10/28/2020 1 2020 MCAH Fall Seminar - CAH Childhood Lead Poisoning Prevention Program (CLPPP) Update October 28, 2020 Presenter: Kevin Officer CLPPP Manager TAKEAWAYS 1. Why childhood lead poisoning is still a concern 2. Status of childhood lead in Iowa 3. CLPPP Program Priorities 4. Title V SPM2 – Blood Lead Testing & Follow Up 2020 Iowa CLPPP Overview October 28, 2020 - MCAH Fall Seminar - CAH
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10/28/2020
1
2020 MCAH Fall Seminar - CAH Childhood Lead Poisoning Prevention Program (CLPPP) Update
October 28, 2020
Presenter: Kevin OfficerCLPPP Manager
TAKEAWAYS
1. Why childhood lead poisoning is still a concern2. Status of childhood lead in Iowa3. CLPPP Program Priorities4. Title V SPM2 – Blood Lead Testing & Follow Up
2020 Iowa CLPPP Overview
October 28, 2020 - MCAH Fall Seminar - CAH
10/28/2020
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Why is lead poisoning still a concern?
Lead exposure to children can result from multiple sources and can cause irreversible and life-long health effects.
- 2018 Federal Action Plan
2020 Iowa CLPPP Overview
Why is lead poisoning still a concern?
No safe blood lead level in children has been identified.– Center for Disease Control & Prevention (CDC)
2020 Iowa CLPPP Overview
10/28/2020
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Why is lead poisoning still a concern?
Even low levels of lead in blood have been shown to affect IQ, ability to pay attention and academic achievement.
2020 Iowa CLPPP Overview
Effects of chronic low-level lead exposure
Childhood lead exposure has been associated with:• higher absenteeism in school • lower class rank• poorer vocabulary and
Childhood Lead Poisoning Prevention Program Priorities
2020 Iowa CLPPP Overview
TITLE V SPM2 –BLOOD LEAD TESTING & FOLLOW UP
2020 Iowa CLPPP Overview
10/28/2020
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MCEH/CLPPP CoIIN – Lead
Exposure Project
Improve Coordinated Care Systems
Decrease lead exposure, Increase
coordinated care Iowa Team –
Studying Care Coordination & BLL testing at County Level
2020 Iowa CLPPP Overview
Title V SPM2 – blood lead testing & follow up
Background – CoIIN Project Participation in 3-Year Maternal & Child Health CoIIN
Project Collaborative Improvement and Innovation Network
Funding: Department of Health & Human Services
To support and improve coordinated systems of care within states to address the needs of maternal, infant, and child populations within those states that are at risk for or experience exposure to lead.
2020 Iowa CLPPP Overview
Title V SPM2 – blood lead testing & follow up
10/28/2020
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Background – CoIIN Project Goals
1. Decrease maternal and child morbidity and mortality associated with exposure to lead.
2. Increase the number of infants and children that have access to a system of coordinated care to address their needs due to lead exposure.
Effect change through: Quality improvement strategies and Collaborative impact
2020 Iowa CLPPP Overview
Title V SPM2 – blood lead testing & follow up
CoIIN Project Activities Clinic Survey of BLL Testing Practices
1. Surveyed: 7 large medical network clinics, 6 small rural clinics
2. Survey results: o No difference in between large network and small rural
clinics.o Within one major network at least three different BLL
testing guidelines were being used.o Majority of respondents had EMR system for follow up
reminders
2020 Iowa CLPPP Overview
Title V SPM2 – blood lead testing & follow up
10/28/2020
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CoIIN Project Activities Clinic Survey of BLL Testing Practices
3. Barriers included:
Parental compliance with follow through of lab orders
No POC system (LeadCare II) on-site for testing
No further testing required if initial BLL low & no change
in environment (providers/parents)
2020 Iowa CLPPP Overview
Title V SPM2 – blood lead testing & follow up
CoIIN Project Activities Clinic Pilot Study
1. 3 Federally Qualified Health Centers: Urban and Rural Practices
2. Pilot Process: o Increase blood lead testing of children 12-35 monthso Every opportunity – well visit, sick visit, medication,
chronic condition, etc.o For each child ages 12-35 months seen, but not
tested, identify the reason they were not tested.o Pay for Performance Incentive
2020 Iowa CLPPP Overview
Title V SPM2 – blood lead testing & follow up
10/28/2020
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CoIIN highlighted the need for increased testing for 1 and 2 year olds – esp. Medicaid eligible children
Adopted State Performance Measure 2: Percent of children ages 1 through 2 years, with a blood lead test in the past year.
Environmental scan to assess provider practices
Require testing of 1 and/or 2 year olds if a low testing county. Goal 75%-1y.o. & 40%-2y.o.