Correspondence between

MEdicaid? HI Dr. Eggleston, Just closing a loop: Molina HP is working with GCHD to set up two Flint school lead testing fairs in January. However, they are still telling GCHD (Toni, CC’d) that they have to submit a request to Medicaid to do so. Just thought | would close a loop if there is one with this email. Eden Eden V. Wells, MD, MPH, FACPM Chief Medical Executive Michigan Department of Health and Human Services 201 Townsend St., 5" Floor CVB Lansing, MI 48913 xxxEND_PAGE:dhhs02_b0442_1786_1787_2

3 bullet down..what’s the first word supposed to be?

OK, is this good to get moving through our communications group? we can do a HAN early Monday if we can get approval by GCHD regarding case management referral number down..--- Current draft, but my fonts went wacky, is what | have right here: Dear Provider, Michigan Medicaid Early Periodic Screening, Diagnosis and Treatment (EPSDT) guidelines require children to be tested for blood lead poisoning at 12 months and 24 months, and between the ages of 36-72 months if not previously tested (hito://www mech state. mis oct). Due to the enhanced public health issue of an increased risk for lead exposure in the City of Flint, providers are advised to follow enhanced guidelines for lead testing in children: e Providers should screen ALL children (regardless of Medicaid/insurance status) aged 0-6 years of age exposed to Flint city drinking water after April 2014. Note: this includes all children younger than 1 year and children between the ages of 3-6 years. e Ifthe child has already been screened within the time period of April 2014-present by a capillary test, healthcare providers should follow-up on any elevated levels >Smcg/dl to ensure confirmatory venous testing is conducted. e Utlie the standard Blood Lead Level (BLL) Quick Reference for Primary Care Providers 22739 xxxEND_PAGE:dhhs02_b0421_1578_1581_1 001579 + All clients with blood lead levelS¢SiMeWal SEs Ne eee WE fuoibere e Providers should inquire about use of a drinking water filter and/or bottled water in all clients residing in city limits. e Healthcare providers should inquire about other potential sources of lead in the household per current recommendations (see: https://www.michigan. e The enhanced lead testing guidelines should be followed until the public health advisory is no longer in effect, as determined by the Geneseee County Health Department. e Resources are available at: \ ich) i

Yes, we need to run it by the health department. i mentioned in an earlier e-mail that the provider reference sheet {baseri on AAP guidelines} that is on the Flint water website indicates referral to case management. It would be helpful, i think, to have a phone number for providers so they can contact case managemant. They should already have this number for the LHD but resetition is nota problern in relation to some of this information.

with link added---- where should this go now?? xxxEND_PAGE:dhhs02_b0421_1578_1581_2 001580

Dear Flint Healtheare Provider, Michigan Medicaid Early Periodic Screening, Diagnosis and Treatment (EPSDT) guidelines require children to be tested for blood lead poisoning at 12 months and 24 months, and between the ages of 36-72 months if not previously tested (hito://www mech state. mis oct). Due to the enhanced public health issue of an increased risk for lead exposure in the City of Flint, providers are advised to follow enhanced guidelines for lead testing in children: e Providers should screen all children aged 0-6 years of age exposed to Flint city drinking water after April 2014. Note: this includes all children younger than 1 year and children between the ages of 3-6 years. e Ifthe child has already been screened within the time period of April 2014-present by a capillary test, healthcare providers should follow-up on any elevated levels >Smcg/dl to ensure confirmatory venous testing is conducted. e Providers should inquire about use of a drinking water filter and/or bottled water in all clients residing in city limits. e Healthcare providers should inquire about other potential sources of lead in the household per current recommendations (see MI Testing Strategy document xxxxxxxxx) e The enhanced lead testing guidelines should be followed until the public health advisory is no longer in effect as determined by the Geneseee County Health Department. e Resources are available and wy mich:

Before being sent to communications committee, a draft--thoughts?: Dear Flint Healthcare Provider, Current lead testing is required for all Medicaid and WIC recipients at ages 1 and 2 years statewide. Due to the enhanced public health issue of an increased risk for lead exposure in the City of Flint, healthcare providers enhance screening for lead poisoning: e Providers should screen all children aged 0-6 years of age exposed to Flint city drinking water April 2014. e This recommendation is expanded to include Flint children aged younger than 1 year and children between the ages of 3-6 years. e Ifthe child has already been screened within the time period of April 2014-present by a capillary test, healthcare providers should follow-up on any elevated levels >Smcg/dl to ensure confirmatory venous testing is conducted. xxxEND_PAGE:dhhs02_b0421_1578_1581_3 001581 Previiders sheldd inquise abexit use of a drinking waiter fitter and/or bettted water in all clients residing in city Hinritse Healtheare providess shoudd inquire about otter potential sourees of lead in thre heusePetd per eurent reeormrniditions ee Ml Testing Straegy detUMRAL woCeowse) TPIS policy is in place until drinkiag wetker is d2@TTRSU safe to drink by the Gereseee County Health Depaartment. Resourees are availaitife abaemancecounonnns ard wavw michigan gov/fintwater xxxEND_PAGE:dhhs02_b0421_1578_1581_4