Correspondence from Lee to Hankins

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July 1, 1991 

Grover G. Hankins 
Principal Deputy General Counsel 
United States Department of Health 

and Human Services 
200 Independence Avenue, SW 
Room 722A 

Washington, D.C. 20201 

Re: Matthews v. Kizer, N.D.Cal. C-90-3620 EFL   

Dear Mr. Hankins: 

Enclosed please find a copy of the summary judgment pleadings 
in the above case against the California Department of Health 
Services concerning lead screening of EPSDT children. HHS is not 
a party to the litigation. The basic issue is the proper 
construction of the directive in HCFA's State Medicaid Manual, 
§51232D, which the parties agree is controlling, for providers to 
"[s]creen all Medicaid-eligible children ages 1-5 for lead 
poisoning." The positions of the parties are set forth in the 
enclosed memoranda and supporting documents. Basically plaintiffs 
construe the term "screen" to mean administering a blood lead test, 
while defendant California Department of Health Services suggests 
that the term means only verbal history-taking which may or may not 
include blood testing. 

  

Earlier today, I faxed to you a copy of the district court's 
order requesting HHS to submit a brief amicus curiae. We ask that 
HHS file such a brief in support of plaintiffs' position. Such a 
position is not only consistent with the 1989 amendments to the 
EPSDT statue and HCFA's authoritative State Medicaid Manual, but 
in line with Secretary Sullivan's recent initiative on lead 
toxicity and expert medical opinion. In the latter respect, you 
should especially review the declarations of Phillip J. Landrigan 
(Exhibit X to plaintiffs' reply brief), John F. Rosen (Exhibit AA 
to plaintiffs' reply brief and Exhibit A to plaintiffs' principal 
brief), and Herbert L. Needleman (Exhibit B to plaintiffs’ 
principal brief). Drs. Landrigan, Rosen and Needleman are among 
the nation's foremost medical authorities on lead poisoning and are 
prominent in the work of HHS' Centers for Disease Control on lead 
poisoning. 3 

  

  

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Letter to Grover G. Hankins 

July 1, 1991 
Page 2 

As I mentioned to you today, HCFA's local office has taken two 
diametrically opposed positions stating that blood lead testing was 
and was not minimally required in letters to the Department of 
Health Services solicited by the Department and its counsel in ex 
parte communications. The letters are exhibits V and W to 
plaintiffs' principal brief. 

Please call me if I can be of further assistance. 
~~ 

ah ; / 
piresrely, In 

Id lle 
Bill Lann Lee 

Attorney for Plaintiffs 
  

BLL: sm 

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