HB 916 — An Act amending the act of November 3, 2022 (P.L.2135, No.150), known as the Childhood Blood Lead Test Act, further providing for title of act, for legislative purpose, for definitions, for lead poisoning prevention, assessment and testing, for duties of department and for blood lead assessment and testing coverage.

PRINTER'S NO.   965

                     THE GENERAL ASSEMBLY OF PENNSYLVANIA



                         HOUSE BILL
                         No. 916
                                                Session of
                                                  2025

     INTRODUCED BY GIRAL, PIELLI, SANCHEZ, McNEILL, HILL-EVANS,
        SCHLOSSBERG, HOHENSTEIN, CIRESI, OTTEN, WEBSTER AND GREEN,
        MARCH 17, 2025

     REFERRED TO COMMITTEE ON HEALTH, MARCH 17, 2025


                                    AN ACT
 1   Amending the act of November 3, 2022 (P.L.2135, No.150),
 2      entitled "An act providing for blood lead assessment and
 3      testing of certain children and pregnant women by health care
 4      providers; imposing duties on the Department of Health; and
 5      requiring certain health insurance policies to cover blood
 6      lead tests," further providing for legislative findings and
 7      for definitions; repealing provisions relating to lead
 8      poisoning prevention, assessment and testing; providing for
 9      lead poisoning prevention, assessment and testing; and
10      further providing for duties of department and for blood lead
11      assessment and testing coverage.
12      The General Assembly of the Commonwealth of Pennsylvania
13   hereby enacts as follows:
14      Section 1.    Section 2 of the act of November 3, 2022
15   (P.L.2135, No.150), known as the Childhood Blood Lead Test Act,
16   is amended by adding paragraphs to read:
17   Section 2.   Legislative findings.
18      The General Assembly finds that:
19          * * *
20          (8)   No safe blood lead level in children has been
21      identified.
22          (9)   The effects of lead poisoning are not reversible.
 1      Section 2.    Section 4 of the act is amended by adding
 2   definitions to read:
 3   Section 4.    Definitions.
 4      The following words and phrases when used in this act shall
 5   have the meanings given to them in this section unless the
 6   context clearly indicates otherwise:
 7      "Birthing facility."      An inpatient or ambulatory health care
 8   facility licensed by the department that provides birthing and
 9   newborn care services.
10      "Blood lead level."       A measure of lead in the blood, measured
11   in micrograms of lead per deciliter of whole blood (µg/dL).
12      * * *
13      "Child."    A child younger than 72 months of age who is a
14   resident of this Commonwealth.
15      * * *
16      "Diagnostic blood lead level testing."      An analysis of a
17   blood sample to determine blood lead levels for the sample,
18   which is obtained by venipuncture or capillary blood sampling
19   for the purpose of any of the following:
20          (1)    Confirming lead poisoning as a follow-up blood lead
21      level test.
22          (2)    Diagnosing a child or pregnant woman showing signs
23      or symptoms of lead poisoning.
24          (3)    Diagnosing a child or pregnant woman suspected of
25      having sustained a significant lead exposure.
26      "Diagnostic evaluation."       Obtaining and evaluating medical
27   history information, conducting a physical examination and
28   diagnostic blood lead level testing, identifying potential
29   sources of lead exposure and evaluating iron status.
30      * * *

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 1      "Lead poisoning."        A blood lead level that meets one of the
 2   following criteria:
 3            (1)   A confirmed blood lead level greater than or equal
 4      to 20 µg/dL in a child or pregnant woman.
 5            (2)   Two blood lead level samples of a child or pregnant
 6      woman, separated by at least 90 days, but not more than 365
 7      days, which indicate a blood lead level greater than or equal
 8      to 15 µg/dL.
 9      "Lead-screening-related services."        Any of the following:
10            (1)   Materials and supplies used to obtain blood
11      specimens for quantitative blood lead level or erythrocyte
12      protoporphyrin analysis.
13            (2)   Laboratory analysis of submitted samples for
14      quantitative blood lead level testing or erythrocyte
15      protoporphyrin analysis.
16            (3)   Evaluation of results obtained from laboratory
17      analysis of samples submitted for quantitative blood lead
18      level or erythrocyte protoporphyrin analysis, as well as
19      related consultation, referral and follow-up of children and
20      pregnant women who potentially have lead poisoning.
21      "Screening test."       A blood sample obtained by venipuncture or
22   capillary blood sampling from an asymptomatic child or pregnant
23   woman not known to have lead poisoning to identify risk of lead
24   poisoning for the child or pregnant woman.
25      Section 3.        Section 5 of the act is repealed:
26   [Section 5.     Lead poisoning prevention, assessment and testing.
27      (a)   Lead testing for children.--
28            (1)   The following apply:
29                  (i)    A health care provider shall consider possible
30            lead exposure in an individual patient by evaluating risk

