On March 14, Gov. Tom Wolf announced the Department of Human Services (DHS) is exploring the possibility of using Medicaid funds to pay for primary prevention measures that focus on identifying and reducing the sources of environmental childhood lead exposure.

“It’s wise for Pennsylvania to consider opportunities to leverage Medicaid funds to combat the detrimental impacts of lead,” Gov. Wolf said. “If it’s approved by the federal government, this proposal could benefit thousands of Pennsylvania’s children who have been exposed to lead or are suffering from lead poisoning, as well as potentially lower health care spending for treating lead-related health problems.”

Pennsylvania submitted a concept paper to the Centers of Medicaid & Medicaid Services (CMS), asking them to consider a demonstration to test the effectiveness of using Medicaid funds for primary prevention measures on lead sources such as lead-based paint, dust, and water sources and increase remediation efforts in lead-contaminated housing and child-care facilities across Pennsylvania.

According to the California Environmental Health Tracking Program, Pennsylvania is sixth in the nation in the percent of children with lead poisoning. The dangers of lead are widely known. Lead poisoning in childhood is a cause of learning and behavior problems that persist for a lifetime.

“Not all communities have the resources to help all children with elevated blood lead levels address the source of exposure or prevent continued exposure,” DHS Sec. Teresa Miller said. “This project could help prevent lead exposure and alleviate the cost of remediation in lead-contaminated housing and child-care facilities across the Commonwealth.”

Lead exposure often does not manifest in physical symptoms, but may result in long-term neurological damage, especially if the exposure occurs during the critical stages of brain development in early childhood.

Lead in a child’s body can slow growth and development, damage the brain and nervous system, cause hearing, speech, learning and behavior problems.

Pennsylvania’s Medical Assistance or Medicaid program has long had a central role in helping tackle lead poisoning.

Medicaid sets the standard for frequency of lead screening for program beneficiaries, incentivizes screening in its managed care system through provider pay for performance incentives, and pays for environmental lead investigations to identify the sources of the lead exposure in children with elevated blood lead levels.

The program also bears the financial consequences of lead exposure, paying for the comprehensive physical and behavioral health services that are available to children who have been exposed.

The proposal requests that CMS consider the possibility of a specialized benefit package under Section 1115 of the Social Security Act, which gives the Secretary of Health and Human Services authority to approve experimental, pilot, or demonstration projects that promote the objectives of Medicaid and the Children’s Health Insurance Program (CHIP).

Acceptance of the proposal would indicate that CMS is willing consider an 1115 waiver application for this type of benefit package.

Upon approval of an 1115 waiver, this demonstration would allow Pennsylvania to test the effectiveness of preventive environmental lead inspection and increased remediation efforts in lowering lead poisoning rates and related spending for services to Medicaid recipients.

The demonstration would be available statewide but targeted at children with a high risk of having elevated blood lead levels across the Commonwealth.

This proposal is one of several initiatives the Wolf Administration has in place or is exploring to combat the pervasive effects of lead exposure among children in Pennsylvania.

The Department of Health’s Bureau of Family Health offers a toll-free Lead Information Line (1-800-440-LEAD) to respond to caller questions and provide electronic materials about lead poisoning and other environmental hazards.

Also, the Health Department oversees the Lead Surveillance Program, which tracks and monitors childhood lead activity through the Pennsylvania National Electronic Disease Surveillance System (PA-NEDSS). 

PA-NEDSS is a web-based application system that receives all lead reports on Pennsylvania's children.  Through PA-NEDSS, the Division of Child and Adult Health Services can identify possible high-risk areas, locate areas of under-testing and identify other potential service need.

For information on health threats from lead from other sources, visit the Department of Health’s Lead Poisoning webpage.

Senate Lead Task Force

The Joint State Government Commission and a special Senate Lead Exposure Task Force will be making recommendations on reducing exposure to lead as early as April as a result of Senate Resolution 33, sponsored by Sen. John Yudichak (D-Luzerne), Minority Chair of the Senate Environmental Resources and Energy Committee.

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[Posted: March 14, 2019]

3/18/2019