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Ohio's next Governor can make a change
Ohio's next Governor can make a change
- Expand funding for the SCHIP program so property owners to remediate the homes where Medicaid children are living.
- Draft and introduce legislation to require Universal Child Testing in Ohio. Michigan, Indiana, Illinois and Wisconsin have already taken this step (see below)
- Oppose House Bill 118 (or its successor). This bill would undermine local lead ordinances and give cash payments to landlords who are already exempt from State Income Taxes.
- Rewrite Ohio Administrative code Section defining "elevated blood lead level" to come into compliance with the CDC reference value of 3.5 Micrograms per deciliter and the HUD Lead Safe Housing Rule.
Universal Child Lead Testing needed to expand child lead testing.
Universal Child Lead Testing needed to expand child lead testing.
Background: Millions of American children missing early lead tests, Reuters finds.
Two problems in Ohio
Too many children who are at risk of lead poisoning are not being tested when they are most vulnerable (universal testing).
To avoid expanding the number of number of inspections of children who test positive for lead exposure, in 2023 Ohio redefined "lead poisoning." Ohio is not in compliance with CDC Action levels.
Here are the details.
For decades Ohio's rules for Child Lead Testing have been built around an antiquated system of 'high risk zip codes'. This system has four flaws
1. The "high risk zip codes have been determined by the number of reports of children with elevated blood lead levels. Ohio only requires testing where testing was previously encountered. We know that environmental lead is found in homes, soil, and water systems as well as near industrial sources.
2. Physicians who are requires to give "the quiz" to parents in the office don't have time to actually perform the test. If they make a referral to a testing lab which means another day off work.
3. Ohio Guidance requires testing at age 1 and age 2...or before age 6 if a child has not been tested before. This protocol ignores the fact that children can be exposed to lead when the child moves to a new location or changes child care locations between the ages of 3-6.
Here's the other problem: In 2023, Ohio Health Department amended the Ohio Administrative Code to create a brand new status of "Elevated Blood Lead Level" for children under age 6 who have a blood lead level of 3.5 micrograms/deciliter to under 10 micrograms/declilter. Rule 3701-30-07 | Public health lead investigations provides that local health departments are not required to conduct a lead risk assessment for children unless they have been determined to have a blood level on 10 microgram/deciliter or greater AKA "lead poisoned" This rule undermines the CDC reference standard of 3.5 micrograms/deciliter.
Among the "lead belt" states, Michigan, Indiana, Illinois, New York, and Wisconsin and the city of Pittsburgh have adopted forms of universal child lead testing and lower thresholds for public health follow up. In each case there are additional testing requirements for high risk factors including age of housing and frequency of testing.
Universal Testing in the News
Universal Testing in the News
June 25, 2026 FOX23 News Illinois to require blood lead testing for all children starting July 1 " Beginning July 1, all children in Illinois will receive routine blood lead testing, expanding the state’s previous testing requirements that only applied to children living in designated high-risk ZIP codes, The Illinois Department of Public Health (IDPH) announced the change as part of its Childhood Lead Program, which aims to identify children exposed to lead and provide early intervention to reduce long-term health impacts. 'There is no safe level of lead in the blood,' IDPH Director Dr. Sameer Vohra said. 'With this move to universal childhood blood lead testing, IDPH is taking another step toward protecting the health and safety of Illinois’ youngest residents.' Under the new statewide requirements, children will automatically receive blood lead tests at 12 months and 24 months of age. Health care providers also must assess all children age 6 and younger for lead exposure using a screening questionnaire. State law requires public health intervention when a child’s confirmed blood lead level exceeds 3.5 micrograms per deciliter. That response includes a home inspection to identify the source of lead exposure, assistance with removing hazards, and education from a public health nurse on preventing further exposure." Here's the official statement from Illinois Department of Health.
