Article 7 - Childhood Lead Poisoning Prevention Act

California Health and Safety Code — §§ 124125-124165

Sections (7)

Amended by Stats. 2018, Ch. 690, Sec. 5. (SB 1041) Effective January 1, 2019.

(a)The Legislature hereby finds and declares that childhood lead exposure represents the most significant childhood environmental health problem in the state today; that too little is known about the prevalence, long-term health care costs, severity, and location of these problems in California; that it is well known that the environment is widely contaminated with lead; that excessive lead exposure causes acute and chronic damage to a child’s renal system, red blood cells, and developing brain and nervous system; that at least one in every 25 children in the nation has an elevated blood lead level; and that the cost to society of neglecting this problem may be enormous.
(b)The Legislature further finds and declares that knowledge about where and to what extent

harmful childhood lead exposures are occurring in the state could lead to the prevention of these exposures, and to the betterment of the health of California’s future citizens. Therefore, the enactment of this article establishes a state Childhood Lead Poisoning Prevention Program. The department shall accomplish all of the following:

(1)Compile information concerning the prevalence, causes, and geographic occurrence of high childhood blood lead levels.
(2)Identify and target areas of the state where childhood lead exposures are especially significant.
(3)Analyze information collected pursuant to this article and, where indicated, design and implement a program of medical followup and environmental abatement and followup that will reduce the incidence of excessive childhood lead exposures in California.
(4)Work, as necessary, with the State Department of Health Care Services to advance lead testing of children enrolled in Medi-Cal.
(c)(1) By March 1, 2019, and by March 1 of each year thereafter, the department shall prepare and prominently post on its Internet Web site information that evaluates the department’s progress in meeting the goals of this section. The information shall also include all of the following:

(A) An annually updated analysis of the data and information identified and compiled relative to paragraphs (1) and (2) of subdivision (b).

(B) To the greatest extent possible, a list of the census tracts in which children test positive at a rate higher than the national average for blood lead in exceedance of the

federal Centers for Disease Control and Prevention’s reference level for elevated blood lead based on the data and information received during the previous calendar year.

(C) The report developed pursuant to Section 105295.

(2)All uses and disclosures of data made pursuant to this section shall comply with all applicable state and federal laws for the protection of the privacy and security of data, including, but not limited to, the Confidentiality of Medical Information Act (Part 2.6 (commencing with Section 56) of Division 1 of the Civil Code), the Information Practices Act of 1977 (Chapter 1 (commencing with Section 1798) of Title 1.8 of Part 4 of Division 3 of the Civil Code), Title 1.81 (commencing with Section 1798.80) of Part 4 of Division 3 of the Civil Code, the federal Health Insurance Portability and Accountability Act of 1996 (Public Law 104-191), and the federal

Health Information Technology for Economic and Clinical Health Act, Title XIII of the federal American Recovery and Reinvestment Act of 2009 (Public Law 111-5), and implementing regulations.

Amended by Stats. 2022, Ch. 528, Sec. 1. (AB 2326) Effective January 1, 2023.

(a)A laboratory that performs a blood lead analysis on a specimen of human blood drawn in California shall report the information specified in this section to the department for each analysis on every person tested.
(b)(1) The analyzing laboratory shall report all of the following:

(A) The test results in micrograms of lead per deciliter.

(B) The name of the person tested.

(C) The person’s birth date.

(D) The person’s

address, including the ZIP Code, and telephone number.

(E) The name, address, telephone number, and National Provider Identifier (NPI) of the health care provider that ordered the analysis.

(F) The name, address, telephone number, Clinical Laboratory Improvement Amendments (CLIA) number, and NPI of the analyzing laboratory.

(G) The accession number of the specimen.

(H) The date the analysis was performed.

(I) The person’s Medi-Cal client identification number (CIN) or, for other health plans, the name of the health plan and the medical plan identification number.

(J) The person’s sex.

(K) The person’s race and ethnicity.

(L) The person’s pregnancy status.

(M) The name, address, and telephone number of the person’s employer, if any.

(N) The date the specimen was drawn.

