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<section article="ghg" article_name="Health - General" number="18-106" title_number="18" title_name="Disease Prevention" subtitle_number="1" subtitle_name="General Responsibilities of Secretary">
  <level label="a">
    <text>The Secretary shall establish and administer a Lead Poisoning Screening Program that will assure the appropriate screening of children in Maryland for lead poisoning.</text>
  </level>
  <level label="b">
    <text>The Lead Poisoning Screening Program shall:</text>
    <level label="1">
      <text>Encourage continuity of care with the child’s continuing care health care provider;</text>
    </level>
    <level label="2">
      <text>Promote timely, appropriate screening of children at risk of being poisoned by lead;</text>
    </level>
    <level label="3">
      <text>Utilize all of the payment mechanisms available to cover lead poisoning screening, including:</text>
      <level label="i">
        <text>Third party payments from insurers;</text>
      </level>
      <level label="ii">
        <text>The Medical Assistance Program;</text>
      </level>
      <level label="iii">
        <text>Primary care medical assistance programs established under waiver from the federal government;</text>
      </level>
      <level label="iv">
        <text>Health maintenance organizations;</text>
      </level>
      <level label="v">
        <text>Federally qualified and Maryland qualified community health centers; and</text>
      </level>
      <level label="vi">
        <text>Any other Medicaid reimbursement or waiver to which the State may be entitled under this section;</text>
      </level>
    </level>
    <level label="4">
      <text>Target children under 6 years of age;</text>
    </level>
    <level label="5">
      <text>Provide lead poisoning screening on a sliding fee scale at sites designated by local health departments for children unable to afford lead poisoning screening; and</text>
    </level>
    <level label="6">
      <text>Employ an initial questionnaire to assess children’s exposure to potential lead hazards, except that children residing in at risk areas identified under subsection (c) of this section shall be screened by a blood test for lead poisoning.</text>
    </level>
  </level>
  <level label="c">
    <text>The Secretary shall target efforts to promote and to provide blood tests for lead poisoning in at risk areas, as identified by:</text>
    <level label="1">
      <text>Census tract and zip code information noting areas with large concentrations of pre-1978 housing; and</text>
    </level>
    <level label="2">
      <text>Highest rates of lead poisoning as evidenced by information provided to and by the Childhood Lead Registry established and maintained by the Department of the Environment.</text>
    </level>
  </level>
  <level label="d">
    <text>The Secretary shall require providers caring for children in areas designated as at risk for lead poisoning, as determined under subsection (c) of this section, to administer a blood test for lead poisoning of children:</text>
    <level label="1">
      <text>Within the time frame specified in regulations adopted by the Department; or</text>
    </level>
    <level label="2">
      <text>In accordance with the guidelines of the Centers for Disease Control and Prevention for children over age 24 months who have not received a blood test for lead poisoning.</text>
    </level>
  </level>
  <level label="e">
    <text>The Secretary may include information on blood testing for lead poisoning collected under this section, § 7-403 of the Education Article, and §§ 6-303 and 6-304 of the Environment Article on any immunization registry developed by the Department.</text>
  </level>
  <level label="f">
    <level label="1">
      <text>Subject to paragraph (2) of this subsection, this section does not require blood testing of a child whose parent or guardian, in accordance with regulations adopted by the Secretary, objects to the testing on the ground that it conflicts with the parent’s or guardian’s bona fide religious beliefs and practices.</text>
    </level>
    <level label="2">
      <text>Paragraph (1) of this subsection does not apply if the responses of the child’s parent or guardian on a questionnaire furnished by the Secretary and administered by a pediatrician indicate that the child is at high risk for lead poisoning.</text>
    </level>
  </level>
</section>
