[Congressional Bills 107th Congress]
[From the U.S. Government Publishing Office]
[H.R. 2788 Introduced in House (IH)]







107th CONGRESS
  1st Session
                                H. R. 2788

 To ensure that children enrolled in Medicaid and other Federal means-
 tested programs at highest risk for lead poisoning are identified and 
                    treated, and for other purposes.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             August 2, 2001

  Mr. Menendez (for himself, Mr. Capuano, Mr. Rush, Mr. Baldacci, Ms. 
Schakowsky, Mr. Frost, Mr. Bonior, Mrs. Jones of Ohio, Mr. Borski, Mr. 
McDermott, Mr. Wexler, Ms. Sanchez, Mr. Engel, Mr. Gutierrez, Mr. Clay, 
 Mr. Cummings, and Mr. Green of Texas) introduced the following bill; 
  which was referred to the Committee on Energy and Commerce, and in 
addition to the Committee on Education and the Workforce, for a period 
    to be subsequently determined by the Speaker, in each case for 
consideration of such provisions as fall within the jurisdiction of the 
                          committee concerned

_______________________________________________________________________

                                 A BILL


 
 To ensure that children enrolled in Medicaid and other Federal means-
 tested programs at highest risk for lead poisoning are identified and 
                    treated, and for other purposes.

    Be it enacted by the Senate and House of Representatives of the 
United States of America in Congress assembled,

SECTION 1. SHORT TITLE; TABLE OF CONTENTS.

    (a) Short Title.--This Act may be cited as the ``Children's Lead 
Screening Accountability For Early-Intervention Act of 2001'' or the 
``Children's Lead SAFE Act''.
    (b) Table of Contents.--The table of contents of this Act is as 
follows:

Sec. 1. Short title; table of contents.
Sec. 2. Findings and purposes.
Sec. 3. Increased lead poisoning screenings and treatments under the 
                            medicaid program.
Sec. 4. Bonus program for improvement of childhood lead screening 
                            rates.
Sec. 5. Authorization to use SCHIP funds for blood lead screening.
Sec. 6. Lead poisoning screening for the Head Start and Early Head 
                            Start programs.
Sec. 7. Lead poisoning screening for special supplemental nutrition 
                            program for Women, Infants, and Children 
                            (WIC).
Sec. 8. Effective date.

SEC. 2. FINDINGS AND PURPOSES.

    (a) Findings.--Congress finds that--
            (1) lead poisoning remains a serious environmental risk, 
        especially to the health of young children;
            (2) childhood lead poisoning can cause reductions in IQ, 
        attention span, reading, and learning disabilities, and other 
        growth and behavior problems;
            (3) children under the age of 6 are at the greatest risk of 
        suffering the effects of lead poisoning because of the 
        sensitivity of their developing brains and nervous systems, 
        while children under the age of 3 are especially at risk due to 
        their stage of development and hand-to-mouth activities;
            (4) poor children and minority children are at 
        substantially higher risk of lead poisoning;
            (5) three-fourths of all children ages 1 through 5 found to 
        have an elevated blood lead level in a Centers for Disease 
        Control and Prevention nationally representative sample were 
        enrolled in or targeted by Federal health care programs, 
        specifically the medicaid program, the special supplemental 
        nutrition program for women, infants, and children (WIC), and 
        the community health centers programs under section 330 of the 
        Public Health Service Act, equating to an estimated 688,000 
        children nationwide;
            (6) the General Accounting Office estimates that \2/3\ of 
        the 688,000 children who have elevated blood lead levels and 
        are enrolled in or targeted by Federal health care programs 
        have never been screened for lead;
            (7) although the Health Care Financing Administration has 
        required mandatory blood lead screenings for children enrolled 
        in the medicaid program who are not less than 1 nor more than 5 
        years of age, less than 20 percent of these children have 
        received such screenings;
            (8) the Health Care Financing Administration mandatory 
        screening policy has not been effective, or sufficient, to 
        properly identify and screen children enrolled in the medicaid 
        program who are at risk;
            (9) only about \1/2\ of State programs have screening 
        policies consistent with Federal policy; and
            (10) adequate treatment services are not uniformly 
        available for children with elevated blood lead levels.
    (b) Purpose.--The purpose of this Act is to create a lead screening 
safety net that will, through the medicaid, women, infants, and 
children (WIC), head start and early head start programs that include 
infants and toddlers, and the maternal and child health block grant 
programs, ensure that children covered by those programs receive blood 
lead screenings and appropriate followup care.

