Minnesota

About the program

The State of Minnesota received $362,645 through cooperative agreement EH21-2102 from the Centers for Disease Control and Prevention (CDC) in the third funding year. The funds address childhood lead poisoning prevention and surveillance programmatic activities being conducted from September 30, 2023, to September 29, 2024.

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 Minnesota, contact the program below.

Minnesota Department of Health

Healthy Homes and Lead Poisoning Prevention Program

625 Robert St. N

St. Paul, MN 55155

Phone: 651-201-5000

Success story: funding year 3

Addressing childhood lead poisoning from an ammunition manufacturing facility in Minnesota

Challenge

During December 2021–January 2023, the Minnesota Department of Health (MDH) blood lead surveillance system and St. Paul-Ramsey County Public Health (SPRCPH) identified four children younger than six years old with blood lead levels (BLL) at or above 5 µg/dL. Investigators determined the children lived with adults who worked at a single facility that manufactures ammunition (referred to as "Facility A"). Environmental investigators found lead dust in each of the children's family homes and vehicles. Investigators did not find any other sources of lead, such as lead-based paint that might affect the children's BLLs.

Intervention

In July 2021, Minnesota modified its Childhood Lead Poisoning Prevention Act (Minnesota Statutes § 144.9504) to address lead that comes from an outside source (such as a business) into private homes. This law change allows the assessing agency to order the responsible person of that location to perform lead hazard reduction and help keep lead contained. MDH issued Corrective Orders in February 2023 that required Facility A to establish a lead dust surveillance plan to prove that lead dust was not leaving the facility. MDH also issued a news release for the community and Health Action Network notification to healthcare providers to encourage household members of Facility A workers to receive a blood test if they are pregnant or younger than 18 years old.

To comply with the required lead dust surveillance plan, Facility A management

• Hired an outside consultant
• Increased employee communication and training
• Banned personal items from work areas
• Provided uniforms and footwear to all workers
• Hired a lead abatement company to clean employee vehicles
• Set up modular buildings to serve as locker rooms to prevent re-contamination after shifts end renovated the administrative building to make the floors cleanable
• Established new cleaning protocols
• Voluntarily worked with their industry association to create educational materials for other businesses about take-home lead.

Impact

As a result of the changes, household members of Facility A's 1,400 employees have decreased lead exposure. Ammunition industry leaders also became more aware of the hazards of take-home lead. Since January 2023, no additional cases of children with blood lead levels above 5 µg/dL have been associated with Facility A. MDH credits its team's quick action to reduce exposure to take-home lead. A similar investigation involving a Minnesota plant from 2018–2019 underscored the importance of protecting families from workplace hazards that make it into homes and made Facility A management more willing to cooperate to make recommended changes and achieve compliance.

Funding for this work was made possible in part by Grant NUE2EH001448 from the Centers for Disease Control and Prevention (CDC). The views expressed in this material do not necessarily reflect the official policies of CDC; nor does mention of trade names, commercial practices, or organizations or imply endorsement by the U.S. Government.

Success story: funding year 2

Closing reporting gaps by matching Medicaid claims to the Minnesota blood lead database

Challenge

Nationally, children enrolled in Medicaid have increased rates of lead exposure. The Early and Periodic Screening, Diagnosis, and Treatment national benefit provides healthcare services for children enrolled in Medicaid and requires that children receive blood lead testing at ages 1 and 2 years. However, blood lead test results are not always reported despite the Minnesota state mandate.

Intervention

The Minnesota Department of Health (MDH) and the Department of Human Services (DHS) established a quarterly data sharing agreement, allowing for the matching at the person level of claims for blood lead tests for children under age 3 years who were enrolled in Medicaid to blood lead test results in the Blood Lead Information System (BLIS) database. The first round of data matching was completed in March 2022. A second round was completed in May 2022. MDH sent letters to the 70 billing facilities with the most unmatched claims to resolve reporting discrepancies. Claims that remained unmatched after the first round of contact to facilities were also included in the second round of contact.

Impact

Two rounds of data matching and outreach recovered 1,188 blood lead test results from April 1, 2019, through December 31, 2021, for children enrolled in Medicaid and an additional 191 lead tests for children who were not enrolled. Most facilities (66%) who received letters worked with MDH to resolve reporting discrepancies.

The data matching process was largely successful: 98% of claims for blood lead tests in the two rounds of matching were matched to test results in BLIS. This indicates that lead tests are consistently reported to MDH. Facilities sent in missing test results when available, recovering 57% of the unmatched lead tests. They also made efforts to account for missing test results by reporting instances of contaminated or insufficient blood specimens and tests completed for children living outside of Minnesota which do not appear in BLIS. Additionally, one facility discovered 71 lead tests that were billed in error and subsequently submitted corrections to DHS. Together, these instances accounted for an additional 10% of the unmatched claims. The matching process is expected to become easier as the bank of matched patient identification numbers increases.

Funding for this work was made possible in part by CDC-RFA-EH21-2102 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: funding year 1

Assessment of eliminating lead in Minnesota drinking water

Challenge

The 2017 Minnesota Legislature directed the Minnesota Department of Health (MDH) to “conduct an analysis to determine the scope of the lead problem in Minnesota’s water and the cost to eliminate lead exposure in drinking water.”

Intervention

The Minnesota Childhood Lead Poisoning Prevention Program (MCLPPP) supported the MDH Drinking Water Protection Program in creating this report, titled "Lead in Minnesota Water: Assessment of Eliminating Lead in Minnesota Drinking Water." In addition to determining the costs of removing lead sources from drinking water, MCLPPP used Minnesota's childhood blood lead surveillance data to estimate the benefits of removing lead from water. These potential benefits include improvements in population mental acuity and IQ, and the resulting increases in lifetime productivity, earnings, and taxes paid.

The report, released in February 2019, provided an opportunity to discuss the benefits of removing lead from drinking water and to remind audiences that most cases of elevated blood lead levels in Minnesota occur because of deteriorated lead-based paint in older homes. Several outreach activities occurred in conjunction with the release of the report. MCLPPP and the Drinking Water Protection Program presented information about lead and the report's findings to the Clean Water Council, which is an advisory body to the State Legislature and Governor. Additionally, an educational Brown Bag session, sponsored by the Clean Water Land and Legacy Amendment fund, was held at the MDH Offices as part of the Clean Water Brownbag series.

Impact

The report estimates the cost of removing the two most significant sources of lead in water, lead service lines and leaded plumbing fixtures, to be between $1.52 billion and $4.12 billion over 20 years. The projected range of benefits is between $4.24 billion and $8.47 billion over 20 years, although there are several reasons to believe the report may have underestimated these benefits. Therefore, the report concludes that resources allocated to reducing lead in drinking water would be expected to yield a return on investment of at least 100%.

A press conference was held when the report was released, resulting in coverage by several local news stations and a blog written by the Environmental Defense Fund. It is expected that this report will be used by policymakers when considering proposals for strategies to reduce lead in drinking water and other sources.

Funding for this work was made possible in part by NUE2EH001389 from the Centers for Disease Control and Prevention (CDC). The views expressed in this material do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government.