Preventing Lead Poisoning Act of 2021

II 117TH CONGRESS 1ST SESSION S. 1826 To amend titles XIX and XXI of the Social Security Act to require a State child health plan to include coverage of screening blood lead tests, to codify such requirement under the Medicaid program, and for other purposes. IN THE SENATE OF THE UNITED STATES MAY 25, 2021 Mr. MENENDEZ (for himself, Mr. PORTMAN, and Mr. BROWN) introduced the following bill; which was read twice and referred to the Committee on Finance A BILL To amend titles XIX and XXI of the Social Security Act to require a State child health plan to include coverage of screening blood lead tests, to codify such requirement under the Medicaid program, and for other purposes. Be it enacted by the Senate and House of Representa- 1 tives of the United States of America in Congress assembled, 2 SECTION 1. SHORT TITLE. 3 This Act may be cited as the ‘‘Preventing Lead Poi- 4 soning Act of 2021’’. 5 VerDate Sep 11 2014 02:01 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00001 Fmt 6652 Sfmt 6201 E:\BILLS\S1826.IS S1826 kjohnson on DSK79L0C42PROD with BILLS 2 •S 1826 IS SEC. 2. REQUIRING A STATE CHILD HEALTH PLAN TO IN- 1 CLUDE COVERAGE OF SCREENING BLOOD 2 LEAD TESTS; CODIFICATION OF REQUIRE- 3 MENT UNDER MEDICAID. 4 (a) CHIP.— 5 (1) IN GENERAL.—Section 2103 of the Social 6 Security Act (42 U.S.C. 1397cc) is amended— 7 (A) in subsection (a), in the matter pre- 8 ceding paragraph (1), by striking ‘‘paragraphs 9 (5), (6), (7) and (8)’’ and inserting ‘‘para- 10 graphs (5) through (12)’’; and 11 (B) in subsection (c), by adding at the end 12 the following: 13 ‘‘(12) COVERAGE OF SCREENING BLOOD LEAD 14 TESTS.— 15 ‘‘(A) IN GENERAL.—The child health as- 16 sistance provided to a targeted low-income child 17 shall include coverage of screening blood lead 18 tests appropriate for age and risk factors and 19 at the times and in the amounts specified in 20 subparagraph (B). 21 ‘‘(B) SPECIFIED TIMES AND AMOUNTS.— 22 The times and amounts specified in this sub- 23 paragraph are, with respect to coverage of 24 screening blood lead tests and a targeted low- 25 income child, the following: 26 VerDate Sep 11 2014 02:01 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00002 Fmt 6652 Sfmt 6201 E:\BILLS\S1826.IS S1826 kjohnson on DSK79L0C42PROD with BILLS 3 •S 1826 IS ‘‘(i) 1 screening blood lead test at the 1 age of 12 months; 2 ‘‘(ii) 1 screening blood lead test at the 3 age of 24 months; 4 ‘‘(iii) in the case of a targeted low-in- 5 come child with no record of any screening 6 blood lead test having been performed and 7 who is between the ages of 24 months and 8 72 months, 1 screening blood lead test; 9 and 10 ‘‘(iv) in the case of any targeted low- 11 income child, 1 or more screening blood 12 lead tests at other such times as are rec- 13 ommended by the child’s health care pro- 14 vider.’’. 15 (2) REPORTING REQUIREMENTS.— 16 (A) IN GENERAL.—Section 2108 of such 17 Act (42 U.S.C. 1397hh) is amended— 18 (i) by redesignating the subsection (e) 19 added by section 501(e)(2) of the Chil- 20 dren’s Health Insurance Program Reau- 21 thorization Act of 2009 (Public Law 111– 22 3, 123 Stat. 87) as subsection (f); and 23 (ii) by adding at the end of the sub- 24 section (e) added by section 402(a) of such 25 VerDate Sep 11 2014 02:01 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00003 Fmt 6652 Sfmt 6201 E:\BILLS\S1826.IS S1826 kjohnson on DSK79L0C42PROD with BILLS 4 •S 1826 IS Act (Public Law 111–3, 123 Stat. 82), the 1 following: 2 ‘‘(8)(A) The number of children provided a 3 screening blood lead test appropriate for age and 4 risk factors in accordance with paragraph (12) of 5 section 2103(c), at the times and in the amounts 6 specified in subparagraph (B) of such paragraph. 