[Congressional Record Volume 147, Number 127 (Wednesday, September 26, 2001)]
[Senate]
[Pages S9877-S9878]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. REED (for himself, Mr. Torricelli, Mrs. Carnahan, Mr. 
        Durbin, Mr. Lieberman, Mr. Wellstone, and Mrs. Clinton):
  S. 1469. A bill to amend the Head Start and Early Head Start programs 
to ensure that children eligible to participate in those programs are 
identified and treated for lead poisoning, and for other purposes; to 
the Committee on Health, Education, Labor, and Pensions.
  Mr. REED. Mr. President, I rise today along with my colleague, 
Senator Torricelli of New Jersey, to introduce two pieces of 
legislation we believe are absolutely critical to our ongoing effort to 
combat childhood lead poisoning. These two bills, the Early Childhood 
Lead Poisoning Prevention Act and the Children's Lead SAFE Act, are 
intended to improve our ability to detect and treat children at high 
risk of lead poisoning, as well as expand our network of Federal 
program sites where children at increased risk of lead poisoning can be 
screened.
  The Early Childhood Lead Poisoning Prevention Act requires WIC and 
Head Start/Early Head Start programs with children under age 3 to 
assess whether a child participant has been screened for lead, and 
provide and track referrals for any child who has not been 
appropriately screened. The bill also calls upon WIC and Head Start/
Early Head Start grantees to ensure that all enrolled children are 
screened for lead poisoning and grants these entities the authority to 
perform or arrange blood lead screening for program participants. 
Lastly, the bill allows WIC clinics and Head Start/Early Head Start 
grantees to seek reimbursement through Medicaid or the State Children's 
Heath Insurance Program, CHIP, for eligible children who have received 
a lead screening test in accordance with CDC recommendations or 
Medicaid policy.
  The Children's Lead Screening Accountability for Early Intervention 
Act, or the Children's Lead SAFE Act, would require Medicaid 
contractors to comply with existing requirements to provide screening, 
treatment and any necessary follow-up services for Medicaid-eligible 
children who test positive for lead poisoning. To be clear, this is not 
imposing any new mandate on State Medicaid contractors. It is simply 
trying to make current law more effective by explicitly requiring 
health care providers to comply with Federal lead screening 
requirements that have been in existence since 1992.
  This new, stronger mandate has become necessary because 82 percent of 
children ages one through five have never been screened for lead 
poisoning, even though they were receiving health care benefits or 
services through Medicaid, WIC, or the Health Centers program, 
according to a recent report from the General Accounting Office, GAO, 
despite long standing Federal requirements. This means that of the 
estimated 890,000 children in the U.S. with elevated blood lead levels, 
over 400,000 have never been identified or treated. Even more 
disconcerting is that 50 percent of our States do not have screening 
policies that are consistent with Federal requirements.
  The reason why our two bills specifically focus on specific Federal 
programs stems from the GAO report, which indicated that 77 percent of 
U.S. children with high levels of lead in their blood are enrolled in 
Federal programs, highlighting the viral role of these programs in 
helping to eliminate the preventable tragedy of childhood lead 
poisoning. Better involvement by Federal programs in promoting 
screening and treatment is also critical to reducing the significant 
health care and special education costs associated with the 
irreversible effects of lead poisoning, which include the impairment of 
mental and physical development.
  We need to find the will and the resources to eradicate lead hazards 
for millions of at-risk children. We also need to make more Americans 
aware of the dangers of lead poisoning. I am committed to addressing 
this crisis, and I hope my colleagues will join us in supporting these 
bills and other lead poisoning prevention efforts.
  I ask consent that the text of the Early Childhood Lead Poisoning 
Prevention Act be printed in the Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1469

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Early Childhood Lead 
     Poisoning Prevention Act of 2001''.

     SEC. 2. 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

[[Page S9878]]

       (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) Rule of construction.--Nothing in this subsection 
     shall be construed as requiring a child eligible to 
     participate in the program described in subsection (a)(1) to 
     undergo a blood lead 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.
       ``(5) 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. 3. LEAD POISONING SCREENING FOR SPECIAL SUPPLEMENTAL 
                   NUTRITION PROGRAM FOR WOMEN, INFANTS, AND 
                   CHILDREN.

       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 of appropriations.--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.
       ``(D) Rule of construction.--Nothing in this paragraph 
     shall be construed as requiring a child eligible to 
     participate in the program under this section to undergo a 
     blood lead 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. 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 2 and 3 (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.
                                 ______