EPSDT Care for Kids Newsletter

EPSDT Care for Kids Newsletter

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Results of Lead Testing for Iowa Children

Brian McPartland and Rita Gergely
Bureau of Lead Poisoning Prevention, Iowa Department of Public Health

Fall 2001

The Iowa Department of Public Health (IDPH) recommends that all children be tested for lead poisoning using a blood lead test, and state and federal law require this for children covered by Medicaid. The results of recent data analyses make clear the need for such testing.

In September 1999, IDPH developed a procedure to match Medicaid data with blood lead data from the STELLAR (Strategic Tracking of Elevated Lead Levels and Remediation) database.

ALL Iowa children should be routinely tested for lead poisoning using a blood lead test.

This test is required by state and federal law for children covered by Medicaid.

This child-specific database holds all blood lead test results reported to the Iowa Department of Public Health. IDPH can use STELLAR to identify multiple blood lead tests on an individual child; store address information for each child; and record all case management actions, such as home nursing visits, chelation, and environmental investigations.

Data matches target key concerns

The IDPH lead program carries out two types of matching of STELLAR data with Medicaid data. In the first match, it uses the results to determine the percentage of Medicaid vs. non-Medicaid children who are being tested and the prevalence of lead poisoning among the Medicaid and non-Medicaid populations.

In January 2000, IDPH used the first type of match to analyze, by birth cohort, data on blood lead levels in Iowa children. Using the STELLAR database, IDPH estimated the percentage of children younger than 6 years old who had received at least one blood lead test l, and to evaluate trends in blood lead testing. IDPH now has complete data on children born in 1992, in 1993, and in 1994.

Of children born in Iowa in 1994:

42.0% of all children enrolled in Medicaid were tested; 17.7% were found to be lead-poisoned
39.0% of all children not enrolled in Medicaid were tested; 7.3 percent were found to be lead-poisoned.

In the second type of match, IDPH reviews claims data to identify claims for EPSDT Care for Kids screens that were done at an appropriate age for blood lead testing. These claims are matched to the STELLAR database to determine if a blood lead test was done. The names of children who received a screen, but did not receive a blood lead test, are being referred back to the local childhood lead poisoning prevention programs so that they can contact the provider to discuss the need for a blood lead test. For example, Mother and Child Health Services in Marshalltown is piloting a project to contact the providers of these screens. They will review the requirement to do a blood lead test in conjunction with an EPSDT Care for Kids screen. The agency will also track the number of children who receive a blood lead test as a result of the provider having been contacted.

For more information about lead poisoning in Iowa, please contact the IDPH Bureau of Lead Poisoning Prevention at 1-800-972-2026.

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