Advocates Criticize Proposed Changes To Lead Poisoning Act

Proposed changes to rules on lead testing for children in Delaware add nurses and definitions of poisoning.

Advocates involved in the rulemaking process for the Childhood Lead Poisoning Prevention Act criticized the Department of Health and Social Services for a proposed regulation at a public hearing on Wednesday.

It removes nurses from the process, only focuses on young children and does not define lead poisoning or elevated blood levels, they said.

The proposed changes involve how the department tests lead levels for young children in the state following unanimous passage of House Bill 222 in 2021.

The regulation would apply to children between the ages of 12 and 24 months, require lead testing by a primary care provider on children between nine and 15 months and again on children between the ages of 21 and 27 months.

Previously, testing would be done on children starting at 22 months.

The proposed changes removed the definitions of high risk, low risk, blood lead registry, and blood lead testing but added definitions for blood lead analysis, child care facilities, screening, testing, parent or guardian, and reference value.

Sarah Bucic, a registered nurse and a member of Lead Free Delaware, said she is concerned with the new regulation because it removes school nurses from the equation.

“My main point is that school nurses are an integral part of childhood lead poisoning prevention,” Bucic said. “We obviously want children to get tested at 12 months and 24 months but for those children who aren’t getting tested, we really want to see school nurses in these regulations rather than administrators.”

In section 10 of the proposed regulation, parents looking to enroll their children in a child care facility, preschool, or kindergarten must provide proof of a blood lead level screening test to a school administrator.

Bucic would prefer that nurses be a part of that process because they have more medical training than administrators.

Amy Roe, a member of the Environmental & Epidemiology subcommittee within the Childhood Lead Poisoning Advisory Committees, said that there aren’t enough reporting requirements in the regulation.

“The reporting requirements part of the regulation are an abomination… We’ve got regulations that require the 12 month test and the 24 month test,” Roe said. “We got regulations that require a test with certain circumstances for children who are younger than six and we’ve got certain reporting for confirmatory tests for screenings above the reference value. And that’s it…everything else is optional.”

Roe said that she takes issue with the regulation for not defining lead poisoning or elevated blood levels and because it doesn’t have any details on enforcement or implementation.

This isn’t the first time the department has tried to make changes to the lead regulation, as on Feb. 1, 2023 and July 1, 2022, the department published proposed changes that they ultimately didn’t adopt.

Those proposed regulations made similar changes to how the department administers the Childhood Lead Poisoning Prevention Act as the most recent proposal, such as changing the standard to test every 12 to 24 months instead of starting at 22 months and adding and removing some definitions.

Larry Lambert, D-Claymont/Arden, was the primary sponsor for House Bill 222 and said that the department should make changes based on the criticism provided by BuciT

“This issue is urgent,” Lambert said. “We don’t have the luxury of being complacent or being slow in this and we appreciate your efforts thus far. Kindly ensure that we’re implementing the feedback of those on the front lines of our advocates, as well as our brothers and sisters in DHSS and in the state.”

Sandra Spence, a member of the Childhood Lead Poisoning Advisory Committee, also said that the department should listen to Bucic and Roe’s criticism.

The public comment period is open until June 8.

Alanna Mozeik, the interim chief of staff and policy lead at the Department of Health and Social Services, said at the hearing that they don’t know how long it will take them to make a decision.

“I think it all depends on the amount of comments that we receive as we truly go line by line in every comment and have discussions about each one,” Mozeik said. “And then the amount of changes that we have to make to the draft regulations as well as the legal review that’s involved.”