Correspondence from Perkins to Van Wye and News Clipping

    National Health Law Program, Inc. 
    

MAIN OFFICE 
2639 South La Cienega Boulevard 

Los Angeles, California 30034 

(213) 204-6010 
Fax #: (213) 204-0891 

May 20, 1991 BRANCH OFFICE 
1815 H. Street, N.W.Suite 705 

Washington, D.C. 20006 

(202) 887-5310 

Harlan Van Wye Fax #: (202) 785-6792 
Deputy Attorney General 
State of California 
Department of Justice 
2101 Webster Street 
Oakland, CA 94612-3049 

Re: Matthews v. Kizer 
  

Dear Harlan: 

This letter confirms our conversation of May 14, 1991. In 

that conversation, you stated that you found no letter from the 

U.S. Department of Health and Human Services stating that 

California's EPSDT program is out of compliance with federal law. 

I told you that a N.Y. Times article stated to the contrary, and 

you asked for a copy of the letter, which is attached (see 

particularly the boxed portion of the article quoting Norman S. 

Hartman). If, after reading this article, you locate an HHS 

letter, please fax a copy to me as soon as possible. 

  

In our conversation, you also stated that, in our depositions 

of Ruth Range and Mary Gregory, we obtained a full description of 

the Department.of Health Services’ position in this case and that, 

at this time, you do not envision relying upon additional 

Departmental employees such as Drs. Goldman and Jackson. 

Sincerely, 

Int [leet 

(3ane Perkins 
Staff Attorney 

JP/vlz 
Enclosure 

cc: Linda Slaughter 
Joel Reynolds 
Mark Rosenbaum 
Bill Lee 
Kim Card/Susan Spellitich 

FUNDED BY THE LEGAL SERVICES CORPORATION 

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Matthews’. press tbdgpicerdu aisti 

  

NYTimes PIS, ect 
  

1(/1272274p 
  

U.S. Lag Found in Lead Poisoning Tests 
  
  

By PHILIP J. HILTS 

WASHINGTON, Dec. 21 — Only one- 
third of the poor children in the country 
are tested for lead poisoning, even 
though such testing is required by a 
1989 law, Federal officials said today. 
Advocacy groups have fought for 

years to obtain lead testing, and treat- 
ment when necessary, for the 12 mil- 
lion children who are poor and consid- 
ered eligible for Medicaid. 

“There has been a failure in most 
states to carry out their obligation to 
screen all poor children, and every 
state in the union is failing when it 
comes to following up with treatment,” 
said Sara Rosenbaum, director of the 
health division at the Children’s De- 
fense Fund in Washington. 

The situation has prompted a law- 
suit, filed on Thursday in Federal Dis- 
trict Court in San Francisco, seeking to 
force California to begin more wide- 
spread screening. 

First State to Be Sued 

This is the first lawsuit to try to force 
a state to comply with a 1989 amend- 
ment to the Federal Medicaid law, 
which required all states to test poor 
children’s blood for lead, as well as to   

“There has been a 

failure in most 

states to screen 

all poor children.’ 
  

carry out other tests like those for vi- 
sion and overall development, said 
Jane Perkins of the National Health 
Law Program, one of several organiza- 
tions that have joined forces in the suit 
against California. The law also re- 
quires that those identified with prob- 
lems must be treated, she said. 

About 57 million homes in the United 
States have lead paint in them, and 10 
million of those have children under 7 
years old at home. Lead poisoning in 
children can cause severe nervous Sys- 
tem damage that can result in poor 
performance in reading, mathematics 
and other important tests. In the worst 
cases, it can cause retardation or 
death. 

In their recent effort to assure wide- 
spread screening around the country, 

  

  

Maker Challenges Deal 

  

On U.S. Weather Radar 
The company making the Federal 

. Government's new weather radar sys- 
tem has asked a review board to invali- 
date the contract, in a move the Gov- 
ernment and the company describe as 
part of intense bargaining to raise the 
price of the systems. 

The system, termed Nexrad for Next: 
Generation Radar, uses new tech- 
nology that Government officials say 
will allow forecasters to be more accu- 
rate and see further ‘into the future. 
The Government has agreed to buy 165 
units — 115 for the National Weather 
Service and 50 for the Department of 
Defense and the Federal Aviation Ad- 
ministration. 

But a prototype of the radar per- 
formed poorly in tests conducted last 
Jear by the Air Force, and the program 
as been hampered by delays and price 

increases. 
The manufacturer, Unisys, and the 
Government have tried to correct the 
problems, which include frequent 
power lapses and incorrect measure- 
ment of wind speed and direction. In 
the process the contract price has 
grown by millions of dollars, and the 
construction schedule has been moved 
back at least six months, although 
Unisys says it still expects to finish 
within a six-year timetable. 

A Better Look at the Weather 

The system, if it works as planned, 
would be an improvement on past 
radars because it could track many 
more radar beams at the same time 
and in the process could study the 
development and movement of 
weather fronts in greater detail. The 
new radar units are part of a $1 billion 
modernization program of the National 
Weather Service. 

The contract, a copy of which was ob- 
tained through a legally enforceable 
request under the Freedom of Informa- 
tion Act, documents the negotiated 
delays and cost increases in a section 
of amendments. 

What began in 1987 as a $359 million 
contract became a $418 million con- 
tract later that year. In the last two 
years, more than $20 million has been 
added to the price for costs related to 
developing the new technology. 

