Letter From Attorney General Lungren to Lann Lee RE: CHDP Program Letter #91-18

    - * 
DANIEL E. LUNGREN State of California 
Attorney General DEPARTMENT OF JUSTICE 

2101 WEBSTER STREET, 12th FLOOR 
OAKLAND, CA 94612-3049 

(510)464-4200 

MAILING ADDRESS: 
455 GOLDEN GATE AVENUE, SUITE 6200 

SAN FRANCISCO, CA 94102-3658 

(510) 464-1173 

     
  

October 24, 1991 

Bill Lann Lee 
NAACP Legal Defense 
and Educational Fund, Inc. 

315 West Ninth Street, Suite 208 
Los Angeles, California 90015 

RE: Erika Matthews, et al. v. Molly Coye 
U.S.D.C. Northern District No. C-90-3620 EFL 
  

Dear Bill: 

Pursuant to our telephone conversation of October 23, 1991 
(as well as plain common sense) I am forwarding a copy of CHDP 
Program Letter #91-18 which distributed Provider Information 
Notice #91-10. Both documents are dated October 21, 1991. 

As we discussed, please let us know who should be listed as 
payee on the warrant for attorneys fees. The Department of 
Health Services is moving expeditiously on this front too. 

All best regards to you and your colleagues. It is always a 
pleasure to deal with cooperative and competent professionals in 
creating a result beneficial to all concerned. 

Sincerely, 

DANIEL E. LUNGREN 
Attorney General 

oid / 

/ rl 7 / ir rT 

(LR 
HARLAN E. VAN WYE 
Deputy Attorney General 

HEV:lej 

Enclosures 

cc: Linda Slaughter (w/out encl.) 

 



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STATE OF CALIFORNIA—HEALTH AND WELFARE AGENCY PETE WILSON, Governor 

DEPARTMENT OF HEALTH SERVICES 
714/744 P STREET 

P.O. BOX 942732 

SACRAMENTO, CA 94234-7320 

(916) 654-0364 October 21, 1991 

  
  

CHDP Program Letter #91-18 

To: Community Child Health and Disability Prevention (CHDP) Program 

Directors and Deputy Directors 

Subject: Provider Information Notice #91-10 Regarding Blood Lead Test 

as a Part of Health Assessment for CHDP Eligible Children 

Ages 6 Months to 72 Months 

Attached is Provider Information Notice #91-10 informing providers of the need 

71 

assess all children from 6 months to 72 months of age for risk of lead 

burden and do a blood lead test when determined to be at risk. 

do blood lead testing on all children at one year of age. 

do blood lead testing on any child under 72 months of age who has not 

been tested. : 

Distributing this notice is a condition of settling the law suit Mathews and 

People United for a Better Oakland v. Coye and must be distributed without any 

changes no later than October 30, 1991 to all your providers. 

Return the “Notice of Distribution" by November 1, 1991 and include the date 

sent to providers. If you have any questi , e contact your Regional 

u (omy 
don H. br 1 Ph.D. cree] 

Child Health and Disability 
Prevention Branch 

Consultant. 

 



   
STATE OF CALIFORNIA—HEALTH AND WELFARE AGENCY PETE WILSON. Governor 
  

  

  

DEPARTMENT OF HEALTH SERVICES 
714/744 P STREET 

P.O. BOX 942732 

SACRAMENTO, CA 94234-7320 

(916) 657-1425 Jer Gtee 1, 1H 

  

CHDP Provider Information Notice #91-10 

To: CHDP Providers 

Subject: Blood Lead Test as a Part of Health Assessment for CHDP Eligible 
Children Ages 6 Months to 72 Months 

In March of 1991, you received a letter from the Director of the Department of 

Health Services which, in part, stated: "Lead poisoning is the most 

significant environmental health problem facing California children today, and 

insufficient consideration is being given this potential problem during 

routine child health evaluations." The Department is acting on this concern 

by expanding the blood lead testing/screening component of the health 
assessment provided to Child Health and Disability Prevention (CHDP) Program 
eligible children. 

Effective November 20, all CHDP eligible children between 6 and 72 months are 
to receive an evaluation for possible lead poisoning as part of each health 
‘assessment. The evaluation shall include, at a minimum: 

1. A blood lead test (Code #15) is to be administered to all CHDP program 
eligible children at approximately one year of age, unless there is 
reason that the test is medically contraindicated or the test is refused 
by the parents. 

