Lead Screening in Children (LSC)
| Date: | November 6, 2024 |
| From: | Health Plan of San Joaquin/Mountain Valley Health Plan (Health Plan) |
| To: | Health Plan Pediatrics and Primary Care Providers |
| Type: | Educational/Informational |
| Subject: | Lead Screening in Children (LSC) |
| Business: | Medi-Cal Managed Care |
Healthcare Effectiveness Data and Information Set (HEDIS)
Lead Screening in Children (LSC)
The Department of Health Services APL 20-016: Blood Lead Screening requires all providers who perform Periodic Health Assessments (PHA) or Well Care Visits on patients between the ages of six months to six years (72 months) must comply with current federal and state laws and industry guidelines issued by the California Department of Public Health’s Childhood Lead Poisoning Prevention Branch (CLPPB) and Centers for Disease Control (CDC) guidelines.
2 Lead Screenings should be completed BEFORE 24 months of age:
- First Screening between the ages of 6 months – 12 months AND
- Second Screening between the ages of 13 months – 24 months
Lead Screenings should be completed for patients:
- Between 24 and 72 months where the patient has no record of a previous blood lead screening performed OR
- If patient is refugee status, follow the CDC Recommended guidelines for Post-Arrival Lead Screenings of Refugees.
Anticipatory guidance for the dangers of lead poisoning MUST BE documented at every PHA and documentation must include evidence of:
- Oral or written anticipatory guidance/education about the dangers of lead poisoning in children provided AND
- Documentation of lead screening lab orders and results OR
- Documentation of signed refusal from the patient’s caregiver including the reason for refusal
Results Follow-up guidelines:
<3.5 mcg/dL Initial blood lead level (BLL) & routine retest may be capillary (CBLL) or venous (VBLL)
- If screened early (before 12 months), retest in 3-6 months as the lead exposure risk increases with increased infant mobility.
- Follow up with VBLL in 6-12 months if indicated.
- Provide education about common sources of lead exposure and information on how to further prevent exposure and that appropriate milestones are being met.
≥3.5 mcg/dL Initial BLL may be capillary or venous. Every retest must be venous.
- Follow the recommendations for <3.5 mcg.dL results AND
- Report results to your state or local health department:
- San Joaquin County: 209-468-2593
- Stanislaus County: 209-558-8860
- El Dorado County: 530-573-3165
- Alpine County(call the state CLLP): 510-620-5600
- Obtain an environmental exposure history from the caregiver to identify potential sources of lead.
- Follow the CDC guidelines for retesting: https://www.cdc.gov/lead-prevention/hcp/clinical-guidance/?CDC_AAref_Val=https://www.cdc.gov/nceh/lead/advisory/acclpp/actions-blls.htm
For more information and Resources please visit:
- https://www.dhcs.ca.gov/formsandpubs/Documents/MMCDAPLsandPolicyLetters/APL2020/APL-20-016.pdf
- https://www.cdph.ca.gov/Programs/CCDPHP/DEODC/CLPPB/Pages/CLPPBhome.aspx
- https://www.cdc.gov/lead-prevention/php/data/blood-lead-surveillance.html?CDC_AAref_Val=https://www.cdc.gov/nceh/lead/data/blood-lead-reference-value.htm
If you have any further questions, please contact your Provider Services Representative, or call our Customer Service Department at 1-888-936-7526 (PLAN). You may also visit https://www.hpsj.com/alerts/ for online access to the documents shared. The most recent information about Health Plan and our services is always available on our website www.hpsj-mvhp.org
