Section 410 IAC 29-1-6 - "Child case management service implementation and coordination" definedAuthority: IC 16-41-39.4-1
Affected: IC 16-41-39.4
Sec. 6.
"Child case management service implementation and coordination" means the following:
(1) For blood lead levels between zero (0) and three and four-tenths (3.4) µ/dL, the following:(A) Notifying the child's primary medical provider within ten (10) working days of receipt of test results by the local health officer.(B) Any additional actions the local health officer believes will assist the family in preventing the child's blood lead level from increasing.(2) For confirmed blood lead levels between three and five-tenths (3.5) and four and nine-tenths (4.9) µ/dL, the following: (A) Notifying the child's primary medical provider within five (5) working days of receipt of test results by the local health officer.(B) Arranging for testing of all children less than seven (7) years of age living in the home.(C) Providing educational materials to the parents, guardians, or other adults living with the child regarding prevention of an elevated blood lead level.(D) Any additional actions the local health officer believes will assist in reducing the child's blood lead level.(3) For confirmed elevated blood lead levels between five (5) and nineteen and nine-tenths (19.9) µ/dL, beginning child case management services within five (5) working days after receipt of test results, including the following: (A) Notifying the child's primary medical provider within five (5) working days of receipt of test results and ensuring coordination of long term services and retesting.(B) Arranging for testing of all children less than seven (7) years of age living in the home.(C) Conducting an initial home visit to include the following:(i) A medical, developmental, and behavioral history.(ii) Lead education, including medical effects and environmental sources.(iii) A determination of potential household exposures.(iv) An evaluation of the risk to other members of the household, including pregnant women.(v) A nutrition assessment or referral for nutrition assessment.(vi) A developmental assessment or referral for developmental assessment.(vii) Referrals to other social services as appropriate.(D) Providing an environmental inspection to include the following: (i) A risk assessment of the child's primary and secondary addresses within ten (10) working days after receipt of test results if the structure was built before 1978, to include the following: (AA) A complete risk assessment, including recommendations to mitigate identified lead hazards.(BB) A written report to the family and the property owner if the family does not own the home.(CC) Education of the family and the owner on lead hazards in the home and measures to protect the child from further poisoning.(ii) An environmental investigation, including the following: (AA) Identification and evaluation of nonstructural exposure sources within the child's environment.(BB) Presentation of results of the environmental investigation, including recommendations for reducing or eliminating exposure.(CC) Education of the family on hazards found and education on temporary and permanent measures to protect the child from further exposure.(E) If the risk assessment finds lead hazards, immediately providing written notice to the property owner of the lead hazards and required remediation options in accordance with 410 IAC 29-4. The notice shall include the risk assessment. The property owner shall be given a reasonable time to implement recommendations for remediating lead hazards within one hundred eighty (180) days. The property owner shall have a clearance examination performed by a properly licensed individual to establish the efficacy of remediation.(F) Providing continuing child case management services until case closure as appropriate to the child's case and not less frequently than one (1) contact every three (3) months, to include the following: (i) Monitoring blood lead levels by retesting according to section 21 of this rule and notification of the primary medical provider of the results and ensuring blood lead testing of other children and pregnant women residing in the home.(ii) Monitoring and evaluation of other aspects of the child's case, including, but not limited to, the following: (AA) Additional home visits to monitor the child's progress and to identify needs that may arise from changes in primary and secondary addresses, housing condition, family composition, occupations of family members, the child's activities, the child's development, medical condition, nutrition, and use of nonprescription medications or household goods.(BB) Contacts with other service providers to monitor and evaluate service delivery, appropriateness, and efficacy.(4) For confirmed elevated blood lead levels between twenty (20) and forty-four and nine-tenths (44.9) µ/dL, initiating child case management services within five (5) working days after receipt of test results and all actions as in subdivision (3) with the following changes:(A) Notifying the child's primary medical provider immediately and ensuring coordination of long term services and follow-up testing.(B) Initiating risk assessment of the child's primary and secondary addresses within five (5) working days after receipt of test results if the structure was built before 1978.(5) For confirmed elevated blood lead levels between forty-five (45) and sixty-nine and nine-tenths (69.9) µ/dL, initiating child case management services within twenty-four (24) hours after receipt of test results and all actions as in subdivision (3) with the following changes: (A) Notifying the child's primary medical provider immediately and ensuring coordination of long term services and follow-up testing.(B) Initiating a risk assessment of the child's primary and secondary addresses within two (2) working days after receipt of test results if the structure was built before 1978.(C) Chelation therapy followed by a venous blood lead test one (1) month after completion of therapy as follows: (i) Chelation therapy may be conducted at the child's home if the home does not have any lead hazards.(ii) If the home has lead hazards, the child must be admitted to a hospital and chelation therapy performed at the hospital.(6) For confirmed elevated blood lead level greater than or equal to seventy (70) µ/dL, initiating child case management services immediately after receipt of test results and all actions as in subdivision (3) with the following changes: (A) Notifying the child's primary medical provider immediately and ensuring coordination of long term services and follow-up testing.(B) Initiating a risk assessment of the child's primary and secondary addresses within twenty-four (24) hours after receipt of test results if the structure was built before 1978.(C) Treatment of the child's EBLL as a medical emergency.(D) Admission of the child to a hospital for chelation therapy.(E) Obtaining a venous blood lead test one (1) month after completion of therapy.Indiana State Department of Health; 410 IAC 29-1-6; filed Jan 2, 2007, 2:49 p.m.: 20070131-IR-410050189FRA; errata filed Mar 29, 2007, 9:58 a.m.: 20070411-IR-410050189ACA; filed Apr 20, 2009, 3:12 p.m.: 20090520-IR-410080318FRA; readopted filed Sep 11, 2013, 3:19 p.m.: 20131009-IR-410130346RFAReadopted filed 11/13/2019, 3:14 p.m.: 20191211-IR-410190391RFAFiled 9/1/2022, 4:06 p.m.: 20220928-IR-410220119FRA