MEDICINE & HEALTH/RHODE ISLAND Evaluation of Case Management Services for Lead Poisoned Children In Rhode Island

Rhode Island mandates that all children under the age of six be screened for lead annually, and that all lead test results be reported to the RI Department of Health. Following the rec-ommendations of the Centers for Disease Control and Pre-vention (CDC) , the Rhode Island Childhood Lead Poison-ing Prevention Program (RI CLPPP) considers children un-der the age of six with a venous blood lead level (BLL)> 10 micrograms per deciliter (µg/dL) to be lead-poisoned.1 Health effects below this level are well documented;2,3 however, due to lack of efficacious interventions below 10 µg/dL, RI CLPPP has retained this threshold as its “action level ” for childhood lead poisoning. The services offered to lead poisoned children in RI vary depending on the severity of the poisoning. (Table 1) Case management services are offered through one of four certi-fied lead centers, non-profit Medicaid-funded agencies. In 2007, RI CLPPP conducted an evaluation of case man-agement services. The three main ob-jectives of the evaluation were to de-termine if: 1) there were demographic differences between families accepting and refusing services; 2) parental knowledge of lead increased after re-ceiving services; and 3) case manage-ment services had an impact on children’s BLLs. METHODS Data from three databases main-tained by the RI Department of Health were linked in order to con-duct the analyses. A total of 827 children were re-ferred to case management betwee