State and Local Childhood Lead Poisoning Prevention Program

Massachusetts State Dept Of Pub Health, Boston MA

Investigators

Abstract

The Massachusetts Department of Public Health Childhood Lead Poisoning Prevention[unreadable] Program (MACLPPP) is seeking funding from the Centers for Disease Control and[unreadable] Prevention as a competitive grantee. Requested CDC funds will be used to enhance our[unreadable] extensive childhood lead poisoning prevention program which has been a part of the[unreadable] Massachusetts Department of Public Health for over twenty-five years. The program[unreadable] includes comprehensive case management teams consisting of a nurse case manager,[unreadable] environmental health inspector and family advocates. These components form a cohesive[unreadable] design which provides families with both medical and environmental intervention as[unreadable] called for by the Massachusetts's Lead Law, one of the strongest primary prevention[unreadable] statutes in the nation. CLPPPP staff, funded by CDC, is also responsible for health[unreadable] education, surveillance and epidemiology, data management, program management,[unreadable] fiscal and information technology support.[unreadable] The population, geographic and economic composition of Massachusetts results in a[unreadable] significant lead burden for children in our jurisdiction. The 1990 US Census indicates[unreadable] that Massachusetts has the second highest percent of pre-1950 housing units, or 46.8% of[unreadable] all housing, exceeded only by New York State, with 47.1%. CDC's own data indicates[unreadable] that there are 58, 454 children living in poverty in Massachusetts; 36,900 of whom live in[unreadable] homes built before 1950. In state fiscal year 2005 there were 3,187 Massachusetts[unreadable] children under the age of six who had lead levels of 10 ug/dL or greater. This is a rate of[unreadable] 1.4%, which is comparable to the national rate of 1.6% in the 1999-2002 NHANES[unreadable] survey. This data on screening and incidence considered in conjunction with our housing[unreadable] stock and our array of both urban and rural communities absolutely illustrates the need[unreadable] for continued CDC support for lead poisoning prevention in Massachusetts.[unreadable] Funding from CDC will ensure that MACLPPP continues comprehensive efforts to[unreadable] provide primary and secondary prevention services to children and their families[unreadable] throughout the commonwealth. The need for these resources will be increased as[unreadable] MACLPPP builds capacity and implements a system-based framework established in our[unreadable] strategic elimination plan to end childhood lead poisoning by 2010. As part of this plan,[unreadable] the Community Mobilization Network initiatives are underway with active programs in[unreadable] three of our highest risk communities. In 2006, MACLPPP plans to reconvene or[unreadable] Strategic Advisory Committee to share the accomplishments of these communities and[unreadable] explore implementation options of other key initiatives. In addition to our community[unreadable] mobilization efforts, MACLPPP has made strides towards building in-roads with Refugee[unreadable] and Immigrant Health Program (RIHP), including incorporating lead-related housing[unreadable] issues into a required questionnaire used to identify appropriate housing when placing[unreadable] refugee families.[unreadable] Massachusetts has afforded families with comprehensive case management services since[unreadable] 1982. Our case management system consists of a three-tiered approach addressing the[unreadable] medical, environmental, and social needs of a family. Furthermore, we continue to see[unreadable] significant progress in primary prevention and improvement of our housing through[unreadable] private sector inspections and remediation, which is due in large part to the strength of our statute and regulations. MACLPPP will use the first budget period to evaluate and[unreadable] formalize our policies and procedures to produce a finalized written case management[unreadable] plan.[unreadable] A critical element in the implementation of many of our major initiatives in Fiscal Year[unreadable] 2006 will be the utilization of the electronic case management system, referred to as the[unreadable] Kyran application. This application allows for the collection of multiple test results for an[unreadable] individual child over years. Furthermore the application allows for multiple children and[unreadable] their corresponding blood tests to be related to an individual address. Extensive work[unreadable] flows for the medical, home visiting, and environmental components have been[unreadable] developed which permits us to track the timeliness and effectiveness of our services. Our[unreadable] epidemiology component continues to track linkages with our data to Medicaid data.[unreadable] Moreover, MACLPPP is preparing to begin a data sharing project with Massachusetts's[unreadable] Women, infants and Children program. MACLPPP is looking forward to developing and[unreadable] enhancing our application allowing greater opportunities for extensive and in-depth[unreadable] program evaluation and surveillance capabilities. One of these new opportunities will[unreadable] involve working with geocoded environmental data to generate an environmental annual[unreadable] report, similar to the Massachusetts Needs Assessment on screening, which will present[unreadable] inspectional and remediation activities by city and town.[unreadable] Primary Prevention efforts continue to be one of MACLPPP's great strengths.[unreadable] MACLPPP is currently preparing a Request for Responses to competitively procure local[unreadable] community-based lead poisoning prevention health education contracts. The recipients of[unreadable] these Lead Health Education Trust Fund contracts will be required to organize and[unreadable] conduct 20 health education presentations annually, attend at least 8 health fairs or other[unreadable] local health events, distribute lead poisoning prevention health education materials[unreadable] throughout their region, and to plan and carry out local Lead Poisoning Prevention Week[unreadable] activities. In addition to our health education activities, environmental primary prevention[unreadable] efforts are still vigorous. As mentioned previously, Massachusetts has a well developed[unreadable] private sector responsible for a significant amount of inspections and remediation work in[unreadable] the state. MACLPPP environmental staff provides vital technical assistance to private[unreadable] lead inspectors, deleading contractors, and homeowners trained and authorized to do[unreadable] some limited deleading activities, in an effort to ensure these activities are done in a[unreadable] manner that protects the public's health and meets regulatory requirements. We continue[unreadable] to authorize owners to do specific deleading activities following regulatory guidelines[unreadable] similar to the federal lead safe work practices. To date we have authorized over 6000[unreadable] owners and owner's agents to undertake low and moderate risk deleading activities on[unreadable] their homes.[unreadable] MACLPPP maintains on-going partnerships with sister agencies like Medicaid, Women[unreadable] Infants and Children program as well as local grantees, community mobilization[unreadable] networks and boards of heath. Through this work we hope to achieve a solid and[unreadable] sustainable framework of both primary and secondary prevention measures that protects[unreadable] children from lead poisoning, improves our housing stock and helps us move towards the[unreadable] elimination lead poisoning by 2010.