310:512-3-4. Providers screening and follow-up (a) Primary provider screening and follow-up. (1) At each routine well-child visit or at least annually if a child has not had routine well-child visits, primary health care providers should assess each child who is at least six months of age but under six years of age for high dose lead exposure using a risk assessment tool based on currently accepted public health guidelines. Each child at high risk for lead exposure should be tested.
(2) Primary health care providers should provide the parent or guardian of each child under six years of age anticipatory guidance on lead poisoning prevention as part of routine care.
(3) Primary health care providers should screen each child for lead exposure starting at 6 months of age, as part of routine well child care.
(4) Each primary health care provider who screens a child for an elevated blood lead level should explain the blood lead test results and any necessary follow-up.
(5) Primary health care providers should provide or make reasonable efforts to ensure the provision of follow-up testing for each child with an elevated blood lead level ≥10 μg/Dl.
(6) Primary health care providers should confirm blood lead levels ≥10 μg/Dl of blood obtained on a capillary fingerstick specimen from a child using a venous blood sample.
(7) For each child who has a confirmed blood lead level of ≥20 μg/Dl (micrograms per deciliter), the primary health care providers should provide or make reasonable efforts to ensure the provision of medical evaluation, or referral for medical evaluation; medical treatment if necessary; and referral to the appropriate local or state health department for environmental management. Medical evaluation should include at a minimum: a detailed lead exposure assessment, a nutritional assessment, including iron status, and a developmental screening.
(b) Non-Primary provider screening and follow-up.
(1) A health care provider who provides services to a child who is at least six months of age but under six years of age and who is not the child's ongoing primary care provider, (such as a hospital inpatient facility, an emergency service if the child's condition permits, or another facility or practitioner which provides services to the child on a one-time or walk-in basis), should inquire if the child has been appropriately screened for lead exposure.
(2) If the child, under 72 months of age, has not received such appropriate lead assessment and screening, the health care provider should screen the child for a blood lead level.
(3) If screening is performed, the blood lead test result should be sent to the child's primary care provider or, if not available, to the local health department for appropriate follow-up.
[Source: Added at 12 Ok Reg 3055, eff 7-27-95]