United States Government Publishing Office publisher pbl distributor dst United States Government Accountability Office Health, Education, and Human Services Division author aut Government Organization text government publication eng GAOREPORTS Legislative Agency Publications gao legislative 2010-08-12 U.S. Government Printing Office 1999-01-15 monographic deposited born digital 109 p. GA 1.13:HEHS-99-18 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-99-18 P0b002ee180393d4c f:he99018 DGPO 2010-08-12 2011-03-24 GAOREPORTS-HEHS-99-18 machine generated eng fdlp REPORT GAOREPORTS-HEHS-99-18 HEHS-99-18 Health hazards Health surveys Health care services Health centers Medical examinations Toxic substances Children Health care programs Disadvantaged persons Early and Periodic Screening, Diagnosis, and Treatment Program National Health and Nutrition Examination Surveys Special Supplemental Food Program for Women, Infants, and Children Medicaid Program Childhood Lead Poisoning Prevention Program WIC Chapter Report HEHS Pursuant to a congressional request, GAO examined: (1) the risk of lead poisoning faced by young children served by federal health care programs; (2) the extent to which children served by these programs have been screened for this condition; (3) key reasons why screenings may not be occurring; and (4) problems that federal health care programs face in ensuring that children who have harmful lead levels in their blood receive timely follow-up treatment and other services.<p/>GAO noted that: (1) the children served by federal health programs remain at significant risk for elevated blood lead levels; (2) three-fourths of all the children found to have an elevated blood lead level in the Centers for Disease Control and Prevention (CDC) 1991-94 survey were enrolled in Medicaid or the Special Supplemental Food Program for Women, Infants and Children (WIC) or were within the target population for the Health Center Program; (3) this equates to nearly 700,000 children nationwide; (4) more than 8 percent of the surveyed children aged 1 through 5 who were served by federal health care programs had a harmful blood lead level, a rate almost five times the rate for children who were not in these federal programs; (4) despite federal policies, most children in federal health care programs have not been screened; (5) for nearly two-thirds of the surveyed children aged 1 through 5 identified by CDC as having elevated lead levels, the blood lead test conducted as part of the CDC survey was the first such test they had received; (6) projecting these results nationally, more than 400,000 U.S. children in federal health care programs have undetected elevated blood lead levels; (7) other data that GAO analyzed for specific federal health programs tended to corroborate the overall low screening rates reported in CDC's survey and also showed that screening rates vary greatly from state to state and locality to locality; (8) screening is often not occurring because federal screening policies are largely not monitored at the federal and state levels; (9) one underlying reason for low screening rates is the widespread belief among providers that lead exposure is no longer a problem in their communities; (10) most state officials GAO contacted lacked reliable, representative data on the prevalence of elevated blood lead levels and the extent of screening in their states; (11) another problem is that many children are not receiving adequate preventive health care services, visiting the doctor only when they are sick; (12) follow-up treatment for children identified with elevated blood lead levels is complex and potentially resource intensive; and (13) at health centers and state and local health departments visited across the country, GAO found wide variation in the extent of timely follow up. https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-99-18/html/GAOREPORTS-HEHS-99-18.htm https://www.govinfo.gov/content/pkg/GAOREPORTS-HEHS-99-18/pdf/GAOREPORTS-HEHS-99-18.pdf GAO/HEHS-99-18 https://www.govinfo.gov/app/details/GAOREPORTS-HEHS-99-18 Chapter Report GAO/HEHS-99-18; Lead Poisoning: Federal Health Care Programs Are Not Effectively Reaching At-Risk Children; Health hazards Health surveys Health care services Health centers Medical examinations Toxic substances Children Health care programs Disadvantaged persons Early and Periodic Screening, Diagnosis, and Treatment Program National Health and Nutrition Examination Surveys Special Supplemental Food Program for Women, Infants, and Children Medicaid Program Childhood Lead Poisoning Prevention Program WIC Public Law 102-531 Public Law 104-299