An Act To Protect Children from Lead Poisoning
Maine Legislature, Session 123, LD 2172
Committee: Health and Human Services
Sponsors: CONNOR, WEBSTER, BRANNIGAN, ADAMS, CUMMINGS, KOFFMAN, PINGREE, SILSBY, MARRACI-IE
Amends: Title 20, Section 1232, 20-A MRSA §63, 20-A MRSA §6353, 20-A MRSA §6355, 20-A MRSA §6357, 20-A MRSA §6358, 22 MRSA §1317-D

Legislative Document 
No. 2172 
H.P.1546 
House of Representatives, January 28, 2008 
An Act To Protect Children from Lead Poisoning 
(EMERGENCY) 
Approved for introduction by a majority of the Legislative Council pursuant to Joint Rule 
203. 
Reference to the Committee on Health and Human Services suggested and ordered printed. 
Presented by Representative CONNOR of Kennebunk. 
17/~ 
/f7.1l!dC~{ 
MILLICENT M. MacFARLAND 
Clerk 
Cosponsored by Representative WEBSTER of Freeport, Senator BRANNIGAN of 
Cumberland and Representatives: ADAMS of Portland, Speaker CUMMINGS of Portland, 
KOFFMAN of Bar Harbor, PINGREE of North Haven, SILSBY of Augusta, Senator: 
MARRACI-IE of Kennebec. 
Emergency preamble. Whereas, acts and resolves of the Legislature do not 
become effective until 90 days after adjournment unless enacted as emergencies; and 
Whereas, lead poisoning of the State's children from environmental sources 
continues to pose a risk to their achieving their maximum developmental and educational 
potential; and 
Whereas, knowledge of the blood lead level of each child prior to entry to 
kindergarten will allow for diagnosis and treatment of lead poisoning; and 
Whereas, in the judgment of the Legislature, these facts create an emergency within 
the meaning of the Constitution of Maine and require the following legislation as 
immediately necessary for the preservation of the public peace, health and safety; now, 
therefore, 
Be it enacted by the People of the State of Maine as follows: 
Sec. 1. 20-A MRSA §63S2, as enacted by PL 1983, c. 661, §'8, is amended to 
read: 
§6352. Immunization and lead poisoning assessment 
To assure a safe and healthful school environment, the Legislature intends that the 
provisions of this subchapter on immunization -shall and lead poisoning assessment apply 
in the schools of the State. 
Sec. 2. 20-A MRS A §6353, sub-§l-A is enacted to read: 
I-A. 
Blood lead level assessment. 
"Blood lead level assessment" means an 
assessment mechanism used for recording blood lead levels. 
Sec. 3. 20-A MRSA §6353, sub-§l-B is enacted to read: 
I-B. Certificate of lead poisoning assessment. 
"Certificate of lead poisoning 
assessment" means a written statement from a primary health care provider stating the 
date that a blood lead level assessment was performed and the results of the assessment. 
Sec. 4. 20-A MRSA §6353, sub-§5-A is enacted to read: 
5-A. Primary health care provider. 
"Primary health care provider" means a 
physician, nurse practitioner, physician assistant or other health care professional 
authorized under the scope of practice rules applicable to the profession under Title 32 to 
provide primary health care. 
Sec. 5. 20-A MRSA §6355, as amended by PL 2001, c. 326, §2, IS further 
amended to read: 
Page I - 123LR3220(OI)-1 
§6355. Enrollment in school 
A superintendent may not pennit any child to be enrolled in or to attend school 
without a certificate of immunization for each disease or other acceptable evidence of 
required immunization or immunity against the disease, EH(eept as follO'lvs. and a 
certificate of lead poisoning assessment, unless: 
1. Written assurance. The parent provides a written assurance the child will be 
immunized within 90 days by private effort or provides, where applicable, a written 
consent to the child's immunization by a health officer, physician, nurse or other 
authorized person in public or private employ~ or provides a written assurance the child 
will be assessed for lead poisoning by a primary health care provider within 90 days; 
2. 
Medical exemption. The parent or the child provides a physician's written 
statement that immunization against one or more of the diseases or the blood lead level 
assessment may be medically inadvisable~~ 
3. Philosophical or religious exemption. The parent states in writing a sincere 
religious belief that is contrary to the immunization or blood lead level assessment 
requirement of this subchapter or an opposition to the immunization or blood lead level 
assessment for philosophical reasons. 
