Childhood lead poisoning is an entirely preventable public health problem. In the District of? Columbia, the estimated prevalence of lead poisoning in children ages 0 to 6, at 2.8% in 2005, is? slightly higher than the 2.6% observed nationally. However, in poorly maintained residences in? low income neighborhoods, this risk is multiplied. More than half of the city?s housing stock? (51%) was constructed prior to 1950, when lead-based paint, the most common source of lead? poisoning in young children, was used.? While the District of Columbia has one of the highest per capita incomes in the United States, it? also has some of the deepest pockets of urban poverty. The poverty rate for 2000, at 20.2%, was? well above the 12.4% observed nationally. More than three-fourths of the District?s residents? with incomes below the federal poverty line (77%) were African America. Almost three-fourths? of the District?s children under age 18 (71%) are District are Medicaid recipients. It is these? impoverished children and families that are most likely to live in deteriorating homes and? apartments where lead-based paint poses the greatest risk. Other risks to these children include? contaminated soil, lead pipes in the home, and parents who are exposed to lead at work.? Additionally, children of immigrants, refugees and asylees may have been exposed to lead? through cooking utensils, pottery, candy, toys, jewelry and other unsafe household items more? commonly encountered in third world countries.? To address the serious public health problem posed by environmental health, the District of? Columbia Department of Health (DOH) seeks funding under a Cooperative Agreement with the? Centers for Disease Control and Prevention (CDC) in support of its Childhood Lead Screening? and Education Program (CLPSEP). Under the auspices of the Cooperative Agreement, the? CLPSEP will undertake a series of activities designed to finalize an Elimination Plan for? environmental lead hazard by 2010, which will be implemented by the CLPSEP pursuant to the? approval of the inter-agency Lead Screening Advisory Committee (LSAC). CLSEP?s goal for? 2010 is to reduce the incidence of new cases of childhood lead poisoning to 25 or fewer per? year?a sharp decline from 2005, when there were 351 new lead poisoning cases.? Under the Cooperative Agreement the CLPSEP will undertake a number of important activities? designed to achieve this goal. Specifically, the CLSEP will expand its capacity to perform blood? lead screening by hiring two new outreach investigators. The annual screening rate will be? increased from 53% to 95% of Medicaid recipients ages 0 to 6 and from 39% to 0% of all? District children in this age range.? Targeted outreach will be conducted in neighborhoods in which residences are under Consent? Decrees for lead-base paint abatement (n = 4,829) and/or replacement of lead pipes (n = 4,539).? Home visits to these residences and surrounding homes will include blood lead testing, visual? risk assessments, and tenant education on lead poisoning prevention. Referrals will be made as? appropriate for environmental investigations by the DOH Environmental Health Administration,? as well to the Department of Housing and Community Development for access to grants and? loans for lead abatement.? Under the Cooperative Agreement, the CLPSEP will continue to provide outreach, education and? lead screening to tenants of all residences to CLPSEP by the DOH Environmental Health? Administration for high environmental lead levels. In addition, the CLPSEP will collaborate? with DC Water and Sewer Authority to provide these services to families occupying receiving? services through the Lead Pipe Replacement Program. Finally, targeted outreach will be? provided to immigrants, refugees, asylees, and culturally diverse populations.? The CLPSEP will enhance its existing case management protocol to strengthen the coordination? and delivery of environmental and medical lead remediation services and enhance the? compliance of families with recommended procedures. The CLPSEP will also design and? implement a database to track property owners whose properties violate federal standards for? environmental lead. Repeated offenders will be referred to law enforcement officials. Finally,? the CLPSEP will implement procedures for screening and referral of low-income children to the? DC Medicaid Program.? The Lead Screening Advisory Committee convened by DOH will continue to meet monthly. Its? membership will be expanded to include additional representatives from the banking, lending,? construction, and real estate industries, to enhance awareness of lead poisoning and provide? education on legal requirements and effective methods for lead abatement. Partnerships with? health care providers, child care providers, and other strategic partners will be strengthened, and? CLPSEP will provide routine training and education to LSAC members to raise their awareness? of childhood lead poisoning. Members will also be used as channels to increase the? dissemination of lead poisoning educational materials to the general public.? Importantly, negotiations to seek Medicaid reimbursement for blood lead screening, home? assessments, and case management services will continue under the Cooperative Agreement.? Year 1 funds are requested in the amount of $1,191,722.?

National Institute of Health (NIH)
National Center for Environmental Health (NCEH)
State and Community-Based Childhood Lead Poisoning Prevention Program (H64)
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Special Emphasis Panel (ZEH1-SRC (99))
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Turner, Tiffany
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DC Department of Health
United States
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