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 1            factors for lead exposure and perform blood lead testing
 2            in accordance with recommendations from the Centers for
 3            Disease Control and Prevention and the American Academy
 4            of Pediatrics by 24 months of age.
 5                  (ii)    If a patient has never been tested in
 6            accordance with recommendations from the Centers for
 7            Disease Control and Prevention and the American Academy
 8            of Pediatrics by 24 months of age, a health care provider
 9            shall consider possible lead exposure and perform blood
10            lead testing in an individual patient between 24 months
11            and 72 months of age.
12                  (iii)    A health care provider shall make reasonable
13            efforts to ensure that a patient's parent or legal
14            guardian understands the risks and benefits of blood lead
15            testing prior to obtaining consent.
16            (2)   If a patient's parent or legal guardian consents to
17      blood lead testing for the patient under paragraph (1) and
18      the results of a capillary blood lead test indicate an
19      elevated blood lead level, the health care provider shall
20      perform a confirmatory blood lead test by venipuncture within
21      12 weeks of the first blood lead test after obtaining the
22      consent of the patient's parent or legal guardian.
23      (b)   Lead exposure risk assessment and testing requirements
24   for pregnant women.--A health care provider shall consider
25   possible lead exposure in individual pregnant women by
26   evaluating risk factors for lead exposure and perform blood lead
27   testing if a single risk factor is identified in accordance with
28   recommendations from the Centers for Disease Control and
29   Prevention and the American College of Obstetricians and
30   Gynecologists.

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 1      (c)   Reporting.--Health care providers and laboratories shall
 2   comply with reporting regulations as specified in 28 Pa. Code §
 3   27.34 (relating to reporting cases of lead poisoning).]
 4      Section 4.    The act is amended by adding a section to read:
 5   Section 5.1.    Lead poisoning prevention, assessment and testing.
 6      (a)   Lead testing requirements for children.--
 7            (1)   A health care provider or certified assistant of a
 8      health care provider shall make reasonable efforts to ensure
 9      that a child under the health care provider's care receives
10      at least one blood lead test by 24 months of age or between
11      the ages of 24 through 72 months of age if the child has
12      never been tested in accordance with recommendations from the
13      Centers for Disease Control and Prevention and the American
14      Academy of Pediatrics.
15            (2)   If the results of a blood lead test under paragraph
16      (1) indicate an elevated blood lead level, the health care
17      provider or certified assistant of the health care provider
18      shall perform a confirmatory blood lead test on the child
19      within 12 weeks of the first blood lead test.
20            (3)   A health care provider or certified assistant of a
21      health care provider shall perform a screening test for a
22      child under the health care provider's care who is designated
23      as high risk through a risk assessment evaluation promulgated
24      by the department on an annual basis from 12 months of age to
25      72 months of age.
26            (4)   Upon recommendation by a health care provider, a
27      health care provider or certified assistant of a health care
28      provider may perform frequent screening tests on an
29      asymptomatic child under the health care provider's care who
30      is younger than 72 months of age.

