South Carolina

About the program

The State of South Carolina received $515,000 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 South Carolina, contact the program below.

SC Department of Public Health

2100 Bull Street

Columbia, SC 29201

Phone: (803) 898-2674

Success story: funding year 3

South Carolina forms Lead Advisory Committee

Challenge

In the 2022 and 2023 sessions of the South Carolina General Assembly, lawmakers introduced several bills to separate South Carolina Department of Health and Environmental Control (DHEC) into its health and environmental control components. During this period of uncertainty over the make-up of the agency, leadership determined that it was prudent to delay development and implementation of a Lead Advisory Committee. This delay hampered the development of key partnerships and outreach efforts to reduce childhood lead exposure. Some of the partners invited to join the Lead Advisory Committee were not actively involved with the state's Childhood Lead Poisoning Prevention Program (CLPPP) until the committee was formed.

Intervention

Anticipating agency restructuring in Spring of 2023, leadership consolidated all CLPPP-funded staff under DHEC Public Health deputyship. At the same time, leadership granted the CLPPP approval to proceed with creating a lead advisory committee (known internally as the Lead Surveillance Work Group.) The CLPPP sent invitations in March 2023 to key partners representing healthcare, Medicaid, primary education and early intervention, and other experts. Potential members were asked to commit to one year of participation (two to three meetings).

Three CDC-funded staff (program manager, client services and outreach coordinator, and the data manager) serve on the Lead Surveillance Work Group. External members include

• the Medical Director for the SC Department of Health and Human Services (Medicaid),
• a representative from the City of Spartanburg (the only U. S. Department of Housing and Urban Development Lead Hazard Control grantee in the state),
• a representative from the state Head Start office,
• a representative from the Catawba Nation (the only federally recognized tribe in SC),
• a representative from Greenville Technical College,
• an Environmental Protection Agency approved lead training provider, and
• a representative from the SC Primary Healthcare Association (SCPHCA).

Impact

The Surveillance Work Group held its first meeting in June 2023. As a result of serving on the work group, the representative from Greenville Technical College has invited the CLPPP Program Manager to virtually join their lead classes to provide program updates and share information about risk assessor positions available within the program. The Outreach Coordinator has been invited to exhibit and present at two training conferences for Head Start and Community Action Partnership staff. The strengthened relationship between CLPPP and the City of Spartanburg has resulted in two referrals to the city for lead-based paint issues that the CLPPP could not address. The members of the work group are providing fresh points of view and challenging the CLPPP to consider things differently. These include the training provider's request of a list of lead sources to share in the classes, the SC DHHS member reviewing the CLPPP's newest publication aimed at health care providers, and an enhanced partnership with Catawba Nation, which resulted in CLPPP purchasing an X-ray fluorescence analyzer for the tribe.

Funding for this work was made possible in part by 1 NUE2EH001434-01-00from 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 2

Partnering to share resources helps two programs spread information about lead poisoning prevention in South Carolina

Challenge

The South Carolina's Department of Health and Environmental Control (DHEC) Bureau of Water (BOW) was awarded a Water Infrastructure and Improvements for the Nation (WIIN) grant from EPA. The BOW hired a contractor to develop outreach materials to publicize the grant to schools and childcare centers around South Carolina. The WIIN Program planned to use these materials to describe the program, to increase interest in voluntary enrollment, and to help facilities ensure lead-safe drinking water for the children whom they serve.

Several months into the grant, BOW's contractor had not made any progress on developing project materials. Without materials to explain the WIIN program, there were few enrollees—even for a free testing program. This resulted in delays in enrolling, testing, and addressing lead in water in childcare centers and Head Start Programs—especially in those areas self-identified as environmental justice communities. An Environmental Justice community is a neighborhood or community, where a substantial proportion of people are living below the poverty line, that is subjected to a disproportionate burden of environmental hazards. The community may also experience a significantly reduced quality of life relative to surrounding communities.