7 ‘‘(B) The number of screening blood lead tests 8 conducted in the State in the fiscal year for all chil- 9 dren eligible for child health assistance up to 72 10 months of age, without regard to the payor or source 11 of funding for such screening blood lead tests.’’. 12 (B) TECHNICAL AMENDMENT.—Section 13 4302(b)(1)(B) of Public Law 111–148 is 14 amended by inserting ‘‘, as added by section 15 402(a) of Public Law 111–3,’’ after ‘‘(42 16 U.S.C. 1397hh(e))’’. 17 (3) EFFECTIVE DATE.— 18 (A) IN GENERAL.—Subject to subpara- 19 graphs (B) and (C), the amendments made by 20 this subsection shall take effect with respect to 21 child health assistance provided on or after the 22 date that is 1 year after the date of the enact- 23 ment of this Act. 24 VerDate Sep 11 2014 02:01 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6201 E:\BILLS\S1826.IS S1826 kjohnson on DSK79L0C42PROD with BILLS 5 •S 1826 IS (B) EXCEPTION FOR STATE LEGISLA- 1 TION.—In the case of a State child health plan 2 under title XXI of the Social Security Act (or 3 a waiver of such plan), which the Secretary of 4 Health and Human Services determines re- 5 quires State legislation in order for the respec- 6 tive plan (or waiver) to meet any requirement 7 imposed by the amendments made by this sub- 8 section, the respective plan (or waiver) shall not 9 be regarded as failing to comply with the re- 10 quirements of such title solely on the basis of 11 its failure to meet such an additional require- 12 ment before the 1st day of the 1st calendar 13 quarter beginning after the close of the 1st reg- 14 ular session of the State legislature that begins 15 after the date of enactment of this section. For 16 purposes of the previous sentence, in the case 17 of a State that has a 2-year legislative session, 18 each year of the session shall be considered to 19 be a separate regular session of the State legis- 20 lature. 21 (C) TECHNICAL AMENDMENT.—The 22 amendment made by paragraph (2)(B) shall 23 take effect as if included in the enactment of 24 Public Law 111–148. 25 VerDate Sep 11 2014 02:01 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\S1826.IS S1826 kjohnson on DSK79L0C42PROD with BILLS 6 •S 1826 IS (b) MEDICAID.— 1 (1) SPECIFIED TIMES FOR SCREENING BLOOD 2 LEAD TESTS.—Section 1905(r) of the Social Secu- 3 rity Act (42 U.S.C. 1396d(r)) is amended— 4 (A) in paragraph (1)(B)(iv), by inserting 5 ‘‘and at the times and in the amounts specified 6 in paragraph (6)’’ after ‘‘factors’’; and 7 (B) by inserting after paragraph (5) the 8 following: 9 ‘‘(6) The times and amounts specified in this 10 paragraph are, with respect to coverage of screening 11 blood lead tests and an individual, the following: 12 ‘‘(A) 1 screening blood lead test at the age 13 of 12 months; 14 ‘‘(B) 1 screening blood lead test at the age 15 of 24 months; 16 ‘‘(C) in the case of an individual with no 17 record of any screening blood lead test having 18 been performed and who is between the ages of 19 24 months and 72 months, 1 screening blood 20 lead test; and 21 ‘‘(D) in the case of any individual who is 22 eligible under the plan and is under the age of 23 21, 1 or more screening blood lead tests at 24 VerDate Sep 11 2014 02:01 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00006 Fmt 6652 Sfmt 6201 E:\BILLS\S1826.IS S1826 kjohnson on DSK79L0C42PROD with BILLS 7 •S 1826 IS other such times as are recommended by the in- 1 dividual’s health care provider.’’. 2 (2) REPORTING REQUIREMENTS.