Lead Screening

POLICY:

NOCAC Child Development will assess all Head Start/Early Head Start (HS/EHS) children for lead poisoning within 90 calendar days of enrollment.

REQUIREMENTS:

Early Head Start enrolled participants:

1. EPSDT recommends lead screenings be performed at 12 and 24 months of age.
2. If there is no documentation that a blood lead test was performed at 12 months for a participant enrolled between 12 and 24 months of age, a blood lead test must be performed as soon as possible.  A second blood lead test may be required to be performed for the participant at 24 months of age based on the primary care physicians risk assessments results.

Head Start enrolled participants:

1. Participants between the ages of 3-5 are required to have proof of, at a minimum of one, lead screening at 24 months or older.
2. The program must obtain documentation that a blood lead test was performed at 24 months.  If a blood lead test was not performed at 24 months, the program must obtain documentation that it was performed soon thereafter.

PROCEDURES:

1. At the initial home visit, the teacher or home visitor will inform parents of the program’s health requirements and determine if the participant is up-to-date on the recommended schedule.
2. NOCAC staff will work with local primary care providers and clinics to obtain results of lead blood testing as per the State’s EPSDT.
3. If a parent does not have a copy of the participant’s last well child visit, a Release of Information will be signed to obtain a copy of this record.  Include a request for the results of the participant’s last blood lead test.
   1. If NOCAC has not received a copy of the physical or blood lead testing results within approximately two weeks after sending the Release of Information, a second request will be mailed.
   2. Two weeks after mailing the second request and the program has not received a response, the lead testing will be performed by the health staff with a parent signed permission.
4. When a determination has been made that NOCAC health staff will perform blood lead screening, the following will be adhered to:
   1. Finger stick lead screening will be performed by the Health/Safety Manager.
   2. Parents will be notified when the screening will be performed.
   3. NOCAC Staff will assist parent to complete the following Child Lab paperwork which authorizes a finger stick.
      1. Lead Blood Work Requisition Form 
      2. Lead Blood Work Permission Slip
      3. Blood Levels in participant Child Lab Screening Procedure
   4. Child Lab permission form must be completed prior to the screening being performed
   5. Verification of parent signature on a parent agreement of services with the lead screening marked appropriately will be done.
   6. Notification of test results will be given to the parent as soon as possible after all screenings are completed by providing the parent with a copy of the results.
5. The following guidelines will be utilized to determine a participant’s need for a referral for treatment and followup.
   1. A blood level of 0 to 3.2 will be considered within normal limits and no further testing is required.
   2. A blood level of 3.3 and above will be considered elevated. The parent will be given written handouts on lead and lead prevention and referred to their primary care provider.
6. Followup on participants with elevated blood levels will be done by the primary care physician performing a repeat blood level by venipuncture. The follow-up test cannot be by finger stick.
7. NOCAC Staff will assist the parent in making and keeping appointments or arranging transportation.
8. Lead screening results will be recorded in ChildPlus and a copy sent to PCP by health data specialist if performed by NOCAC.
9. Participants will not be excluded from the program because of incomplete blood lead test results.

Forms and Additional Guidance:

• Release of Information