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California State Auditor Logo COMMITMENT • INTEGRITY • LEADERSHIP

Childhood Lead Levels

Millions of Children in Medi-Cal Have Not Received Required Testing for Lead Poisoning

Report Number: 2019-105


Supplemental Data About Childhood Lead Testing

Thousands of California children have experienced elevated lead levels, and millions of children who should have been tested for elevated lead levels did not receive all of the tests they should have because the two agencies charged with preventing and detecting lead poisoning in California are failing to accomplish the duties with which they have been entrusted. DHCS is failing to meet its responsibility to ensure that children enrolled in Medi-Cal receive tests to determine whether they have elevated lead levels. Similarly, CDPH has failed to focus on addressing lead hazards before children are exposed to them and has not met legislative requirements concerning lead poisoning. When we compared DHCS' information on children in Medi-Cal ages one and two years old who had not received the required lead tests with CDPH's data on the location of children under six with elevated lead levels, we found that some of the geographic areas with the largest populations of children with elevated lead levels also had a large number of children enrolled in Medi-Cal who missed required lead tests. For example, as shown in the animation below, the census tract with the most children who had elevated lead levels also had over 700 missed lead tests for children in Medi-Cal.





Use the interactive graphic below to view the number of children with elevated lead levels and the number of missed Medi-Cal lead tests by census tract, state assembly district, or state senate district.




Accessible Content
Display by: Census Tract State Assembly District State Senate District



Source: Analysis of DHCS' Management Information System/Decision Support System data and CDPH's case management system data.

Note: We were able to map over 99 percent of required and missed Medi-Cal lead tests, as well as 92 percent of children with elevated lead levels. To protect the confidentiality of the individuals summarized in the data, we include only areas with at least the following information for children ages 1 and 2 enrolled in Medi-Cal: 21 required tests, one missed test, and one completed test.
* This number is within 20 of the number of total tests required. We redacted this data to protect the confidentiality of individuals summarized.
** This number is within the range of 1 to 20. We masked the true number of missed tests to protect the confidentiality of individuals summarized.


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