Intervention

DHEC's CLPPP partnered with BOW to jointly develop outreach materials to publicize the WIIN Testing Program and explain the risks of lead exposure. These materials provided useful information for school officials, childcare operators, and parents who might not be aware of risks associated with lead. Information about the Lead Testing in Schools and Child Care Programs Grant was added to existing CLPPP educational and outreach materials in response to a WIIN team request. During February and March 2022, DHEC WIIN personnel and CLPPP personnel worked with the agency's Creative Services and Print Services teams on updating existing materials to promote both programs. Additionally, the creative team used artwork from a CLPPP table display to create a new rack card with step-by-step information for applying to the Lead Testing in Schools and Child Care Programs on the back.

Impact

As a result of this collaboration, there is a consistent look to the outreach materials. The WIIN Program (and other programs within the BOW such as the Office of Rural Water) has the outreach materials that it needs. The CLPPP and WIIN programs share information about each other's work via presentations, conferences, and mailed information packets, doubling the outreach. These materials have been shared with approximately 200 schools, childcare centers, and individuals. These booklets and brochures are also available from DHEC's Educational Materials Library, free of charge, to healthcare providers and others who request them. The "rack card" outreach project is one example: https://scdhec.gov/sites/default/files/Library/CR-013135.pdf. This collaboration has helped DHEC with the Core Strategy of "Linking Children to Recommended Services" through follow-up done when testing reveals exceedances of standards for facility water at schools, childcare facilities, or Head Start Centers.

Funding for this work was made possible in part by NUE1EH001264 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.

Success story: funding year 1

Reducing childhood lead exposure in South Carolina's Catawba Indian Nation

Challenge

Childhood lead exposure is often closely correlated with social determinants of health such as poverty and minority status. National data suggests that one-third of Native American children live below the Federal Poverty Level, defined as a family of four living on $26,500 or less annually, have decreased access to resources and tend to live in home built before 1978, which increases their risk of lead exposure. The Catawba Indian Nation (CIN) is the only federally recognized tribe in South Carolina. Over 3,000 enrolled members of the tribe and other Native and non-Native American family members that do not meet the strict criteria for tribal enrollment live across South Carolina. Governmental, medical, and social services for enrolled tribal members and non-enrolled family members are provided to South Carolina residents and bordering North Carolina residents by the Indian Health Services (IHS) Clinic and other governmental and non-governmental entities. However, no other governmental, philanthropic, or similar organization provides services to the CIN population on tribal lands.

Intervention

The South Carolina Childhood Lead Poisoning Prevention Program (SC CLPPP) collaborated with the CIN tribal government to enhance surveillance of blood lead levels among tribal children, identify geographic areas and subpopulations at higher risk for lead exposure, and provide lead hazard education to enrolled members and their communities. SC CLPPP used CDC funds to help CIN to enhance their childhood lead surveillance and outreach activities in February 2019. These included developing educational materials, attending community events, training staff to conduct prevention activities, and establishing data sharing processes with SC CLPPP.

Impact

By September 2019, CIN staff had accomplished the following:

• Obtained a list of all tribal-enrolled children younger than six years of age to initiate outreach activities.
• Met with their Head Start program director and distributed lead education at a Head Start open house.
• Identified three facilities that serve CIN enrolled members to ensure they are electronically interfaced with IHS for electronic lab reporting.
• Initiated a survey to determine the extent of existing pre-1978 housing occupied by enrolled tribal members.
• Identified seventeen pre-1978 houses that enrolled tribal members occupy and verified that nine children live in four of these households.
• Set up EPA Lead Risk Assessor training for CIN staff to conduct risk assessments on pre-1978 housing.
• Featured a public service announcement for 30 days about take-home lead in the IHS Clinic.
• Wrote an article for the tribal newsletter about health risks associated with lead exposure.
• Met with the tribal executive to obtain permission to share the database on enrolled children birth through six years of age with SC CLPPP.
• Attended the 2019 Southeastern Lead Consortium Annual Meeting.
• Distributed lead educational information at tribal community events, the IHS clinic, a tribal Back-to-School event, Little Peoples Academy, Catawba Indian Nation Family Services, and Camp Kic-A-Way.

The CIN has taken early and impactful steps to enhance surveillance, identify areas and groups at higher risk for lead exposure and provided lead hazard education to a population that has not received these services before.

Funding for this work was made possible in part by the Cooperative Agreement Number [NUE2EH001362] 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.