Detailed Instructions: In this task, you are given text for US Congressional and California state bills, your task is to generate a summary for this bill.
Problem:SECTION 1. SHORT TITLE.

This Act may be cited as the ''Childhood Lead Poisoning Protection
Act of 1998''.

SEC. 2. FINDINGS AND PURPOSES.

(a) Findings.--Congress finds that--
(1) lead poisoning remains a serious environmental risk,
especially to the health of young children;
(2) childhood lead poisoning can cause reductions in IQ,
attention span, reading, and learning disabilities, and other
growth and behavior problems;
(3) children under the age of 6 are at the greatest risk
because of the sensitivity of their developing brains and
nervous systems;
(4) poor children and minority children are at
substantially higher risk of lead poisoning;
(5) it is estimated that more than 500,000 children
enrolled in Medicaid have harmful levels of lead in their
blood;
(6) children enrolled in Medicaid represent 60 percent of
the 890,000 children in the United States with elevated blood
lead levels;
(7) although the Health Care Financing Administration has
required mandatory blood lead screenings for children enrolled
in Medicaid who are not less than 1 nor more than 5 years of
age, approximately two-thirds of children enrolled in Medicaid
have not been screened or treated;
(8) the Health Care Financing Administration mandatory
screening policy has not been effective, or sufficient, to
properly identify and screen children enrolled in Medicaid who
are at risk;
(9) uniform lead screening requirements do not exist for
children not enrolled in Medicaid; and
(10) adequate treatment services are not uniformly
available for children with elevated blood lead levels.
(b) Purpose.--The purpose of this Act is to create a lead screening
safety net that will, through Medicaid and other entitlement programs,
ensure that low-income children at the highest risk of lead poisoning
receive blood lead screenings and appropriate followup care.

SEC. 3. INCREASED LEAD POISONING SCREENINGS AND TREATMENTS UNDER THE
MEDICAID PROGRAM.

