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Elizabeth M. Whitehorn, Director

Provider Blood Lead Screening Report

Illinois Department of Healthcare and Family Services

PA 098-0690 Lead Poisoning Prevention Act: Reports of HFS Director

In response to legislation enacted through Public Act 098-0690 HFS developed provider-level blood lead reports to fulfill Sec. 6.3. “Information provided by the Department of Healthcare and Family Services”, section (b) that states:

“The Director of Healthcare and Family Services shall prepare a report documenting the frequency of lead testing and elevated blood and lead levels among children receiving benefits from the Department of Healthcare and Family Services. On at least an annual basis, the Director of Healthcare and Family Services shall prepare and deliver a report to each health care provider who has rendered services to children receiving benefits from the Department of Healthcare and Family Services.  The report shall contain the aggregate number of children receiving benefits from the Department of Healthcare and Family Services to whom the provider has provided services, the number and percentage of children tested for lead poisoning, and the number and percentage of children having an elevated blood lead level. The Department of Public Health may exclude health care providers who provide specialized or emergency medical care and who are unlikely to be the primary medical care provider for a child.  Upon the request of a provider, the Department of Public Health may generate a list of individual patients treated by that provider according to the claims records and the patients’ lead test results.”

The data contained in the report provides the number of children <=6 years of age to whom each provider delivered an EPSDT visit (“n”); of those children among “n” who received a blood lead screen, regardless of the provider who conducted the blood lead screen; the number of children with known or unknown blood lead screen results; and the number of children with an elevated blood lead level (EBLL) (>=10 μg/dL).

The report provides two percentages:

  •        Blood Lead Screening Percentage: The number of children given an EPSDT visit by a provider 

    (denominator) who were also given a blood lead screen (numerator), regardless of the provider who conducted the lead screen.

  •       Elevated Blood Lead Level Percentage: The number of children given a blood lead screen and who 

    have a blood lead level result available using DPH data (denominator) having an EBLL (numerator).

The blood lead screening data has been extracted from claims and encounter data received by HFS and from lead data from IDPH lab. Blood lead results data are available only from IDPH. For consistency with other reporting, EPSDT visits are defined using CMS-416 coding specifications identifying initial or periodic screens furnished with age restrictions applied (<=6 years) for this report. The measurement period is the calendar year, 2014. Age is calculated as of December 31 of the measurement period. Providers are identified using their NPI. Providers having more than one NPI are identified using the minimum NPI number assigned to them. 

For more information about the coding used, please refer to the Specifications document. For more information about HFS requirements for conducting blood lead screening please refer to the Handbook for Providers of Healthy Kids Services.