SEC. 3. INCREASED LEAD POISONING SCREENINGS AND TREATMENTS UNDER THE 
              MEDICAID PROGRAM.

    (a) Reporting Requirement.--Section 1902(a)(43)(D) of the Social 
Security Act (42 U.S.C. 1396a(a)(43)(D)) is amended--
            (1) in clause (iii), by striking ``and'' at the end;
            (2) in clause (iv), by striking the semicolon and inserting 
        ``, and''; and
            (3) by adding at the end the following new clause:
                            ``(v) the number of children who are under 
                        the age of 3 and enrolled in the State plan 
                        under this title and the number of those 
                        children who have received a blood lead 
                        screening test;''.
    (b) Mandatory Screening Requirements.--Section 1902(a) of the 
Social Security Act (42 U.S.C. 1396a(a)) is amended--
            (1) in paragraph (64), by striking ``and'' at the end;
            (2) in paragraph (65), by striking the period and inserting 
        ``; and''; and
            (3) by inserting after paragraph (65) the following new 
        paragraph:
            ``(66) provide that each contract entered into between the 
        State and an entity (including a health insuring organization 
        and a medicaid managed care organization) that is responsible 
        for the provision (directly or through arrangements with 
        providers of services) of medical assistance under the State 
        plan shall provide for--
                    ``(A) compliance with mandatory blood lead 
                screening requirements that are consistent with 
                prevailing guidelines of the Centers for Disease 
                Control and Prevention for such screening; and
                    ``(B) coverage of qualified lead treatment services 
                described in section 1905(x) including diagnosis, 
                treatment, and follow-up furnished for children with 
                elevated blood lead levels in accordance with 
                prevailing guidelines of the Centers for Disease 
                Control and Prevention.''.
    (c) Reimbursement for Treatment of Children With Elevated Blood 
Lead Levels.--Section 1905 of the Social Security Act (42 U.S.C. 1396d) 
is amended--
            (1) in subsection (a)--
                    (A) in paragraph (26), by striking ``and'' at the 
                end;
                    (B) by redesignating paragraph (27) as paragraph 
                (28); and
                    (C) by inserting after paragraph (26) the following 
                new paragraph:
            ``(27) qualified lead treatment services (as defined in 
        subsection (x)); and''; and
            (2) by adding at the end the following new subsection:
    ``(x)(1) In this subsection:
            ``(A) The term `qualified lead treatment services' means 
        the following:
                    ``(i) Lead-related medical management, as defined 
                in subparagraph (B).
                    ``(ii) Lead-related case management, as defined in 
                subparagraph (C), for a child described in paragraph 
                (2).
                    ``(iii) Lead-related anticipatory guidance, as 
                defined in subparagraph (D), provided as part of--
                            ``(I) prenatal services;
                            ``(II) early and periodic screening, 
                        diagnostic, and treatment services (EPSDT) 
                        described in subsection (r) and available under 
                        subsection (a)(4)(B) (including as described 
                        and available under implementing regulations 
                        and guidelines) to individuals enrolled in the 
                        State plan under this title who have not 
                        attained age 21; and
                            ``(III) routine pediatric preventive 
                        services.
            ``(B) The term `lead-related medical management' means the 
        provision and coordination of the diagnostic, treatment, and 
        follow-up services provided for a child diagnosed with an 
        elevated blood lead level (EBLL) that includes--
                    ``(i) a clinical assessment, including a physical 
                examination and medically indicated tests (in addition 
                to diagnostic blood lead level tests) and other 
                diagnostic procedures to determine the child's 
                developmental, neurological, nutritional, and hearing 
                status, and the extent, duration, and possible source 
                of the child's exposure to lead;
                    ``(ii) repeat blood lead level tests furnished when 
                medically indicated for purposes of monitoring the 
                blood lead concentrations in the child;
                    ``(iii) pharmaceutical services, including 
                chelation agents and other drugs, vitamins, and 