2. Any child over one year of age, but less than 73 months, who has noc 
been tested for. lead. poisoning is to also receive a blood lead test 
(Code #15) during the child’s next subsequent periodic health assessment 
unless there is reason that the test is medically contraindicated or the 
test is refused by the parents. 

3. A series of five (5) questions, intended to identify children at high 
risk for lead poisoning, is to be directed to each child's 
parent/guardian. The questions (See attached list) are to be asked ac 
each periodic health assessment, beginning with the 6 month visit. 

A child is considered low risk only if all five questions are answered 
"No." If any child is determined to be high risk from initial or 
subsequent questioning, a blood lead test (Code #15) is to be 
administered immediately unless there is reason that the test is 
medically contraindicated or the test is refused by che parents. 

 



  

4 AC each subsequent periodic health assessment, Lf a child is determined 

vs be high risk under paragraphs 1, 2, or 3 apove, a1 blood test 

(Coda #15) is to be performed, unless thera is reason chat the rest is 

medically contraindicated or rhe test is refused by the parcncs. 

s A child is to be referred for appropriate diagnosis and/or treatment 

when the results of tha blood leval test exceed 13 ug/dL. A child whose 

blood lead test results are greater chan 10 ug/dL and less than 13 ug/dL 

ig to be retasted at intervals consistent with the Qetober 1991 Canters 

for Dissase Control statement enticled, Pravencing Lead Poisoning In 

Young Children. 

The reimbursement rates for the healch assessment and the blood lead test are 

unchanged. 

These changas {in the cesting/scrcening seococol are being made because of 

reecant medical and scientific advancas. The concent of =his provider 

information letter 1s intended to be consistent with these changes. The 

Cancers for Disease Control scatement recommends a second universal test ac 

about two vears of age if resources allow. The Department will keep you 

informed of further davelopments and more derailad inscructions will follow, 

Please feel free TO call your lecal CHDP program director if you nave any 

questicns. 

  

fLR..2 
Molly Joel Cove, M.D. a2 A 

Director 

Attachment 

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CHILDHOOD LEAD POISONING EVALUATION QUESTIONNAIRE 

The following questions are to be answered by the parents/guardians of CHDP 
eligible children under 72 months of age at each periodic health assessment. 

1. Does your child live in or regularly visit a house or other location 
with peeling or chipping paint built before 1960? (This can include a 
day care center, preschool, scheccl, barn, home of babysitter, relative, 

friend, etc.) 

Yes No 

Does your child live in or regularly visit a house built before 1960 
with recent or ongoing renovation or remodeling? 

Yes No 

Does your child have a parent, brother, sister, housemate or playmate 

who is being treated or followed for lead poisoning (i.e., blood lead 

> 10 ug/dL? a 

Yes No 

Does your child live with someone whose job or hobby involves exposure 
to lead (i.e., painting, soldering, automobile battery manufacturing or 
recycling, vehicle radiator repair)? : 

Yes No 

Does your child live near an active lead smelter or battery recycling 
plant or other industry likely to release lead? 

Yes No 

 



o @ 
REPORT OF DISTRIBUTION 

  

PROVIDER INFORMATION NOTICE #91-10 

BLOOD LEAD TEST AS A PART OF HEALTH ASSESSMENT 

FOR CHDP ELIGIBLE CHILDREN AGES 6 MONTHS TO 72 MONTHS 

TO: 

PROVIDER INFORMATION CLERK 
CALIFORNIA STATE DEPARTMENT OF HEALTH SERVICES 
CHILD HEALTH AND DISABILITY PREVENTION BRANCH 
714 P STREET, ROOM 708 

P.O. BOX 942732 

SACRAMENTO, CA 94234-7320 

THIS PROVIDER INFORMATION NOTICE WAS SENT TO PROVIDERS IN 

COUNTY /COMMUNITY ON . 
(DATE) 
  

  

a, 

. 

SIGNATURE OF SENDER 
  

PLEASE NOTE THAT NO CHANGE IS TO BE MADE IN THIS NOTICE OR ATTACHMENTS. 

PLEASE COMPLETE THIS FORM AND FORWARD TO ADDRESS SHOWN ABOVE. 

THANK YOU FOR YOUR COOPERATION.