Connecticut

Objective: Determine whether Public Act 07-02 (universal blood lead screening legislation) has had an effect on increasing screening rates among 1-and 2-year-old children across Connecticut.

View the 2009 Connecticut Logic Model

Abstract: On, June 26, 2007, the Connecticut State Legislature enacted Public Act 07-02. The act, which mandates universal blood lead screening in the state, became effective January 1, 2009. Accordingly, primary care providers (PCPs) who provide pediatric care are now required to perform an annual blood lead test for (a) all children 1 and 2 years of age; (b) every child under the age of 6 who has not yet been screened—regardless of risk factors; and (c) any child whose risk assessment determines that he or she is at risk for elevated blood lead levels (EBLLs).

In addition to mandatory universal screening, Public Act 07-02 also lowers the blood lead level at which an environmental and medical case is opened. From the original one test indicating a blood lead level of at least 20 micrograms per deciliter (μg/dL), the act now requires case opening after two consecutive tests (3 months apart) indicating a blood lead level between 15 and 19 μg /dL.

Key-informant interviews, discussions, and site visits—as well as feedback from the CDC Public Health Advisor and from Connecticut Lead Poisoning Prevention and Control Program (CT LPPCP) staff—resulted in a logic model that depicts the program’s screening-related activities in relation to the program’s goal of increasing screening rates. In this way, the model assists in satisfying the newly mandated universal screening legislation.

Additionally, 10 preliminary recommendations now ensure that CT LPPCP reaches its goal of mandatory universal screening. These include

1. Emphasizing with PCPs mandatory universal lead screening in all education, outreach, and training activities;
2. Increasing the coordination of education and outreach activities conducted by the Connecticut Department of Public Health, local health departments, and other organizations;
3. Using the surveillance system and GIS to identify and map high-risk and underscreened areas;
4. Using these surveillance data and GIS maps to inform targeted education and outreach activities;
5. Expanding education and outreach activities to include churches and faith-based organizations, as well as self-insured companies;
6. Working to enforce the mandatory universal screening legislation by implementing a Medicaid Healthcare Effectiveness Data and Information Set (HEDIS) measure for lead screening and working with the Medicaid program to increase the reimbursement rate for PCPs who screen;
7. Continuing to collaborate with PCP-allies to provide education and outreach to other PCPs;
8. Encouraging PCPs to work in teams, including medical doctors, social workers, physician assistants, nurses, and outreach workers;
9. Working with local health departments to ensure that PCPs are aware of the case manager who deals with childhood lead poisoning prevention and control at their local health department; and
10. Considering housing a Lead Care II machine for CT LPPCP staff to screen children during education and outreach activities.

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