In 2019, approximately 1 out of every 40 Maine children under age 6 years who were tested for lead in the blood had lead poisoning. This means that an estimated 347 out of 14,367 (2.4%) children tested for lead poisoning had a blood lead level (BLL) of 5 micrograms of lead per deciliter of blood (?g/dL) or higher. While both the number and the percentage of children identified with lead poisoning has been declining in Maine since 2003 when an estimated 1,500 children, or nearly 11 percent of children tested, had a BLL of 5 ?g/dL or higher, the Maine Center for Disease Control and Prevention?s Childhood Lead Poisoning Prevention Unit (CLPPU) continues to pursue its longstanding goal of eradicating childhood lead poisoning in Maine, and to operate under the principle that there is no safe level of lead in a child?s body.Maine has already established a robust, comprehensive primary and secondary lead poisoning prevention effort. In 2016, Maine became one of the first jurisdictions in the U.S. to provide case management and environmental interventions for children with blood lead levels as low as 5 ug/dL (the U.S. CDC?s current reference level for elevated blood lead in children less than 6 years old). In 2019, in response to persistently low blood lead testing rates, the Maine Legislature amended state law to require all children to be tested for lead at ages 1 and 2 years. Maine CLPPU also conducts statewide activities targeted to at-risk populations and community-based primary prevention activities in high-risk areas through a dedicated State revenue stream. The proposed project, therefore, builds upon this solid foundation to fill key program gaps and strengthen existing efforts.Funding from this cooperative agreement will be used for the secondary prevention of childhood lead poisoning, including to: 1) improve blood lead testing and reporting in Maine in alignment with Maine and federal blood lead testing requirements; 2) maintain and expand M
aine?s capacity to conduct blood lead surveillance; and 3) improve Maine?s ability and processes to link lead-exposed children to recommended services.Major activities supported by the cooperative agreement, or leveraged using state resources, will include: a) working with a Statewide Lead Advisory Committee and partners including Maine?s Medicaid administration agency to improve to improve blood lead screening in high-risk areas and among MaineCare-enrolled children through the use of blood lead testing report cards; b) operating and upgrading a lead poisoning case management and surveillance system in order to collect, analyze, report, and disseminate important data about lead poisoning in Maine; and, c) improving Maine?s processes to link lead-exposed children to services such as environmental lead investigations of the home environment and other recommended services such as nursing visits and early intervention services.This project will result in improved blood lead testing and reporting rates for children less than 6 years of age at risk for lead exposure; improved use of surveillance system data to capture missing data on child demographic and follow-up information; improved rates of children less than 6 years of age with elevated blood lead levels linked to recommended services; and, decreased disparities in blood lead levels by race/ethnicity and socioeconomic status.