County officials are taking steps to have more Bartholomew County children tested for lead toxicity.
In July, Indiana State Health commissioner Dr. Kristina Box sent out a letter to all 92 county health departments that announced Medicaid is now paying for case management for lead testing and screening, said Bartholomew County Health nursing division director Amanda Organist.
And the local health department wants more kids tested.
That’s why Organist is asking the Bartholomew County commissioners to amend an ordinance that allows her department to seek co-payments from private insurers for lead testing, screening, case management, risk assessment and follow up visits.
The amendment seeks the private insurer’s pay rate, which Organist says differs for each insurance company. Currently, only Medicaid — which is intended for low-income individuals — pays for all of the services, she said.
The commissioners gave the amended ordinance their initial approval, and a final vote could be taken on Monday.
Lead exposure can affect many organs and systems in the body and has been linked to anemia, nervous system damage, kidney and brain damage and several other medical conditions. In some cases, very high lead exposure can be fatal.
Even though federal law requires all children eligible for Medicaid to be screened for lead poisoning at 12 and 24 months, Indiana health officials say that is not happening.
According to the state’s 2017 Childhood Lead Surveillance Report, while 94% of all Medicaid-eligible children received the measles-mumps-rubella vaccine, only 11% were given the required blood test to detect lead.
If a lead toxicity screening shows five micrograms per deciliter or greater of lead, the Bartholomew County Health department will get involved with home visits and education, Organist said. If the test show 10 micrograms or more, home visits are made and case management is instituted, she said.
But that’s not the policy for all Hoosier counties. Indiana’s current threshold for a child to receive many of these services through Medicaid is 10 micrograms per deciliter — twice as high as what the Centers for Disease Control and Prevention recommends.
A large coalition made up of doctors, legal experts, advocacy groups, and others is petitioning the state to lower its threshold for when all public health agencies should address elevated blood lead levels in children. The issue is expected to be brought up when the Indiana General Assembly convenes next month.
Federal efforts to reduce lead exposure in recent decades has reduced the number of American children with elevated blood lead levels from 14.8 million in 1978 to around 500,000 today.
Of the 564 Bartholomew County children tested in 2018, only four had confirmed elevated blood lead levels, according to online statistics posted by the Indiana State Dept. of Health.
In 2017, there were 813 local children tested, with 10 results indicating the possibility of elevated blood lead levels. However, none of the 10 cases were confirmed as lead toxicity, the website stated.
In 2016, there were 618 children tested, with 18 confirmed elevated blood lead levels, according to the website.
Health experts urge communities to be cautious because there is no known safe level of lead for young children, according to the Centers for Disease Control and Prevention.
This year, Bartholomew County health officials has been trying to remind the public that the potential for lead poisoning remains in our area. Earlier this year, the county secured a $10,000 state grant to increase the number of children screened for lead, as well as provide ongoing technical education to local healthcare providers and to the public.
Lead exposure can come from a variety of sources. For examples, homes built before 1960 in historic sections of Columbus, including the downtown area, may present a higher-than-normal risk of lead poisoning if plumbing and decor have not been upgraded, local health officials said.
The most common cause of toxicity is deteriorating, chipped lead-based paint in homes built before 1978. Federal authorities estimate that approximately 24 million housing units in the United States have deteriorated leaded paint, as well as elevated levels of lead-contaminated house dust.
Another source is lead pipes, as well as brass plumbing components and copper pipes soldered with lead, that can release the toxic metal into tap water. Household dust can also be contaminated with lead from paint chips. It can also be brought into the house on shoes or boots after engaging in activities such as sanding old paint off older exterior buildings, Organist said.
Additionally, bullets, stained glass and certain types of pottery, toys, food and candy produced in countries with lax lead regulations are potential sources of lead exposure.
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The Bartholomew County Health Department will provide testing for blood lead levels in children age 6 or younger at no cost.
However, parents need to make an appointment by calling 812-379-1555, followed by Option 1.
The testing is administered at the nursing division of the Bartholomew County Health Dept., 2675 Foxpointe Drive, Suite B.
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