Ohio Department of Job and Family Services Office of Ohio Health Plans Bureau of Health Plan Policy

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Ohio Department of Job and Family ServicesOffice
of Ohio Health Plans - Bureau of Health Plan
PolicyLead Testing Initiatives for the Office
ofOhio Health PlansNovember 2005
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ODJFS and ODH Data Harmonization

• Began with Budget Bill requiring ODJFS and Ohio
  Department of Health (ODH) to merge mutual data
  sets to understand lead testing needs of Medicaid
  children under 6.
• Initiative has been a collaboration of data and
  other program activities since 1998 between the
  two departments. With data matching occurring
  since 1999.
• In 1999 51 of the STELLAR database was matched
  Medicaid eligible children. In 2003 and 2004 the
  match yielded 67 of the children being Medicaid
  eligible.

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Why Collaboration?

• Progress is being made in lead testing of
  Medicaid children. In under 5 years OHP, with
  the help of ODH, have almost doubled the Medicaid
  annual testing rates.
• Without ODH data the Medicaid claims and
  encounter data information would be incomplete.
  Annually there are approximately 2-3 thousand
  lead tests documented in STELLAR for Medicaid
  eligible children with no matching claim.
• ODJFS works closely with ODH and local
  initiatives to better understand the local needs
  and
  
• 60-65 of Ohio Medicaid children live in what is
  considered high risk zip codes.
  

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Achievements

• Medicaid Provider training is now being conducted
  for all new Medicaid providers with training for
  OSMA and OHA.
  
• The emphasis being on educating and office
  protocol development.
  

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Lead Poisoning Prevention and Testinghttp//jfs.o
hio.gov/ohp/0001provider.stm

• Lead Poisoning Prevention and Testing is a
  Federal and State Mandate for providers that
  serve Medicaid.
  
• Children enrolled in Medicaid (fee-for-service or
  managed care) must receive a blood lead screening
  test at 12 and 24 months of age.
  
• State regulations mandate that test results be
  reported to the Ohio Department of Health.

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Lead Poisoning PreventionHelpful Tools

• Inform and educate parents on why having a lead
  test for their child is important.
  
• Obtain educational material from Lead Poisoning
  Prevention Regional Resource Centers (see website
  previous slide).
  
• If drawing blood in the office is not possible
  then schedule a lab visit for the patient while
  they are in the office.
  
• Contact the County Department of Job Family
  Services Healthchek Coordinator for information.

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Lead Poisoning Prevention

• Use a medical reminder system to identify
• When a child is coming into your office and has
  not yet had a recorded blood test or test ordered
  for lead.
  
• When lab results have not returned to the
  office.
  
• Identify parents that need to be contacted as
  follow-up for parents who did not comply with a
  blood test order.
  
• Identify when a childs first or second birthday
  is approaching.
  
• Tell parents why the blood is being drawn.

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Healthchek and Lead Testing

• Keeping Healthchek Coordinators informed.
• State supported county collaborative including
  partners from HMG MCP, CAA, HS, ECS, Child Care,
  Children Services, County/City HD, Local LPP,
  RRC, and others.
• Working towards automating Lead testing data from
  claims system.

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Birthday Card Announcements

• Continue with efforts on birthday cards to 10 and
  22 month old children each month.

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Provider and Web Update

• http//jfs.ohio.gov/ohp/bhpp/lpplpt/providerlead.s
  tm.
  
• http//jfs.ohio.gov/ohp/bhpp/lpplpt/consumerlead.s
  tm.
  
• Continuation of articles on Lead Poisoning
  Prevention and Lead Testing efforts in the
  Provider Update. http//jfs.ohio.gov/ohp/bcps/Prov
  iderUpdate/index.stm.
• Transmittal letters to providers.

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Studies and Data

• Provision of Provider information to ODH for
  PLANET training.
  
• EQRO study on FFS and MCP on follow up care and
  medical chart reviews.
  
• MEDTAPP study on the website.
• Most current summarized data on the website.

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Lead Data at a Glance
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Other Ongoing Efforts

• Letters were sent to Medicaid Providers for a 3
  year performance measure.
  
• Included a reminder to 20k providers through an
  existing MHTL on CMS requirements and HB 248.
  
• Tested effectiveness of Birthday Cards and Lead
  testing did increase.
  
• ODJFS Directors Performance Measures for OHP.
• Lead testing performance measures for MCPs.
• Immunization card includes information on lead
  testing.
  
• Collaboration through the ODH Lead Advisory
  Council.
  
• Work with ODH on education of Medicaid Providers.

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Looking into the Future

• Immunization Registry interface to include up to
  date Lead STELLAR data.
  
• MITS
• Designing useful data tools for community
  partners.

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• Lead Poisoning ODJFS Activities contact
• Donna Bush at bushd_at_odjfs.state.oh.
• Phone [phone].