WASHINGTON (AP) _ Only about 20 percent of the children in Medicaid are getting screened for elevated blood levels of lead, which can retard growth and lower in intelligence, a federal official suggested Wednesday.
The federal-state insurance program for the poor requires that all Medicaid-eligible children receive a blood screening test for lead at 12 months and 2 years, as recommended by the Centers for Disease Control and Prevention.
Any child age 2 to 6 for whom no record of a test exists also must be screened, program rules says.
Medicaid pays for the screenings and any diagnostic or treatment services required for children found to have elevated blood lead levels. It also will pay for a one-time investigation to find the source of the lead.
But Medicaid has run into problems collecting data on screening tests and ensuring the tests are performed, said Ruben King-Shaw, deputy administrator for the federal Centers for Medicare and Medicaid Services.
``We have very few powers to enforce this kind of provision,'' King-Shaw told a Senate Banking, Housing and Urban Affairs subcommittee. He estimated that about 20 percent of Medicaid-enrolled children under 6 are screened _ which translates into roughly 1.3 million children.
King-Shaw said that virtually the only enforcement mechanism available to the agency for health care providers who do not perform the screening is a suspension of Medicaid payments.
``I don't know that people want to see that as an enforcement measure,'' he said. He said the agency is doing outreach and education to improve the screening rate among poor children.
Sen. Jack Reed, D-R.I., the subcommittee chairman, asked King-Shaw to recommend to Congress changes in law that would help enforcement.
``The efforts to achieve the long-established goal of eliminating lead poisoning by the year 2010 have stalled,'' he said.
While average blood lead levels in U.S. children have fallen dramatically over the past 20 years, the CDC estimates that 500,000 to 750,000 children have blood lead levels above the recommended threshold. Many live in older, poorer neighborhoods where housing still contains lead paint.
For the 2003 budget year, which begins Oct. 1, President Bush proposed $126 million for a lead paint hazards program run by the Housing and Urban Affairs Department, compared with $110 million in the current year.
A department official estimated it would cost about $230 million a year, for 10 years, to fully mitigate lead paint hazards in the nation's low-income housing stock.