Oregon

The Oregon Childhood Lead Poisoning Prevention Program (OCLPPP) wanted to determine the best strategy for identifying eligible children and educating families about Early Intervention/Early Childhood Special Education (EI/ECSE) services. According to the current policy under the Oregon Department of Education (ODE), only children with an elevated blood lead level (BLL) at or above 10 micrograms per deciliter (µg/dL), which accounts for about one quarter of Oregon’s elevated BLL cases, are eligible to receive EI/ECSE services. OCLPPP also wanted to expand these services to children with elevated BLLs at or above 5 µg/dL.

OCLPPP collaborated with ODE and determined that the best strategy for identifying eligible children and educating families on the referral process was a two-part approach:

1. For medical providers, EI/ECSE information was posted on OCLPPP’s website including weblinks to ODE’s site.
2. For families, a letter and ODE brochure were mailed directly to families whose child was eligible according to the current policy (at or above 10 µg/dL).

In early 2019, OCLPPP used the 2012 National Toxicology Program monograph, Health Effects of Low-Level Lead, to demonstrate that sufficient evidence exists for cognitive and developmental delays with elevated BLLs less than 10 µg/dL. ODE reduced the eligibility criteria to the current CDC blood lead reference value, which now identifies every child with an elevated BLL greater than 5 µg/dL as being eligible for EI/ECSE services in Oregon. OCLPPP revised information on the program’s website and held webinars to share this information with health departments. OCLPPP encourages all health department staff members that perform elevated BLL investigations to bring along the ODE brochure for EI/ECSE referrals.

Because ODE now provides information on EI/ECSE referrals as a regular part of case management to families of children with an elevated BLL at or above 5 µg/dL, more children are receiving these services than before the intervention.