                minerals prescribed for treatment of an EBLL;
                    ``(iv) medically indicated inpatient services 
                including pediatric intensive care and emergency 
                services;
                    ``(v) medical nutrition therapy when medically 
                indicated by a nutritional assessment, that shall be 
                furnished by a dietitian or other nutrition specialist 
                who is authorized to provide such services under State 
                law;
                    ``(vi) referral--
                            ``(I) when indicated by a nutritional 
                        assessment, to the State agency or contractor 
                        administering the program of assistance under 
                        the special supplemental nutrition program for 
                        women, infants and children (WIC) under section 
                        17 of the Child Nutrition Act of 1966 (42 
                        U.S.C. 1786) and coordination of clinical 
                        management with that program; and
                            ``(II) when indicated by a clinical or 
                        developmental assessment, to the State agency 
                        responsible for early intervention and special 
                        education programs under the Individuals with 
                        Disabilities Education Act (20 U.S.C. 1400 et 
                        seq.); and
                    ``(vii) environmental investigation, as defined in 
                subparagraph (E).
            ``(C) The term `lead-related case management' means the 
        coordination, provision, and oversight of the nonmedical 
        services for a child with an EBLL necessary to achieve 
        reductions in the child's blood lead levels, improve the 
        child's nutrition, and secure needed resources and services to 
        protect the child by a case manager trained to develop and 
        oversee a  multi-disciplinary plan for a child with an EBLL or 
by a childhood lead poisoning prevention program, as defined by the 
Secretary. Such services include--
                    ``(i) assessing the child's environmental, 
                nutritional, housing, family, and insurance status and 
                identifying the family's immediate needs to reduce lead 
                exposure through an initial home visit;
                    ``(ii) developing a multidisciplinary case 
                management plan of action that addresses the provision 
                and coordination of each of the following items as 
                appropriate--
                            ``(I) determination of whether or not such 
                        services are covered under the State plan under 
                        this title;
                            ``(II) lead-related medical management of 
                        an EBLL (including environmental 
                        investigation);
                            ``(III) nutrition services;
                            ``(IV) family lead education;
                            ``(V) housing;
                            ``(VI) early intervention services;
                            ``(VII) social services; and
                            ``(VIII) other services or programs that 
                        are indicated by the child's clinical status 
                        and environmental, social, educational, 
                        housing, and other needs;
                    ``(iii) assisting the child (and the child's 
                family) in gaining access to covered and non-covered 
                services in the case management plan developed under 
                clause (ii);
                    ``(iv) providing technical assistance to the 
                provider that is furnishing lead-related medical 
                management for the child; and
                    ``(v) implementation and coordination of the case 
                management plan developed under clause (ii) through 
                home visits, family lead education, and referrals.
            ``(D) The term `lead-related anticipatory guidance' means 
        education and information for families of children and pregnant 
        women enrolled in the State plan under this title about 
        prevention of childhood lead poisoning that addresses the 
        following topics:
                    ``(i) The importance of lead screening tests and 
                where and how to obtain such tests.
                    ``(ii) Identifying lead hazards in the home.
                    ``(iii) Specialized cleaning, home maintenance, 
                nutritional, and other measures to minimize the risk of 
                childhood lead poisoning.
                    ``(iv) The rights of families under the Residential 
                Lead-Based Paint Hazard Reduction Act of 1992 (42 
                U.S.C. 4851 et seq.).