(O) The source of the specimen, specified as venous, capillary, arterial, cord blood, or other.

(P) The name, address, telephone number, and CLIA number of the referring laboratory, if any.

(Q) The testing methodology used for blood lead analysis specified as point of

care, inductively coupled plasma mass spectrometry, graphite furnace atomic spectroscopy, or other.

(2)The changes made to this subdivision by the act adding this paragraph shall become operative on July 1, 2023.
(c)The analyzing laboratory may report to the department other information that directly relates to the blood lead analysis or to the identity, location, health care management, or environmental management of the person tested.
(d)If the result of the blood lead analysis is a blood lead level equal to or greater than the most recent federal Centers for Disease Control and Prevention (CDC) reference level for an elevated blood lead level (BLL), the report required by this section shall be submitted within three

working days of the analysis. If the result is less than the CDC reference level for an elevated BLL, the report required by this section shall be submitted within 30 calendar days of the analysis. Timing of reporting shall be based on rounding of results to the nearest whole number.

(e)A report required by this section shall be submitted by electronic transfer.
(f)All information reported pursuant to this section shall be confidential, as provided in Section 100330, except that the department may share the information as follows:
(1)To the individual to whom the information pertains.
(2)With the prior written voluntary consent of the individual to whom

the information pertains or the person authorized to give consent on behalf of the individual, such as a child’s parent or guardian.

(3)When required by state or federal law.
(4)When compelled by an order of the court or an administrative hearing officer, if a protective order that prohibits any further disclosure is secured prior to disclosure.
(5)For the purpose of surveillance, case management, coordination of care, investigation, environmental assessment, environmental remediation, or abatement with the local health department, environmental

health agency authorized pursuant to Section 101275, building department, health care providers treating patients with elevated blood levels or receiving case management services, or a federal, state, or local governmental agency.

(6)For research, as defined in Part 46 of Title 45 of the Code of Federal Regulations, as may be amended, if the request for information is approved by the Committee for the Protection of Human Subjects (CPHS) for the California Health and Human Services Agency, the requesting entity provides documentation to the department that demonstrates, to the department’s satisfaction, that the entity has established the procedures and ability to maintain the confidentiality of the information, and the requesting entity has agreed, in writing, to maintain the confidentiality of the information.
(7)With the State Department of Health Care Services for the purpose of determining whether children enrolled in Medi-Cal are being screened for lead poisoning and receiving appropriate related services.
(g)(1) The State Department of Health Care Services and health care providers may further disclose the information reported pursuant to this section to a managed health care plan in which a beneficiary who is the subject of the information is enrolled, who may further disclose this information to the beneficiary’s health care provider to proactively offer and coordinate care and treatment services and administer payment programs.
(2)The local health department, environmental health agency, building

department, researcher, or federal, state, or local governmental entity shall not further disclose the information and shall otherwise maintain the confidentiality of the information in the manner provided in Section 100330.

(3)Notwithstanding any other law, a disclosure authorized pursuant to this section, except to the State Department of Health Care Services and to health care providers, shall include only the information necessary for the stated purpose of the requested disclosure, be used only for the approved purpose, and not be further disclosed.
(4)The State Department of Health Care Services and health care providers shall use, disclose, and maintain the confidentiality of information shared with it pursuant to this subdivision in accordance with the federal Health

Insurance Portability and Accountability Act of 1996, as may be amended, and pursuant to regulations promulgated thereto, and other laws applicable to information in possession of the State Department of Health Care Services and health care providers.

(h)The director may assess a fine up to five hundred dollars ($500) against a laboratory that knowingly fails to meet the reporting requirements of this section.
(i)A laboratory shall not be fined or otherwise penalized for failure to provide the patient information required by this section if the result of the blood lead analysis is a blood lead level less than the most recent CDC reference level for an elevated BLL and if all of the following circumstances exist:
(1)The test sample was sent to the laboratory by another health care provider.
(2)The laboratory requested the information from the health care provider who obtained the sample.
(3)The health care provider who obtained the sample and sent it to the laboratory failed to provide the patient’s information.
(j)A laboratory shall request from the health care provider who obtained the blood sample or ordered the test all information required by this section, as applicable. If the health care provider cannot, or will not, provide the requested information, the laboratory is not required to report the information.

