Cleveland.com - Sherrod Brown Urges Medicaid to Fix System That Leaves Millions of Kids Untested for Lead Poisoning

News Article

By Rachel Dissell, Brie Zeltner

Sen. Sherrod Brown is calling for new measures to bolster chronically low lead poisoning testing rates in Ohio and nationwide.

In a letter to the head of the federal agency that provides health insurance to the needy, Brown and Democratic senators from two other states today asked to increase screening levels and improve the response when tests show a child has been poisoned.

Hundreds of thousands of children under the age of six are poisoned by lead each year in the United States, according to the Centers for Disease Control and Prevention.

In Cleveland, more than 13,700 children had positive blood lead tests in 2014.

That number, though, is based only on children who are screened. Most who should be are not.

Children, particularly the poor, who live in older, badly-maintained housing are at the highest risk of poisoning from contact with deteriorating lead-based paint, lead dust, and soil contamination. Exposure to lead can lead to irreversible brain damage, behavioral issues, and educational delays.

"Children in Cleveland are being poisoned by their own homes -- and those are only the children we know about," Brown told The Plain Dealer. "Too many are never tested for elevated blood levels, which means we can't identify opportunities to clean up these hazards or treat them."

The three-page letter sent to the acting director for the Centers for Medicare & Medicaid Services (CMS) by Brown and fellow Democratic senators Debbie Stabenow, of Michigan and Ron Wyden, of Oregon, calls for an overhaul of the current CMS testing system.

Read the full letter here or in the document viewer below.

Medicaid, the federal program that provides health insurance to low-income children and families, has required some level screening for Medicaid-covered children since 1989, though standards have changed.

Most states, including Ohio, are supposed to test all Medicaid-covered children twice before the age of two. The CDC in recent years has allowed for more targeted testing for children known to be at higher risk of poisoning due to the quality and age of their housing, among other factors.

Despite the standards, studies have shown that many children who receive Medicaid are not tested.

As far back as 1999, a Government Accountability Office (GAO) report found only 20 percent of Medicaid-eligible children were screened for lead.

Last year, The Plain Dealer's Toxic Neglect series reported that 70 to 80 percent of children under 6 in Cuyahoga County should be tested but aren't.

Ohio State's Kirwan Institute calculated that figure based on state department of health data and predicted that as many as 40 percent of children under 6 in certain Cleveland neighborhoods were poisoned.

Ohio law also requires that children served by Medicaid be screened twice before the age of 2.

In the past seven years, only 21 percent of those children were screened through Medicaid providers, according to data reported by the state to the federal government.

Ohio Medicaid spokesman Sam Rossi told The Plain Dealer last year thaSen. Sherrod Brown is calling for new measures to bolster chronically low lead poisoning testing rates in Ohio and nationwide.

In a letter to the head of the federal agency that provides health insurance to the needy, Brown and Democratic senators from two other states today asked to increase screening levels and improve the response when tests show a child has been poisoned.

Hundreds of thousands of children under the age of six are poisoned by lead each year in the United States, according to the Centers for Disease Control and Prevention.

In Cleveland, more than 13,700 children had positive blood lead tests in 2014.

That number, though, is based only on children who are screened. Most who should be are not.

Children, particularly the poor, who live in older, badly-maintained housing are at the highest risk of poisoning from contact with deteriorating lead-based paint, lead dust, and soil contamination. Exposure to lead can lead to irreversible brain damage, behavioral issues, and educational delays.

"Children in Cleveland are being poisoned by their own homes -- and those are only the children we know about," Brown told The Plain Dealer. "Too many are never tested for elevated blood levels, which means we can't identify opportunities to clean up these hazards or treat them."

The three-page letter sent to the acting director for the Centers for Medicare & Medicaid Services (CMS) by Brown and fellow Democratic senators Debbie Stabenow, of Michigan and Ron Wyden, of Oregon, calls for an overhaul of the current CMS testing system.

Read the full letter here or in the document viewer below.

Medicaid, the federal program that provides health insurance to low-income children and families, has required some level screening for Medicaid-covered children since 1989, though standards have changed.

Most states, including Ohio, are supposed to test all Medicaid-covered children twice before the age of two. The CDC in recent years has allowed for more targeted testing for children known to be at higher risk of poisoning due to the quality and age of their housing, among other factors.

Despite the standards, studies have shown that many children who receive Medicaid are not tested.

As far back as 1999, a Government Accountability Office (GAO) report found only 20 percent of Medicaid-eligible children were screened for lead.

Last year, The Plain Dealer's Toxic Neglect series reported that 70 to 80 percent of children under 6 in Cuyahoga County should be tested but aren't.

Ohio State's Kirwan Institute calculated that figure based on state department of health data and predicted that as many as 40 percent of children under 6 in certain Cleveland neighborhoods were poisoned.

Ohio law also requires that children served by Medicaid be screened twice before the age of 2.

In the past seven years, only 21 percent of those children were screened through Medicaid providers, according to data reported by the state to the federal government.

Ohio Medicaid spokesman Sam Rossi told The Plain Dealer last year that Medicaid is required to pay for the screenings but isn't responsible for ensuring providers follow screening law.

In June, a Reuters investigation called "Unsafe at any level" examined testing in a dozen states, including Ohio. The news service found that fewer than half -- only 41 percent of one- and two- year-olds-- got the mandated screening.

Cleveland has one of the highest lead poisoning case loads in the state. The city has struggled to keep up with investigating the roughly 400 or so cases a year considered severe enough to require an investigation of a child's surrounding to find the source of the toxin.

In a recent interview, Mayor Frank Jackson said more screening will help clarify the scope of the problem.

"Every child should be tested before they go to school," Jackson said.

The senators' letter asks Medicaid officials to:

Review and update lead screening protocols for low-income children covered by Medicaid and the Children's Health Insurance Program.
Reduce barriers to screening, including better educating doctors and parents on which children should be screened.
Ensure physicians follow testing protocols and make it easier for children get tests and results in doctor's offices or clinics, instead of blood being drawn and tested at separate laboratories.
Work with states and cities to make sure that Medicaid-covered children who need it get the case management and environmental investigations required identify and remediate lead hazards.
t Medicaid is required to pay for the screenings but isn't responsible for ensuring providers follow screening law.

In June, a Reuters investigation called "Unsafe at any level" examined testing in a dozen states, including Ohio. The news service found that fewer than half -- only 41 percent of one- and two- year-olds-- got the mandated screening.

Cleveland has one of the highest lead poisoning case loads in the state. The city has struggled to keep up with investigating the roughly 400 or so cases a year considered severe enough to require an investigation of a child's surrounding to find the source of the toxin.

In a recent interview, Mayor Frank Jackson said more screening will help clarify the scope of the problem.

"Every child should be tested before they go to school," Jackson said.

The senators' letter asks Medicaid officials to:

Review and update lead screening protocols for low-income children covered by Medicaid and the Children's Health Insurance Program.
Reduce barriers to screening, including better educating doctors and parents on which children should be screened.
Ensure physicians follow testing protocols and make it easier for children get tests and results in doctor's offices or clinics, instead of blood being drawn and tested at separate laboratories.
Work with states and cities to make sure that Medicaid-covered children who need it get the case management and environmental investigations required identify and remediate lead hazards.

Source