Sec. 6. 20-A MRSA §6357, as enacted by PL 1983, c. 661, §8 and amended by 
PL 2003, c. 689, Pt. B, §6, is further amended to read: 
§6357. Records; report 
1. Record keeping. Each superintendent shall keep uniform records of the blood 
lead level assessment status and of the immunizations and immunization status of each 
child based on the certificate of immunization, other acceptable evidence and other 
available documents. The records shall must be part of the child's permanent education 
records. These records shall be are confidential, except that state and local health 
personnel shall must have access to them in connection with an emergency, as provided 
by the United States Family Educational Rights and Privacy Act of 1974, Public Law 93-
380, United States Code, Title 20, Section 1232g(b) (1) (1) and regulations adopted under 
that Act. 
2. 
Annual report of immunization and lead poisoning assessment status. By 
December 15th of each year, each superintendent shall submit to the Director of the 
Bureau of Health, Maine Center for Disease Control and Prevention within the 
Department of Health and Human Services, and to the commissioner a summary report of 
the immunization status and blood lead level assessment status of the children entering 
school, as prescribed by rule. 
Sec. 7. 20-A MRSA §6358, sub-§l, as amended by PL 2001, c. 326, §3 and PL 
2003, c. 689, Pt. B, §6, is further amended to read: 
1. Rules authorized. The commissioner and the Director of the Bureau of Health, 
Maine Center for Disease Control and Prevention within the Department of Health and 
Human Services, shall jointly issue rules necessary for the effective implementation of 
this subchapter, including, but not limited to, rules specifying the form and content of 
blood lead level assessment information and status and those diseases for which 
immunization is required and establishing school record keeping and reporting 
requirements or guidelines and procedures for the exclusion of nonimmunized children 
and children who have not been assessed for lead poisoning from school. Rules adopted 
pursuant to this subchapter specifying the diseases for which immunization is required are 
major substantive rules as defined in Title 5, chapter 375, subchapter II-A 2-A. Rules 
regarding blood lead level assessment information and status are routine technical rules as 
defined in Title 5, chapter 375, subchapter 2-A. 
Sec. 8. 22 MRSA §1317-D, sub-§3, as enacted by PL 2001, c. 683, §3 and 
affected by §1O, is amended to read: 
3. Testing of children covered by MaineCare program. As required by Section 
1905(r)(5) of the Social Security Act and the federal Omnibus Budget Reconciliation Act 
of 1989, the program must require the testing of blood lead levels of all children covered 
by the MaineCare program at one year of age and 2 years of age annually through and 
including 5 years of age to the extent allowed by federal law and regulation. The drawing 
of blood for the testing may be done in the health care provider's office or may be 
referred to another laboratory. 
Sec. 9. 22 MRS A §1317-D, sub-§4, as enacted by PL 2001, c. 683, §3 and 
affected by § 10, is amended to read: 
4. Testing of children not tested through the MaineCare program. The program 
must require the testing of blood lead levels of all children not covered by tested through 
the MaineCare program under subsection 3 at one year of age and ~ annually through and 
including 5 years of age unless, in the professional judgment of the provider of primary 
health care, in conjunction "'lith the use of the lead poisoning risk assessment tool, the 
child's le'lel of risk does not 'Narrent a blood lead level test. The drawing of blood for the 
testing may be done in the health care provider's office or may be referred to another 
laboratory. 
Sec. 10. Maine Revised Statutes headnote amended; revision clause. In 
the Maine Revised Statutes, Title 20-A, chapter 223, subchapter 2, in the subchapter 
headnote, the word "immunization" is amended to read "immunization and blood lead 
level risk assessment" and the Revisor of Statutes shall implement this revision when 
updating, publishing or republishing the statutes. 
Emergency clause. 
In view of the emergency cited III the preamble, this 
legislation takes effect when approved. 
SUMMARY 
This bill expands the lead poisoning assessment and blood level testing program to 
require annual testing of children under 6 years of age and eliminates the exception that 
provides discretion to the provider of primary health care. It retains the exception for a 
parent or guardian who objects on the grounds of sincerely held religious or philosophical 
beliefs. It requires evidence of blood lead level screening for enrollment in public school 
in this State. It requires a school superintendent to keep records of blood lead level 
assessment status and to report to the Commissioner of Education and the Director of the 
Maine Center for Disease Control and Prevention within the Department of Health and 
Human Services regarding the blood lead level assessment status of children entering 
school.