(a) Penalty for Insufficient Increases in Lead Poisoning
Screenings.--
(1) Performance improvement.--Section 1903 of the Social
Security Act (42 U.S.C. 1396b) is amended by adding at the end
the following:
''(x) Performance Improvement.--
''(1) In general.--Notwithstanding section 1905(b),
beginning with fiscal year 2000 and for each fiscal year
thereafter, with respect to any State that fails to meet
minimum blood lead screening rates stated in paragraph (2), the
Federal medical assistance percentage determined under
section 1905(b) for the State for the fiscal year shall be reduced by 1
percentage point, but only with respect to--
''(A) items and services furnished under a State
plan under this title during that fiscal year;
''(B) payments made on a capitation or other risk-
basis under a State plan under this title for coverage
occurring during that fiscal year; and
''(C) payments under a State plan under this title
that are attributable to DSH allotments for the State
determined under section 1923(f) for that fiscal year.
''(2) Minimum blood lead screening rates.--The minimum
acceptable percentages of 2-year-old Medicaid-enrolled children
who have received at least 1 blood lead screening test are--
''(A) 50 percent in fiscal year 2000;
''(B) 60 percent in fiscal year 2001;
''(C) 70 percent in fiscal year 2002;
''(D) 80 percent in fiscal year 2003; and
''(E) 90 percent in each fiscal year after fiscal
year 2003.
''(3) Modification or waiver.--The Secretary may modify or
waive the application of paragraph (1) in the case of a State
that the Secretary determines has performed during a fiscal
year such a significant number of lead blood level assessments
that the State reasonably cannot be expected to achieve the
minimum blood lead screening rates established by paragraph
(2).''.
(2) Reporting requirement.--Section 1902(a)(43)(D) of the
Social Security Act (42 U.S.C. 1396a(a)(43)(D)) is amended--
(A) in clause (iii), by striking ''and'' at the
end;
(B) in clause (iv), by striking the semicolon and
inserting '', and''; and
(C) by adding at the end the following:
''(v) the number of children who are not
more than 2 years of age and enrolled in the
Medicaid Program and the number and results of
lead blood level assessments performed by the
State, along with demographic and identifying
information that is consistent with the
recommendations of the Centers for Disease
Control and Prevention with respect to lead
surveillance;''.
(b) Mandatory Screening Requirements.--Section 1902(a) of the
Social Security Act (42 U.S.C. 1396a(a)) is amended--
(1) in paragraph (65), by striking the period and inserting
''; and''; and
(2) by adding at the end the following:
''(66) provide that each contract entered into between the
State and an entity (including a health insuring organization
and a Medicaid managed care organization) that is responsible
for the provision (directly or through arrangements with
providers of services) of medical assistance under the State
plan shall provide for--
''(A) compliance with mandatory screening
requirements for lead blood level assessments (as
appropriate for age and risk factors) that are
commensurate with guidelines and mandates issued by the
Secretary through the Administrator of the Health Care
Financing Administration; and
''(B) coverage of appropriate qualified lead
treatment services, as prescribed by the Centers for
Disease Control and Prevention guidelines, for children
with elevated levels of lead in their blood.''.
(c) Reimbursement for Treatment of Children With Elevated Blood
Lead Levels.--Section 1905 of the Social Security Act (42 U.S.C. 1396d)
is amended--
(1) in subsection (a)--
(A) in paragraph (26), by striking ''and'' at the
end;
(B) by redesignating paragraph (27) as paragraph
(28); and
(C) by inserting after paragraph (26) the
following:
''(27) qualified lead treatment services (as defined in
subsection (v);''; and
(2) by adding at the end the following:
''(v)(1) The term 'qualified lead treatment services' means all
appropriate and medically necessary services that are provided by a
qualified provider, as determined by the State, to treat a child
described in paragraph (2), including--
''(A) environmental investigations to determine the source
of a child's lead exposure, including the costs of qualified
and trained professionals (including health professionals and
lead professionals certified by the State or the Environmental
Protection Agency) to conduct such investigations and the
costs of laboratory testing of substances suspected of being
significant pathways for lead exposure (such as lead dust, paint chips,
bare soil, and water);
''(B) professional case management services to coordinate
access to such services; and
''(C) emergency measures to reduce or eliminate lead
hazards to a child, if required (as recommended by the Centers
for Disease Control and Prevention).
''(2) For purposes of paragraph (1), a child described in this
paragraph is a child who--
''(A) has attained 6 months of age but has not attained 73
months of age; and
''(B) has been identified as having a blood lead level that
equals or exceeds 20 micrograms per deciliter (or persistently
equals or exceeds 15 micrograms per deciliter).''.
(d) Effective Date.--
(1) In general.--The amendments made by this section apply
on and after October 1, 1998.
(2) Extension of effective date for state law amendment.--
In the case of a State plan under title XIX of the Social
Security Act which the Secretary of Health and Human Services
determines requires State legislation in order for the plan to
meet the additional requirements imposed by the amendments made
by this section, the State plan shall not be regarded as
failing to comply with the requirements of this section solely
on the basis of its failure to meet these additional
requirements before the first day of the first calendar quarter
beginning after the close of the first regular session of the
State legislature that begins after the date of the enactment
of this Act. For purposes of the previous sentence, in the case
of a State that has a 2-year legislative session, each year of
the session is considered to be a separate regular session of
the State legislature.

SEC. 4. LEAD POISONING SCREENING FOR SPECIAL SUPPLEMENTAL NUTRITION
PROGRAM FOR WOMEN, INFANTS, AND CHILDREN.

Section 17(d) of the Child Nutrition Act of 1966 (42 U.S.C.
1786(d)) is amended by adding at the end the following:
''(4) Lead poisoning screening.--
''(A) In general.--Subject to subparagraph (B), for
an infant or child to be eligible to participate in the
program under this section, a member of the family of
the infant or child shall provide proof to the State
agency, not later than 180 days after enrollment of the
infant or child in the program and periodically
thereafter (as determined by the State agency), that
the infant or child has received a blood lead test for
lead poisoning using an assessment that is appropriate
for age and risk factors.
''(B) Waivers.--A State agency or local agency may
waive the requirement of subparagraph (A) with respect
to an infant or child if the State agency or local
agency determines that--
''(i) the area in which the infant or child
resides does not pose a risk of lead poisoning;
or
''(ii) the requirement would be contrary to
the religious beliefs or moral convictions of
the family of the infant or child.
''(C) Screenings by state agencies.--
''(i) In general.--On the request of a
member of a family of an infant or child who
has not been screened for lead poisoning and
who seeks to participate in the program, at no
charge to the family, a State agency shall
perform a blood lead test on the infant or
child that is appropriate for age and risk
factors.
''(ii) Reimbursement.--On the request of a
State agency that screens for lead poisoning
under clause (i) an infant or child that is
receiving medical assistance under a State plan
under title XIX of the Social Security Act (42
U.S.C. 1396 et seq.), the Secretary of Health
and Human Services shall reimburse the State
agency, from funds that are made available
under that title, for the cost of the screening
(including the cost of purchasing portable
blood lead analyzer instruments approved for
sale by the Food and Drug Administration and
providing screening with the use of such
instruments through laboratories certified
under section 353 of the Public Health Service
Act (42 U.S.C. 263a)).''.

