At a glance
CDC supports Montana 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 successes.
About the program
The State of Montana 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 Montana, contact the program below.
Montana Department of Public Health & Human Services
2401 Colonial Dr.
Helena, MT 59604
Phone: (406) 417-9848
Note:
Success story: funding year 3
Creating a local partnership project to address childhood lead poisoning in Montana
Challenge
Most county and tribal health departments in Montana do not have dedicated staff time or sufficient resources to conduct lead poisoning prevention. Staff time is limited to following up on reportable blood lead test results. While the state health department has the resources, it does not have direct authority over local health jurisdiction (LHJ) activities because Montana Public Health is governed by a decentralized system. This system impedes state-wide initiatives to streamline efforts to prevent childhood lead poisoning in Montana.
Intervention
With input from state leadership and key partners, the Montana Childhood Lead Poisoning Prevention Program (MT CLPPP) launched the Local Partnership Project (LPP) in early 2023 to address local challenges through specific task orders. These task orders were designed to provide targeted support to local health jurisdictions (LHJs) by funding part-time staff positions and program-specific materials. To assess needs, MT CLPPP conducted a survey, with over 80% of responding LHJs (51 out of 60) expressing interest. As a result, eight health departments received funding. The funds are designated for four key activities: 1) conducting lead poisoning prevention outreach, 2) completing blood lead reporting and investigations, 3) collaborating with community groups, and 4) connecting lead-exposed children to necessary services.
Impact
The eight funded health departments provide public health services to over 38% of the children in Montana under 5 years old and contain 34% of the housing units built before 1950. In addition, four of these are home to federal superfund sites where lead is a concern. In total, over $180,000 will be allocated to counties for salaries yearly for approximately three years, and an average of $2,000 will be provided yearly to each county in additional funding. The LPP increases the local capacity to make sustainable improvements towards increasing blood lead testing and reporting, enhancing child lead surveillance through strategic local partnerships, and improving local referrals to services recommended for children with excessive lead exposure or risk. The MT CLPPP team encourages cross-county collaboration and coordination and regularly meets with funded health department who are required to submit quarterly reports to track performance and ensure deliverables are met. To assess the effectiveness of the Local Partnership Project, MT CLPPP will evaluate blood lead reporting by recipient jurisdiction to determine if there has been a change in reporting rates for the jurisdictions and whether the change, if any, is significant compared to changes in other jurisdictions. The results of this evaluation will be used to inform ongoing outreach and assistance to LHJs.
Funding for this work was made possible in part by NUE2EH001420 from CDC. The views expressed in this material do not necessarily reflect the official policies of CDC; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.
Success story: funding year 2
Improving blood lead surveillance in children at risk in Montana
Challenge
Prior to 2021, Montana did not have an active long-term childhood lead poisoning prevention program. The Administrative Rules of Montana (ARM) for reportable conditions and diseases only required laboratory reporting of venous-drawn blood lead results at or above 5 µg/dL. Montana Department of Public Health and Human Services (DPHHS) data from 2019 to 2020 showed that only 13% of children eligible for Medicaid were tested for blood lead compared with the estimated national testing prevalence of at least 45%. All children enrolled in Medicaid are required to be tested at ages 12 and 24 months. Further, using the results of a 2012 lead surveillance pilot study in Montana, DPHHS estimated that 88% of all children ages 1–2 years (regardless of Medicaid status) who may have had a blood lead level (BLL) of 5 µg/dL or higher went undetected during 2019–2020.
Intervention
In September 2021, the DPHHS launched the Montana Childhood Lead Poisoning Prevention Program (MT CLPPP) to increase blood lead testing for children younger than 6 years of age, enhance state-wide blood lead surveillance, and improve linkages to intervention services. DPHHS also conferred with local health jurisdictions about lowering Montana's reportable BLL from 5 to 3.5 µg/dL to be consistent with CDC's updated blood lead reference value. With strong support from partners, DPHHS drafted a rule amendment to the ARM for reportable conditions. DPHHS filed the amendment in July 2022, and it was adopted into the ARM two months later without opposition on September 24, 2022.
The ARM amendment expands reporting requirements to include all venous blood lead test results, regardless of BLL or age, and capillary blood lead test results ≥3.5 µg/dL for children younger than 16 years. MT CLPPP launched an outreach campaign to communicate these reporting rule changes to healthcare providers, laboratories, and local and tribal health jurisdictions.
Impact
The amendment to the blood lead reporting ARM has significantly increased the number of blood lead test results reported to the state. From September to December 2022, laboratories reported 73 cases with a BLL at or above 3.5 µg/dL compared with a yearly average of 17 cases from 2014 to 2019. By requiring more test results to be reported, the MT CLPPP will be able to improve state-wide blood lead surveillance and help identify children at risk of lead exposure sooner and connect them with recommended services. Outreach about the rule amendment has also increased awareness of MT CLPPP and lead poisoning prevention among local health jurisdictions and healthcare providers. By focusing on rule amendment, MT CLPPP will ensure the sustainability of Montana’s statewide lead poisoning prevention efforts.
Funding for this work was made possible in part by NUE2EH001420 from the CDC. The views expressed in this material do not necessarily reflect the official policies of the CDC; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.