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.


  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.


These services are voluntary. Public health nurse case managers will work closely with clients, their family members, and health care 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.

Department of Health is available to provide support to local public health staff in investigating lead in blood cases.

Health care providers recommend appropriate follow-up testing, share public health lead investigation results and a plan of care, and provide guidance about lead risk and prevention.

Families can help by participating in phone conversations to identify risk factors for lead exposure. Then, based on the investigation, a plan of care is mailed to the family, along with 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. They should also:

  • Participate in developmental screenings using the Ages & Stages® Questionnaire.
  • Continue with public health case management until the child has a blood lead level less than 3.5 micrograms per deciliter.

If needed, families can schedule home visits with a public health nurse and an environmental health specialist so that risk areas can be tested for lead. Our team also can work to get referrals for Early Intervention, WIC Nutrition, or other agencies to assist with family needs.

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Role of Public Health Case Management