Bill Text - HB1642 (2022)

Relative to lead testing in children.

Revision: Dec. 27, 2021, 8:52 a.m.

HB 1642-FN - AS INTRODUCED

 

 

2022 SESSION

22-2592

07/10

 

HOUSE BILL 1642-FN

 

AN ACT relative to lead testing in children.

 

SPONSORS: Rep. Grassie, Straf. 11; Rep. Knirk, Carr. 3; Rep. Langley, Hills. 8; Rep. Woods, Merr. 23; Sen. Watters, Dist 4; Rep. Chretien, Hills. 42; Rep. Meuse, Rock. 29

 

COMMITTEE: Health, Human Services and Elderly Affairs

 

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ANALYSIS

 

This bill establishes a blood lead level testing requirement for children entering day care and public schools, as well as reporting requirements for health care providers regarding the tests.

 

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Explanation: Matter added to current law appears in bold italics.

Matter removed from current law appears [in brackets and struckthrough.]

Matter which is either (a) all new or (b) repealed and reenacted appears in regular type.

22-2592

07/10

 

STATE OF NEW HAMPSHIRE

 

In the Year of Our Lord Two Thousand Twenty Two

 

AN ACT relative to lead testing in children.

 

Be it Enacted by the Senate and House of Representatives in General Court convened:

 

1  Health and Sanitation; Physical Examination of Pupils; Lead Testing Requirement.  Amend RSA 200:32 to read as follows:

200:32  Physical Examination of Pupils.  There shall be a complete physical examination by a licensed physician, physician assistant, or advanced practice registered nurse of each child prior to or upon first entry into the public school system and thereafter as often as deemed necessary by the local school authority.  The result of the child's physical examination shall be presented to the local school officials on a form provided by the local school authorities.  The form shall include at least one result of blood lead level testing required under RSA 130-A:5-a, RSA 130-A:5-b, or RSA 130-A:5-c and results shall be reported to the department of health and human services.  Results shall be included in publicly shared community health profiles.  No physical examination shall be required of a child whose parent or guardian objects thereto in writing on the grounds that such physical examination is contrary to the child's religious tenets and teachings.

2  Child Day Care, Residential Care, and Child-Placing Agencies; Records; Lead Testing Required.  Amend RSA 170-E:19 to read as follows:

170-E:19  Records.  Every child day care agency shall keep and maintain such records as the department shall prescribe by rule pertaining to the admission, progress, health and discharge of children under the care of the child day care agency and shall report relative to such matters to the department whenever called for, upon forms prescribed by rule.  Health forms shall include at least one result of blood lead level testing required under RSA 130-A:5-a, RSA 130-A:5-b, or RSA 130-A:5-c.  At least one blood lead level test result shall be a requirement for entry in child day care facilities.  Results shall be reported to the department and shall be included, by the department, in publicly shared community health profiles. All records regarding children and all facts learned about children and their relatives shall be kept confidential both by the child day care agency and by the department.

3  Lead Paint Poisoning Prevention and Control; Universal Testing; Health Care Providers; Not Liable; Child Blood Level Testing Report Required.  Amend RSA 130-A:5-a to read as follows:

130-A:5-a  Universal Testing; Health Care Providers; Not Liable.  All health care providers who provide primary medical care shall conduct blood testing of all one and 2-year old patients to determine a blood lead level.  Health care providers shall report, on a form developed by the department, an accounting of all children referred for blood lead level testing, the results of blood lead level testing to the department at least annually.  Reports shall include the total number of children served by the practice annually as well as the total number of children that failed to follow through in response to a referral for a test. A health care provider shall not be liable for not performing a test for blood lead level when a parent or guardian has been informed of the blood test requirement and has refused to consent or has failed to follow through in response to a referral for a test.  Nothing in this section shall prevent a health care provider from recommending blood testing for children younger than one year or older than 2 years should circumstances, including potential lead hazard exposures, warrant such testing.

