One of the things that puzzled me about the Flint lead poisoning is why the problem took so long to identify. Medicaid gives strong incentives to managed care organizations to test their pediatric members for lead poisoning. Michigan has their own lead policy:
All Medicaid enrolled children are considered to be at high risk for blood lead poisoning. In accordance with the Centers for Medicare and Medicaid Services guidelines, Michigan Medicaid policy requires that all Medicaid enrolled children be blood lead tested at 12 and 24 months of age, or between 36 and 72 months of age if not previously tested.
Public Act 55 of 2004 required that by October 1, 2007, 80% of Medicaid enrolled children were to have been blood lead tested. MDCH designed a report, theMedicaid Blood Lead Testing report, to monitor compliance with this law.
The January 2013 report showed that there were 3,000+ kids in Medicaid under the age of 2 in Genesee County. 70% of those kids had a lead screening.
Someone should have been screaming that the Medicaid pediatric population was seeing a massive lead level spike. It should have been either at the provider level, or more readily, at the insurer level as they should have been seeing the claims for follow-up visits after positive lead tests started to come back in high numbers. And if the providers and insurers were not screaming their heads off, the Michigan medicaid administrative offices should have been as soon as they started to see the claims come across their data encounter system.
Unfortunately, it looks like the state of Michigan put their head in the sand (via the ACLU)
In a posting Monday on the website FlintWaterStudy.org, Virginia Tech professor Marc Edwards accused the state of neglecting the lead-poisoning issue even though Michigan officials knew as early as summer 2014 that there was a problem.
“They [Michigan Department of Human and Services officials] discovered scientifically conclusive evidence of an anomalous increase in childhood lead poisoning in summer 2014 immediately after the switch in water sources, but stood by silently as Michigan Department of Environmental Quality (MDEQ) officials repeatedly and falsely stated that no spike in blood lead levels (BLL) of children had occurred,” wrote Edwards
Lead poisoning is something that should be picked up through multiple systems. I can’t figure out why the public health system failed so obviously.