Baltimore, MD

The Baltimore City Childhood Lead Poisoning Prevention Program (CLPPP) sought to locate resources for homeowners of children with blood lead levels at or above 5 µg/dL. The program would encourage the abatement of deteriorating lead paint. Additionally, they sought to provide homeowners with direct access to funds to address other areas in the home that may be in disrepair due to lead.

During 2020–2021, Maryland Medicaid collaborated with the Environmental Health Bureau and the Department of Housing and Community Development (DHCD) to form a new program called Healthy Homes for Healthy Kids. Together, they secured Children’s Health Insurance Program (CHIP) administrative funds from the Centers for Medicare and Medicaid Services (CMS) to support the new program.

Homeowners in the following jurisdictions can now directly access funds for lead abatement, renovations, and home repair: Baltimore City, Baltimore County, Charles County, Dorchester County, Frederick County, Harford County, Prince George’s County, St. Mary’s County, and Wicomico County. A homeowner can also access funds for lead abatement in the secondary residence of a close relative where the child spends a significant amount of time (i.e., grandparents’ home).

During fiscal years 2021 and 2022, the Healthy Homes for Healthy Kids program provided abatement and remediation for 45 families with children exposed to lead in Baltimore City. In Baltimore City, 17 homes were also provided with new windows and roofs. They also had repairs done to plumbing to address water damage. Relocation services were provided to residents participating in the program.

Baltimore City has the highest percentage of children with blood lead levels greater than or equal to 5 μg/dL.  in Maryland. The city’s housing stock is old and deteriorating (90% of housing units were built before 1980), which presents a significant risk of childhood lead exposure. Additionally, 19% of the population lives below the poverty level which is a risk factor for childhood lead exposure. In 2017, only 54% of 1-year-old and 52% of 2-year-old children in Baltimore received a blood lead test, of which 3.8% had elevated blood lead levels (BLLs) between 5–9 μg/dL and 0.9% had elevated BLLs greater than or equal to 10 μg/dL.

The Maryland Department of the Environment (MDE) Lead Poisoning Prevention Program strategically collaborated with the Baltimore City Health Department (BCHD) Lead Poisoning Prevention Program to increase educational outreach to high-risk areas. Middle East (zip code 21213), Park Heights (zip code 21215), and Sandtown (zip code 21217) have the highest number of children with BLLs ≥ 10 µg/dL. Activities included:

• Educating parents, caregivers, and guardians of children under the age of six years about lead hazards.
• Educating healthcare providers on BCHD’s Childhood Lead Poisoning Provider Toolkit for routine care of infants and children who may be at risk of lead exposure.
• Establishing partnerships with community organizations, including the Judy Center, Baltimore City Housing Community Action Centers, and the Enoch Pratt Free Library; and
• Cross-training home visiting services to provide education for at-risk families. 

BCHD leveraged general funds from the City of Baltimore to purchase a LeadCare II analyzer to administer point-of-care testing at several locations, including the Esperanza Center, the Baltimore City Health Department Immunization Clinic, Head Start locations, and Adventure Dental. All these locations serve economically challenged and minority populations.  

BCHD also met with several managed care organizations (MCOs), including Amerigroup, Maryland Physicians’ Care, Med Star Family Choice, United Health Care, and the University of Maryland Health Plans, to gather information on current blood lead testing practices among their healthcare providers. BCHD engaged in joint outreach and testing events with each MCO and targeted blood lead testing to MCO members that live in BCHD’s jurisdiction. Additionally, BCHD partnered with the Department of Housing and Community Development to hold monthly meetings to coordinate lead hazard control violations, inspections, outreach, and referral services for families.

More than 40 Baltimore City Head Start Directors, parents, healthcare professionals, and educational instructors received education about lead hazards and lead poisoning prevention. The Maryland Department of Health and the Maryland Department of Housing and Community Development provided additional funding for in-home services to educate families about the risks of lead exposure and link families to lead hazard reduction resources. The number of referrals made to MCOs for blood lead testing has steadily increased, and MCOs regularly contact BCHD to host testing and outreach events focused on individuals who have not yet received a test.