The New York Times Magazine, Sunday, August 22 - Unauthorized ...

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States Criticized on Lax Lead Tests for Poor Youths auditors found that fewer than 1 percent of the children on Medicaid had been tested for lead poisoning. Elsewhere, they said, rates range from 3 percent in Montana to 10 percent in Colorado, 40 percent in New Jersey and 46 percent in Alabama. Many states, including Connecticut, said they did not have statewide data on testing rates or the prevalence of lead poisoning. New York has a state law that requires day-care centers and nursery schools to ask parents for evidence of screening. The New York City Health Department reported that more than 40 percent of children ages 1 to 5 had been tested. Statewide data for New York were not immediately available. Despite the Federal requirements, Thomas W. Bedell, the Medicaid director in Washington state, said: "We don't believe we have much of a problem with lead exposure here. So we don't think it's cost-effective to impose 100 percent screening. There are better ways to spend our money." Dr. Maxine D. Hayes, the acting health officer for Washington state, added, "We don't think it's right for the Federal Government to dictate what states should do" in testing children. Under Federal rules, Medicaid will pay for testing and treating a child, but will not pay for testing of substances like water and paint that are sent to a laboratory for analysis. "Medicaid reimbursement is available only for the provision of medical services," said Sally K. Richardson, director of the Federal Medicaid program. "Water and paint are environmental elements. If a child has already been diagnosed as lead-poisoned, the testing of these elements serves no direct medical purpose." But public health experts say this policy often cripples efforts to identify the cause of a child's lead poisoning. The advisory panel that voiced concern about the low rates of screening also said this week that Medicaid should pay for laboratory tests of dust, water and other substances in the homes of children poisoned by lead. "Such testing is good public health policy, and it's definitely the standard of care for treating lead-poisoned kids," said Dr. Cummins, the chairwoman of the panel, the Advisory Committee on Childhood Lead Poisoning Prevention. Heather M. Mauro, a resident of Atco, N.J., said she felt fortunate that her children had been tested for lead because the tests detected high levels of lead in all four youngsters. Their home, a large Victorian, was built in the late 1800's or early 1900's. http://www.nytimes.com/library/national/082299lead-poison.html (3 of 4) [8/22/1999 10:22:43 PM]
States Criticized on Lax Lead Tests for Poor Youths Lead poisoning can cause learning disabilities, behavior problems and neurological damage in children, and Mrs. Mauro said she believed that her children had suffered such problems because of exposure to lead. State officials across the country are encouraging families on Medicaid to join health maintenance organizations. But Sara Rosenbaum, a professor of health law and policy at George Washington University, said that in their contracts with H.M.O.'s, states rarely specified the full range of services that should be provided to children with lead poisoning. In New Jersey, Edward J. Rogan, a spokesman for the Department of Human Services, said "we are not happy" with the fact that only 40 percent of children on Medicaid have been tested for lead poisoning. "We want to strengthen our contracts with H.M.O.'s to make sure they achieve a greater level of screening," he said. Connecticut officials said they did not have statewide data on lead testing of Medicaid recipients. In Hartford, where doctors and hospitals have made special efforts to eliminate lead poisoning, a recent study of 877 preschoolers found that 93 percent had been tested. But Judith Solomon, executive director of the Children's Health Council, a child advocacy group, said, "We don't assume the results would be the same in other parts of the state." Home | Site Index | Site Search | Forums | Archives | Marketplace Quick News | Page One Plus | International | National/N.Y. | Business | Technology | Science | Sports | Weather | Editorial | Op-Ed | Arts | Automobiles | Books | Diversions | Job Market | Real Estate | Travel Help/Feedback | Classifieds | Services | New York Today Copyright 1999 The New York Times Company http://www.nytimes.com/library/national/082299lead-poison.html (4 of 4) [8/22/1999 10:22:43 PM]
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