Update on Medicaid Lead Poisoning Letter

Executive Summary

Update on Medicaid Lead Poisoning Screening Letter

MEMO TO: Advocates for Lead Poisoning Prevention and Health Care for Low-Income Families
FROM: Don Ryan, Alliance to End Childhood Lead Poisoning Jane Perkins, National Health Law Program
RE: Sign-On Letter to Secretary Thompson re: Medicaid Blood Lead Screening
[See below for full text of letter]
The group sign-on letter protesting the planned retreat on lead poisoning screening for children served by Medicaid was delivered to HHS Secretary Thompson today.
The response to our electronic alert has been overwhelming. A total of 50 national organizations and almost 200 regional, state and local organizations joined in calling on Secretary Thompson to block the planned retreat of federal leadership and oversight on Medicaid screening. In addition, more than 200 individuals, including many staff of state and local health and housing agencies co-signed the letter. We greatly appreciate the rapid response from such a broad range of organizations and individuals.
A copy of this letter and all the co-signers is available at www.healthlaw.org or atwww.aeclp.org/medicaid.doc.
We will keep you apprised of developments on this front. If you have the time and energy, please call your Representative in Congress and urge them to sign onto the letter to Secretary Thompson that Representatives Menendez and Gutierrez are now circulating to voice Congressional opposition to this policy change. If you don't know your representative's number, you can call the main switchboard at 202-225-3121 and ask to be connected.
[See below for full text of letter, or click to view in PDF Format]
April 22, 2002
Honorable Tommy Thompson
Department of Health and Human Service
Hubert Humphrey Building
200 Independence Avenue, S.W.
Washington, DC 20201
Dear Secretary Thompson:
We, the undersigned 473 national, regional, state, and local organizations and individuals, call on the Department of Health and Human Services (HHS) to ensure that children are screened and treated for lead poisoning under Medicaid, as federal law requires.
Achieving the national goal of protecting all children from lead poisoning requires concerted effort by many sectors, most critically action to make housing safe from lead hazards. As the program serving the health needs of our most vulnerable children, Medicaid?s role is essential to the national prevention equation: screening low-income children at risk for lead poisoning and providing the services needed to those found poisoned.
Children served by Medicaid are undisputedly at the most elevated risk for lead poisoning. Medicaid enrollees account for an estimated 93% of severely lead-poisoned children and 60% of all children with elevated blood lead levels.
It is equally clear that low-income communities of color bear the brunt of this disease.
National health data confirm poisoning rates eight times higher among low-income children than children from upper-income families, while African-American children are at five times higher risk than white children. In highest risk neighborhoods in many cities, one-third of preschool children are poisoned by lead, a shameful statistic and a formula for school failure.
Despite wide knowledge of these facts, screening for lead poisoning by state Medicaid programs is abysmal. In 1998 GAO found 81% noncompliance with blood lead screening requirements. Since that time, only eight states have reported screening rates above 20 percent. It is now painfully clear that the vast majority of lead-poisoned children served by Medicaid are never identified. As a result, poisoned children do not receive the services they need and lead hazards in their homes are left in place to poison siblings and future occupants.
Given these failures, we are strongly opposed to the Centers for Medicare and Medicaid Services? (CMS) plan to walk away from the problem by terminating the federal role in setting minimal protective standards for Medicaid blood lead screening. As you noted in your confirmation hearings before the Senate Finance Committee, we must strive to bring greater focus and resources to reduce the health disparities that persist in this country for minority and other under-served communities. The continuing poisoning of low-income children demands leadership by HHS, not abdication of federal responsibility.
We call on HHS to:
  • maintain protective standards for lead poisoning screening and treatment that account for variations in risks and patterns of lead poisoning across the country;
  • maintain the State Medicaid Manual §5123.2.D.1. in its current format and do not allow states to adopt a plan that allows less than universal screening of Medicaid-eligible children until new recommendations for targeting Medicaid screening are provided by the federal Advisory Committee on Childhood Lead Poisoning Prevention;
  • follow CDC guidance in setting lead screening standards for age and risk factors and rely on the recommendations of the federal Advisory Committee on Childhood Lead Poisoning Prevention in making subsequent revisions to the State Medicaid Manual to accommodate appropriate targeting of Medicaid lead screening services, and disseminate their recommendations and CMS policy to the states in a letter to State Medicaid Directors;
  • require states to report blood lead screening data annually and to hold states accountable;
  • insist that states develop reliable and representative data on prevalence rates to identify communities and populations at elevated risk; and,
  • immediately authorize Medicaid payments for analyzing samples to identify lead paint chips and dust hazards in a poisoned child?s home to guide corrective action.
