Agenda Item   



                                                                                                                        ASR Control  16-000991




legal entity taking action:

Board of Supervisors

board of supervisors district(s):

All Districts

SUBMITTING Agency/Department:

Health Care Agency   (Approved)

Department contact person(s):

Donna Fleming (714) 834-2980 



David Souleles (714) 834-3882



Subject:  Ratify Amendment to Agreement for Childhood Lead Poisoning Prevention Program


      ceo CONCUR

County Counsel Review

Clerk of the Board


Approved Agreement to Form




3 Votes Board Majority




    Budgeted: Yes

Current Year Cost: N/A

Annual Cost: N/A




    Staffing Impact:


# of Positions:

Sole Source: No

    Current Fiscal Year Revenue: $311,341

  Funding Source: State:100% (Childhood Lead Poisoning Prevention)

County Audit in last 3 years: No



    Prior Board Action: 8/19/2014 #24, 3/6/2012 #22, 4/20/2010 #45




Approve and ratify the Standard Agreement Amendment No. 14-10027 A01 for the Childhood Lead Poisoning Prevention Program with the California Department of Public Health to increase the agreement amount by $311,341 to a new agreement amount of $3,216,225 for the period of July 1, 2014, to June 30, 2017.







The Health Care Agency requests approval of the Standard Agreement Amendment with the California Department of Public Health for the Childhood Lead Poisoning Prevention Program to provide education and case management services to reduce exposure and incidence of childhood lead poisoning.






Since 1993, the Health Care Agency (HCA) has received funding from the California Department of Public Health (CDPH) to operate a Childhood Lead Poisoning Prevention Program (CLPPP).  Program services include: outreach and education activities, case management services including identification of the cause and linkage to physicians for children identified as having elevated blood lead levels.  These efforts have supported decreased childhood exposure to lead. 


Though the number of children reported with elevated blood lead levels is trending down, Orange County ranks second highest among California counties in the number of children with elevated blood lead levels.  In 2012, the most recent year for which complete data is available through the CDPH, Orange County had a reported 1,165 children with elevated blood lead levels.  The table below from the Orange County Conditions of Children, 2015 provides trend data from the six most recent years available.



On July 19, 2016, HCA received a Standard Agreement Amendment No. 14-10027 A01 with the CDPH in the amount of $3,216,225 for the three-year period of July 1, 2014, to June 30, 2017. This amount includes $974,428 for FY 2014-15, $965,228 for FY 2015-16, and $1,276,569 for FY 2016-17; and reflects an annual increase of $311,341 as compared to FY 2015-16.  The funding received is passed through the State.  Prior CLPPP Agreements were approved by the Board on April 20, 2010, March 6, 2012, and August 19, 2014.


In May 2012, the U.S. Centers for Disease Control and Prevention (CDC) adopted recommendations made by the Advisory Committee on Childhood Lead Poisoning Prevention, which included using a lower reference value of 5mcg/dL when identifying and treating lead exposure in children. In consideration of those changes, CDPH recently lowered the threshold for the State elevated blood lead level case definition and expanded the scope of work under the proposed agreement to include case management of children at lower blood lead levels.


The funding, including the increase, enables HCA to:


provide intensive case management, home visitation and environmental investigation services to children who meet the State case definition;


conduct case management for children with lower-level elevated blood lead levels to prevent them from developing into high-level cases;


perform community outreach and education activities;


develop and implement activities designed to prevent lead-exposed children and at-risk children from further exposure to lead hazards; and


develop collaboration with local building departments and other groups to ensure that lead hazards are properly identified and eliminated.


In 2015, County CLPPP provided case management services to 894 new and existing cases and conducted 55 home visits and environmental investigations.  In addition, CLPPP participated in over 422 education and outreach events, including health fairs, paint and hardware stores, medical providers and other community organizations in which lead poisoning prevention educational materials and information were distributed to more than 24,525 individuals. 


This Standard Agreement Amendment does not include subcontractors or pass through to other providers.  See Attachment C for Contract Summary form.


HCA requests that the Board approve the Standard Agreement Amendment for the CLPPP with the CDPH, as referenced in the Recommended Actions.








Revenue for this Standard Agreement Amendment is included in HCA's FY 2016-17 Adopted Budget.











Attachment A - Standard Agreement Amendment No. 14-10027 A01 with the California Department of Public Health
Attachment B - Redline Summary to Attachment A