physician or registered nurse who is trained to read, understand, and interpret standard poison information resources and transmit that information in a logical, concise, and understandable way to health care professionals and the general public, and communicate information from standardized center treatment protocols approved by the Medical Director.

Poison Specialty Consultants –

medical toxicologists, or

professionals in any number of fields who provide technical information in their area of expertise concerning poison management and treatment. Examples may include botanist, entomologist, industrial hygienist, pharmacist, clinical toxicologist, or veterinarian.

Regional Poison Control Center, Regional Poison Resource Center or Center – a Human Poison Control Center designated by the Illinois Department of Public Health, in accordance with the Act and this Part. (Section 15 of the Act)

Registered Nurse – a person licensed as a registered professional nurse under the Illinois Nursing Act of 1987 [225 ILCS 65].

TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER f: EMERGENCY MEDICAL SERVICES AND HIGHWAY SAFETY
PART 215 REGIONAL POISON CONTROL CENTER CODE
SECTION 215.150 INCORPORATED AND REFERENCED MATERIAL

Section 215.150 Incorporated and Referenced Material

a) The following materials are incorporated in this Part:

Accreditation of Poison Control Centers 2014 standards, which may be obtained from the American Association of Poison Control Centers (AAPCC), 515 King Street, Suite 510, Alexandria VA 22314. AAPCC can be contacted at 703-894-1859 or emailed at info@aapcc.org.

b) State of Illinois statutes referenced in this Part:

1) Emergency Medical Services Systems Act [210 ILCS 50]

2) Hospital Licensing Act [210 ILCS 85]

3) Pharmacy Practice Act [225 ILCS 85]

4) Medical Practice Act of 1987 [225 ILCS 60]

5) Nurse Practice Act [225 ILCS 65]

6) State Employee Indemnification Act [5 ILCS 350]

c) All incorporations by reference of standards of nationally recognized organizations refer to the regulations and standards on the date specified and do not include any amendments or editions subsequent to the date specified.

(Source: Added at 40 Ill. Reg. 16204, effective December 9, 2016)

Section 215.200 Rights and Obligations of Regional Poison Control Centers

a) The Director or his or her designee shall designate at least one and no more than three Regional Poison Control Centers. (Section 15 of the Act)

b) Human poison control centers wishing to be designated as a Regional Poison Control Center shall submit an application in accordance with Section 215.300.

c) If there are more than three applicants for designation as a Regional Poison Control Center or there is more than one applicant for the same geographic service area, the Director shall consider the following criteria in selecting an applicant for designation:

1) Whether the applicant has previously served as a Department-approved Regional Poison Control Center;

2) Whether the applicant is affiliated with a medical school, school of nursing, school of pharmacy or other health care professional teaching program;

3) How quickly the applicant can establish 24 hour operations in full compliance with the American Association of Poison Control Centers' Accreditation of Poison Control Centers standards and the requirements of this Part; and

4) The applicant's prior experience in providing poison control consultation services.

d) Applicants shall be notified, in writing, if they have or have not been designated as a Regional Poison Control Center.

e) Regional Poison Control Centers shall comply with the American Association of Poison Control Centers' Accreditation of Poison Control Centers standards within two years after designation unless the Center has been granted an extension by the Department. (Section 15 of the Act) The extension shall be provided in writing.

1) The Department's decision to grant an extension shall be based on, but not limited to, the following circumstances:

A) The applicant has experienced hardship in hiring staff, for reasons other than level of compensation; or

B) The applicant is waiting until designation to appoint a Medical or Managing Director.

2) An application for an extension shall contain the following information:

A) A description of how the applicant has attempted to comply with this Section;

B) The reasons for noncompliance;

C) A detailed plan for achieving compliance. The detailed plan shall include specific timetables;

D) The period of time for which the extension is being sought; and

E) An explanation of how the extension will not reduce the quality of poison control services provided by the applicant.

f) A Regional Poison Control Center shall maintain its designation unless it voluntarily closes, giving the Department at least a 90-day prior written notice of the intent to close, or the Department revokes or suspends the designation, in writing, for the Center's failure to comply with the Act and this Part. (Section 15 of the Act) Proceedings to revoke or suspend a Center's designation shall be conducted in accordance with the Department's Rules of Practice and Procedure in Administrative Hearings (77 Ill. Adm. Code 100).

g) Poison Control Centers shall cooperate to reduce the cost of operations, collect information on poisoning exposures, and provide education to the public and health professionals. (Section 15 of the Act)

h) Regional Poison Control Centers shall be considered State agencies for purposes of the State Employee Indemnification Act [5 ILCS 350]. (Section 15 of the Act)

i) Poison Control Centers shall create and then maintain all business, patient contact and financial records for no less than four years. All records shall be available to the Department for inspection or copying during normal business hours upon request. Information specific to any particular patient or caller shall be considered strictly confidential and shall not be subject to FOIA or otherwise released to the public.

