II

107TH CONGRESS

1ST SESSION S. 1469

To amend the Head Start and Early Head Start programs to ensure that

children eligible to participate in those programs are identified and treated for lead poisoning, and for other purposes.

IN THE SENATE OF THE UNITED STATES

SEPTEMBER 26, 2001

Mr. REED (for himself, Mr. TORRICELLI, Mrs. CARNAHAN, Mr. DURBIN, Mr.

LIEBERMAN, Mr. WELLSTONE, and Mrs. CLINTON) introduced the following bill; which was read twice and referred to the Committee on

Health, Education, Labor, and Pensions

A BILL

To amend the Head Start and Early Head Start programs

to ensure that children eligible to participate in those

programs are identified and treated for lead poisoning,

and for other purposes.

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled,

3 SECTION 1. SHORT TITLE.

4 This Act may be cited as the ‘‘Early Childhood Lead

5 Poisoning Prevention Act of 2001’’.
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1 SEC. 2. LEAD POISONING SCREENING FOR THE HEAD

2 START AND EARLY HEAD START PROGRAMS.

3 Section 645A of the Head Start Act (42 U.S.C.

4 9840a) is amended—

5 (1) in the first sentence of subsection (d), by in6 serting before the period the following: ‘‘and shall

7 comply with subsection (h)’’; and

8 (2) by adding at the end the following:

9 ‘‘(h) LEAD POISONING SCREENING.—

10 ‘‘(1) IN GENERAL.—An entity shall—

11 ‘‘(A) determine whether a child eligible to

12 participate in the program described in sub13 section (a)(1) has received a blood lead screen14 ing test using a test that is appropriate for age

15 and risk factors upon the enrollment of the

16 child in the program; and

17 ‘‘(B) in the case of a child who has not re18 ceived a blood lead screening test, ensure that

19 each enrolled child receives such a test either by

20 referral or by performing the test (under con21 tract or otherwise).

22 ‘‘(2) SCREENINGS BY ENTITIES.—

23 ‘‘(A) IN GENERAL.—An entity may (under

24 contract or otherwise) perform a blood lead

25 screening test that is appropriate for age and
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1 risk factors on a child who seeks to participate

2 in the program.

3 ‘‘(B) REIMBURSEMENT.—

4 ‘‘(i) CHILDREN ENROLLED IN OR ELI5 GIBLE FOR MEDICAID.—On the request of

6 an entity that performs or arranges for the

7 provision of a blood lead screening test

8 under subparagraph (A) of a child that is

9 eligible for or receiving medical assistance

10 under a State plan under title XIX of the

11 Social Security Act (42 U.S.C. 1396 et

12 seq.), the Secretary of Health and Human

13 Services, notwithstanding any other provi14 sion of, or limitation under, title XIX of

15 the Social Security Act, shall reimburse

16 the entity, from funds that are made avail17 able under that title, for the Federal med18 ical assistance percentage (as defined in

19 section 1905(b) of the Social Security Act

20 (42 U.S.C. 1396d(b)) of the cost of the

21 test and data reporting. Such costs shall

22 include, if determined to be desirable by

23 the State agency, the costs of providing

24 screening through clinical laboratories cer25 tified under section 353 of the Public
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1 Health Service Act (42 U.S.C. 263a), or

2 purchasing, for use at sites providing serv3 ices under this section, blood lead testing

4 instruments and associated supplies ap5 proved for sale by the Food and Drug Ad6 ministration and used in compliance with

7 such section 353.

8 ‘‘(ii) CHILDREN ENROLLED IN OR EL9 IGIBLE FOR SCHIP.—In the case of a blood

10 lead screening test performed under sub11 paragraph (A) (by the entity or under con12 tract with the entity) on a child who is eli13 gible for or receiving medical assistance

14 under a State plan under title XXI of the

15 Social Security Act, the Secretary of

16 Health and Human Services, notwith17 standing any other provision of, or limita18 tion under, such title XXI, shall reimburse

19 the entity, from funds that are made avail20 able under that title, for the enhanced

21 FMAP (as defined in section 2105(b) of

22 the Social Security Act (42 U.S.C.

23 1397ee(b)) of the cost of the test and data

24 reporting. Such costs shall include the
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1 costs described in the second sentence of

2 clause (i).

3 ‘‘(3) AUTHORIZATION FOR EARLY HEAD

4 START.—There is authorized to be appropriated

5 such sums as may be necessary to carry out this

6 subsection with respect to blood lead screening tests

7 performed under this subsection on an infant or

8 child, and any data reporting with respect to such

9 infant or child, who is not eligible for coverage under

10 title XIX or XXI of the Social Security Act, or is

11 not otherwise covered under a health insurance plan.

12 ‘‘(4) RULE OF CONSTRUCTION.—Nothing in

13 this subsection shall be construed as requiring a

14 child eligible to participate in the program described

15 in subsection (a)(1) to undergo a blood lead screen16 ing test if the child’s parent or guardian objects to

17 the test on the ground that the test is inconsistent

18 with the parent’s or guardian’s religious beliefs.

19 ‘‘(5) HEAD START.—The provisions of this sub20 section shall apply to head start programs that in21 clude coverage, directly or indirectly, for infants and

22 toddlers under the age of 3 years.’’.
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1 SEC. 3. LEAD POISONING SCREENING FOR SPECIAL SUP2 PLEMENTAL NUTRITION PROGRAM FOR

3 WOMEN, INFANTS, AND CHILDREN.

4 Section 17(d) of the Child Nutrition Act of 1966 (42

5 U.S.C. 1786(d)) is amended by adding at the end the fol6 lowing:

7 ‘‘(4) LEAD POISONING SCREENING.—

8 ‘‘(A) IN GENERAL.—A State agency

9 shall—

10 ‘‘(i) determine whether an infant or

11 child eligible to participate in the program

12 under this section has received a blood lead

13 screening test using a test that is appro14 priate for age and risk factors upon the

15 enrollment of the infant or child in the

16 program; and

17 ‘‘(ii) in the case of an infant or child

18 who has not received a blood lead screen19 ing test—

20 ‘‘(I) refer the infant or child for

21 receipt of the test; and

22 ‘‘(II) determine whether the in23 fant or child receives the test during

24 a routine visit with a health care pro25 vider.

