Services for Medical Providers

The Douglas County Health Dept. Childhood Lead Poisoning Prevention Program provides the following services to medical providers in Douglas County:

• Medical Office or Clinic Inservice for Staff

• Screening guidelines

  • Medicaid Screening Requirements
  • Targeted Screening Guidelines (see below)
    • Guidelines for testing in Iowa can be found at http://www.idph.state.ia.us/eh/common/pdf/lead/testplan.pdf with a flowchart on page 39 and questionaire on page 38. Questions can be directed to the Iowa Department of Public Health Bureau of Lead at 1-800-972-2026 or http://www.idph.state.ia.us/eh/lead_poisoning_prevention.asp
• Lead Specimen Collection Techniques
  • Samples of collection devices
  • Staff Training
    
    
• Literature for patient education
• Case Management of all children through age six with blood lead levels > 10 ug/dL (all blood lead tests are reportable under NE statute - see below).
  • General patient/family education
  • Co-ordination of care and follow-up testing following CDC guidelines between patient, physician or other primary medical provider, and CLPPP.
  • Family education including a home visit with assessment of possible exposure sources and exposure history. Referrals as needed for follow-up care or intervention (BLLs 15 ug/dL and above).
  • Environmental assessment for lead-based paint with lead hazard reduction follow-up and enforcement (BLLs 15 ug/dL and above).
  • Venous or capillary retesting (at home if needed) at no charge
    
    
• Treatment guidelines
  • Retesting Schedules for children with previously elevated blood lead levels and notification to clinic when children are due for retesting
  • Oral Chelation (Chemet) information
  • Medical Staff Advisory contacts - call 444-7825 for names of physicians with experience treating children with elevated blood lead levels

The DCHD CLPPP uses the following documents in developing policies and recommendations:

• Managing Elevated Blood Lead Levels Among Young Children: Recommendations from the Advisory Committee on Childhood Lead Poisoning Prevention(CDC) March 2002.   http://www.cdc.gov/nceh/lead/CaseManagement/caseManage_main.htm

• Recommendations for Blood Lead Screening of Young Children Enrolled in Medicaid: Targeting a Group at High Risk.

  Recommendations for Blood Lead Screening of Young Children Enrolled in Medicaid: Targeting a Group at High Risk.

  MMWR (Morbidity and Mortality Weekly Report) 2000 (Vol. 49, No. RR-14). http://www.cdc.gov/mmwr/pdf/rr/rr4914.pdf

• Screening Young Children for Lead Poisoning: Guidance for State and Local Public Health Officials, Centers for Disease Control and Prevention (CDC, 1997) http://www.cdc.gov/nceh/lead/guide/guide97.htm

• Preventing Lead Poisoning in Young Children - 4th revision of the statement on Preventing Lead Poisoning in Young Children by the Centers for Disease Control (CDC, 1991) http://aepo-xdv-www.epo.cdc.gov/wonder/prevguid/p0000029/p0000029.asp

• American Academy of Pediatrics Recommends Targeted Lead Screening Universal Screening in High-Risk Areas http://www.aap.org/policy/re9815.html