[Congressional Record Volume 145, Number 76 (Tuesday, May 25, 1999)]
[Senate]
[Pages S5961-S5962]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. TORRICELLI (for himself, Mr. Reed, Mr. Lautenberg, Mr. 
        Bryan, Mrs. Boxer, Mrs. Feinstein, Mr. Dodd, Mr. Rockefeller, 
        Mr. Biden, Mr. Schumer, Mrs. Murray, Mr. Durbin, and Mr. 
        Kerry):
  S. 1120. 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; to the Committee on 
Finance.


                        children's lead safe act

 Mr. TORRICELLI. Mr. President, today I rise with Senator Reed 
to introduce legislation that will ensure that children enrolled in 
federal health care programs receive screening and appropriate care for 
lead poisoning. Our bill, the ``Children's Lead SAFE Act of 1999'' 
would go a long way to eliminate childhood lead poisoning.
  We know lead exposure is one of the most dangerous health hazards for 
young children because their nervous systems are still developing. Lead 
poisoning in children causes damage to the brain and nervous systems, 
which leads to IQ loss, impaired physical development and behavioral 
problems. High levels of exposure can cause comas, convulsions, and 
even death.
  Despite our success over the past twenty years to reduce lead 
poisoning in the U.S., it continues to be the number one environmental 
health threat to children, with nearly one million preschoolers 
affected. Poor and minority children are most at-risk because of diet 
and exposure to environmental hazards such as old housing. These 
children frequently live in older housing which contains cracked or 
chipped lead paint, where children primarily contract lead poisoning by 
ingesting paint chips or lead dust.
  Mr. President, 75 percent of At-Risk children are enrolled in federal 
health care programs. Kids in these programs are five times more likely 
to have high blood levels. In 1992, Congress instructed Health Care 
Financing Adm. (HCFA) to require States to lead screen Medicaid 
children under the age of two. Despite this, the GAO report shows that 
mandatory screening isn't happening. Two-thirds of Medicaid children 
have never been screened (as required). And only 20 percent of all 
children in federal programs have been screened.
  In fact, only half the States have screening policies consistent with 
federal law. In my own state of New Jersey, the GAO report showed that 
only 39 percent of Medicaid children have been screened. Despite 
federal requirements, for whatever reason--insufficient outreach, lax 
government oversight or parental ignorance, too many kids are not 
getting screened.
  The Children's Lead SAFE Act would address this problem by 
establishing clear and consistent standards for screening and treatment 
and by involving all relevant federal health programs in this battle. 
Our legislation is modeled on the recommendations made by the GAO.
  It requires all federal programs serving at-risk kids to be involved 
in screening. It requires State Medicaid contracts to explicitly 
require providers (HMO's) to follow federal rules for screening and 
treatment. It expands Medicaid coverage to include treatment services 
and environmental investigations to determine the source of the 
poisoning. WIC centers (with 12 percent of the at-risk population) will 
be required to assess whether a child has been screened and if they 
have not to provide the necessary referral and follow-up to ensure that 
screening occurs. Head Start facilities would similarly have the 
responsibility for ensuring that their children are screened.
  In addition, our legislation would improve data so we can identify 
problems and use that information to educate providers about the extent 
of the problem. CDC would develop information-sharing guidelines for 
State and local health departments, the labs that perform the test and 
federal programs. It would also require each State to report on the 
percent of the Medicaid population they are screening.
  Finally, our legislation would make sure agencies have sufficient 
resources to do screening by reimbursing WIC and Head Start for costs 
they incur in screening. The legislation would also create a bonus 
program whereby a state will receive a per child bonus for every child 
it screens above 65 percent of its Medicaid population.
  Mr. President, the health and safety of our children would be greatly 
enhanced with the passage of this important legislation. Childhood lead 
poisoning is easily preventable, and there is no excuse for not 
properly screening and providing care to our kids. Our bill would 
accomplish this and ensure adequate care. I ask my colleagues to join 
me in recognizing this problem and supporting its solution.
  Mr. REED. Mr. President, I rise today to introduce legislation with 
Senator Torricelli that would ensure that children enrolled in federal 
health care programs receive screening and appropriate follow-up care 
for lead poisoning. Our bill, the ``Children's Lead SAFE Act of 1999'' 
is an effort to eliminate a disease that continues to wreak 
irreversible damage upon our nation's children.
  Despite our success over the past twenty years to reduce lead 
poisoning

[[Page S5962]]

in the U.S., it continues to be the number one environmental health 
threat to children, with nearly one million preschoolers affected. This 
problem is particularly severe among African American children who are 
at five times higher risk than white children and low-income children 
are at eight times higher risk than children from well-to-do families.
  Minorities and low-income children are disproportionately affected by 
lead poisoning because they frequently live in older housing which 
contains cracked or chipped lead paint, where children primarily 
contract lead poisoning by ingesting paint chips or lead dust.
  If undetected, lead poisoning can cause brain and nervous system 
damage, behavior and learning problems and possibly death.
  Research shows that children with elevated blood-lead levels are 
seven times more likely to drop out of high school and six times more 
likely to have reading disabilities. It costs an average of $10,000 
more a year to educate a lead-poisoned child. We will continue to pay 
for our failure to eradicate this preventable tragedy through costs to 
our education and health care system, and losses in lifetime earnings, 
unless we act now to protect our children.
  As I mentioned, this disease is entirely preventable, making its 
prevalence among children all the more frustrating. We do have 
solutions--parents who are aware, housing that is safe, and effective 
screening and treatment for children who are at risk--to name a few.
  Unfortunately, our current system is not adequately protecting our 
children. In January 1999, the General Accounting Office reported that 
children in federally funded health care programs such as Medicaid, 
Women Infant and Child (WIC) and the Health Centers program, are five 
times more likely to have elevated blood lead levels. The report also 
found that despite longstanding federal requirements, two-thirds of the 
children in these programs--more than 400,000--have never been screen 
and, consequently, remain untreated.
  Early detection of lead poisoning is critical to ensure that a child 
is removed from the source of exposure and to determine whether other 
children, such as siblings or friends, have also been exposed. 
Screening is also important to determine whether a child's lead 
poisoning is so severe as to require medical management to mitigate the 
long-term health and developmental effects of lead.
  Mr. President, our comprehensive legislation is designed to make sure 
no child falls through the cracks, by establishing clear and consistent 
standards for screening and treatment and by holding accountable those 
who are responsible for carrying out the requirements. The legislation 
supports improved management information systems to provide state- and 
community-level information about the extent to which children have 
elevated blood lead levels. It also expands and coordinates lead 
screening and treatment activities through other federal programs 
serving at-risk children such as WIC, Early Head Start, and the 
Maternal and Child Health Block Grant programs. Finally, the bill ties 
incentives for screening to additional federal funding for cleaning up 
lead-contaminated houses.
  Mr. President, we propose this legislation in an effort to rid 
children of the detrimental effects of lead poisoning. Every child has 
a right to screening and follow-up care. This bill will significantly 
increase the number of poisoned children who are screened and treated 
and help communities, parents, and physicians to take advantage of 
every opportunity that they have to detect and treat lead poisoning 
before its irreversible effects set in.
  I ask by unanimous consent that the text of this bill be printed in 
the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:
  The bill was not available for printing. It will appear in a future 
issue of the Record.
                                 ______