The ultimate solution to lead poisoning may well require Medicaid to play a larger role in prevention. We urge you to take these immediate steps to give meaning to President Bush?s pledge to ?Leave No Child Behind.?
National Organizations
Don Ryan
Alliance To End Childhood Lead Poisoning ? Washington, DC
Jane Perkins
National Health Law Program ? Chapel Hill, NC
Nancy McFall Jean
Alliance for Children and Families
Patricia Thompson
Alliance for Fairness in Reforms to Medicaid ? Washington, DC
Mary Crosby
American Academy of Child and Adolescent Psychiatry
Molly Hicks
American Academy of Pediatrics ? Washington, DC
Doreen Croser
American Association on Mental Retardation
Robin Dalberg
American Civil Liberties Union ? New York, NY
Darryl Alexander
American Federation of Teachers
Leslie Antoniel
American Group Psychotherapy Association, Inc. ? New York, NY
Jeff Huebner, MD
American Medical Student Association ? Reston, VA
Lizbet Boroughs
American Psychiatric Association
Don Hoppert
American Public Health Association ? Washington, DC
Mary Goldman
Americans for Democratic Action ? Southern Pennsylvania
Pat Gallagher
The Ark
Liz Savage
The Arc of the United States ? Washington, DC
Hilda Crespo
The ASPIRA Association ? Washington, DC
Stephen Pfeiffer, PhD.
Association for the Advancement of Psychology
Barbara Allen
Child Welfare League of America ? Washington, DC
Ana Margarita Tenorio
Children?s Environmental Health Network ? Washington, DC
Karen Florini
Environmental Defense ? Washington, DC
Kenneth A. Cook
Environmental Working Group ? Washington, DC
Julie Ward
Epilepsy Foundation of America
Judy Waxman
Families USA ? Washington, DC
Janis Connallon
Family Voices ? Washington, DC
Virginia Ruiz
Farmworker Justice Fund, Inc ? Washington, DC
Claire L. Barnett
Healthy Schools Network, Inc ? Albany, NY
Elise Miller, M. Ed.
Institute for Children?s Environmental Health ? Langley, WA
Sue Swenson
The Joseph P. Kennedy, Jr. Foundation ? Washington, DC
Lynn Kersey
Maternal and Child Health Access
Lee Wasserman 
National Lead Assessment and Abatement Council ? Livingston, NJ
Marianne Takas
National Association of Child Advocates ? Washington, DC
Kellye M. Nelson, MPH
National Association of Community Health Centers, Inc. ? Washington, DC
Tom Bryant
National Association of County Behavioral Health Directors
Hilary Shelton
NAACP ? Washington, DC
Elizabeth Priaulx 
National Association of Protection and Advocacy Systems ? Washington, DC
David Inoue
National Association of Public Hospitals and Health Systems ? Washington, DC
Pat Johnson
National Association for Children?s Behavioral Health
Eileen Meier
National Association of School Nurses ? Washington, DC
Libby Kuffner Nealis
National Association of School Psychologists ? Bethesda, MD
Francesca O?Reilly
National Association of Social Workers ? Washington, DC
Nick Farr
National Center for Healthy Housing? Columbia, MD
Stephen A. Weil
National Coalition for Lead-Safe Kids ? Olney, MD
Andy Igrejas
National Environmental Trust
Gideon Anders and Catherine M. Bishop
National Housing Law Project ? Oakland, CA
Rebecca E. Fox
National Partnership for Women & Families ? Washington, DC
Joel R. Reynolds
Natural Resources Defense Council
Susan Munro
Steans Family Foundation ? Chicago, IL
Richard Rabin
Task Force on Child Lead Poisoning
Zakia Shabazz
United Parents Against Lead ? Richmond, VA
Regional, State, and Local Organizations
Carol Fanconi
Advocates for Children and Youth, Inc. ? Baltimore, MD
Charles Vukotich
Allegheny County Health Department ?Pittsburgh, PA
Fayette Endstrom, MD, FAAP
American Academy of Pediatrics ? Maryland Chapter
Jeff Huebner, MD
American Medical Student Association ? Reston, VA
Mary Goldman
Americans for Democratic Action ? Southern Pennsylvania
Redick C. Loring
The Arc of the Midlands ? Columbia, SC
Peter Beilenson, MD
Baltimore City Health Department ? Baltimore, MD
Arlene Prather-O'Kane, RNC
Black Hawk County Health Dept. ? Waterloo, IA
Thomas Plant
Boston Childhood Lead Poisoning Prevention Program ? Boston, MA
Jean Zotter, Esq.