26 ‘‘(B) SCREENINGS BY STATE AGENCIES.—
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1 ‘‘(i) IN GENERAL.—A State agency

2 may (under contract or otherwise) perform

3 a blood lead screening test that is appro4 priate for age and risk factors on an infant

5 or child who seeks to participate in the

6 program.

7 ‘‘(ii) REIMBURSEMENT.—

8 ‘‘(I) CHILDREN ENROLLED IN OR

9 ELIGIBLE FOR MEDICAID.—On the re10 quest of a State agency that performs

11 or arranges for the provision of a

12 blood lead screening test under clause

13 (i) of an infant or child that is eligible

14 for or receiving medical assistance

15 under a State plan under title XIX of

16 the Social Security Act (42 U.S.C.

17 1396 et seq.), the Secretary of Health

18 and Human Services, notwithstanding

19 any other provision of, or limitation

20 under, title XIX of the Social Security

21 Act, shall reimburse the State agency,

22 from funds that are made available

23 under that title, for the Federal med24 ical assistance percentage (as defined

25 in section 1905(b) of the Social Secu-
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1 rity Act (42 U.S.C. 1396d(b)) of the

2 cost of the test and data reporting.

3 Such costs shall include, if determined

4 to be desirable by the State agency,

5 the costs of providing screening

6 through clinical laboratories certified

7 under section 353 of the Public

8 Health Service Act (42 U.S.C. 263a),

9 or purchasing, for use at sites pro10 viding services under this section,

11 blood lead testing instruments and as12 sociated supplies approved for sale by

13 the Food and Drug Administration

14 and used in compliance with such sec15 tion 353.

16 ‘‘(II) CHILDREN ENROLLED IN

17 OR ELIGIBLE FOR SCHIP.—In the case

18 of a blood lead screening test per19 formed under clause (i) (by the State

20 agency or under contract with the

21 State agency) on an infant or child

22 who is eligible for or receiving medical

23 assistance under a State plan under

24 title XXI of the Social Security Act,

25 the Secretary of Health and Human
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1 Services, notwithstanding any other

2 provision of, or limitation under, such

3 title XXI, shall reimburse the State

4 agency, from funds that are made

5 available under that title, for the en6 hanced FMAP (as defined in section

7 2105(b) of the Social Security Act (42

8 U.S.C. 1397ee(b)) of the cost of the

9 test and data reporting. Such costs

10 shall include the costs described in the

11 second sentence of subclause (I).

12 ‘‘(C) AUTHORIZATION OF APPROPRIA13 TIONS.—There is authorized to be appropriated

14 such sums as may be necessary to carry out

15 this paragraph with respect to blood lead

16 screening tests performed under this paragraph

17 on an infant or child, and any data reporting

18 with respect to such infant or child, who is not

19 eligible for coverage under title XIX or XXI of

20 the Social Security Act, or is not otherwise cov21 ered under a health insurance plan.

22 ‘‘(D) RULE OF CONSTRUCTION.—Nothing

23 in this paragraph shall be construed as requir24 ing a child eligible to participate in the program

25 under this section to undergo a blood lead
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1 screening test if the child’s parent or guardian

2 objects to the test on the ground that the test

3 is inconsistent with the parent’s or guardian’s

4 religious beliefs.’’.

5 SEC. 4. EFFECTIVE DATE.

6 (a) IN GENERAL.—Except as provided in subsection

7 (b), the amendments made by this Act take effect on the

8 date that is 18 months after the date of enactment of this

9 Act.

10 (b) WIC AND EARLY HEAD START WAIVERS.—

11 (1) IN GENERAL.—A State agency or contractor

12 administering the program of assistance under the

13 special supplemental nutrition program for women,

14 infants and children (WIC) under section 17 of the

15 Child Nutrition Act of 1966 (42 U.S.C. 1786), or an

16 entity carrying out activities under section 645A of

17 the Head Start Act (42 U.S.C. 9840a) may be

18 awarded a waiver from the amendments made by

19 sections 2 and 3 (as applicable) if the State where

20 the agency, contractor, or entity is located estab21 lishes to the satisfaction of the Secretary of Health

22 and Human Services, in accordance with require23 ments and procedures recommended in accordance

24 with paragraph (2) to the Secretary by the Director

25 of the Centers for Disease Control and Prevention,
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1 in consultation with the Centers for Disease Control

2 and Prevention Advisory Committee on Childhood

3 Lead Poisoning Prevention, a plan for increasing the

4 number of blood lead screening tests of children en5 rolled in the WIC and the Early Head Start pro6 grams in the State.

7 (2) DEVELOPMENT OF WAIVER PROCEDURES

8 AND REQUIREMENTS.—Not later than 12 months

9 after the date of enactment of this Act, the Director

10 of the Centers for Disease Control and Prevention,

11 in consultation with the Centers for Disease Control

12 and Prevention Advisory Committee on Childhood

13 Lead Poisoning Prevention, shall develop and rec14 ommend to the Secretary of Health and Human

15 Services criteria and procedures (including a time16 table for the submission of the State plan described

17 in paragraph (1)) for the award of waivers under

18 that paragraph.

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