[Congressional Record Volume 141, Number 137 (Wednesday, September 6, 1995)]
[Extensions of Remarks]
[Page E1707]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]


             INNOVATIVE, COST-SAVING LEAD POISONING PROGRAM

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                        HON. BENJAMIN L. CARDIN

                              of maryland

                    in the house of representatives

                      Wednesday, September 6, 1995
  Mr. CARDIN. Mr. Speaker, today, I want to share information on a new, 
innovative treatment and prevention system for lead poisoning, 
conceived in Baltimore, that is achieving far better results for 
greater numbers of children, at a dramatically lower cost than 
traditional treatments. Approximately 15 percent of the children in the 
United States, that is one in every six under 6 years of age, have high 
levels of lead in their blood. I urge my colleagues, whose constituents 
face this problem, to take note of this treatment model and consider 
endorsing the approach in their own districts.
  The sad truth is that, even though lead poisoning is entirely 
preventable, it is the No. 1 environmental disease that threatens 
children in our country. The long term effects of lead can cause 
learning disabilities, hyperactivity, impaired hearing and speech, even 
brain damage.
  Most children are treated for lead poisoning on an outpatient basis 
and receive chelation therapy. Children with dangerously high levels of 
lead in their bodies are treated on an inpatient basis. The good news 
is that traditional treatments are usually reimbursed by insurance 
companies and provide necessary relief to the children. The bad news is 
that traditional treatment has not focused on the root cause of lead 
poisoning: the child's environment. This often leads to multiple 
poisonings and very costly medical care for each child. This revolving 
door syndrome is traumatic for the child and family, frustrating for 
care provides and costly to the payors.
  An exciting new model, called the Community Lead Poisoning Prevention 
and Treatment Center, created by the Kennedy Kreiger Institute, a 
leading speciality pediatric facility located in Baltimore, MD, offers 
a leap forward in lead poisoning treatment and a significant reduction 
in costs to State and Federal Government.
  The key elements to the model are:
  Kennedy Kreiger Institute provides a community-based setting for 
chelation therapy, a renovated rowhouse conveniently located near the 
outpatient clinic. This is important because it allows children to be 
treated in a home-like setting, ensures that they live in a lead-free 
environment--thus avoiding repeated poisoning--and it costs much less 
than in-hospital treatment.
  Kennedy Krieger Institute uses a comprehensive case management 
approach, addressing not only treatment but also correction of the 
child's home environment. The institute will facilitate the family's 
relocation to a lead-free environment or abatement of lead in the 
family's current dwelling. This crucial, commonsense component in 
treating a wholly environmental disease has been absent from 
traditional treatment. Kennedy Kreiger Institute's comprehensive 
approach also includes community outreach and education regarding 
sources and negative effects of lead poisoning, abatement, nutrition, 
and proper household cleaning techniques.
  Kennedy Krieger created a partnership with the Maryland Department of 
Health and Mental Hygiene [DHMH] to secure a waiver from Medicaid. DHMH 
pays a years capitated rate to Kennedy Krieger, a fixed amount well 
below normal inpatient costs. DHMH does not limit its authorization of 
dollars to medical treatment only. Recognizing the institute's 
expertise in treating lead poisoning, the department allows these 
experts flexibility to prescribe a mix of services appropriate to the 
individual child and family. The department frees the experts to do 
what is right for the child, focusing on prevention and reducing the 
revolving door syndrome. Isn't it refreshing to see a government agency 
act sensibly, removing constraints for real, lasting results for these 
children?
  The results have been striking. Since the program's inception in the 
summer of 1994, 150 children from 133 families have been enrolled; 95 
percent of the children have lower blood lead levels at the second 
visit than at the enrollment visit and continue to have lower blood 
lead levels; 84 percent of the families who brought their children to 
the Kennedy Krieger Institute for their second visit now live in lead 
safe environments; and 60 families have participated in educational 
programs, and a team of six individuals is being trained in the first 
Lead Patrol class to educate their communities about lead poisoning 
issues.
  Substantially improved results are only the beginning. When the 
historical costs of treating children with lead poisoning are applied 
to the current group of children enrolled in the program and compared 
with the current costs to payors, the program costs represent 37 
percent of the historical costs. During its first year of operation, 
the total cost savings will reach $2 million, of which the State of 
Maryland will save between $500,000 and $1 million. Not only has 
Kennedy Krieger reduced the costs of treating lead poisoned children, 
it has also improved upon the quality of care given.
  I have simplified my explanation of the program in the interest of 
time. There is so much more to this exciting program, and I urge you to 
encourage your local pediatric hospitals and health departments to 
contact the Kennedy Krieger Institute. In the interest of children 
across the Nation, the institute will be happy to share information and 
work with local organizations to replicate the model in towns and 
cities where lead poisoning is such a tragic, yet preventable problem.


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