Boston Urban Asthma Coalition ? Dorchester, MA
Meera Dep
California Women?s Law Center
Terri L. Stangl
Center for Civil Justice ? Saginaw, MI
Ronald R. Jones
Center for Community Action for Primary Prevention ? Columbia, MD
Abigail English, JD
Center for Adolescent Health & the Law ? Chapel Hill, NC
Marcel J. Casavant, MD, FACEP, FACMT
Central Ohio Lead Clinic ? Columbus, OH
Edward H. Hancock, MD
Central Va. Lead Poisoning Prevention Program ? Lynchburg, VA
Roberta Hazen Aaronson
Childhood Lead Action Project ? Providence, RI
Ellen J. Shemitz
Children?s Alliance of New Hampshire ? Concord, NH
Judith Solomon
Children?s Health Council ? Hartford, CT
Teresa Holtrop, MD
Children?s Hospital of Michigan
Morri Markowitz, MD
Children's Hospital at Montefiore ? Bronx, NY
Mae Le
Chinese Progressive Association ? New York, NY
Joe Squillance
Citizens for Missouri?s Children ? St. Louis, MO
Whitlynn Battle
Citizens Lead Education and Poison Prevention Organization ? Birmingham
Mothers? Environmental Coalition of Alabama
Pri de Silva, MSW
Coalition for Community Health ? Los Angeles, CA
Larry Gross
Coalition for Economic Survival (CES) ? Los Angeles, CA
Kären Ahern
Coalition for Environmental Safe Schools ? Bainbridge Island, WA
Ruth Ann Norton
Coalition to End Childhood Lead Poisoning ? Baltimore, MD
Mishelle Macias
Colorado Lead Poisoning Prevention Program
Jonathan M. Stein, General Counsel
Community Legal Services, Inc. ? Philadelphia, PA
Dennis Livingston
Community Resources ? Baltimore, MD
Amy McLean Salls
Connecticut Citizen Research Group ? Hartford, CT
Shirley Berget
Connecticut Legal Services, Inc ? Willimantic, CT
Stephanie Pollack
Conservation Law Foundation
Luz Gomez Pardini, MPH, RD
Contra Costa County Health Services ? Martinez, CA
Chris Kippes, MS
Cuyahoga County Board of Health
Angela Smith
Department of Building and Housing Development ? Harrisburg, PA
Lynette Stokes, Ph.D., MPH, Chief
DC Department of Health Environmental Health Administration ? Washington, DC
Reid Steinkraus
Douglas County Health Department CLPPP ? Omaha, NE
Hazel Brown
Duval County Health Department CLPPP ? Jacksonville, FL
Chris Hoebelheinrich, RN, BSN
Early Head Start ? Omaha, NE
Betty Richter-Reba
East Brunswick Community Housing Corporation
Beverly Baldinger
Edgecombe-Nash Preventive Maintenance Program ? Rocky Mount, NC
John Roberts
Engineering Plus ? Sammamish, PA
Stuart Greenberg
Environmental Health Watch ? Cleveland, OH
Sue Bull
The Family Tree Baltimore, MD
Janvier Gasana
Florida Alliance to Eradicate CLP ? North Miami, FL
Paul Haan
Get the Lead Out ? Grand Rapids, MI
Vicki Veltri
Greater Hartford Legal Assistance, Inc ? Hartford, CT
Ed Petsche
Greater Minneapolis Day Care Association ? Minneapolis, MN
Ellen Yacknin, Esq.
Greater Upstate Law Project, Inc ? Rochester, NY
Clare McGorrian
Health Law Advocates, Inc. ? Boston, MA
Neil Gendel
Healthy Children Organizing Project ? San Francisco, CA
Sue Charette
Healthy Homes = Healthy Kids, Detroit Project
Linda Kite
Healthy Homes Project (SAJE) ? Los Angeles, CA
Jeremy M. Giller
HELP Lead Safe Center ? Providence, RI
Emily Bormann, RN.C BSN
Home Care Connection ? N. Humboldt, IA
Rene Iannarelli
Home Caring Services, Inc. ? Burlington, IA
Arnold Cohen
Housing & Community Development Network of New Jersey
Marlene Garza
Housing Rights Center ? Los Angeles, CA
Tom Neltner
Improving Kids' Environment ? Indianapolis, IN
Elyse Pivnick, MCP
Isles, Inc. ? Trenton, NJ
Erin Farley
Jose Luiz Gonzalez ? Chico, CA
Riyaz Kanji
Kanji and Katzen ? Ann Arbor, MI
Gary Goldstein, MD
Kennedy Krieger Institute ? Baltimore, MD
Jane Zehnder-Merrel
Kids Count in Michigan ? Lansing, MI
Diane E. Thompson
Land of Lincoln Legal Assistance Foundation, Inc. ? East St. Louis, IL
Justine Maloney
Skye Schulte

Related Content