1. Texas Childhood Lead Poisoning Prevention Program Diana L. Salzman, MPH Adult Lead Surveillance Coordinator

2. Reporting Authority Texas Health and Safety Code, Ch. 88 (June 2003) All blood lead levels (BLL) are reportable to the Texas Department of State Health Services (DSHS) - Children Texas Health and Safety Code, Ch. 84 (April 2003) – Adults All BLLs are reportable to DSHS

3. Reporting Authority TX Administrative Code Title 25 Part 1 Allows for case management of children with elevated blood lead levels (EBLLs)

4. Texas Childhood Lead Poisoning Prevention Program Department of State Health Services – Austin, Texas Data surveillance component Medical and environmental follow up component

5. Texas Childhood Lead Poisoning Prevention Program Department of State Health Services – Austin, Texas Process over 450,000 blood lead reports per year Receive blood lead reports from over 17,000 healthcare providers and 70 laboratories per year

6. Texas Childhood Lead Poisoning Prevention Program Department of State Health Services – Austin, Texas From 1996-2004 received 117,453 blood lead reports with results ≥ 10 mcg/dL Receive ~ 1400 cases per year ≥ 15 mcg/dL

7. Texas Childhood Lead Poisoning Prevention Program Department of State Health Services – Austin, Texas Refer EBLLs to local health departments (LHD) or public health regions (PHR) for follow up Develop educational materials for public and health care professionals Repository for blood lead reports and related information

8. Texas Childhood Lead Poisoning Prevention Program Regional Health Departments – 11 PHR Regional Lead Contact – Case manager, Texas Health Steps coordinator (Medicaid), environmental inspector Triage children with EBLLS when no LHD exists in child’s jurisdiction Refers to regional nurse, case manager or environmental inspector

9. Texas Childhood Lead Poisoning Prevention Program Local Health Departments Tx CLPPP funds 6 LDHs – Bexar County, Webb County, Travis County, El Paso County, City of Houston, City of Dallas Follow up children with EBLLs in respective jurisdictions Some LHDs have environmental inspectors Conduct environmental investigations for EBLL children (home, school, or daycare)

10. Texas Childhood Lead Poisoning Prevention Program Additional Partners Federal Agencies Federal Drug Administration (FDA) Centers for Disease Control and Prevention (CDC) Housing and Urban Development (HUD) Environmental Protection Agency (EPA)

11. Texas Childhood Lead Poisoning Prevention Program DSHS Food and Drug Safety DSHS Office of Border Health DSHS Medicaid/Texas Health Steps DSHS Laboratories (public and private) DSHS Environmental Lead Program

12. Texas Childhood Lead Poisoning Prevention Program Plans Applying for CDC 5 year grant (FY 2006- 2010) Fund additional local health departments Screening plan being reviewed for possible expansion

13. Texas Childhood Lead Poisoning Prevention Program Data Approaches 97.5% of blood lead reports are received electronically 87% of the blood lead reports received are for Medicaid enrolled children Obtaining environmental inspection data

14. Texas Childhood Lead Poisoning Prevention Program Testing Approaches Medicaid/Texas Health Steps guidelines (12 and 24 months) State plan recommends testing all children at 12 and 24 months

15. Texas Childhood Lead Poisoning Prevention Program Mexico Related Issues Texas CLPPP coordinates directly with the Office of Border Health for all issues related to Mexico. The Office of Border Health works closely with the Texas Secretary of State on health related issues

16. Questions?