At a glance
CDC supports Mississippi and other state and local health departments, or their bona fide agents, through cooperative agreements to support childhood lead poisoning prevention activities. Read about the program's success.
About the program
The State of Mississippi received $465,000 through cooperative agreement EH21-2102 from the Centers for Disease Control and Prevention (CDC) in the third funding year. The funds address childhood lead poisoning prevention and surveillance programmatic activities being conducted from September 30, 2023, to September 29, 2024.
The strategies focus on:
- Ensuring blood lead testing and reporting
- Enhancing blood lead surveillance
- Improving linkages to recommended services
To learn more about these efforts in Mississippi, contact the program below.
Mississippi State Department of Health
570 E. Woodrow Wilson Drive
Jackson, MS 39216
Phone: 601-576-7447
Note:
Success story: funding year 3
Mississippi increases confirmatory lead testing rates
Challenge
Over the years, the Mississippi Lead Poisoning Prevention and Healthy Homes Program (MS LPPHHP) has identified families of children with capillary blood lead levels (BLLs) greater than or equal to CDC's blood lead reference value (BLRV) who have not returned to their primary care provider for a confirmatory venous BLL test. Since the program only provides services to families of children who have a confirmatory venous test, it was imperative for the program to address this issue.
Intervention
Beginning in July 2020, the program began the Presumptive Positive Project, which entailed sending the Request to Follow-up document to primary care providers to increase the percentage of children with higher capillary BLLs who receive a confirmatory blood lead test. This document is faxed monthly to providers who tested a child during the previous month with a presumptive positive BLL at or above the BLRV (which changed from 5 to 3.5 μg/dL on March 1, 2022). It serves as a reminder to the provider that the child must receive a confirmatory test based on the CDC guidelines. The provider is to complete this form and fax back to the program for documentation purposes. If the provider does not fax the document back, the program faxes the form to the provider three more times (14 days apart), for a total of four faxes to request the confirmatory test. Initially, when the first Request to Follow-up fax was sent to the provider, a Parent Follow-up letter was also sent to the family alerting them about the need to have the child retested to confirm the child's BLL. However, in April 2022, the program began sending the Parent Follow-up letter each time the Provider Follow-Up letter was faxed.
Impact
Between 1997 and 1999, only 2.8% of children with capillary BLLs of 5 μg/dL or higher received confirmatory venous testing within the same reporting period. In contrast, since the initiation of the Presumptive Positive Project in mid-2020, the rate of confirmatory venous testing for children with capillary BLLs of 3.5 μg/dL or higher has increased to 35.6%.
During January 1997 to December 1999, a total of 142 children had capillary BLLs of 5 μg/dL or higher, with only 6 of them receiving confirmatory venous testing. In comparison, from June 1, 2020, to December 2023, a total of 4,939 children had capillary BLLs of 3.5 μg/dL or higher, and 1,759 of them underwent confirmatory venous testing within the same reporting period.
Lastly the findings highlight a remarkable improvement in the rate of confirmatory venous testing within the same reporting period following the implementation of the Presumptive Positive Project, suggesting enhanced diagnostic accuracy and appropriate follow-up care for children with higher capillary BLLs.
Funding for this work was made possible in part by the Cooperative Agreement Number
[NUE2EH001427] from the Centers for Disease Control and Prevention (CDC). The views expressed in this material do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.
Success story: funding year 1
Expanded eligibility for early intervention services in Mississippi
Challenge
Historically, the Mississippi Lead Poisoning Prevention and Healthy Homes Program (MS LPPHHP) has referred children with elevated blood lead levels (BLLs) greater than or equal to 15 μg/dL to the Mississippi State Department of Health First Steps Early Intervention Program (EIP). EIP is a voluntary program, and most parents accept their referral; however, children with elevated BLLs less than 15 μg/dL were unable to qualify for these services.
Intervention
In January 2019, the State Interagency Coordinating Council lowered the threshold for an EIP referral from 15 μg/dL to 10 μg/dL. The council made this decision following input from the Mississippi State Department of Health's Pediatric Clinician and data analysis from MS LPPHHP that highlighted the number of children that would be eligible for a referral at a BLL of 10 μg/dL.
For children with elevated BLLs greater than or equal to 10 μg/dL to receive EIP services, a referral form must be submitted by MS LPPHHP. After receiving the referral, EIP completes the following steps:
- A notice of referral letter is mailed to the family within two days.
- A service coordinator is assigned and contacts the family within five days.
- The service coordinator has forty-five days to determine eligibility by conducting a comprehensive and multidisciplinary evaluation assessment of the child and family.
- An Individualized Family Service Plan is developed that identifies educational, medical, and developmental services needed to support the child and family. The family is linked to social support and services, ensuring the provision of family-focused, evidence-based early intervention practices within thirty days.
Additionally, MS LPPHHP and EIP are in the process of revising the Child Health Referral form to make it a two-way referral, which would also allow EIP to make referrals to MS LPPHHP.
Impact
Since lowering the threshold for automatic EIP eligibility, the MS LPPHHP has made 40 referrals to EIP for children with elevated BLLs greater than or equal to 10 μg/dL. Furthermore, decreasing the blood lead level (BLL) threshold for EIP resulted in referring 22 children to services needed to improve their quality of life that they would not have received when a threshold for a referral was a BLL greater than or equal to 15 μg/dL.
Funding for this work was made possible in part by NUE2EH001396 from the Centers for Disease Control and Prevention (CDC). The views expressed in this material do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.