SJR 380 - Joint Subcommittee Studying Lead Poisoning Prevention
The lead poisoning
prevention study evolved from the 1993 study of lead paint abatement to
its present posture of seeking to prevent lead poisoning. SJR 380, the
2005 enabling resolution, directed the joint subcommittee to: (i) monitor
the evolution of the data-sharing partnership established in the health
and human services data sharing statute, § 32.1-127.1:04; (ii) monitor
the completion of the reference database of statewide health-related data
elements required by SB 565 of 2004; (iii) examine issues relating to
lead poisoning among immigrant and adopted children; and (iv) seek to
assist the Department of Health and the Department of Housing and Community
Development in every appropriate way in maintaining federal funding.
Poisoning in Virginia: Elimination Plan
Nancy K. Van Voorhis, the director of the Lead-Safe Virginia Program discussed
efforts to detect instances of childhood lead poisoning in Virginia. The
Program targets resources to increase testing of high-risk and Medicaid
enrolled children ages 12-36 months.
Ms. Van Voorhis reported
that the federal Centers for Disease Control Meeting announced 10 essential
lead program elements in October. Virginia, she noted, does not currently
have two of elements, i.e., (i) regulatory authority to require abatement
of lead hazards in housing units containing children with elevated blood
lead levels; and (ii) statutory protection for clients from retaliatory
eviction or discrimination related to disclosure of lead hazards.
Ms. Van Voorhis identified
the key issues for Lead-Safe Virginia as the potential for elimination
of federal funding after 2010 and the "lack of a standard Virginia
process to assure that hazards are removed to prevent future lead exposures.
Data Sharing Partnership
Kim S. Barnes, a policy analyst from the Department of Health's Office
of Family Health Services, discussed interagency collaborations in general
during 2005. She acknowledged the cost savings to the Commonwealth as
a result of the data sharing initiative that was established as a 2002
initiative of the joint subcommittee.
Ms. Barnes stated
that the Governor's Task Force on Information Technology in Healthcare,
a uniform foster child personal health record and a VDH/Carilion electronic
health record pilot, is under construction. This effort will provide a
mechanism for sharing medical information about foster children, including
any elevated blood lead levels that will provide a valuable and effective
means of tracking foster children's health.
Nikki Nicholau, the Deputy Director of the Virginia Department of Housing
and Community Development, addressed the accomplishments of the 2002 federal
grant for lead abatement in homes. The grant was used to abate a total
of 103 units located on the Eastern Shore, Danville, Petersburg, and Richmond
at a cost of $1.9 million.
Ms. Nicholau stated
that the Department had been awarded a new grant of $3 million for a project
beginning in 2005. The new grant will be used primarily for units that
have been cited for multiple incidents of lead.
Ms. Nicholau gave
the committee an overview of their partnership efforts with the Health
Department, the VCU Center for Environmental Studies, housing development
organizations and within the Department of Housing and Community Development.
Their partnership with the Health Department lead to a "LeadTrax"
System which pinpoints addresses with multiple addresses and to collaborative
training in communities.
Screening Diagnosis and Treatment Outreach
Tammy Whitlock, the Manager of the Maternal and Child Health Division
of the Department of Medical Assistance Services, addressed the joint
subcommittee on outreach activities relating to screening for lead poisoning.
Ms. Whitlock clarified
the federal requirements that mandate lead testing for all Medicaid enrolled
children at ages one and two, and children without a medical history up
to age six. Ms. Whitlock noted that a memo is currently in development
to define the lead testing strategies and mandates for EPSDT screeners.
With the use of Labcorp or other contracted entities being mandated, VDH
sent out letters to the health departments informing them of proper billing
procedures. In the future, DMAS will send the parents of children in Medicaid
and Medicaid MCOs a postcard reminding them of the need for testing at
9 months and 21 months.
Report on SB 565:
Reference Database of Statewide Health-Related Data
Charles W. Lawver, the Director of Information Architecture at the Department
of Medical Assistance Services (DMAS), spoke about implementation of SB
565 (2004), the Health Care Data Element Project. The project is building
a relational database of individual data elements from the information
systems of each of the Health and Human Resources agencies to be used
in research and improve the planning, delivery, and financing of the health
care available to all Virginians. Mr. Lawver identified the steps that
are being taken for full implementation of the project.
of Lead Contractors and Workers
Joseph C. Kossan, a regulatory administrator from the Department of Professional
and Occupational Regulation, informed the Joint Subcommittee about the
current regulatory infrastructure of the Board for Asbestos, Lead, and
Home Inspectors. Mr. Kossan explained that the Board's regulations must
not be any more stringent than federal Environmental Protection Agency
regulations and thus cover only projects that meet the definition of lead
abatement and are conducted in target housing and child-occupied facilities.
The regulation revisions in 2003 and 2004 conformed Virginia's regulations
to EPA's more recent regulations by removing the licensing requirement
for lead-based paint activities conducted in public buildings, commercial
buildings and superstructures. He also described a voluntary reciprocity
agreement that relates to training.
During its work session,
the Joint Subcommittee deliberated concerning its legislative actions
for the 2006 Session, addressing three issues on the study's continuation,
the two CDC essential program elements required for the 2006 grant funding
cycle that Virginia lacks, and mechanisms for engaging the health care
community in eliminating lead poisoning.
The Department of
Health observed that the CDC's goal for elimination of lead poisoning
is 2010, the 2006 grant will be competitive, and will not be given to
all 50 states. To cite the joint subcommittee as a forum and advocate
for enhancing its programs will be significant for Virginia's application.
After extended discussion,
the joint subcommittee recommended seeking continuation for an additional
two years in order to assist the agencies, in all appropriate ways, to
seek funding. Further, if no regulatory solutions result from a December
conference involving the stakeholders, two bills to provide the essential
program elements will be introduced.
The Hon. William
Pat Davis or Ken