Less than a third of Wisconsin children on Medicaid were tested for lead poisoning at ages 1 and 2 last year, despite a federal requirement that all such children get the testing, a new state report says.

Children on Medicaid are three times as likely to have lead poisoning than other children, so many children who could face developmental problems from lead exposure are not being identified, a Madison pediatrician said.

“We’re missing a lot of kids,” said Dr. Beth Neary, who is on the steering committee of the Wisconsin Environmental Health Network. “We’re missing a lot of opportunities to prevent further poisoning and to intervene.”

Elizabeth Goodsitt, spokeswoman for the state Department of Health Services, said the department “is working with multiple partners at the state and local levels to provide outreach to families, communities, and health care providers on the importance of blood lead testing in an effort to increase testing.”

In 2016, 32 percent of children on Medicaid were tested for lead poisoning at ages 1 and 2, according to a health department report released this month.

In 2014, 42 percent of such children got the testing. It has been required by the federal government since 1992, though it’s unclear how much the rule is enforced.

At greater risk

Children on Medicaid, the state-federal health program for low-income people, are at greater risk for lead poisoning largely because they are more likely to live in older housing with lead paint.

Testing among all children under age 6 has declined in Wisconsin since 2010, when more than 106,000 children were screened. The figure dropped last year to 87,000, about 20 percent of children under 6.

From 2006 to 2011, the state sent report cards to doctors who had 25 or more children on Medicaid, telling them how many of the patients had been tested and listing those who hadn’t. The report cards boosted testing rates, the health department said.

The program stopped after 2011 because Congress decreased funding to the Centers for Disease Control and Prevention’s lead poisoning prevention program, Goodsitt said.

The CDC grant to the state was reinstated in September 2014, leading the health department to resume the report cards in November 2016, she said.

That could boost testing rates again starting this year, Neary said.

Last year, 60 percent of 1-year-olds and 48 percent of 2-year-olds on Medicaid were tested for lead poisoning, but 32 percent were screened at both ages. Among children ages 3 to 5 who hadn’t been previously tested, 14 percent were tested.

Important time

Blood lead levels typically are highest between 18 and 36 months of age, when children become mobile and frequently put their hands in their mouths, the health department said.

“A normal blood lead test at 1 year of age does not mean the child is not at risk for lead poisoning later on,” the new report said.

Despite Wisconsin’s decline in testing in recent years, the state screens a higher proportion of children than the national average, according to the health department.

Last year, 5 percent of all children tested in the state had blood lead levels considered problematic. The rate generally has gone down in recent years but remains above the national average.

Tests positive for lead poisoning can lead to home inspections resulting in the removal of lead paint, contaminated soil and other sources of lead, Neary said. In extreme cases, a treatment called chelation can remove lead from the body.

The measures can decrease the risk of developmental problems, such as learning disabilities and behavioral problems related to brain damage, but can’t undo harm already done, Neary said.

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David Wahlberg is the health and medicine reporter for the Wisconsin State Journal.