            ``(E) The term `environmental investigation' means the 
        process of determining the source of a child's exposure to lead 
        by an individual that is certified or registered to perform 
        such investigations under State or local law, including the 
        collection and analysis of information and environmental 
        samples from a child's living environment. For purposes of this 
        subparagraph, a child's living environment includes the child's 
        residence or residences, residences of frequently visited 
        caretakers, relatives, and playmates, and the child's day care 
        site. Such investigations shall be conducted in accordance with 
        the standards of the Department of Housing and Urban 
        Development for the evaluation and control of lead-based paint 
        hazards in housing and in compliance with State and local 
        health agency standards for environmental investigation and 
        reporting.
    ``(2) For purposes of paragraph (1)(A)(ii), a child described in 
this paragraph is a child who--
            ``(A) has attained 6 months but has not attained 6 years of 
        age; and
            ``(B) has been identified as having a blood lead level that 
        equals or exceeds 20 micrograms per deciliter (or after 2 
        consecutive tests, equals or exceeds 15 micrograms per 
        deciliter, or the applicable number of micrograms designated 
        for such tests under prevailing guidelines of the Centers for 
        Disease Control and Prevention).''.
    (d) Enhanced Match for Data Communications System.--Section 
1903(a)(3) of the Social Security Act (42 U.S.C. 1396b(a)(3)) is 
amended--
            (1) in subparagraph (D), by striking ``plus'' at the end 
        and inserting ``and''; and
            (2) by inserting after subparagraph (D), the following new 
        subparagraph:
                    ``(E)(i) 90 percent of so much of the sums expended 
                during such quarter as are attributable to the design, 
                development, or installation of an information 
                retrieval system that may be easily accessed and used 
                by other federally-funded means-tested public benefit 
                programs to determine whether a child is enrolled in 
                the State plan under this title and whether an enrolled 
                child has received mandatory early and periodic 
                screening, diagnostic, and treatment services, as 
                described in section 1905(r); and
                    ``(ii) 75 percent of so much of the sums expended 
                during such quarter as are attributable to the 
                operation of a system (whether such system is operated 
                directly by the State or by another person under a 
                contract with the State) of the type described in 
                clause (i); plus''.
    (e) Report.--The Secretary of Health and Human Services, acting 
through the Administrator of the Health Care Financing Administration, 
annually shall report to Congress on the number of children enrolled in 
the medicaid program under title XIX of the Social Security Act (42 
U.S.C. 1396 et seq.) who have received a blood lead screening test 
during the prior fiscal year, noting the percentage that such children 
represent as compared to all children enrolled in that program.
    (f) Emergency Measures.--
            (1) In general.--Subject to paragraph (2), the Secretary of 
        Health and Human Services or the State agency administering the 
        State plan under title XIX of the Social Security Act (42 
        U.S.C. 1396 et seq.) shall use funds provided under title XIX 
        of that Act to reimburse a State or entity for expenditures for 
        medically necessary activities in the home  of a lead-poisoned 
child with an EBLL of at least 20, or a pregnant woman with an EBLL of 
at least 20, to prevent additional exposure to lead, including 
specialized cleaning of lead-contaminated dust, emergency relocation, 
safe repair of peeling paint, dust control, and other activities that 
reduce lead exposure. Such reimbursement, when provided by the State 
agency administering the State plan under title XIX of the Social 
Security Act, shall be considered medical assistance for purposes of 
section 1903(a) of such Act.
            (2) Limitation.--Not more than $1,000 in expenditures for 
        the emergency measures described in paragraph (1) may be 
        incurred on behalf of a child or pregnant woman to which that 
        paragraph applies.
    (g) Rule of Construction.--Nothing in this Act or any amendment 
made by this Act shall be construed as requiring a child enrolled in 
the State medicaid program under title XIX of the Social Security Act 
to undergo a lead blood screening test if the child's parent or 
guardian objects to the test on the ground that the test is 
inconsistent with the parent's or guardian's religious beliefs.