December 11, 2025. Press Release. New Jersey Department of Health Expands Program for Lead and Mercury Screening in Pregnant People and Newborns The New Jersey Department of Health (NJDOH) announces the expansion of its universal prenatal and newborn screening for lead and mercury program into Saint Peter’s University Hospital in New Brunswick, NJ, with the goal of increasing access and improving health outcomes for pregnant people and newborns. Universal prenatal screening provides an opportunity for mothers and health care providers to identify emergency cases of exposure that would otherwise go undiagnosed or untreated. This empowers mothers to be proactive in limiting lead and mercury exposure during pregnancy and facilitates interventions by health care providers to address disparities and improve health outcomes for women and newborns. It is important for mothers to limit exposure to these toxic metals, as it can lead to an array of health complications such as preeclampsia, kidney damage, endocrine disruption, and impaired motor function. In newborns, exposure can cause neurological damage, organ malformation, preterm birth, learning disabilities, lower IQ, behavioral disorders, and death."
Planet Detroit offers an excellent tutorial on Michigan's Universal Testing Law. Visit CLASH's webpage on Universal Testing
January 28, 2025. Milwaukee Journal Sentinel. Tony Evers announces lower threshold for lead poisoning as part of children's health focus "Gov. Tony Evers announced a new rule Tuesday that lowers the lead poisoning threshold in Wisconsin. "The new rule will lower the threshold from 5 micrograms per deciliter to 3.5 micrograms per deciliter, according to a press release, and put the number more in line with the Centers for Disease Control and Prevention's recommendations. The lower threshold is intended to identify more children with lead poisoning and expose them to services. The rule is the latest attempt from Evers' administration to address lead poisoning across Wisconsin, but especially in Milwaukee, where children have to be checked often for exposure to lead."
January 18, 2024 Press release. DHS Recommends Blood Lead Tests for All Children. "Tests now encouraged for children ages 1 and 2, and those aged 3-5 who have not been previously tested. The Wisconsin Department of Health Services (DHS) recommends universal blood lead testing for children living in Wisconsin. Universal testing means all children should receive a blood lead test at ages 1 and 2 as well as any child between ages 3 and 5 who has not had a previous test. Children under 6 residing in the city of Milwaukee require additional testing per local health department guidelines."
Related: October 23, 2024. Press Release. MHD Issues New Testing Recommendations to Protect Children. "New Testing Recommendations: [Milwaukee Health Department] MHD has updated its testing guidelines to better safeguard children in the city. Previously, MHD did not recommend universal testing annually after 24 months unless a child tested positive for elevated blood lead levels. However, due to Milwaukee’s large population, the high prevalence of lead paint and other lead hazards, and the deterioration of older homes, MHD is now adopting a more aggressive testing schedule than both its previous recommendations and the state’s current guidelines. MHD’s new recommendations call for universal blood lead testing for all children in Milwaukee at 12, 18, and 24 months, and then annually through the age of 5, regardless of their previous testing schedule or results. This approach provides earlier detection and more frequent monitoring in areas at high risk for lead exposure."
October 3, 2023. Detroit Free Press. Universal lead testing requirement landmark moment for Michigan, advocates say
June 9, 2016. Reuters. Millions of American children missing early lead tests, Reuters finds.
Wait there's more
Wait there's more
Ohio law requires all healthcare providers to administer blood lead tests to children at age 1 and 2, or up to age 6 if no previous test has been completed based on the following criteria: the child is on Medicaid, lives in a high-risk ZIP code, or has certain other risk factors.
Here's are the problems with the ZIP code system.
Ohio established the high-risk Zip Code system decades ago based on past experience of medical professionals. These "high risk" zip codes reflect where lead hazards exist. Sebring
Neither ODH nor Ohio Medicaid Services monitor or incentivize health care providers to improve the rate child lead testing. A recent effort at Akron General Hospital shows improvements is child lead testing can be made at the point of care.
A recent study in reported in Medscape that confusing rules about who should be tested present a barrier to overworked pediatricians.
This is not just an Ohio Problem, but other states have addressed it by enacting universal child testing.
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