Pennsylvania Consolidated & Unconsolidated Statutes
Act 150 - CHILDHOOD BLOOD LEAD TEST ACT - ENACTMENT

An Act
 
Providing for blood lead assessment and testing of certain children and pregnant women
by health care providers; imposing duties on the Department of Health; and requiring
certain health insurance policies to cover blood lead tests.

 
The General Assembly of the Commonwealth of Pennsylvania hereby enacts as follows:
 
Section 1.  Short title.
This act shall be known and may be cited as the Childhood Blood Lead Test Act.
Section 2.  Legislative findings.
The General Assembly finds that:
(1)  Lead is a naturally occurring element that is toxic to humans when ingested or inhaled.
(2)  Severe lead poisoning causes convulsions, intellectual disabilities, seizures and
sometimes death.

(3)  Low-level exposure to lead reduces intelligence, delays cognitive growth and impairs
physical development.

(4)  Children who are in utero or less than seven years of age are most sensitive to lead
poisoning because their brains and nervous systems are still developing.

(5)  The only way to diagnose a child with an elevated blood lead level is through a blood
test.

(6)  The health and development of children is endangered by chipping or peeling lead-based
paint or lead-contaminated dust or soil in homes and neighborhoods throughout this
Commonwealth.

(7)  Other sources of lead exposure can be through lead service lines for drinking water
and lead solder used in drinking water lines, and lead in consumer products such as
toys, foods, cosmetics and ceramics are also of concern.

Section 3.  Legislative purpose.
The purposes of this act are:
(1)  To substantially reduce, and eventually eliminate, the incidence of childhood lead
poisoning in this Commonwealth.

(2)  To improve public awareness of lead safety issues in housing and educate both property
owners and tenants about practices that can reduce the incidences of lead poisoning.

(3)  To encourage the testing of all children in this Commonwealth by two years of age
so that prompt diagnosis and treatment, as well as the prevention of harm, are possible.

Section 4.  Definitions.
The following words and phrases when used in this act shall have the meanings given
to them in this section unless the context clearly indicates otherwise:

"Blood lead test."  A blood lead draw, whether by capillary, venous or unknown sample type, that produces
a quantifiable result and is analyzed by a Clinical-Laboratory-Improvement-Amendments-certified
facility or an approved portable device.

"Department."  The Department of Health of the Commonwealth.
"Elevated blood lead level."  A single blood lead test, whether capillary or venous, at or above the Centers for
Disease Control and Prevention's reference range value.

"Government program."  Any of the following:
(1)  The Commonwealth's medical assistance program established under the act of June 13,
1967 (P.L.31, No.21), known as the Human Services Code.

(2)  The children's health insurance program under Article XXIII-A of the act of May 17,
1921 (P.L.682, No.284), known as The Insurance Company Law of 1921.

"Health insurance policy."  A policy, subscriber contract, certificate or plan issued by an insurer that provides
hospital or medical/surgical health care coverage. The term does not include any of
the following:

(1)  An accident-only policy.
(2)  A credit-only policy.
(3)  A long-term care or disability income policy.
(4)  A specified disease policy.
(5)  A Medicare supplement policy.
(6)  A fixed indemnity policy.
(7)  A dental-only policy.
(8)  A vision-only policy
(9)  A workers' compensation policy.
(10)  An automobile medical payment policy.
(11)  A policy under which benefits are provided by the Federal Government to active or
former military personnel and their dependents.

(12)  A hospital indemnity policy.
(13)  Any other similar policy providing for limited benefits.
"Insurer."  An entity that offers, issues or renews an individual or group health, accident or
sickness insurance policy, contract or plan and that is subject to any of the following:

(1)  40 Pa.C.S. Ch. 61 (relating to hospital plan corporations) or 63 (relating to professional
health services plan corporations).

(2)  The Insurance Company Law of 1921, including section 630 and Article XXIV.
(3)  The act of December 29, 1972 (P.L.1701, No.364), known as the Health Maintenance Organization
Act.

