Medi-Cal: blood lead screening tests.

Existing law provides for the Medi-Cal program, which is administered by the State Department of Health Care Services, under which qualified low-income individuals receive health care services. The Medi-Cal program is, in part, governed and funded by federal Medicaid program provisions. Existing law authorizes the department to enter contracts with managed care plans to provide Medi-Cal services. Under existing law, Medi-Cal covers early and periodic screening, diagnosis, and treatment for individuals under 21 years of age, consistent with federal law. Existing law requires the State Department of Public Health to adopt regulations establishing a standard of care under which a child is evaluated for risk of lead poisoning by health care providers during the child's periodic health assessment. This bill would require the State Department of Health Care Services to ensure that a child enrolled in Medi-Cal receives blood lead screening tests at 12 and 24 months of age, or at any time at which the child is identified as having a high risk of lead exposure, as described by the State Department of Public Health, and that a child 2 to 6 years of age, inclusive, receives a blood lead screening test if there is no record of a previous test for that child. The bill would require the department to report its progress toward blood lead screening tests for all enrolled children, as specified, in its annual External Accountability Set as part of the annual external quality review organization review, and annually on its Internet Web site, to ensure Medi-Cal managed care plans make certain each enrolled child receives required blood lead screening tests, and to ensure Medi-Cal managed care plans require health care providers to test enrolled children, as specified. The bill would further require the department to ensure a Medi-Cal managed care plan notifies a child's parent, parents, guardian, or other person charged with his or her support and maintenance, and the child's health care provider, with specified information, including when a child has missed a required blood lead screening test, as specified. The bill would require a contract between the department and a Medi-Cal managed care plan to ensure the plan and its contractors meet the standard of care for early and periodic screening when providing lead testing. This bill would require the State Department of Public Health to prepare provider training guidelines, curriculum, and resources to educate providers about childhood lead poisoning prevention, exposure risks, exposure health effects, and sources of exposure. The bill would require the State Department of Health Care Services to ensure a Medi-Cal managed care plan notifies and educates a contracted health care provider that, for 2 consecutive 12-month periods, fails to blood lead test at least 80% of the enrolled children, as specified, and to ensure that education reflects the training guidelines, curriculum, and resources developed by the State Department of Public Health. The bill would provide that it is the goal of the state that all children at risk of lead exposure receive blood lead screening tests. The bill would also make findings and declarations.