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California Moving to Boost Lead Poisoning Prevention Programs for At-Risk Kids

Policy Analysis
Tuesday, June 19, 2018

An estimated half to three-fourths of lower-income young children in California don’t get the lead poisoning tests required by state and federal law. In response, state lawmakers are taking steps to strengthen the state’s childhood lead poisoning prevention efforts.

While all children can be exposed to lead in drinking water and old paint, and through other sources, kids from lower-income families are considered most at risk. This summer, legislators are considering bills to ensure that all 1- and 2-year olds on Medi-Cal, the state-run low-income health insurance program, are tested for lead levels in their blood. The bills would increase the accountability and transparency of lead poisoning prevention programs and make sure that useful information on lead exposure and sources of lead contamination is readily available to the public and decision-makers.

In January, an EWG analysis of state data found that between 2012 and 2016, almost three-fourths of California toddlers enrolled in Medi-Cal were not tested for lead in their blood. Our estimate was later reinforced by the state Department of Health Care Services, or DHCS, which reported that on average, each year 28 percent of the state’s toddlers are tested.

Now, DHCS and the California Department of Public Health, or DPH, have released an analysis combining and matching the two agencies’ test data. The combined analysis found that in 2015, about 49 percent of 1- to 2-year-olds on Medi-Cal were tested, and about 41 percent of 2- to 3-year-olds were tested.  

The discrepancy in the two agencies’ data is because DHCS and DPH collect blood testing data from different sources and in different ways. DHCS’ numbers come from Medi-Cal records of blood tests that are actually billed to the insurance program. DPH’s numbers come from the labs and doctor’s offices that conducted the tests, and that data may not even say if the child tested is on Medi-Cal.

But that’s just one of the serious shortcomings in California’s state and local lead prevention programs that EWG’s investigation uncovered. The state does not compile data on the causes of childhood lead poisoning cases, interventions provided to lead-poisoned children, and efforts to abate sources of lead exposure. County lead poisoning prevention programs submit extensive information on local cases of lead-exposed children to the Department of Public Health, but the department does not use or aggregate this local data and does not make it available to the public.

These are not merely bureaucratic details. There is no safe level of exposure to lead. To truly prevent childhood lead exposure, state and local health officials must work together in coordinated fashion to identify all children at risk and all sources of potential exposure, and determine what intervention strategies are most effective. Only then can they act to protect kids from lifetime harm to the brain and nervous system.

EWG-sponsored childhood lead bills include:

  • AB 2122, by Assembly Member Eloise Reyes. The bill requires DHCS, Medi-Cal managed health care contracts, and the contracts’ providers, to ensure that children enrolled in the insurance program receive required blood lead tests. It also requires the department to notify a child’s parent or guardian, as well as the child’s health care provider, if a child misses a required blood lead test. Finally, the bill requires the department to ensure that providers are educated about lead-testing requirements and the risks of childhood lead exposure.
  • SB 1041, by Sen. Connie Leyva. This bill sets a state childhood blood lead testing goal and directs the Department of Public Health to achieve the goal and report on its progress meeting it. The bill also requires the department to notify health care providers about state and federal child lead-testing requirements, and for the providers to notify parents.  
  • SB 1097, by Sen. Ben Hueso. This bill requires the Department of Public Health to provide the public with more information about county-level childhood lead testing, exposure rates, the sources of lead directly related to particular childhood lead poisoning cases, and if those sources have been removed or abated.  
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