Section 5.  Lead poisoning prevention, assessment and testing.
(a)  Lead testing for children.--
(1)  The following apply:
(i)  A health care provider shall consider possible lead exposure in an individual patient
by evaluating risk factors for lead exposure and perform blood lead testing in accordance
with recommendations from the Centers for Disease Control and Prevention and the American
Academy of Pediatrics by 24 months of age.

(ii)  If a patient has never been tested in accordance with recommendations from the Centers
for Disease Control and Prevention and the American Academy of Pediatrics by 24 months
of age, a health care provider shall consider possible lead exposure and perform blood
lead testing in an individual patient between 24 months and 72 months of age.

(iii)  A health care provider shall make reasonable efforts to ensure that a patient's parent
or legal guardian understands the risks and benefits of blood lead testing prior to
obtaining consent.

(2)  If a patient's parent or legal guardian consents to blood lead testing for the patient
under paragraph (1) and the results of a capillary blood lead test indicate an elevated
blood lead level, the health care provider shall perform a confirmatory blood lead
test by venipuncture within 12 weeks of the first blood lead test after obtaining
the consent of the patient's parent or legal guardian.

(b)  Lead exposure risk assessment and testing requirements for pregnant women.--A health
care provider shall consider possible lead exposure in individual pregnant women by
evaluating risk factors for lead exposure and perform blood lead testing if a single
risk factor is identified in accordance with recommendations from the Centers for
Disease Control and Prevention and the American College of Obstetricians and Gynecologists.

(c)  Reporting.--Health care providers and laboratories shall comply with reporting regulations
as specified in 28 Pa. Code § 27.34 (relating to reporting cases of lead poisoning).

Section 6.  Duties of department.
(a)  Comprehensive educational program.--The department shall conduct a public information
campaign to inform parents of young children, physicians, nurses and other health
care providers of the lead assessment and testing requirements of this act.

(b)  Distribution of literature about childhood lead poisoning.--
(1)  The department shall provide culturally and linguistically appropriate educational
materials regarding childhood lead poisoning, the importance of assessments and testing
for elevated lead levels, prevention of childhood lead poisoning, treatment of childhood
lead poisoning, remediation and, when appropriate, the requirements of this act.

(2)  Educational materials shall be available at no cost and shall be developed for specific
audiences, including health care providers, homeowners, landlords and parents or caregivers.

Section 7.  Blood lead assessment and testing coverage.
(a)  General rule.--A health insurance policy or government program covered under this
section shall provide to covered individuals or recipients blood lead tests as follows:

(1)  In the case of individuals or recipients who are pregnant, one blood lead test per
pregnancy if a single risk factor is identified in accordance with recommendations
from the Centers for Disease Control and Prevention and the American College of Obstetricians
and Gynecologists.

(2)  In the case of individuals or recipients who are under two years of age, at least
one blood lead test by 24 months of age in accordance with recommendations from the
Centers for Disease Control and Prevention and the American Academy of Pediatrics
and, if the result of the blood level test indicates an elevated blood lead level,
another blood lead test by venipuncture within 12 weeks of the blood level test in
which the elevated blood lead level was indicated.

(b)  Copayments, deductibles and coinsurance.--Coverage under this section shall be subject
to copayment, deductible and coinsurance provisions and any other general exclusions
or limitations of a health insurance policy or government program to the same extent
as other medical services covered by the policy or program are subject to these provisions.

(c)  Construction.--This section shall not be construed as limiting benefits which are
otherwise available to an individual under a health insurance policy or government
program.

Section 8.  Implementation.
Section 7 shall apply as follows:
(1)  For health insurance policies for which either rates or forms are required to be filed
with the Insurance Department or the Federal Government, section 7 shall apply to
any policy for which a form or rate is first filed on or after the effective date
of this section.

(2)  For health insurance policies for which neither rates nor forms are required to be
filed with the Insurance Department or the Federal Government, section 7 shall apply
to any policy issued or renewed on or after 180 days after the effective date of this
section.

Section 9.  Effective date.
This act shall take effect in 60 days.

Structure Pennsylvania Consolidated & Unconsolidated Statutes