(Source: Amended at 40 Ill. Reg. 16204, effective December 9, 2016)

Section 215.300 Application for Designation as a Regional Poison Control Center

a) The applicant may be a hospital licensed by the Department, or a non-hospital-based entity that has an agreement with a hospital licensed by the Department to provide clinical expertise.

b) All applicants shall submit a written program plan to the Department that includes a description of the geographic area to be served by the proposed Regional Poison Control Center and the following information about the licensed hospital:

1) Hospital name and address;

2) Number of adult intensive care beds;

3) Number of pediatric intensive care beds;

4) Number of medical/surgical beds;

5) Laboratory capabilities;

6) Psychiatric service capabilities;

7) Renal dialysis capabilities;

8) Affiliation with a medical school, school of nursing, school of pharmacy or other health care professional teaching program (see Section 215.200(c)(2) of this Part); and

9) Location of the applicant in relation to the proposed geographic service area.

c) All applicants shall submit a written application to the Department documenting detailed information on the methods and time frames for complying with Section 215.500 of this Part if designation is granted, including the following information:

1) Name and qualifications of the proposed Poison Center's Medical Director;

2) Availability of a comprehensive poison information resource file, in accordance with Section 215.400(b);

3) Adequately trained and supervised poison information specialists, in accordance with Section 215.500(b); and

4) Toll-free telephone number that does not impose a direct fee to members of the public and health care providers calling for poison information.

(Source: Amended at 40 Ill. Reg. 16204, effective December 9, 2016)

Section 215.400 Operation of a Regional Poison Control Center

a) The Center shall be in operation and have toll-free telephone availability on a 24-hour-a-day, 365-days-a-year basis to both the general public and health care providers.

b) The Center staff shall have immediate access during all hours of operation to comprehensive poison information, which shall include:

1) Current toxicology information resources available at the telephone answering site;

2) A comprehensive set of references covering both general and specific aspects of acute poison management, available at the telephone answering site;

3) Primary information resources (reprint files, systems, etc.) and access to a major medical library and/or information system; and

4) Poison specialty consultants available on an on-call basis.

c) The Center shall have written management protocols for responding to calls that provide a consistent approach to evaluation and treatment of toxic exposures and that are approved by the Center's Managing Director and Medical Director. These protocols shall be followed and be available at the telephone answering site.

d) The Center shall have a health education component that includes, at a minimum:

1) Instruction in prevention, care and management of poisonings for health care professionals, which may include EMS personnel, nurses, pharmacists, physicians and other providers;

2) Outreach education for the general public concerning poison prevention and first response; and

3) Cooperation with medical toxicology fellowship programs.

e) The Center shall have a data management system that is kept current and:

1) Maintains patient confidentiality;

2) Provides a sufficient narrative to allow for peer review and medical and legal audit; and

3) Collects data elements to allow for prompt filing of quarterly reports in accordance with Section 215.600.

f) The Center shall provide services to all patients regardless of ability to pay or source of payment.

(Source: Amended at 40 Ill. Reg. 16204, effective December 9, 2016)

TITLE 77: PUBLIC HEALTH
CHAPTER I: DEPARTMENT OF PUBLIC HEALTH
SUBCHAPTER f: EMERGENCY MEDICAL SERVICES AND HIGHWAY SAFETY
PART 215 REGIONAL POISON CONTROL CENTER CODE
SECTION 215.500 STAFFING

Section 215.500 Staffing

a) The Center shall have a Medical Director who is a physician, board certified or board eligible in medical toxicology. The Medical Director shall have a medical staff appointment at a comprehensive poison treatment facility and be involved in the management of poisoned patients. In addition to clinical, academic teaching and research activities, the Medical Director shall formally commit at least 10 hours per week to poison center operational activities involving staff training, development of medical guidelines and quality assurance activities. The Medical Director shall be responsible for:

1) Establishing Center policies;

2) Developing medical protocols;

3) Case review;

4) Quality assurance;

5) Providing patient care, telephone supervision and case consultation; and

6) Providing training and support to poison information specialists.