Amended by Stats. 2017, Ch. 507, Sec. 8. (AB 1316) Effective January 1, 2018.

The Legislature hereby finds and declares that the activities conducted by the department pursuant to Section 124130 have confirmed and supported the findings specified in Section 124125 and, in addition, have resulted in the following findings:

(a)Very few children are currently tested for elevated blood lead levels in California. The lead registry established pursuant to Section 124130 has been effective at identifying incidents of occupational lead poisoning; however, because childhood lead screening is not now required in California, the registry is unable to serve as the exclusive mechanism to identify children with elevated blood lead levels. Additional blood lead screening needs to be done to identify children at high risk of lead

poisoning.

(b)Based on emerging information about the severe deleterious effects of low levels of lead on children’s health, the lead danger level is expected to continue to be lowered.
(c)Lead poisoning poses a serious health threat for significant numbers of California children. Based on lead registry reports and targeted screening results, the department has estimated that tens of thousands of California children may be suffering from blood lead levels greater than the danger level.
(d)The implications of lead exposure to children and pregnant women from lead brought home on the clothing of workers are unknown, but may be significant.
(e)Levels of lead found in soil and paint around and on housing constitute a health hazard to children living in

the housing. No regulations currently exist to limit allowable levels of lead in paint surfaces in California housing.

Added by Stats. 2017, Ch. 507, Sec. 9. (AB 1316) Effective January 1, 2018.

The department shall use an electronic database consistent with the goals outlined in Section 124125 to support electronic laboratory reporting of blood lead tests reported pursuant to Section 124130, management of lead-exposed children, and assessment of sources of lead exposures.

Added by Stats. 1995, Ch. 415, Sec. 8. Effective January 1, 1996.

(a)The department shall design and implement a screening program for lead exposure of children not older than seven years old in migrant labor camps where lead-based paint has been identified pursuant to Section 50710.5.
(b)The department may implement the screening program through the local health departments utilizing the department’s protocols. Notwithstanding any other provision of law, the department may contract with a nonprofit organization to assist in administration of the program. The contract shall not be subject to competitive bidding requirements.

Amended by Stats. 2004, Ch. 193, Sec. 128. Effective January 1, 2005.

The department shall continue to direct the Childhood Lead Poisoning Prevention Program to implement a program to identify and conduct medical followup of high-risk children, and to establish procedures for environmental abatement and followup designed to reduce the incidence of excessive childhood lead exposures in California. In implementing this program, the department shall utilize its own studies, as well as relevant information from the scientific literature and childhood lead poisoning programs from outside California. The particular activities specified in this section shall be initiated by January 1, 1990, and completed on or before January 1, 1993. The program shall include at least all of the following components:

(a)Lead screening. The department shall:
(1)Design and implement at least one pilot blood lead screening project targeting children at high risk of elevated blood lead levels. In designing any pilot projects, the department shall give special consideration to conducting screening through the Child Health Disability and Prevention Program.
(2)Conduct a pilot screening project to evaluate blood lead levels among children of workers exposed to lead in their occupations.
(3)Develop and issue health advisories urging health care providers to conduct routine annual screening of high-risk children between the ages of one and five years of age.
(4)Develop a program to assist local health departments in identifying and following up cases of elevated blood lead levels.
(5)Develop and conduct programs to educate health care providers regarding the magnitude and severity of, and the necessary responses to, the childhood lead poisoning problem in California.
(b)The department, in consultation with the Department of Housing and Community Development, shall adopt regulations governing the abatement of lead paint in and on housing, including, but not limited to, standards for enforcement, testing, abatement, and disposal.
(c)The department shall conduct a study to evaluate whether abatement of lead in soil is effective at reducing blood lead levels in children.

Added by Stats. 1995, Ch. 415, Sec. 8. Effective January 1, 1996.

After January 1, 1993, the department, through the Childhood Lead Poisoning Prevention Program, shall continue to take steps that it determines are necessary to reduce the incidence of excessive childhood lead exposure in California.