SEC. 4. BONUS PROGRAM FOR IMPROVEMENT OF CHILDHOOD LEAD SCREENING 
              RATES.

    (a) In General.--The Secretary of Health and Human Services (in 
this section referred to as the ``Secretary'') may establish a program 
to improve the blood lead screening rates of States for children under 
the age of 3 enrolled in the medicaid program.
    (b) Payments.--If the Secretary establishes a program under 
subsection (a), the Secretary, using State-specific blood lead 
screening data, shall, subject to the availability of appropriations, 
annually pay a State an amount determined as follows:
            (1) $25 per each 2-year-old child enrolled in the medicaid 
        program in the State who has received the minimum required (for 
        that age) screening blood lead level tests (capillary or venous 
        samples) to determine the presence of elevated blood lead 
        levels, as established by the Centers for Disease Control and 
        Prevention, if the State rate for such screenings exceeds 65 
        but does not exceed 75 percent of all 2-year-old children in 
        the State.
            (2) $50 per each such child who has received such minimum 
        required tests if the State rate for such screenings exceeds 75 
        but does not exceed 85 percent of all 2-year-old children in 
        the State.
            (3) $75 per each such child who has received such minimum 
        required tests if the State rate for such screenings exceeds 85 
        percent of all 2-year-old children in the State.
    (c) Use of Bonus Funds.--Funds awarded to a State under subsection 
(b) shall only be used--
            (1) by the State department of health in the case of a 
        child with an elevated blood lead level who is enrolled in 
        medicaid or another Federal means-tested program designed to 
        reduce the source of the child's exposure to lead; or
            (2) in accordance with guidelines for the use of such funds 
        developed by the Secretary in collaboration with the Secretary 
        of Housing and Urban Development.
    (d) Authorization of Appropriations.--There is authorized to be 
appropriated to carry out this section, $30,000,000 for each of fiscal 
years 2002 through 2006.

SEC. 5. AUTHORIZATION TO USE SCHIP FUNDS FOR BLOOD LEAD SCREENING.

    (a) Optional Application to SCHIP.--
            (1) In general.--Section 2107(e)(1) of the Social Security 
        Act (42 U.S.C. 1397gg(e)(1)) is amended by adding at the end 
        the following new subparagraph:
                    ``(E) At State option, section 1902(a)(66) 
                (relating to blood lead screening and coverage of 
                qualified lead treatment services defined in section 
                1905(x)).''.
            (2) Conforming amendment.--Section 2110(a) of the Social 
        Security Act (42 U.S.C. 1397jj(a)) is amended--
                    (A) by redesignating paragraph (28) as paragraph 
                (29); and
                    (B) by inserting after paragraph (27) the following 
                new paragraph:
            ``(28) qualified lead treatment services (as defined in 
        section 1905(x)), but only if the State has elected under 
        section 2107(e)(1)(E) to apply section 1902(a)(66) to the State 
        child health plan under this title.''.
    (b) Inclusion in Medicaid Reporting Requirement.--
            (1) In general.--Section 1902(a)(43)(D)(v) of the Social 
        Security Act (42 U.S.C. 1396a(a)(43)(D)(v)), as added by 
        section 3(a)(3), is amended by inserting ``or, if the State has 
        elected under section 2107(e)(1)(E) to apply paragraph (66) to 
        the State child health plan under title XXI, in the State plan 
        under title XXI,'' after ``this title''.
            (2) Report to congress.--Section 3(e) of this Act is 
        amended--
                    (A) by inserting ``or in the State children's 
                health insurance program under title XXI of that Act 
                (42 U.S.C 1397aa et seq.)'' after ``(42 U.S.C. 1396 et 
                seq.)''; and
                    (B) by striking ``that program'' and inserting 
                ``those programs''.

SEC. 6. LEAD POISONING SCREENING FOR THE HEAD START AND EARLY HEAD 
              START PROGRAMS.