4  Lead Paint Poisoning Prevention and Control; Blood Lead Testing; Annual Opt-Out Report Established.  Amend RSA 130-A:5-c to read as follows:

130-A:5-c  Blood Lead Testing.  All parents or legal guardians shall have their children who are residing in this state tested for blood lead level at the ages of one and 2.  A child shall be exempt from this required blood lead level testing if a parent or legal guardian objects to such testing and provides a statement to such effect or if a physician licensed under RSA 329, or a physician exempted under RSA 329:21, III, certifies that blood lead level testing may be detrimental to the child's health.  The latter exemption shall exist only for the length of time that, in the opinion of the physician, testing would be detrimental to the child.  The commissioner shall develop an opt out form for the purposes of this section and shall make such form available to health care facilities.  The form shall include simple opt out language in a font and size easily readable by the average adult reader.  Health care providers shall report at least annually, the total number of opt out forms exempted under this section.

5  Effective Date.  This act shall take effect 60 days after its passage.

 

LBA

22-2592

12/22/21

 

HB 1642-FN- FISCAL NOTE

AS INTRODUCED

 

AN ACT relative to lead testing in children.

 

FISCAL IMPACT:      [ X ] State              [    ] County               [    ] Local              [    ] None

 

 

 

Estimated Increase / (Decrease)

STATE:

FY 2022

FY 2023

FY 2024

FY 2025

   Appropriation

$0

$0

$0

$0

   Revenue

$0

$0

$0

$0

   Expenditures

$0

$1,200,600

$156,700

$161,000

Funding Source:

  [ X ] General            [    ] Education            [    ] Highway           [    ] Other

 

METHODOLOGY:

This bill:

  1. Requires that the form provided by the Department of Health and Human Services to local public school officials for reporting the results of a child's physical examination include one result of blood lead level testing, and requires schools to provide the results to the Department.  The Department is then required to report the results in publicly-shared community health profiles.
  2. Requires that the form pertaining to admission, progress, health, and discharge provided by a child day care agency include one result of blood lead level testing.  Further requires that at least one test be a requirement for entry into day care facilities, that such facilities report the results to the Department, and that the Department report the results in publicly-shared community health profiles.
  3. Requires health care providers to report, on a form developed by the Department, an accounting of all children referred for blood lead level testing and the results of such tests at least annually.

 

The Department states that in order to fully implement the requirements of the bill, the following will be necessary:

 

  • The Department will need to establish a data-sharing process with each individual school (or school district), as well as each individual licensed childcare facility in the state.  The Department notes that there are approximately 102 school administrative units (SAU) and more than 700 licensed childcare facilities in the state.
  • The Department will need to de-identify and aggregate the data collected in order to share it publicly while complying with data privacy and data reliability standards.
  • The Department will need to monitor compliance with blood lead testing requirements on the part of the 700 licensed childcare facilities.
  • A new data system will need to be developed to store the additional data elements required by the bill, requiring the Department to do the following:
    • Establish a contract with a software vendor to develop and purchase a data system to transfer and store required data elements;
    • Secure necessary software licenses;
    • Establish a secure file transfer protocol site or a secure file data portal that would allow schools and childcare facilities to report information to the Department; and
    • Establish a reporting mechanism for the health care systems, schools, and childcare facilities to report the names and number of children that they serve.

 

The Department anticipates a cost of $850,000 to purchase a new database system meeting the bill's requirements.  Additional costs are estimated at $250,000 for the development of a vendor contract, data system development, and Department of Information Technology (DOIT) resources. Ongoing maintenance for the data system is estimated at $50,000 per year.

 

In addition to the costs noted above, the Department states it will need to hire one full-time Senior Management Analyst (labor grade 26, starting at step 5).  The costs for that position are as follows:

 

 

FY 2023

FY 2024

FY 2025

     Salary

 $        59,800

 $        64,700

 $        67,300

     Benefits

 $        31,300

 $        35,000

 $        36,700

     Other

 $         9,500

 $         7,000

 $         7,000

          Position Total

 $     100,600

 $     106,700

 $     111,000

 

 

It is assumed that the fiscal impact will begin in FY23.

 

AGENCIES CONTACTED:

Department of Health and Human Services