New Childhood Lead Poisoning Report Issued (Jan. ’99)

The General Accounting Office has just issued another report that concludes that federal health programs are not effectively serving children at risk for lead poisoning: Lead Poisoning: Federal Health Care Programs Are Not Effectively Reaching At-Risk Children. The findings of the report add to those of a February 1998 report, which found that the Medicaid program is failing to screen the vast majority of Medicaid-eligible children for lead poisoning.
In the most recent report, the GAO has found that: (1) Elevated lead blood levels are a significant problem for poor children served by WIC, Medicaid and other federal health care programs; (2) Most of these children are not being screened for lead; (3) There is a lack of government oversight and enforcement regarding lead poisoning detection and prevention.  While the GAO supports the controversial notion that a state could be excused from universal screening of children, it takes the position that ?most Medicaid programs and many state health departments lack the data needed to assess risk and develop targeted screening recommendations.?
The GAO recommends that the Secretary of Health and Human Services:
  • improve collection and public dissemination of information about lead poisoning prevalence rates, especially among Medicaid children;
  • improve state reporting to HCFA and HCFA oversight;
  • improve states? Medicaid contracts with managed care organizations to include clearly-stated lead screening protocols;
  • improve state compliance by issuing guidance and monitoring to assure that lead screening, environmental investigations, case management, and necessary treatment are all paid for by state Medicaid programs;
  • investigate opportunities for improving lead screening rates by coordinating with other agencies, such as immunization programs under the WIC program.
The report can be obtained from GAO at (202) 512-6000 or from the GAO website.
NOTE: This link is to an Adobe Acrobat ".pdf" file and requires Adobe Acrobat software (available for free from Adobe)
  • GAO Report [HEHS-99-18] Lead Poisoning: Federal Health Care Programs Are Not Effectively Reaching At-Risk Children Size: 234274 , January, 1999. TEXT , PDF ,SUMMARY
  • GAO Report [HEHS-98-78] Medicaid: Elevated Blood Lead Levels in Children Size: 24663 , February 20, 1998. TEXT , PDF , SUMMARY
The National Health Law Program has successfully challenged inadequate lead testing in a number of states and in a national class action suit which resulted in the issuance of the HCFA guidelines for screening.  (These guidelines are included in Part 5 of HCFA?s State Medicaid Manual, which is available from the HCFA website at:   Please keep us informed of activities in your state and with respect to this report.  Jane Perkins and Kristi Olson in the Chapel Hill office at (919) 968-6308 or through email at: [email protected] [email protected].

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