    Section 645A of the Head Start Act (42 U.S.C 9840a) is amended--
            (1) in the first sentence of subsection (d), by inserting 
        before the period the following: ``and shall comply with 
        subsection (h)''; and
            (2) by adding at the end the following:
    ``(h) Lead Poisoning Screening.--
            ``(1) In general.--An entity shall--
                    ``(A) determine whether a child eligible to 
                participate in the program described in subsection 
                (a)(1) has received a blood lead screening test using a 
                test that is appropriate for age and risk factors upon 
                the enrollment of the child in the program; and
                    ``(B) in the case of a child who has not received a 
                blood lead screening test, ensure that each enrolled 
                child receives such a test either by referral or by 
                performing the test (under contract or otherwise).
            ``(2) Screenings by entities.--
                    ``(A) In general.--An entity may (under contract or 
                otherwise) perform a blood lead screening test that is 
                appropriate for age and risk factors on a child who 
                seeks to participate in the program.
                    ``(B) Reimbursement.--
                            ``(i) Children enrolled in or eligible for 
                        medicaid.--On the request of an entity that 
                        performs or arranges for the provision of a 
                        blood lead screening test under subparagraph 
                        (A) of a child that is eligible for or 
                        receiving medical assistance under a State plan 
                        under title XIX of the Social Security Act (42 
                        U.S.C. 1396 et seq.), the Secretary of Health 
                        and Human Services, notwithstanding any other 
                        provision of, or limitation under, title XIX of 
                        the Social Security Act, shall reimburse the 
                        entity, from funds that are made available 
                        under that title, for the Federal medical 
                        assistance percentage (as defined in section 
                        1905(b) of the Social Security Act (42 U.S.C. 
                        1396d(b)) of the cost of the test and data 
                        reporting. Such costs shall include, if 
                        determined to be desirable by the State agency, 
                        the costs of providing screening through 
                        clinical laboratories certified under section 
                        353 of the Public Health Service Act (42 U.S.C. 
                        263a), or purchasing, for use at sites 
                        providing services under this section, blood 
                        lead testing instruments and associated 
                        supplies approved for sale by the Food and Drug 
                        Administration and used in compliance with such 
                        section 353.
                            ``(ii) Children enrolled in or eligible for 
                        schip.--In the case of a blood lead screening 
                        test performed under subparagraph (A) (by the 
                        entity or under contract with the entity) on a 
                        child who is eligible for or receiving medical 
                        assistance under a State plan under title XXI 
                        of the Social Security Act, the Secretary of 
                        Health and Human Services, notwithstanding any 
                        other provision of, or limitation under, such 
                        title XXI, shall reimburse the entity, from 
                        funds that are made available under that title, 
                        for the enhanced FMAP (as defined in section 
                        2105(b) of the Social Security Act (42 U.S.C. 
                        1397ee(b)) of the cost of the test and data 
                        reporting. Such costs shall include the costs 
                        described in the second sentence of clause (i).
            ``(3) Authorization for early head start.--There is 
        authorized to be appropriated such sums as may be necessary to 
        carry out this subsection with respect to blood lead screening 
        tests performed under this subsection on an infant or child, 
        and any data reporting with respect to such infant or child, 
        who is not eligible for coverage under title XIX or XXI of the 
        Social Security Act, or is not otherwise covered under a health 
        insurance plan.
            ``(4) Head start.--The provisions of this subsection shall 
        apply to head start programs that include coverage, directly or 
        indirectly, for infants and toddlers under the age of 3 
        years.''.

SEC. 7. LEAD POISONING SCREENING FOR SPECIAL SUPPLEMENTAL NUTRITION 
              PROGRAM FOR WOMEN, INFANTS, AND CHILDREN (WIC).

