State Comptroller Thomas P. DiNapoli found that the state Department of Health wasn’t doing enough to monitor its lead-prevention program and failed to provide follow-up services for dozens of children who had elevated blood-lead levels, according to a report released Aug. 8.
The audit looked at the Lead Poisoning Prevention Program’s administration outside of the city. The state initiative was established to minimize children’s exposure to lead, as well as to provide follow-up services for those whose tests showed elevated blood-lead levels. The department also oversees several other programs aimed at preventing lead exposure.
The Comptroller’s Office found that Department of Health staff did not consistently assess how local health departments were implementing the program. Although the state was supposed to review how health departments in each county were implementing the initiative once every three years, the report noted that as of June 2018, reviews for 27 of the 56 counties it assessed were outstanding. And the lead program in four counties had not been reviewed by the state since 2010.
“Lead-poisoning poses a major health risk to children and can cause anemia, hearing loss, lower IQs or even death,” Mr. DiNapoli said. “My auditors found the Health Department regional offices are not consistently conducting on-site reviews of local health departments that carry out the state’s lead prevention program.”
It’s a problem the Comptroller feared might get worse: in April, the state lowered the blood-lead level that mandates follow-up services to 5 micrograms per deciliter of blood, the same threshold the U.S. Centers for Disease Control and Prevention uses to recommend a public-health intervention. That means the number of elevated blood-lead tests that required follow-up was less than a third of the 80,946 tests that would have been conducted under the current standard.
“This underscores the importance of improved monitoring of local health departments moving forward, as they will be required to handle significantly more cases,” the report stated.
Claim $35M Annual Cost
The New York State Association of County Health Officials previously estimated that the new threshold would cost local health departments about $35 million per year, including for additional staff.
Although the local health departments were required to provide follow-up services, such as risk-reduction educational materials, follow-up blood tests and nutritional counseling, in a sample of 400 cases in Albany, Suffolk and three other counties, the Comptroller determined that there was no evidence such information was provided in 43 cases.
“This is a serious issue and the department needs to make sure all lead-poisoned children get the services they need,” Mr. DiNapoli said.
Sally Dreslin, the state Health Department’s Executive Deputy Commissioner, said that the agency was revising its review process for local health departments, but she insisted that all children who required follow-up services received it.
‘No Lack of Service’
“The Department’s review indicated that the assurance of follow-up care was plainly noted in the paper and/or on-site electronic case files, but not duplicated in LeadWeb,” she wrote, referring to the system used to track lead cases. “The Department asserts that the issue is a matter of documentation, rather than a lack of service to the children.”
The city has come under a barrage of criticism since it was revealed that the Housing Authority did not perform thousands of required lead-paint inspections, and that 1,160 children living in public housing had tested positive for elevated blood-lead levels. Late last month, the city Department of Education reported that it found lead-paint in 938 classrooms in almost 800 elementary schools built before 1985, and received backlash from parents and community groups saying the agency did not do enough to inform affected families.
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