The Government and Unisys are cur- 
rently negotiating further price in- 
creases, Government officials and a 
Unisys spokesman said. 

Company Files Complaint 
At the same time. ag3 NC to Aide   

ing ourselves to doing work that we 
won't be paid for,” said William J. 
Beckham, a spokesman for the unit of 
the company that makes the radar sys- 
tem. 

The Government has already paid 
for 10 units and is planning to pay for 
the other radar units as it goes along. 
Though the complaint asks for the 

contract to be invalidated, Mr. Beck- 
ham said the company still wants to 
construct the Government's weather 
radar system. “What we are finding in 
the course of things is that if you are in 
a development-type contract you have 
to make changes and there are costs in- 
volved,” Mr. Beckham said. “And who 
pays the costs? That's the issue.” 

Different Interpretations 

The Government agreed that the 
basic disagreement over the contract 
was over costs. 

“Like most contracts, it is capable of 
being interpreted in many ways,” said 
Gray Castle, the Deputy Under Secrep 

  

Bargaining over a 
project to update 
the Weather 
Service. 

  
  

tary of Commerce, who oversees the 
Weather Service. “And the way they in- 
terpret it is that they should get more 
money.” 

But he said he is confident that the 
radar system will be produced. “We 
need these radars and they need the 
business,” he said. 

Hanging over the contract discus- 
sions is the poor financial health of 
Unisys, which reported a $356.8 million 
deficit in the third quarter of this year 
and did not pay a dividend to share- 
holders. 

The first radar unit was supposed to 
have been delivered to Norman, Okla., 
in October, but the Government has de- 
clined to accept delivery because of 
problems with the computer software. 

The delays are especially important 
since the Weather Service has a radar 
system that is decades behind the 
times. The antiquated equipment has 
proven unreliable and difficult to re- 

Pair Secause snare: 

.| and and green light from another.” 

Federal Medicaid officials set a goal 
for states to test a minimum of 80 per- 
cent of the Medicaid-eligible children 
within the next few years, said a Medic- 
aid official who insisted that his name 
not be used. Eventually, the goal is to 
test all poor children at least once. 

35% Get Early Screening 

Now, however, overall compliance is 
not good, the official said. Reports from 
the states show that only 35 percent of 
poor children are getting early screen- 
ing tests, including the lead poisoning 
test. 

Younger children are doing better: 
as of September, two-thirds of poor 
children under 5 around the country 
have been tested, he said, but only 13 
percent of those from 6 to 20 have been 
tested, he said. “The states are begin- 
ning to do a lot better, and have im- 
proved greatly in the past two years,” 
he added. ; 

Connie Rice of the NAACP Legal De- 
fense and Educational Fund, another 
party to the suit against California, 
said: ‘“Minorities and the poor bear the 
brunt of this problem and they're being 
needlessly contaminated while the 
state twiddles its thumbs. This prob- 
lem is not limited to California, and we 
hope this suit will be a national model 
for others who seek to compel states to 
meet the desperate health care needs 
of their children.” 

Plaintiffs in the California suit are 
two children from Long Beach, Jalisa 
Matthews, who is 1 year old, and her 
sister, Erika, 2, who were both refused 
testing by the state, said Joel R. Reyn- 
olds, a lawyer for the Natural Re- 
sources Defense Council, another 
group taking part in the suit. 

‘Slow Poisoning’ of Children 

“The State Department of Health 
Services cannot continue to ignore the 
slow poisoning of our children,” he 

states the duty to test and treat thou- 
sands of children who may be victims 
of lead poisoning. That duty must now 
be enforced by the courts.” - 

A spokesman for the state health de- 
partment, Norman S. Hartman, said, 
‘We believe we are in compliance with 
the Federal standards as we see 
them.” Mr. Hartman said the state had 
been told by the Health Care Financing 
Administration's regional office that it 
was in compliance. 

| He said that screening for lead poi- 
soning was required, but that screening 

. might not require tests. Instead, a doc- 
“tor doing a child’s physical examina- 
tion asks questions that elicit answers 
indicating whether a child lives in a 

_house that poses high risk. - 
However, Medicaid officals said the 

State of California was recently sent a 
letter declaring that the state was out 
of compliance with Federal law be- 
cause it was not screening enough chil- 
dren. 

Mr. Hartman said the matter was 
confused because “we seem to be get- 
ting a red light from one department 

The Federal Government has begun] 
a new initiative on lead poisoning, 
which will lower the threshold at which 
lead in blood is considered hazardous. 
This will increase the number of chil- 
dren officially considered at risk from 
several hundred thousand to four mil- 
lion to six million. 

“The administration now has got to 

  
said Senator Harry M. Reid, Democrat 
of Nevada. “This cleanup should have 
begun 30 years ago.” Mr. Reid and two 
other Democratic Senators, Bill Brad- 

man of Connecticut, sponsored a bill 
last year to ban more uses of lead in the 
country. The measure failed to reach 
the floor before the end of the last Con- 

introduce it again this session. 
Use of lead paint in houses is now 

banned, but it is still used commercial 
ly. While leaded gasoline is not permit- 
ted in most gas stations now, a billion 
gallons is still sold each year in this 
country for older automobiles, farm 

said.   
ley of New Jersey and Joseph I. Lieber- 5 

gress, but the Senators said they would oo 

equipment and other uses, Mr. Reid n 

THE NEW YORK TIMES NATIQ 

  
said. “Congress has clearly given ve 

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put their money where their mouth is,” |