Blood-lead testing of Medicaid-eligible children is critical. A federal study found that more than 80% of lead poisoned children were eligible for Medicaid. Therefore, Medicaid has required testing since 1990.

Indiana recently released its 1999 blood lead testing results for Medicaid eligible children per federal mandate. This is the first time this information has been made available.

How can the numbers be so low — especially when the mandate is to reach 100%? How many children with lead poisoning were never tested and have suffered permanent damage as a result? Here is a sampling of the reasons IKE has heard so far.

• The data is incomplete. When a local health department conducts a test, the test is not logged into Medicaid until the doctor authorizes payment. Authorizations do not seem to be given. Therefore, many tests done by local health department tests are not included.
• Not all children get a medical screen. The data shows that about half don’t get an annual medical screen. However, 69% get a screen before 12-months old — our most at-risk kids.
• Doctors don’t order the tests. Some doctors don’t believe lead is a serious problem. Or they don’t see enough high levels to warrant the test. Whatever the reasons, this seems to be the greatest barrier to significantly increasing tests.
• Parents don’t get the tests as directed by the doctor. It is hard to tell how prevalent this problem is.