As a result of revised childhood lead screening guidelines from the CDC and more aggressive screening requirements for Medicaid recipients, the North Carolina Childhood Lead Poisoning Prevention Program (CLPPP) has prioritized testing for high risk children. In October 1998, the state health director issued guidelines that included mandatory screening of Medicaid children at both 12 and 24 months of age and lowered the blood lead action level for environmental investigation from 20 to 10 micrograms per deciliter (ug/dL). In addition, the WIC Program initiated statewide lead screening services for children not tested by their regular doctor. In order to evaluate the impact of these policy initiatives, a data matching project was undertaken by the State Center for Health Statistics and the Divisions of Environmental Health (CLPPP), Public Health (WIC), and Medical Assistance (Medicaid). Comparison of the lead screening registry and Medicaid billing data indicate that the screening rate among Medicaid 1- and 2-year-olds increased by nearly 50% from 1998 to 2000. Overall, the number of children identified with elevated exposure also increased sharply by 25% (10-19 ug/dL) and 53% (>20 ug/dL). The percentage of children with low level elevations (10-14 ug/dL) who received appropriate follow-up testing increased from 24% to 62% over this same time period. Although these gains are impressive, the overall screening rate remains low for this high risk population (<60%) and individual county rates varied tremendously with higher screening rates observed in rural and eastern counties where the percent of low income and minority residents is greatest.
Learning Objectives: At the conclusion of the session, participants should be able to: 1) identify two successful strategies to increase lead screening among high risk children; and 2) describe three outcome measures used to quantify the success of program efforts.
Keywords: Lead, Medicaid
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.