Childhood lead poisoning: screening and prevention.

Existing law establishes the Childhood Lead Poisoning Prevention Program, which is administered by the State Department of Public Health. Existing law requires the department to adopt regulations establishing a standard of care that include the determination of specified risk factors for lead exposure, including a child's time spent in a home, school, or building built before 1978. Existing law requires the department to ensure appropriate case management for children who have been identified with lead poisoning, and authorizes the department to contract with any public or private entity, including any local agency, to perform that duty. This bill would add several risk factors to be considered as part of the standard of care specified in regulations, including a child's residency in or visit to a foreign country. The bill would require the department to update its formula for allocating funds to a local agency that contracts with the department to administer the Childhood Lead Poisoning Prevention Program, and to revise funding allocations before each contract cycle. Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law authorizes the department to enter contracts with managed care plans to provide Medi-Cal services, and imposes requirements on the Medi-Cal managed care plans, including network adequacy standards. Under existing law, Medi-Cal covers early and periodic screening, diagnostic, and treatment services for individuals under 21 years of age, consistent with federal law. Existing regulations of the department require a health care provider who performs a periodic health assessment of a child who receives services from a publicly funded program for low-income children, to order the child screened for lead poisoning, as specified, unless a parent or guardian of the child, or other person with legal authority to withhold consent, refuses to consent to the screening or if the risk of screening is a greater risk to the child's health than the risk of lead poisoning. Existing regulations also require the health care provider to provide oral or written guidance to a parent or guardian that includes information relating to the risk of childhood lead poisoning. This bill would require a contract between the department and a Medi-Cal managed care plan to require the Medi-Cal managed care plan, on a quarterly basis, to identify every enrollee who is a child without a record of completing the blood lead screening tests, and to remind the contracting network provider of the requirement to perform the required blood lead screening tests and the requirement to provide the oral or written guidance to a parent or guardian relating to risk of childhood lead poisoning. The bill would require the department to develop and implement procedures to ensure compliance with those requirements would authorize the department to impose sanctions for a violation of those requirements. The bill would authorize the department to implement these provisions by means of plan or county letters, or other similar instructions.