NH Pediatric Blood Lead Level Testing Requirements

On February 27, 2019, NH DHHS issued a health alert regarding pediatric blood lead level (BLL) testing requirements for NH DPHS Health AlertNew Hampshire.

Key Points and Recommendations:

  • Blood lead level (BLL) testing is now required by NH law for all one- and two-year old children residing in NH (NH RSA 130-A:5-a); the State’s Lead Paint Poisoning Prevention and Control law was changed in April 2018.
  • Children younger than one year or older than 2 years of age who have potential lead hazard exposures are also recommended to be tested for elevated BLLs.
  • All health insurance companies are now mandated to cover the cost of the blood lead level testing.
  • The New Hampshire Department of Health and Human Services’ (NH DHHS) Child Medical Management Quick Guide (see attachment) recommends that any child with a BLL of 5 micrograms per deciliter (µg/dL) or greater (capillary or venous) has a follow-up blood lead level test within three to six months.
  • A parent/guardian can refuse BLL testing for their child, but providers need to inform the parent/guardian of the recommendation, the risks of not having a child’s BLL tested, and then properly document the refusal in the patient’s medical record. An opt-out form will be developed by NH DHHS to facilitate clinician discussions (RSA 130-A:5-c).
  • All healthcare providers who conduct capillary BLL testing and identify a child with a detectable BLL need to provide the parent/guardian with the attached NH DHHS factsheet describing the health effects of lead poisoning, the advisability of obtaining a confirmatory venous blood sample, and the benefits of identifying and addressing lead hazards (NH RSA 130-A:3-a). The factsheet has been translated into additional languages which can be found at: https://www.dhhs.nh.gov/dphs/bchs/clpp/parents.htm 
  • Healthcare providers using any point-of-care Magellan LeadCare™ instrument for capillary testing are required under NH RSA 130-A:3 to report the results of BLL testing to the DHHS Healthy Homes and Lead Poisoning Prevention Program. BLL test results should be faxed within three to five business days. BLLs greater than 45 µg/dL should be reported immediately. Results should be faxed to 603-271-3991.

Read the full DHHS Alert