Indiana State Building

IDOH Guidance on Child Lead Testing

IDOH Guidance on Child Lead Testing Law, Effective January 1, 2023

On March 10, 2022, Governor Holcomb signed into law a bill requiring healthcare providers to ensure children under the age of seven receive lead testing, and if not, to offer this testing to the child’s parent or guardian. The bill is scheduled to take effect on January 1, 2023. 

The law includes references to a “blood lead screening test”, “screening children”, and “lead poisoning screening”. Each of these references refers to a capillary or venous blood lead test as defined in 410 IAC 29-1-3 and 410 IAC 29-1-25.

The law instructs the Indiana Department of Health (IDOH) to “establish guidance and standards for health care providers” who conduct screening and testing. Below is that guidance:

To ensure uniformity between HEA 1313 and the Medicaid Early and Periodic, Screening, Diagnostics, and Treatment (EPDST) guidelines, IDOH is requiring all providers to follow the steps below:

  1. Children should receive a blood lead test between the ages of nine (9) and fifteen (15) months, or as close as reasonably possible to the patient’s appointment. 
  2. Children should have another blood lead test between the ages of twenty-one (21) and twenty-seven (27) months, or as close as reasonably possible to the patient’s appointment. 
  3. Any child between twenty-eight (28) and seventy-two (72) months that does not have a record of any prior blood lead test must have a blood lead test performed as soon as possible. 

If a provider can verify, via the Children’s Health and Immunization Registry Program (CHIRP), or the records from another provider, that blood lead testing has occurred at the required interval(s), they are not obligated to repeat the procedure.

If a parent or guardian refuses to allow their child to be tested, providers are encouraged to document the refusal in writing and have the parent or guardian sign an attestation of refusal. A sample refusal attestation form is available on the IDOH Testing Requirements webpage. Providers are expected to keep a copy of the refusal, either digital or hard copy, with the patient record until the child reaches age 7. Providers are only required to keep a single refusal on file if a parent or guardian indicates they will not allow initial or follow-up testing.   

Pursuant to IC-41-39.4-3, all blood lead testing must be reported to IDOH within one week of receiving the result. Both providers and laboratories must report results.

If you would like education on how to conduct blood lead testing in-office, or would like IDOH support in obtaining capillary testing supplies or lab support, please reach out to the Lead and Healthy Homes Division at 317-233-1250.

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