Department of Health Services Provider Information Notice - Blood Lead Test

    STATE OF CALIFORMIA—HEALTH AND WELFARE AGENCY 

  

DEPARTMENT OF HEALTH SERVICES 
7vA)744 P STREET 
P.O, BOX 242732 

  

SACRAMENTO, CA 94234-7320 

(916) 654-0364 Qctobar 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 6b Months to 72 Months 

Attached is Provider Information Notice #91-10 informing providars of the need 
to: 

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

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

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

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

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 vour providers, 

Return the "Norice of Distribution” by Novembar 1, 1991 and include the date 
sent to providers. If you have any questions, please contact your Regional 
Consultant. 

CAE 

dsr Dolo 
don H. Cumming, Ph.D., crseef 

Child Health and Disability 

Prevention Branch 

Ea vEs THEE AD I0idH fad ZI IET Te SCAT 

  

PETE WILSON, Governor



   STATE OF CALIFORMNIA—NHEALTH AND WELFARE AGENCY 
A ——— 

DEPARTMENT OF HMEALTH SERVICES 
714,744 B STREET 

PO. BOX 9473732 
SACRAMENTO, CA 74234-7320 
(316) 657-1428 

id dd PLES Bl 

    
  EE ee CY — 

  

CHDP Provider Information Notice 91-10 

Te: CHDP Providars 

Subjact: Blood lead Test as a Part of Health Assessment for CHDP Eligible 
Children Ages 6 Months to 72 Monchs 

In March of 1991, you received a letter from the Diractor 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 {3 acting on this concern by expanding the blood lead testing/screening component of the health assessment provided tae 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 =ach health assessment. Tha evaluation shall include, at a minimum: 

L. A blood lead test (Code #15) is to be administered to all CHDP program eligible children at approximately one year of age, unless thers 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, wha has noc been tesatsd for. lead poisoning is to also receive a blood lead test (Code #15) during the child's next subsequent periodic health a3zessment unless there is reason that the test is medically contraindicated or the tagst is refused by the parents. 

3, A seriez 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 attachad list) are to be asked at each periodic health assessment, beginning with the 6 month visit. 

A child is considared low risk only if all five questions are answered “No." If any child ig determined to be high risk from inicial or subsequent questioning, a blood lead teat (Code #135) is to be administerad immediately unless there is raason that the test is medically contraindicated or the test is refused by tha parents. 

   
TEI IMMES HET 40 S9T440 foHd CHET 16-C8-0 EEE 

  

PETE WHION. Governor



At cach subsequent periodic health assessment, if a child is determined 
to be high risk under paragraphs 1. 2. or 3 above. 3 blood test 
(Code ff153) is to be performed, unless there is reason that the test is 
madically contraindicated or the test is refused by the parents, 

A child is to be referred for appropriate diagnosis and/or rreatment 
when the results of the blood level test exceed 15 ug/dL. A child whose 
blood lead test results are greater than 10 ug/dL and lass than 15 ug/dL 
is to be retested at intervals consistent with the Ocrebar 1991 Centers 
for Disease Control statement entitled, Preventing Lead Polsoning In 
Young Children. 

The reimbursement races for the health assessment and rhe hlood laad tast are 
unchanged. 

These changes in the testing/screening protocol are being made because of 
recent medical and scientific advances. The content of this provider 
information lattar ig intended to be consistent with these changes. The 
Centers for Disease Control statement recommends a second universal test ac 
about two years of age if resources allew. The Department will keep you 
informed of further davelopments and more detailed instructions will follow, 

Please feal free to call your leeaal CHDP program director if you have any 
questions. 

(Hl (R 0 
Molly Joel Coye, H. 
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. 

i. 

=e 

Does your child live in or regularly visit a house or other location 
with peeling or chipping paint built before 19607 (This can include a 
day care center, preschool, schscl, barn, home of babysitter, relative, 
friend, etc.) 

Yes No 

    

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

Yes No 

Does your ¢hild have a parent, brother, sister, housemate or playmate 
who is being treated or followed for lead poisoning (i.e., blood lead 
2 10 ug/dL? 

Yes No 

  

Does your ehild 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 

  

S3D1MM3S TOF 40 301440 SHA PE:@T 16/52/81 

 



  

REPORT OF DISTRIBUTION 

PROVIDER INFORMATION NOTICE #91-10 

BLOOD LEAD TEST AS A PART OF HEALTH ASSESSMENT 
FOR CHDP ELIGIBLE CHILDREN AGES & 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) 

  

  

’ 

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. 

5% S30IMY3S HEI 40 321440 ‘SHA SE:0T TE/SZ-31