—Section 3 1902(a)(43)(D) of such Act (42 U.S.C. 4 1396a(a)(43)(D)) is amended— 5 (A) in clause (iii), by striking ‘‘section 6 2108(e) and’’ and inserting ‘‘section 2108(e),’’; 7 (B) in clause (iv), by striking the semi- 8 colon and inserting ‘‘, and’’; and 9 (C) by inserting after clause (iv) the fol- 10 lowing: 11 ‘‘(v)(I) the number of children pro- 12 vided a screening blood lead test appro- 13 priate for age and risk factors in accord- 14 ance with paragraph (1)(B)(iv) of section 15 1905(r), at the times and in the amounts 16 specified in paragraph (6) of such section, 17 and 18 ‘‘(II) the number of screening blood 19 lead tests conducted in the State in the fis- 20 cal year for all children eligible for medical 21 assistance up to 72 months of age, without 22 regard to the payor or source of funding 23 for such screening blood lead tests;’’. 24 VerDate Sep 11 2014 02:01 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00007 Fmt 6652 Sfmt 6201 E:\BILLS\S1826.IS S1826 kjohnson on DSK79L0C42PROD with BILLS 8 •S 1826 IS (c) CLARIFICATION.—None of the amendments made 1 by this section shall be construed as prohibiting a State 2 from providing coverage of screening blood lead tests 3 under title XIX or XXI of the Social Security Act at a 4 frequency that is greater than the frequency described in 5 such amendments or to an individual outside of the ages 6 described in such amendments. 7 SEC. 3. GRANTS FOR LEAD POISONING RELATED ACTIVI- 8 TIES. 9 Section 317O of the Public Health Service Act (42 10 U.S.C. 247b–16) is amended— 11 (1) by redesignating subsections (c) and (d) as 12 subsections (e) and (f), respectively; 13 (2) by inserting after subsection (b) the fol- 14 lowing: 15 ‘‘(c) GRANTS FOR PURPOSES OF STATE COORDINA- 16 TION.—For purposes of supporting State coordination of 17 operations and activities as described in subsection (b), 18 the Secretary, acting through the Director of the Centers 19 for Disease Control and Prevention, shall award additional 20 grants to States receiving amounts under subsection (a) 21 to support the following activities in such States: 22 ‘‘(1) Development or maintenance of a State- 23 based registry of data related to blood lead testing 24 of children up to 6 years of age, which includes data 25 VerDate Sep 11 2014 02:01 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00008 Fmt 6652 Sfmt 6201 E:\BILLS\S1826.IS S1826 kjohnson on DSK79L0C42PROD with BILLS 9 •S 1826 IS on the number of children up 72 months of age test- 1 ed for lead, the prevalence of confirmed elevated 2 blood lead levels in tested children less than 6 years 3 of age, and the insurance status of children tested 4 for lead at less than 6 years of age. 5 ‘‘(2) Development or maintenance of data-link- 6 ing capabilities between the State health department 7 and State Medicaid office with respect to blood lead 8 testing for children up to 72 months of age. 9 ‘‘(3) Regular reporting, as defined by the Sec- 10 retary, of blood lead testing data for children up to 11 72 months of age regardless of the payor or source 12 of funding for such blood lead testing. 13 ‘‘(d) BEST PRACTICES.—The Secretary, acting 14 through the Director of the Centers for Disease Control 15 and Prevention, shall publish best practices for data collec- 16 tion standards related to childhood blood lead testing, with 17 the aim of improving data standardization across relevant 18 State agencies.’’; and 19 (3) in subsection (f), as so redesignated, by 20 striking ‘‘such sums as may be necessary for each of 21 the fiscal years 2001 through 2005’’ and inserting 22 ‘‘$5,000,000 for each of fiscal years 2022 and 23 2023’’. 24 Æ VerDate Sep 11 2014 02:01 Jun 11, 2021 Jkt 019200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6301 E:\BILLS\S1826.IS S1826 kjohnson on DSK79L0C42PROD with BILLS