Public Health Case Management

Public health case management services are alerted when a child’s blood lead level is at or above 3.5 micrograms per deciliter (μg/dL). Case management services continue until a child has a blood lead level of less than 3.5 micrograms per deciliter.

The goal of case management is to provide education and resources to decrease exposure and eliminate sources of lead.

STEPS

1. We work with healthcare providers to fully understand the client’s background, including languages spoken. We find out if the client already knows of their child’s lead in blood level, and if any follow-up has been scheduled. We also discuss questions or concerns about the lead in blood level result.
2. We reach out to the family and offer them a voluntary questionnaire, which provides us with more detailed information about the child’s surroundings and possible sources of exposure.
   Once the investigation is complete, we provide plans of care, education materials, and follow-up for the family’s reference. Additionally, based on age, some children will be interviewed and screened for developmental delays using Ages & Stages® guidelines and questions.
3. We continue to monitor blood lead level until it remains below the reference value. During this time, we work with the family and their healthcare provider to ensure the client’s safety and well-being.

WHAT TO EXPECT if your child has a blood lead level ≥3.5 mcg/dL

These services are voluntary. Public Health Nurse Case Managers will work closely with the family and healthcare providers to reduce levels of lead in blood and to encourage follow-up testing. If a family declines case management, Public Health Nurses will continue to work with the Healthcare Provider to provide follow-up guidance.

Public Health Nurses work with families to identify possible lead exposures. Then, based on the exposures, a plan of care is developed and mailed to the family, along with links to health education materials in the family’s primary language. It is important for the family to review these materials to learn about lead risk, prevention, and nutrition. Public Health Nurses also encourage developmental screenings using the ASQ or use the ASQ screening on the WithinReach website (scroll down to Start an ASQ Screening). Families continue with public health case management until the child has a blood lead level less than 3.5 micrograms per deciliter.

A Public Health Nurse may offer a home visit with an Environmental Health Specialist so that risk areas can be tested for lead if a specific need has been determined by the Public Health Nurse, after the lead risk investigation phone call has been completed. Home visits for testing are limited due to staffing limitations. Our team can also assist families in getting referrals for development, nutrition, or other family resource needs.

Click here or click the image below for a full-size printable graphic