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 1      (b)   Lead testing requirements for pregnant women.--A health
 2   care provider or certified assistant of a health care provider
 3   shall make reasonable efforts to ensure that a pregnant woman
 4   under the health care provider's care receives at least one
 5   blood lead test as part of the pregnant woman's prenatal care.
 6      (c)   Testing methods.--Health care providers shall ensure
 7   that screening tests are conducted by venipuncture or capillary
 8   blood sampling in accordance with regulations promulgated by the
 9   department.
10      (d)   Reporting.--Health care providers and laboratories shall
11   comply with reporting regulations as specified in 28 Pa. Code §
12   27.34 (relating to reporting cases of lead poisoning).
13      (e)   Nonapplicability.--If a child's parent or legal guardian
14   or a pregnant woman receiving prenatal care objects in writing
15   to a blood lead test on religious grounds or on the basis of a
16   strong moral or ethical conviction similar to a religious
17   belief, a health care provider or certified assistant of the
18   health care provider shall perform a diagnostic evaluation in
19   the least invasive manner practicable.
20      Section 5.     Section 6(b)(1) of the act is amended, the
21   subsection is amended by adding paragraphs and the section is
22   amended by adding a subsection to read:
23   Section 6.     Duties of department.
24      * * *
25      (b)   Distribution of literature about childhood lead
26   poisoning.--
27            (1)   The department shall provide culturally and
28      linguistically appropriate educational materials regarding
29      childhood lead poisoning, the risk factors associated with
30      lead exposure, the importance of assessments and testing for

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 1      elevated lead levels, prevention of childhood lead poisoning,
 2      treatment of childhood lead poisoning, remediation and, when
 3      appropriate, the requirements of this act.
 4            * * *
 5            (3)   A hospital, birthing facility or health care
 6      provider shall provide the information under subsection (a)
 7      and the educational materials under this subsection without
 8      cost to a parent of a newborn prior to discharge from the
 9      hospital or birthing facility or, if childbirth occurs in a
10      setting other than a hospital or birthing facility, by a
11      health care provider who assists the parent during
12      childbirth.
13            (4)   A parent of a newborn prior to discharge from a
14      hospital or birthing facility, or after a childbirth that
15      takes place in a setting other than a hospital or birthing
16      facility, shall sign an acknowledgment statement in a form
17      determined by the department that the parent received the
18      information under subsection (a) and the educational
19      materials under this subsection. A hospital, birthing
20      facility or health care provider shall provide a copy of the
21      acknowledgment statement to the parent and keep another copy
22      of the acknowledgment statement on file at the hospital,
23      birthing facility or setting other than a hospital or
24      birthing facility, as applicable.
25      (c)   Liability.--A hospital, birthing facility or health care
26   provider shall not be civilly or criminally liable for the
27   action or inaction of a parent with regard to lead exposure
28   based on the information under subsection (a) and the
29   educational materials under subsection (b).
30      Section 6.    Section 7(a) of the act is amended and the

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 1   section is amended by adding subsections to read:
 2   Section 7.     Blood lead assessment and testing coverage.
 3      (a)   [General rule] Coverage.--A health insurance policy or
 4   government program covered under this section shall provide to
 5   covered individuals or recipients [blood lead tests as follows:
 6            (1)   In the case of individuals or recipients who are
 7      pregnant, one blood lead test per pregnancy if a single risk
 8      factor is identified in accordance with recommendations from
 9      the Centers for Disease Control and Prevention and the
10      American College of Obstetricians and Gynecologists.
11            (2)   In the case of individuals or recipients who are
12      under two years of age, at least one blood lead test by 24
13      months of age in accordance with recommendations from the
14      Centers for Disease Control and Prevention and the American
15      Academy of Pediatrics and, if the result of the blood level
16      test indicates an elevated blood lead level, another blood
17      lead test by venipuncture within 12 weeks of the blood level
18      test in which the elevated blood lead level was indicated.]
19      coverage for all of the following:
20            (3)   Screening tests and lead-screening-related services
21      for children younger than 72 months of age and pregnant
22      women.
23            (4)   Diagnostic evaluations.
24      (a.1)     Services.--The department shall provide the following
25   services for children younger than 72 months of age and pregnant
26   women who are not covered by a health insurance policy:
27            (1)   Screening tests and lead-screening-related services.
28            (2)   Diagnostic evaluations.
29      (a.2)     Reimbursement.--The department shall not be required
30   to reimburse a third party for services under subsection (b)

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1   that are not provided by the department.
2      * * *
3      Section 7.   This act shall take effect in 60 days.




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