CHAPTER 310

FORMERLY

SENATE BILL NO. 78

AS AMENDED BY SENATE AMENDMENT NOS. 1 AND 2 AND

HOUSE AMENDMENT NO. 4 AS AMENDED BY HOUSE AMENDMENT NO. 2 TO

HOUSE AMENDMENT NO. 4

AN ACT TO AMEND TITLE 16 AND TITLE 18 OF THE DELAWARE CODE PROVIDING FOR A CHILDHOOD LEAD POISONING PREVENTION ACT RELATING TO MANDATORY LEAD POISONING TESTING AND HEALTH INSURANCE COVERAGE.

WHEREAS: Lead poisoning is the foremost environmental problem and preventable disease in children, leading to morbidity, mortality, mental retardation and learning disabilities; and

WHEREAS, three of four houses built in Delaware prior to 1980, a total of 143,493 homes, have been painted with lead-based paint; and

WHEREAS, hazardous blood-lead levels are estimated to affect as many as 1 of every 7 children under seven years of age in Delaware; and

WHEREAS, some public health experts estimate that the rate of lead poisoning among children at risk now exceeds the rate of paralytic polio at the height of the polio epidemic of the 1950's; and

WHEREAS, symptoms of lead poisoning in children are often difficult to detect unless lead blood level screening is conducted in accordance with guidelines set forth by the Centers For Disease Control; and

WHEREAS, the monetary and social costs of lead poisoning in children far exceed the costs of monitoring and preventing the disease.

NOW, THEREFORE:

BE IT ENACTED BY THE GENERAL ASSEMBLY OF THE STATE OF DELAWARE:

Section 1. Amend Part II, Title 16, Delaware Code by adding thereto a new chapter, designated as Chapter 26, which new chapter shall read as follow:

"CHAPTER 26. CHILDHOOD LEAD POISONING

PREVENTION ACT

§2601 Short Title

This Act shall be known and may be cited as the Childhood Lead Poisoning Prevention Act.

§2602 Physicians and Health Care Facilities to Screen Children

(a) Every health care provider who is the primary health care provider for a child shall order screening of that child, in accordance with standards promulgated by the Division of Public Health, at or around twelve months of age for lead poisoning.

(a) For a child who is deemed by the primary health care provider, pursuant to guidelines promulgated by the Division of Public Health, to be at high risk for lead poisoning, that health care provider shall order screening of that child for lead poisoning in accordance with guidelines and criteria set forth by the Division of Public Health.

(b) Unless the child Is at high risk for lead poisoning, as determined by the primary health care provider, pursuant to guidelines promulgated by the Division of Public Health, screening shall not be required for any child who is over twelve (12) months of age on the effective date of this legislation.

(d) ll laboratories involved in lead level analysis will participate in a universal reporting system as established by the Division of Public Health.

(e) Nothing in this section shall be construed to require any child to undergo a lead blood level screening or test whose parent or guardian objects on the grounds that the screening or test conflicts with his or her religious beliefs.

(a) All laboratories involved in blood lead level analysis will
participate in a universal reporting system as established by the State Board of Health.

§ 2603. Screening prior to child care or school enrollment.

For every child born on or after the effective date of this statue and who has reached the age of twelve months, child care facilities and public and private nursery schools, preschools, and kindergartens, shall require screening for lead poisoning for admission or continued enrollment. A statement shall be provided from the child's primary health care provider that the child has been screened for lead poisoning or in lieu thereof a certificate signed by the parent or guardian stating that the screening is contrary to that person's religious beliefs.

§ 2604 Reimbursement by Third Party Payers,

Screening, screening-related services and diagnostic evaluations as required by subsection 2602 shall be reimbursable under health insurance contracts and group and blanket health insurance as provided by Chapter 33 and Chapter 35, respectively, of Title 18."

Section 2. Amend Chapter 33, Title 18 of the Delaware Code by adding thereto a new section to read:

"§ 3337

All individual health insurance policies which are delivered or issued for delivery in this State by any health insurer, health service corporation, health maintenance organization, or any health services and facilities reimbursement program operated by the State and which provide a benefit for outpatient services shall also provide a benefit for a baseline lead poisoning screening test for children at or around 12 months of age. Benefits shall also be provided for lead poisoning screening and diagnostic evaluations for children under the age of six years who are at high risk for lead poisoning in accordance with guidelines and criteria set forth by the Division of Public Health. Such testing shall be deemed to be a covered service, notwithstanding any policy exclusions for services which are part of or related to annual or routine examinations. Nothing in this Section shall prevent the operation of such policy provisions as deductibles, coinsurance allowable charge limitations, coordination of benefits or provisions restricting coverage to services rendered by licensed, certified or carrier-approved providers or facilities. Nothing in this Section shall apply to accident-only, specified disease, hospital indemnity, Medicare supplement, long-term care, or other limited health insurance policies.

This section shall apply to all policies, contracts, certificates or programs issued, renewed, modified, altered, amended, or reissued on or after March 1, 1995."

Section 3. Amend Chapter 35, Title 18 of the Delaware Code by adding thereto a new section to read:

"§3554. Lead Poison Screening Reimbursement.

All group and blanket insurance policies, which are delivered or issued for delivery in this State by any health insurer, health service corporation, health maintenance organization or any health services and facilities reimbursement program operated by the State which provide a benefit for outpatient services shall also provide a benefit for a baseline lead poisoning screening test for children at or around 12 months of age. Benefits shall also be provided for lead poisoning screening and diagnostic evaluations for children under the age of six years who are at high risk for lead poisoning in accordance with guidelines and criteria set forth by the Division of Public Health. Such testing shall be deemed to be a covered service, notwithstanding any policy exclusions for services which are part of, or related to, annual or routine examinations. Nothing in this Section shall prevent the operation of such policy provisions as deductibles, coinsurance allowable charge limitations, coordination of benefits or provision restricting coverage to services rendered by licensed, certified or carrier-approved providers or facilities. Nothing in this Section shall apply to accident-only, specified disease, hospital indemnity, Medicare supplement, long-term care, or other limited health insurance policies.

This section shall apply to all policies, contracts, certificates or programs issued, renewed, modified, altered, amended, or reissued on or after March 1, 1995."

Section 4. If any provision of the Act or the application thereof to any person or circumstance is held invalid, such invalidity shall not affect other provisions or applications of the Act which can be given effect without the invalid provision or application, and to that end the provisions of this Act are declared to be severable.

Section 5. The provisions of this Act shall become effective on March 1, 1995.

Approved July 8, 1994.