HB 79 — An Act providing for blood lead testing of certain children by health care practitioners; and imposing duties on the Department of Health.

PRIOR PRINTER'S NO.

82 PRINTER'STHE NO.GENERAL ASSEMBLY OF PENNSYLVANIA HOUSE BILL Session of No.

2935 THE GENERAL ASSEMBLY OF PENNSYLVANIA HOUSE BILL Session of No.

DAVIS, KENYATTA, OTTEN, HILL-EVANS, SAMUELSON, SCHLOSSBERG, SIMS, INNAMORATO, McCLINTON, DiGIROLAMO, MULLINS, RAVENSTAHL, KORTZ, DALEY, VITALI,VITALI AND WARREN, ROEBUCK,JANUARY GAINEY,28, CEPHAS,2019 BULLOCK,REFERRED CIRESI,TO D.COMMITTEE ON CHILDREN AND YOUTH, JANUARY 28, 2019 AN ACT Providing for blood lead testing of certain children by health care providers, for health insurance coverage for blood lead testing and imposing duties on the Department of Health.

MILLER, ROZZI, READSHAW, FRANKEL, WHEATLEY, McCARTER, O'MARA, LEE AND BOBACK, JANUARY 28, 2019 AS REPORTED FROM COMMITTEE ON CHILDREN AND YOUTH, HOUSE OF REPRESENTATIVES, AS AMENDED, NOVEMBER 20, 2019 AN ACT Procare providers, for health insurance coverage for blood lead <-- testing PRACTITIONERS;

and imposing duties on the Department <-- of Health.

<-- The General Assembly finds and declares as follows:

20190HB0079PN2935 - 2 - (5) To require the testing of all children in this Commonwealth at one and two years of age so that prompt 20190HB0079PN0082 - 2 - diagnosis and treatment, as well as the prevention of harm, are possible.

Section 44. 2.

<-- 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:

"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.

"HEALTHSection CARE5. FACILITY." A HOSPITAL OR HEALTH CARE FACILITY <-- THAT IS LICENSED, CERTIFIED OR OTHERWISE REGULATED TO PROVIDE HEALTH CARE SERVICES UNDER THE LAWS OF THIS COMMONWEALTH.

"HEALTH CARE PRACTITIONER." AS DEFINED IN SECTION 103 OF THE ACT OF JULY 19, 1979 (P.L.130, NO.48), KNOWN AS THE HEALTH CARE FACILITIES ACT.

Section 5 3.

<-- (a) Lead testing requirements.-- <-- (1) A health care provider shall make reasonable efforts to ensure that patients under the health care provider's care receive a blood lead test between nine and twelve months of age and again at approximately 24 months of age.

(2) If the results of the blood lead test indicate an 20190HB0079PN2935 - 3 - 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.

(b) Nonapplicability.--The testing requirements in this section shall not apply if a child's parent or legal guardian 20190HB0079PN0082 - 3 - objects in writing to the blood lead test on religious grounds or on the basis of a strong moral or ethical conviction similar to a religious belief.

(A)Section LEAD6. TESTING REQUIREMENTS.--A CHILD SHALL RECEIVE A <-- BLOOD LEAD TEST BETWEEN NINE AND 12 MONTHS OF AGE AND AGAIN AT APPROXIMATELY 24 MONTHS OF AGE.

THE FOLLOWING APPLY:

(1) A HEALTH CARE PRACTITIONER PROVIDING HEALTH CARE SERVICES TO CHILDREN UNDER TWO YEARS OF AGE SHALL PERFORM LEAD TESTING ON THOSE CHILDREN, UNLESS THE HEALTH CARE PRACTITIONER, AFTER QUERYING THE STATEWIDE REGISTRY PROVIDED FOR UNDER SECTION 4(C), DETERMINES THAT THE CHILD HAS ALREADY UNDERGONE LEAD TESTING.

(2) A CHILD WHO HAS NOT HAD HIS BLOOD LEAD LEVEL TESTED BETWEEN APPROXIMATELY NINE AND 12 MONTHS OF AGE AND AGAIN AT APPROXIMATELY 24 MONTHS OF AGE SHALL HAVE HIS BLOOD LEAD LEVEL TESTED AS SOON AS POSSIBLE AFTER 24 MONTHS OF AGE BUT BEFORE 72 MONTHS OF AGE.

(B) ADDITIONAL TESTING.--IF THE RESULTS OF A BLOOD LEAD TEST INDICATE A BLOOD LEAD LEVEL AT OR ABOVE THE REFERENCE VALUE FOR EXPOSURE IDENTIFIED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION, THE HEALTH CARE PRACTITIONER SHALL PERFORM A CONFIRMATORY BLOOD LEAD TEST BY VENIPUNCTURE WITHIN 12 WEEKS OF 20190HB0079PN2935 - 4 - THE FIRST BLOOD LEAD TEST AND WITHIN THE TIME FRAME RECOMMENDED BY THE CENTERS FOR DISEASE CONTROL AND PREVENTION.

(C) REPORTING.--HEALTH CARE PRACTITIONERS, HEALTH CARE FACILITIES AND LABORATORIES SHALL COMPLY WITH 28 PA.

CODE § 27.34 (RELATING TO REPORTING CASES OF LEAD POISONING).

Section 6 4.

<-- (a) Comprehensive educational program.--The department shall conduct a public information campaign to inform parents of young children, physicians, nurses HEALTH CARE PRACTITIONERS, HEALTH <-- CARE FACILITIES and other health care providers of the lead testing requirements under 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 testing for elevated lead levels, INSURANCE COVERAGE FOR TESTING, <-- INCLUDING INFORMATION REGARDING THE MEDICAL ASSISTANCE (MA) EARLY AND PERIODIC SCREENING, DIAGNOSTIC AND TREATMENT (EPSDT) PROGRAM AND HOW TO ENROLL, 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, PRACTITIONERS, HEALTH CARE FACILITIES, <-- homeowners, landlords and parents or caregivers.

(c) Statewide registry.--The department shall develop an electronic system to provide for the confidential storage and management of blood lead testing information that enables a 20190HB0079PN2935 - 5 - health care provider PRACTITIONER to review a patient's history <-- to determine the status of blood lead testing required under this act.

<-- (a) General rule.--A health insurance policy or government program covered under this section shall provide to covered individuals or recipients who are under two years of age coverage for one blood lead test during the time period between 20190HB0079PN0082 - 4 - nine and twelve months of age, one blood lead test at approximately 24 months of age and, if the results of either of the blood level tests indicate an elevated blood lead level, an additional blood lead test by venipuncture within 12 weeks of the blood level test in which the elevated blood lead level was indicated.

20190HB0079PN2935 - 6 - (ii) A credit only policy.

20190HB0079PN0082 - 5 - (viii) A dental only policy.

(2) For health insurance policies for which neither 20190HB0079PN2935 - 7 - rates nor forms are required to be filed with the Insurance Department or the Federal Government, this act shall apply to any policy issued or renewed on or after 180 days after the effective date of this section.

Section 99. 5.

<-- The department shall MAY promulgate rules and regulations <-- necessary to administer this act.

Section 1010. 6.

Effective DateDate. DATE.

<--20190HB0079PN0082 - 6 - This act shall take effect in 60 days.

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