How Medicaid can help protect kids from lead poisoning

Aug. 26--Ohio is expanding its efforts to protect children from lead poisoning now that the federal government gave the state more flexibility to use Medicaid funds to remove lead hazards.

There are far fewer lead poisoned children in Ohio than there were 20 years ago, but thousands still test positive every year. Children living in older housing with peeling paint -- often poor children with insurance through Ohio Medicaid -- are at particular risk of being poisoned by ingesting bits of old paint.

Ohio Gov. Mike DeWine announced last week that the Ohio Department of Medicaid is now federally approved to enhance and expand Medicaid's lead abatement program in partnership with the Ohio Department of Health.

"As I said when I rolled out my plan to fight lead poisoning in March, no child should be poisoned in their own home. As a result of this approval, Medicaid dollars will be used in more meaningful ways to abate lead and make homes safe for families," DeWine said in a statement.

More than 100 children under the age of 6 in Montgomery County were found to have above 5 micrograms per deciliter of lead in the blood in 2017, Ohio Health Department data shows. Ohio law requires action be taken by local health departments when children test above 5 micrograms per deciliter of lead in their blood.

With this approval, Medicaid will have greater flexibility to fund Ohio Department of Health lead hazard control projects in homes where a Medicaid-eligible child or pregnant woman lives, and to remove lead hazards in residential properties within targeted areas of the state.

The newly passed state budget for state fiscal year 2020-2021 marked $5 million in each year to fund this effort.

In the past, many property owners didn't use the program and the federally-approved changes are important because they will help make sure the money gets used.

Some of these changes include:

--Removing the requirement that property owners pay toward the total cost of lead abatement properties. Homeowners also used to be required to provide proof of homeowners' insurance and copies of birth certificates documenting the age of children living in the home, and those requirements are now removed.

--Considering new types of properties for lead hazard control funding under the program, such as a grandparent's house where the child spends more than six hours a week. This change recognizes that children can get lead poisoned outside of their own home.

--Giving permission to use program funding for workforce development, including hiring and training environmental case managers and community health workers supporting the parents and guardians of low-income children and pregnant women who have lead poisoning.

--Added flexibility to use program funding for primary prevention activities, including to abate a wider range of properties in target areas of the state and to purchase supplies that have been shown to reduce the presence of lead hazards in the home (e.g., HEPA vacuums, water filters, and other cleaning supplies). Initial targeted counties include Cuyahoga, Hamilton, Franklin, Summit, Lucas, and Mahoning.

A tiny amount of lead dust has the potential to cause learning disabilities, speech and hearing problems, and behavioral problems, among other challenges. However, given how many houses in Ohio were built before 1978, when lead paint was still used, it is a difficult and expensive public health problem to address.

Shannon Jones, executive director of Groundwork Ohio, which advocates on early childhood issues, said the best intervention is to prevent children from lead poisoning in the first place. But because of how common older housing is, she said it is important that the DeWine administration's approach also includes helping children with lead poisoning get help early, well before they are school age.

"What we know about the interventions and about the brain science around young children is we have to get there much earlier for the intervention to be really maximized," Jones said.

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