Federal Medicaid Testing Requirement
Federal regulations require that all children enrolled in Medicaid receive a blood lead test at 12 and 24 months of age, or at 24 to 72 months of age if no record of a previous test exists. The Department of Health (DOH) recommends screening all children not covered by Medicaid at 12 and 24 months of age using this clinical algorithm (PDF).
Who Should be Tested
Talk to your health care provider about whether your child needs to be tested for lead. Your health care provider may ask you questions to see if your child is at risk of lead exposure. The only way to know for sure if your child has been exposed to lead is to have their blood tested.
If any of the following are true, your child could be at risk of lead exposure, and you should talk to your health care provider about a blood lead test.
My child lives in, or regularly visits a home built before 1978 that:
- Has peeling or chipping paint.
- Is now being remodeled.
- Was recently remodeled.
My child has:
- Chewed old painted surfaces.
- Licked or chewed vinyl mini-blinds.
- Put metal or painted toys or jewelry in their mouth.
- Been given the traditional remedies Azarcon, Greta, Paylooah, or the cosmetic Kohl.
- A brother, sister, or playmate with lead poisoning.
- Recently immigrated or been adopted from another country.
- Used pottery or ceramics made in other countries for cooking, storing, or serving food or drink.
Someone does one of these things in my house:
- Stained glass.
- Pottery with lead glazes.
- Making fishing weights.
- Reloading ammunition.
- Soldering with lead solder.
Someone who lives in my house works at:
- Remodeling older homes.
- Refinishing furniture.
- A battery factory or recycling plant.
- A metal products factory (lead or brass).
- A lead mining or smelting operation.
- A chemical factory.
- A radiator repair shop.
- An indoor firing range.
How Testing is Done
A health care provider will test your child's blood for lead. The test is simple. To find out how much lead is in a child's blood, a small amount of blood is taken from the child's arm or finger.
- Taking blood from a child's finger is called a finger-stick or a capillary test. You may be able to get the results that day. If your child's lead level is considered high, you may be asked to follow up on the capillary test with a venous blood test, which can be more accurate.
- The other test in which blood is taken from an arm vein (venous blood test) involves drawing blood into a tube and sending it to a lab. There could be a wait-time of several days to receive the results back from the lab.
What the Test Results Mean
A blood lead test tells us how much lead is in someone’s blood. This is known as the blood lead level. Blood lead levels are reported in micrograms per deciliter or “µg/dL”.
There is no known safe level of lead. The blood lead level will tell if your child has been exposed to lead in the last month.
Washington State’s blood lead action level is 3.5 µg/dL. This level is based on the national blood lead reference value (BLRV), which identifies a blood lead level higher than over 97% of U.S. children under age 6.
If your child has a blood lead level of 3.5 µg/dL or higher, you may be contacted by your child’s health care provider, Medicaid/Apple Health plan, and/or local public health agency for follow-up.
Handout:
Spanish: El plomo y la salud de su hijo (PDF)
If My Child Has Been Exposed to Lead
- The best thing you can do is identify the source of lead and remove or reduce your child’s access to that source.
- If your child has a blood lead test result of 3.5 µg/dL or higher, your health care provider should schedule additional testing to confirm and monitor their blood lead level.
- You may receive a phone call, letter, or email from your local health department or Medicaid/Apple Health plan. They can help you identify possible sources of lead in your child’s environment.
- Unless your child’s blood lead level is 45 µg/dL and above, there is no medication for lead exposure.
- Feed your child a diet that will help protect them from lead. Lead absorption is increased when there is not enough iron or calcium in a child’s diet. Give your child healthy foods, high in calcium, iron and vitamin C, and low in fat. Remember to wash your child’s hands with soap and water often, especially before meals and after playing outside.
More Information
Lead in Washington State - Who is at risk, health effects, and how to prevent exposure.