EWG Issues Recommendation Budget Request 4265-012-BCP-2018-GB, pertaining to implementation of AB 1316 (Quirk, C. Garcia) of 2017

The Environmental Working Group (EWG) actively participates in advocating and contributing to legislation in CA to improve protections for constituents of California.

SmartOakland signed in support of this letter submitted Feb. 22, 2018. The content is provided for you inline here and in pdf format here.

February 22, 2018
Assembly Member Juan Arambula, Chair
Assembly Budget Subcommittee No. 1 on Health and Human Services
State Capitol
Sacramento, CA 95814

RE: Budget Request 4265-012-BCP-2018-GB, pertaining to implementation of AB 1316 (Quirk,
C. Garcia) of 2017

Dear Assembly Member Arambula:

The undersigned organizations write in support of the Department of Public Health’s budget   re quest (Budget Request 4265-012-BCP-2018, Alternative #1) to fully fund implementation of AB 1316(Chapter 507, 2017), a bill that revamps the department’s Childhood Lead Poisoning Prevention Program. Within this budget request, the department proposes several funding options, including reduced and no-funding alternatives. We ask that the Budget Committee fully fund the bill’s implementation and reject any funding option or budget language that does not ensure the bill’s directive is carried out.

According to the department’s estimates, implementation of AB 1316 will cause another 300,000 children to receive blood lead tests each year. As newly analyzed data demonstrate, more robust blood lead testing is sorely needed.Since the 1970s, federal and state policies banning the use of lead in gasoline and paint have resulted in drastic reductions in childhood lead exposure. However, legacy lead – lead remaining in paint,plumbing, contaminated soil, and pipes – continues to endanger children who encounter the neurotoxin. As infrastructure ages, lead exposure risks become more ubiquitous.

In addition, new sources of lead have been identified, and local officials report that children are
frequently exposed to potentially dangerous levels of lead by consuming certain spices, handling imported toys, make-up, and ritual items, and when treated with home remedies (Please see the attached statement from Debbie Katz, a retired Sacramento County environmental health officer.)

Although chil dren in California are still exposed to lead, many who are most at risk of lead poisoning are not tested for lead exposure as required. A recent analysis (enclosed) found that each year,between 2012 and 2016, as many as three-quarters – 529,000 on average each year – of the state’s toddlers most likely to be lead-poisoned did not receive lead tests in accordance with federal and stateregulations.*

This finding supports another analysis, published last year in the peer-reviewed journal Pediatrics.

This analysis found that more than 63 percent of California’s children with elevated blood lead levels above 10 mcg/dL are not identified.

When California children are blood lead tested, the test results raise concerns. In 2012, children tested in 145 zip codes had elevated blood lead levels (>5 mcg/dL), as defined by the Centers for Disease Control and Prevention, above the average national rate. In many of these zip codes, five to 14 percent of children tested had elevated levels, which is two to over five times the national rate. These rates dwarf those of children in the now notorious case of Flint, Michigan, where five percent, or twice the national average, of children tested have elevated BLLs.

Unfortunately, these elevated BLL rates do not provide a complete picture of childhood lead exposure in California. Because only some children are tested, and the children who are most likely to be lead poisoned don’t receive required tests, it is possible that more children are lead compromised than the data show. However, without more rigorous testing, we will never know.
Eleven other states currently require that doctors test all children for lead exposure, and these states, not coincidentally, identify lead-poisoned kids at much higher rates than does California.
California’s kids deserve better. We should identify many more kids who are lead poisoned or
exposed, and the Department of Public Health’s regulations, and its Childhood Lead Poisoning
Prevention Program, should be reformed to make this happen.

AB 1316 requires the Department of Public Health to revise its regulations that determine how doctors evaluate and test children for lead poisoning. The bill requires the department, when revising the regulations, to consider the most significant environmental risk factors for lead poisoning. These factors must include, but not be limited to, a child’s time spent in any older building, and a child’s proximity to a former steel or lead smelter, or to a freeway. Other states, such as New York, use these risk factors and others to assess children for potential lead exposure.

AB 1316 also implements the Department of Toxic Substances Control Independent Review Panel’s recommendation that the Department of Public Health be required to use its blood lead level data to identify potential “hot spots” for lead exposure. In addition, the bill requires the department to provide more information to the public about the Childhood Lead Poisoning Prevention Program’s work and the prevalence of high child blood lead levels, and the bill requires the department to expand its data management system. Finally, the bill makes statutory changes requested by the department.

The Department of Public Health’s Budget Request 4265-012-BCP-2018-GB proposes budget
augmentations to fund AB 1316’s implementation. We ask that the Committee fund the budget
request’s Alternative #1, or that the Committee act to guarantee that the department swiftly implement the bill’s directives.

Sincerely,

  • Andria Ventura, Toxics Program Manager Clean Water Action
  • Susan Little, Senior Advocate, California Governmental Affairs Environmental Working Group
  • Jim Lindburg, Legislative Director Friends Committee
  • Miriam Rotkin-Ellman, Senior Scientist, Health and Environment Program, Natural Resources Defense Council
  • Michael Green, Chief Executive Officer, Center for Environmental Health
  • Diana Vazquez, Policy Advocate, California Environmental Justice Aliance (CEJA)
  • Emily Rusch, Executive Director, CalPIRG
  • Daphne Macklin, California Coalition of Welfare Rights Organizations
  • Stephanie Hayden, Director, Co-Founder SmartOakland.org

* At a February 13, 2018 by the Assembly Environmental Safety and Toxic Materials Committee, the Department of Health Care Services provided updated 2016 lead testing numbers for Medi-Cal 1 and 2 year olds. According to the department’s new data, 640,384 kids ages 1 and 2 years old continuously enrolled Medi-Cal in 2016. Only 235,694 of these children were blood lead tested, indicating that 37% of children, on average, were tested that year. This includes children that were blood lead tested under managed care and as fee-for-service. This updated data, however, does not change the conclusion that, on average, between 2012 and 2016, only 28% of Medi-Cal 1 and 2 year olds were lead-tested as required.

Cc: Assembly Member Phil Ting, Chair, Assembly Budget Committee
Members, Assembly Budget Subcommittee No. 1 on Health and Human Services
Assembly Member Bill Quirk, Chair, Assembly Environmental Safety
and Toxic Materials Committee
Speaker Anthony Rendon, California State Assembly