At a glance
CDC supports Texas 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 Texas received $665,000 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 Texas, contact the program below.
Texas Department of State Health Services
1100 W 49th ST.
Austin, TX 78756
Phone: 512-776-7111
Note:
Success story: funding year 3
Texas Childhood Lead Poisoning Prevention Program meets increased demand for follow-up care
Challenge
In 2021, CDC lowered the blood lead reference value (BLRV) from 5 µg/dL to 3.5 µg/dL to identify children with blood lead levels that are higher than most children's levels. The lowered BLRV helps to address health disparities from lead exposure. The Texas Childhood Lead Poisoning Prevention Program (TX CLPPP) implemented the lower BLRV in January 2023. This adjustment doubled the number of children eligible for intervention, demanding swift and effective interventions to maintain the high standards of care for children at risk of lead exposure in Texas.
Intervention
TX CLPPP added a new team member to implement a more streamlined and efficient process to help prevent childhood exposure to lead and refer those with blood lead levels (BLLs) at or above the BLRV to services. The new employee contributed to the case management workflow and brought valuable expertise in training of other new staff in prevention strategies. Two temporary staff members added the additional support needed to process the increase in parent and provider notifications for medical case management follow-up.
Impact
Despite the challenges of the lower BLRV, in 2023 TX CLPPP continued to meet the goal of providing guidance regarding referral and proper follow-up care to over 95% of children in Texas with BLLs at or above 3.5 µg/dL. This achievement showcases the dedication and resilience of the TX CLPPP team and underscores the effectiveness of added team members in managing a 72% increase in the number of children to receive intervention.
Funding for this work was made possible in part by [RFA-EH21-2102] from the Centers for Disease Control and Prevention (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 testing in Texas through a multi-faceted education and outreach plan
Challenge
The number of children tested for blood lead in Texas dropped 24%, from 337,982 children tested in 2019 to 265,571 in 2020. A slight increase in testing (8%, to 286,693 children) in 2021 was still below pre-pandemic testing numbers.
Intervention
The Texas Childhood Lead Poisoning Prevention Program (TXCLPPP) designed a multifaceted educational and outreach plan to promote and increase blood lead testing. From September 2021, to September 2022, TXCLPPP completed the following activities:
- Two newsletters: They published a spring and fall newsletter distributed to partners and available online.
- Eight webinar presentations: They presented to various partners, including the San Antonio Head Start Consortium, Texas Health Steps (THS) Provider Relations Outreach Meeting, THS managed care organizations medical directors, and the Strategic Planning Committee.
- One Texas Department of State Health Services Grand Rounds presentation: This was created in collaboration with THS, University of Texas at Austin, Dell Medical School, and the University of Texas at El Paso.
- Three in-person events: They exhibited at the Texas Pediatric Society Conference, Texas Nurse Practitioner Conference, and at the Day of Lead Event, in collaboration with San Antonio Green and Healthy Homes.
- One podcast recording: This was created with the Texas Medical Association.
- One social media campaign: This was launched during National Lead Poisoning Prevention Week in October 2021.
- Six new community connections: They helped to broaden outreach by establishing relationships with the Dell Medical Health Leadership Apprentice Program, Building and Strengthening Tenant Action (BASTA) – Austin, City of Houston Lead Abatement Program, San Antonio Head Start, Commission on State Emergency Communication, and the Texas Medical Association.
Impact
In 2022, the number of children ages 0–14 years tested for blood lead was 313,079, an approximately 18% increase from 2020, and a 9% increase from 2021. Through outreach events, TXCLPPP has also identified additional focus areas for future educational and outreach events to continue to improve testing rates in Texas.
Funding for this work was made possible in part by 6 NUE2EH001458-02-01 from the Centers for Disease Control and Prevention (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.
Success story: funding year 1
Increasing electronic reporting for improved efficiency in Texas
Challenge
Electronic health records are mandated in Texas, but electronic reporting of child blood lead level (BLL) test results is not mandated. Manual data entry of records requires a significant amount of resources and is prone to human error. Maintaining a database of more than 10 million BLL records, the Texas Department of State Health Services (DSHS) increased electronic reporting of BLL test results from 84% to nearly 87% of all records from 2014 to 2016. Still, it continued to receive an overwhelming number of hard copy results for processing―an additional 75,000 results in 2016 alone. Furthermore, the Texas Childhood Lead Poisoning Prevention Program (TX CLPPP) used a separate database for tracking the investigation and coordination of higher BLL cases. A more efficient approach was needed for collecting and reporting BLL data.
Intervention
TX CLPPP developed a pilot program to increase electronic reporting of BLL results by large healthcare providers and facilities. TX CLPPP developed a user-friendly electronic reporting tool that electronically validates and verifies the inclusion of all required data elements as results are submitted. These electronic spreadsheets are then transmitted to TX CLPPP via secure file transfer protocol for processing into a database shared with the state. TX CLPPP not only developed a more efficient system for data reporting sharing, it also identified organizations not yet filing results electronically and engaged them to adopt this process.
Impact
TX CLPPP received more than 92% of records electronically for the 9/30/2017 to 3/31/2018 reporting period, surpassing its 90% goal. TX CLPPP has since broadened its initiative to engage other organizations in electronic reporting and plans to update reporting rules to support this vital functionality.
Funding for this work was made possible in part by NUE2EH001357] 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.