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LINCOLN — If Nebraska truly wants to address the problem of lead poisoning in children, it ought to do what Iowa does and require blood testing before a child enters kindergarten.
That's the view of State Sen. Brenda Council of Omaha, who is asking the Legislature to make blood tests for lead part of the immunization regime that parents, or the state, must undertake.
Lead tests, which the senator estimates would cost between $7 and $22, would join the pre-kindergarten requirement for immunizations for such infectious diseases as measles, hepatitis B and chicken pox.
Lead poisoning is of considerable concern in Omaha. It is home to the largest residential Superfund site in the nation due to lead contamination, mostly in eastern Omaha, caused primarily by a lead smelting plant that long ago operated on the riverfront.
Health officials who testified in support of mandatory testing said lead poisoning is the No. 1 environmental threat to children. It contributes to diminished IQ, poor academic performance and behavioral problems. Reducing lead poisoning, they told the Legislature's Education Committee last week, could decrease crime and increase graduation rates.
In Iowa, where tests are mandated, about 90 percent of all kids are screened for lead poisoning. Only 16 percent of Nebraska youths are tested.
Even in Omaha, with its federally funded lead cleanup, relatively few children are tested. Just 28 percent are screened in Douglas County.
But Council's lead testing bill, which has 14 co-sponsors, faces an obstacle blocking lots of good ideas in the State Capitol this year — cost.
The state estimates that it would spend an additional $147,390 in state and federal funds by 2011-12 if it were required to test all children covered by Medicaid, not just those kids deemed at high risk of lead poisoning who are screened now.
Lead testing “is something we need to take a serious look at, and the fiscal note will certainly be a problem,” said Sen. Greg Adams of York, chairman of the Legislature's Education Committee.
This is a tough year for ideas that cost money because of the recession's impact on state tax revenue.
“Death by fiscal note” is a common phrase in the rotunda — the term for bills that are killed or fail to advance because of their cost.
One example was a proposal for better training of school staff members to handle kids with life-threatening allergies. It was shot down partly because its estimated cost was $46,000
Last week legislators plowed under a proposal to help beginning farms and small businesses obtain low-interest bank loans. That proposal would have cost $27,200 to implement, plus an additional $28,700 in lost revenue.
Council, who also is facilitator of a community advisory group that oversees the federal Environmental Protection Agency's work in Omaha, contends that the fiscal note on her bill is inflated. Even if there would be extra expense, she says, the state could save millions of dollars in the long run in health expenses.
The cost of special education services for such children alone is staggering, she told lawmakers on the Education Committee last week.
Council said the State Department of Health and Human Services has wrongly assumed that all Medicaid-eligible students must be tested under her proposal, Legislative Bill 962.
The bill, she said, has an “opt-out” provision that would allow the blood tests to be skipped if a doctor, through a questionnaire, determined that a child was at low risk of lead poisoning.
Currently, HHS tests about 2,740 children a year who are on Medicaid or in the Children's Health Insurance Program (CHIP) if the youngsters are determined, through an agency questionnaire, to be at high risk of lead poisoning. At least two risk factors must be found, such as living in a home that was built prior to the banning of lead paint in 1978, ingesting paint chips or living near facilities that emit lead.
HHS officials say they think few children would qualify for skipping the lead test under LB 962. That means almost all of the 8,500 children covered by Medicaid or CHIP would be tested at a cost of about $17 each, or $147,390.
Council said she plans to ask for a review of the fiscal note in hopes of reducing the expense projection.
In any case, the senator said, such tests would be worthwhile. She pointed out that the Legislature recently mandated that all seventh-graders, beginning this July, be immunized against whooping cough, and there were 276 cases of that disease in 2008.
By contrast, 441 students were found to have elevated levels of lead in their blood statewide in 2008, Council said, even though only a fraction of all students in Nebraska are tested for lead poisoning.
Contact the writer:
402-473-9584, paul.hammel@owh.com
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