    Section 17(d) of the Child Nutrition Act of 1966 (42 U.S.C. 
1786(d)) is amended by adding at the end the following:
            ``(4) Lead poisoning screening.--
                    ``(A) In general.--A State agency shall--
                            ``(i) determine whether an infant or child 
                        eligible to participate in the program under 
                        this section has received a blood lead 
                        screening test using a test that is appropriate 
                        for age and risk factors upon the enrollment of 
                        the infant or child in the program; and
                            ``(ii) in the case of an infant or child 
                        who has not received a blood lead screening 
                        test--
                                    ``(I) refer the infant or child for 
                                receipt of the test; and
                                    ``(II) determine whether the infant 
                                or child receives the test during a 
                                routine visit with a health care 
                                provider.
                    ``(B) Screenings by state agencies.--
                            ``(i) In general.--A State agency may 
                        (under contract or otherwise) perform a blood 
                        lead screening test that is appropriate for age 
                        and risk factors on an infant or child who 
                        seeks to participate in the program.
                            ``(ii) Reimbursement.--
                                    ``(I) Children enrolled in or 
                                eligible for medicaid.--On the request 
                                of a State agency that performs or 
                                arranges for the provision of a blood 
                                lead screening test under clause (i) of 
                                an infant or child that is eligible for 
                                or receiving medical assistance under a 
                                State plan under title XIX of the 
                                Social Security Act (42 U.S.C. 1396 et 
                                seq.), the Secretary of Health and 
                                Human Services, notwithstanding any 
                                other provision of, or limitation 
                                under, title XIX of the Social Security 
                                Act, shall reimburse the State agency, 
                                from funds that are made available 
                                under that title, for the Federal 
                                medical assistance percentage (as 
                                defined in section 1905(b) of the 
                                Social Security Act (42 U.S.C. 
                                1396d(b)) of the cost of the test and 
                                data reporting. Such costs shall 
                                include, if determined to be desirable 
                                by the State agency, the costs of 
                                providing screening through clinical 
                                laboratories certified under section 
                                353 of the Public Health Service Act 
                                (42 U.S.C. 263a), or purchasing, for 
                                use at sites providing services under 
                                this section, blood lead testing 
                                instruments and associated supplies 
                                approved for sale by the Food and Drug 
                                Administration and used in compliance 
                                with such section 353.
                                    ``(II) Children enrolled in or 
                                eligible for schip.--In the case of a 
                                blood lead screening test performed 
                                under clause (i) (by the State agency 
                                or under contract with the State 
                                agency) on an infant or child who is 
                                eligible for or receiving medical 
                                assistance under a State plan under 
                                title XXI of the Social Security Act, 
                                the Secretary of Health and Human 
                                Services, notwithstanding any other 
                                provision of, or limitation under, such 
                                title XXI, shall reimburse the State 
                                agency, from funds that are made 
                                available under that title, for the 
                                enhanced FMAP (as defined in section 
                                2105(b) of the Social Security Act (42 
                                U.S.C. 1397ee(b)) of the cost of the 
                                test and data reporting. Such costs 
                                shall include the costs described in 
                                the second sentence of subclause (I).
                    ``(C) Authorization for wic.--There is authorized 
                to be appropriated such sums as may be necessary to 
                carry out this paragraph with respect to blood lead 
                screening tests performed under this paragraph on an 
                infant or child, and any data reporting with respect to 
                such infant or child, who is not eligible for coverage 
                under title XIX or XXI of the Social Security Act, or 
                is not otherwise covered under a health insurance 
                plan.''.

SEC. 8. EFFECTIVE DATE.

    (a) In General.--Except as provided in subsection (b), the 
amendments made by this Act take effect on the date that is 18 months 
after the date of enactment of this Act.
    (b) WIC and Early Head Start Waivers.--
            (1) In general.--A State agency or contractor administering 
        the program of assistance under the special supplemental 
        nutrition program for women, infants and children (WIC) under 
        section 17 of the Child Nutrition Act of 1966 (42 U.S.C. 1786), 
        or an entity carrying out activities under section 645A of the 
        Head Start Act (42 U.S.C. 9840a) may be awarded a waiver from 
        the amendments made by sections 6 and 7 (as applicable) if the 
        State where the agency, contractor, or entity is located 
        establishes to the satisfaction of the Secretary of Health and 
        Human Services, in accordance with requirements and procedures 
        recommended in accordance with paragraph (2) to the Secretary 
        by the Director of the Centers for Disease Control and 
        Prevention, in consultation with the Centers for Disease 
        Control and Prevention Advisory Committee on Childhood Lead 
        Poisoning Prevention, a plan for increasing the number of blood 
        lead screening tests of children enrolled in the WIC and the 
        Early Head Start programs in the State.
            (2) Development of waiver procedures and requirements.--Not 
        later than 12 months after the date of enactment of this Act, 
        the Director of the Centers for Disease Control and Prevention, 
        in consultation with the Centers for Disease Control and 
        Prevention Advisory Committee on Childhood Lead Poisoning 
        Prevention, shall develop and recommend to the Secretary of 
        Health and Human Services criteria and procedures (including a 
        timetable for the submission of the State plan described in 
        paragraph (1)) for the award of waivers under that paragraph.
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