Arizona

The State of Arizona received $310,390 through cooperative agreement EH21-2102 from the Centers for Disease Control and Prevention (CDC) in FY 2022. The funds address childhood lead poisoning prevention and surveillance programmatic activities being conducted from September 30, 2022 to September 29, 2023.

The strategies focus on

  • Ensuring blood lead testing and reporting
  • Enhancing blood lead surveillance
  • Improving linkages to recommended services

To learn more about these efforts in Arizona, contact the program below.

Arizona Department of Health Services
Childhood Lead
150 North 18th Avenue, Suite140
Phoenix, AZ 85007
Phone: 602-542-1025

Success Story 2023

Ensuring Refugee Children Receive Follow-up Testing for Lead in Arizona

Challenge

In 2022, the Arizona Childhood Lead Poisoning Prevention Program (AZ CLPPP) observed a sharp
increase in the number of refugee children with blood lead levels (BLLs) above CDC’s blood lead reference value (BLRV) of 3.5 µg/dL. There were 205 cases in 2022 compared to only 21 in 2021. It is important to note that in 2021 the BLRV was 5 ug/dl. Arizona adopted the new BLRV of 3.5 ug/dl in 2022. The majority of the refugees in 2022 were from Afghanistan. AZ CLPPP encountered several challenges when providing case management for these children. Newly arrived refugee infants, children, adolescents, and pregnant and lactating women and girls are tested for lead during their initial health screening exam within 30 to 90 days of arriving in Arizona at a local refugee medical clinic. However, the follow-up test would need to be scheduled by the primary care provider. AZ CLPPP provided case management for children 16 years and younger. Many (41% of) children and adolescents who had a BLL at or above the BLRV during the initial exam did not receive follow-up tests. Other challenges included communicating lead poisoning prevention messages due to language barriers and the inability to identify the resettlement agency assigned to the child. Identifying the resettlement agency assigned to each case is important to address these challenges.

Intervention

In the spring of 2022, AZ CLPPP began to address these challenges by reestablishing relationships with the resettlement agencies and the local medical clinics that serve refugee populations. To address the information gap, the program requested that refugee clinics include the resettlement agency information and primary language for each child when reporting BLL results to the health department. Since most children who are recently arrived refugees are covered by Medicaid, the program also formed relationships with managed care organizations (MCOs) to get healthcare provider information and access translation services when contacting families by phone.

Once the child’s healthcare provider is identified, AZ CLPPP will fax the healthcare provider to let them know that the child is overdue for a blood lead test. Additionally, AZ CLPPP translated health education materials into specific languages to distribute to refugees and provided educational resources to resettlement agencies for inclusion in the medical orientation for newly arrived refugee families. The program also updated its case management protocol for refugees to ensure routine follow-up of their cases.

Impact

MCOs currently provide the program with missing provider information and send follow-up testing reminders to families. This effort is still underway; however, AZ CLPPP anticipates that this effort will lead to improved follow-up testing among children who are refugees and expanded messaging with the refugee communities throughout Arizona about lead poisoning prevention.

Funding for this work was made possible in part by NUE2EH001471 from the Centers for Disease Control and Prevention (CDC). The views expressed in this material do not necessarily reflect the official policies of the CDC; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.

Success Story 2021

Arizona’s Interactive Tool to Map Lead Exposure Risk

Challenge

Arizona uses a targeted screening approach to identify children who are at risk for lead exposure. The Arizona Childhood Lead Poisoning Prevention Program (AZ CLPPP) has traditionally targeted high-risk zip codes to focus blood lead testing efforts. However, risk can vary greatly from one neighborhood to the next within a single zip code. Therefore, a tool was needed to help families and providers assess a child’s risk, and to provide a better and more representative recommendation based on a child’s neighborhood rather than the zip code.

Intervention

The AZ CLPPP collaborated with the Arizona Environmental Public Health Tracking Program to develop an interactive, web-based neighborhood-level mapping tool. To help identify high-risk zip codes, that tool was implemented statewide in the 2018 Targeted Lead Screening Plan, effective January 1, 2018. The interactive map allows users to enter an address and receive screening recommendations for children living in that neighborhood. The mapping tool is compatible with smart phones for easy access.

Impact

The tool empowers parents and allows them to be more informed and engaged in their child’s healthcare needs. The tool has been used over 3,500 times to provide screening recommendations since it went live January 1, 2018.

Funding for this work was made possible in part by EH14-1408 from the Centers for Disease Control and Prevention (CDC). The views expressed in this material do not necessarily reflect the official policies of the CDC; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.