b) The Center shall have an adequate number of properly trained and supervised poison information specialists to assure that phone calls are answered promptly and that poison information is provided in a timely manner. Specialists in poison information shall be registered nurses, pharmacists or physicians who are qualified to understand and interpret standard poison information resources and to transmit that information in a logical, concise, and understandable way to both health professionals and the public. All specialists in poison information shall complete a training program approved by the Medical Director.

c) Each Center shall have a full-time Managing Director responsible for operations, personnel, data analysis, and other administrative functions. The Managing Director of a Regional Poison Control Center shall be a registered nurse, pharmacist, physician or shall hold a degree in a health science discipline. This individual may also be the Medical Director. This individual should be certified or eligible for certification by the American Board of Medical Toxicology for physicians or by the American Board of Applied Toxicology for non-physicians. In the absence of certification, the Managing Director shall demonstrate ongoing interest and expertise in toxicology as evidenced by publications, research and continuing education. The Managing Director shall be able to clearly demonstrate full-time commitment to Center-related activities, including the areas of clinical toxicology, education, research and administration.

Section 215.600 Quarterly Data Submission

The following data shall be collected by the Center and submitted to the Department, as a three-month total, by the 30th of the month following March 31, June 30, September 30 and December 31. The Department shall audit quarterly reports in response to a complaint if the complaint concerns information submitted in the report.

a) Total Center encounters:

1) Total poisonings,

2) Information requests,

3) Education requests.

b) Age group of poison contact subject:

1) Under 5 years old,

2) 5-12 years old,

3) 13-18 years old,

4) 19-30 years old,

5) 31 years old and over, or

6) Unknown age.

c) Substance encountered:

1) Prescription medications,

2) Over-the-counter medications,

3) Veterinary medication,

4) Household products,

5) Insect/arachnid/reptile/animal bite/sting,

6) Beauty aids/cosmetics,

7) Plants,

8) Pesticides,

9) Hydrocarbon,

10) Street drug, or

11) Other.

d) Routes of poison contact:

1) Ingested,

2) Inhaled,

3) Skin contact,

4) Bites/stings,

5) Wound/puncture,

6) Eye contact, or

7) Other.

e) Reason why contact occurred:

1) Accident,

2) Prescribed,

3) Intentional,

4) Recreational,

5) Suicide,

6) Industrial/work-related, or

7) Other.

f) Source of call:

1) Local hospital,

2) Clinic/physician office,

3) Family/friend,

4) Self, or

5) Other.

g) Initial Center treatment rendered:

1) Instructed in home care, including follow-up calls and documented to private physician;

2) Local medical facility or physician office advised in initial care of patient;

3) After initial instructions, patient referred to local human poison control center;

4) After initial instructions, patient referred to local hospital;

5) Patient referred directly to private physician; or

6) After initial instructions, patient referred to ophthalmologist.

h) Final disposition of patients treated from subsections (g)(2), (3), (4), (5) and (6) of this Section:

1) Patient treated at medical facility and released;

2) Patient treated at medical facility and admitted;

3) Patient treated at medical facility and transferred to Regional Poison Control Center;

4) Patient refused care recommendations;

5) Death; or

6) Unknown.

i) Use of grant funds, if applicable.

Section 215.700 Misrepresentation

After December 31, 1999, no person shall use the phrase "poison center" or words of similar meaning in relation to himself or hold himself out as a poison center without first obtaining designation therefor pursuant to the Act and this Part.

Section 215.800 Advisory Committee

a) The Director of Public Health shall appoint an advisory committee that shall advise the Department concerning the regulation of Regional Poison Control Centers under the Poison Control System Act.

b) The composition of the advisory committee shall be as follows:

1) Two board-certified toxicologists;

2) Three emergency department physicians, one of whom is an EMS Medical Director and one of whom is a pediatric emergency physician;

3) An EMS Coordinator;

4) A pharmacist;

5) A consumer;

6) A representative of the Illinois Department of Healthcare and Family Services;

7) The chief of the Department's Division of Emergency Medical Services and Highway Safety;

8) A representative from a health care professional society;

9) The Managing Director of a Regional Poison Control Center; and

10) The Medical Director of a Regional Poison Control Center.

c) The Department shall provide travel expenses to the advisory committee members pursuant to State travel rules (80 Ill. Adm. Code 2800 and 3000).

(Source: Amended at 40 Ill. Reg. 16204, effective December 9, 2016)

Section 215.APPENDIX A American Association of Poison Control Centers' Criteria for Certification as a Regional Poison Center (Repealed)

Section 215.APPENDIX A American Association of Poison Control Centers' Criteria for Certification as a Regional Poison Center (Repealed)

(Source: Repealed at 40 Ill. Reg. 16204, effective December 9, 2016)