Track, Monitor, and Respond: Three Keys to Better Lead Screening for Children in Medicaid

Executive Summary

This document provides guidance on how to screen for lead poisoning in children.

Track, Monitor,and Respond


Three Keys to Better Lead Screening for Children in Medicaid
Cooperative Agreement 18-C-91119/3-01
Submitted to The Centers for Medicare and Medicaid Services
by The Alliance To End Childhood Lead Poisoning


Introduction and Purpose
The primary audience for Track, Monitor, and Respond is people in regional, state, and local Medicaid offices with responsibility for carrying out policy of the Centers for Medicare and Medicaid Services (CMS) on lead screening and follow-up care for young Medicaid beneficiaries. Included in this intended target audience are state Medicaid agency (SMA) personnel – administrators, EPSDT coordinators, quality assurance specialists and managers, and others who work closely with health care providers and managed care plans to develop and monitor performance specifications.
The purpose of the following materials is to facilitate problem solving by providing information on tracking, monitoring, and responding to lead screening efforts of managed care plans and health care providers. Such screening is a required component of EPSDT because, as a group, young children in Medicaid are more likely than other children to be exposed to lead. Most often, their exposure is due to the presence of lead paint hazards in their homes. Such exposure is associated with difficulties in learning and behavior, but these problems can be mitigated for children whose exposure comes to light because of blood lead screening and who receive timely and appropriate follow-up care. Central to improving lead screening is promotion of this service among health care providers, using the information about screening penetration and case finding that good tracking makes available. CMS’s inclusion of lead screening data in the required annual CMS Form 416 report further underscores the importance of tracking the provision of this service.
The materials are divided into three sections designed to build upon each other:
  • The Tracking section has recommendations on collecting essential information on lead screening;
  • The Monitoring section has suggestions on strategies for utilizing this information;
  • The Responding section is a case-study of a visible and effective response to health care providers that is based on tracking and performance monitoring.
By making lead screening and follow-up care available to our nation’s highest-risk children, the Medicaid program plays a central role in preventing lead poisoning and its consequences. The following materials, designed to be quickly and easily read and to refer the reader to more extensive sources where necessary, are intended to stimulate new strategies and efforts that will further strengthen this role.

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