SEC. 5. LEAD POISONING SCREENING FOR EARLY HEAD START PROGRAMS.

Section 645A of the Head Start Act (42 U.S.C 9840a) is amended--
(1) in subsection (c)(2), by inserting before the semicolon
the following: '', if the families comply with subsection
(i)''; and
(2) by adding at the end the following:
''(i) Lead Poisoning Screening.--
''(1) In general.--Subject to paragraph (2), for a child to
be eligible to participate in a program described in subsection
(a)(1), a member of the family of the child shall provide proof
to the entity carrying out the program, not later than 180 days
after enrollment of the child in the program and periodically
thereafter (as determined by the entity), that the child has
received a blood lead test for lead poisoning using an
assessment that is appropriate for age and risk factors.
''(2) Waivers.--The entity may waive the requirement of
paragraph (1) with respect to a child if the entity determines
that--
''(A) the area in which the child resides does not
pose a risk of lead poisoning; or
''(B) the requirement would be contrary to the
religious beliefs or moral convictions of the family of
the child.
''(3) Screenings by entities.--
''(A) In general.--On the request of a member of a
family of a child who has not been screened for lead
poisoning and who seeks to participate in the program,
at no charge to the family, the entity shall perform a
blood lead test on the child that is appropriate for
age and risk factors.
''(B) Reimbursement.--On the request of an entity
that screens for lead poisoning under subparagraph (A)
a child that is receiving medical assistance under a
State plan under title XIX of the Social Security Act
(42 U.S.C. 1396 et seq.), the Secretary shall reimburse
the entity, from funds that are made available under
that title, for the cost of the screening (including
the cost of purchasing portable blood lead analyzer
instruments approved for sale by the Food and Drug
Administration and providing screening with the use of
such instruments through laboratories certified under
section 353 of the Public Health Service Act (42 U.S.C.
263a)).''.
Solution:
Childhood Lead Poisoning Protection Act of 1998 - Amends title XIX (Medicaid) of the Social Security Act to provide for a reduced Federal medical assistance percentage for States that fail to meet specified minimum blood lead screening rates established by this Act, subject to waiver by the Secretary of Health and Human Services in the case of a State that has performed during a fiscal year such a significant number of lead blood level assessments that the State reasonably cannot be expected to achieve the appropriate minimum blood lead screening rate.
Requires the State Medicaid plan to provide for reporting to the Secretary: (1) the number of children who are not more than two years of age and enrolled in the Medicaid program; and (2) the number and results of lead blood level assessments performed by the State, along with demographic and identifying information consistent with the recommendations of the Centers for Disease Control and Prevention (CDC) with respect to lead surveillance.
Requires each contract between the State and an entity responsible for provision of medical assistance under the State plan to provide for: (1) compliance with mandatory screening requirements for lead blood level assessments commensurate with guidelines and mandates issued by the Secretary through the Administrator of the Health Care Financing Administration; as well as (2) coverage of appropriate qualified lead treatment services, as prescribed by CDC guidelines, for children with elevated levels of lead in their blood. Allows reimbursement for qualified lead treatment services for children with elevated blood lead levels.
Amends the Child Nutrition Act of 1966 and the Head Start Act to mandate lead poisoning screening for an infant or child to be eligible to participate in either the special supplemental nutrition program for women, infants, and children, or early Head Start programs.