Local Health Departments
- Specimen Testing and Reporting Requirements
- Indiana statute (410 IAC 29-3-1) requires that ALL blood lead tests, REGARDLESS OF RESULTS are required to be reported to IDOH by the entity examining the specimen (i.e. Laboratory, Clinic, Physician, etc.) not later than one (1) week after completing the test.
- The IDOH Lead and Healthy Homes Division can accept blood lead level testing results through HL7 messaging OR direct entry into the Lead Data Flow (LDF) database and the Children and Hoosier Immunization Registry Program (CHIRP)
- Lead Data Flow (LDF): Blood lead level test results can be entered directly into LDF electronic gateway portal. An account will be created for each person that reports test results. See below for instructions regarding creating an account.
- Children and Hoosier Immunization Registry Program (CHIRP): Providers can enter blood lead test results directly into CHIRP as a means for submitting results to IDOH. Entered test results remain editable after submission. Contact the CHIRP Help Desk at 1-888-227-4439 for problems accessing CHIRP. Contact Scile Wilz at email@example.com with other questions.
- Options and instructions for signing up for electronic reporting into LDF and through HL7 messaging are found here.
- Contact Hazarath Thanneeru (firstname.lastname@example.org) with questions about blood lead level reporting or signing up for electronic reporting.
IDOH can also accept test results through secure fax or secure email, but this method is not recommended as the best option for submitting blood lead level testing results and should be considered a temporary or short-term option for submitting results. Per 410 IAC 29-3-1(b) any provider or lab submitting more than 50 results per year will be required to report electronically.
- Laboratory Reporting Form - This form is only used for individual, single-use reporting of blood lead test results sent via fax to IDOH.
- Universal Screening (Testing): On March 10, 2022, Governor Holcomb signed House Enrolled Act (HEA) 1313 into law requiring health care providers to confirm that children under 7 have been tested for lead, and if not, to offer this testing to the parent or guardian of that child. Children should receive a blood lead test between 9 and 13 months, or as close as reasonably possible, and again between 21 and 27 months of age, or as close as reasonably possible. Any child between 28 and 72 months with no record of a previous blood lead test must have one as soon as possible.
- Medicaid Recipient Testing: Indiana statute requires that ALL children enrolled in Medicaid are to receive a blood lead level test at 12 and 24 months of age. Any child between 24 and 72 months with no record of a previous blood lead screening test must receive one.
- Refugee Infants and Children Testing: All refugee infants and children up to age 16, particularly refugee and internationally adopted children, should be evaluated with a blood test for lead exposure at the domestic medical screening visit. Repeat blood lead testing for all refugee infants and children >= 6 years of age, regardless of initial screening BLL results is to be done within 3-6 months after initial testing.
IDOH State Laboratory Testing & Supply Ordering
Blood Lead Test Kits and lab supplies can be ordered directly from the IDOH Laboratory through LimsNet, a web-based sample submission system. The LimsNet sign in location is found here; https://eportal.isdh.in.gov/limsnet/login.aspx. For help, contact the LIMS Helpdesk at LimsAppSupport@health.in.gov.
- To use LimsNet, a submitter must also sign up for an Access Indiana account at https://www.in.gov/access/.
- Supply ordering information is available on the blood lead test order page.
Available publications and brochures will continue to be ordered from the Lead and Healthy Homes program. See Resources & Educational Materials section.
- The analysis of blood lead specimens and the ordering of lead testing and shipping supplies are available to participating physicians FREE of charge from the IDOH State Laboratory.
- IDOH Indiana State Laboratory Blood Lead Specimen Collection and Shipping Guidance
- IDOH Indiana State Laboratory Blood Lead Specimen Collection and Shipping Guidance for WIC Program Participation
- All Indiana Department of Health Lead (Pb) Sample Submission Forms can be found in I-Lead.
- If you do not have access to I-Lead, contact Hazarath Thaneeru (email@example.com)
- Case Management and Risk Assessment Information
- Childhood Blood Lead Level Care and Action Case Management Guidelines (aka "the Rainbow Chart")
- Lead Case Management Training
- The overall goal of the free two-module course, located on Indiana Train (INTrain), is to provide an alternate option for the required lead case management training concerning the protocols and procedures for case management services of children with elevated blood lead levels. In person training continues to be available, is preferred, and should be the first option used. However, if circumstances require it, completing this course (Modules 1 and 2) AND making contact with the Lead and Healthy Homes Health Educator, Sue Henry, will satisfy the training requirement. Contact Sue Henry at firstname.lastname@example.org or 317-232-8608. Sue can also be contacted for questions and to schedule in person trainings at your health department.
- Instructions found here for steps on how to:
1) Create a INTrain account,
2) Register for the Lead Case Management Training – Indiana course,
3) Take the Lead Case Management Training – Indiana course
When a county receives a confirmed blood lead level equal to or greater than 5.0 mµ/dL, a home visit and risk assessment are required. Risk assessments are on site investigations to determine the existence, nature, severity and location of lead-based paint hazards. During the site visit, assessors may collect samples of dust, soil, paint, water, and other materials to help identify surfaces/items that may be lead hazards.
Following sample analysis, risk assessors compile a report explaining the results of the investigation and options for reducing and/or eliminating lead hazards. This report is sent directly to the owner and occupant ― if different ― of the property and is also made available to case managers in NBS.
All risk assessments are saved in Indiana’s I-LEAD system for future reference, as property owners are required to disclose any known lead hazards at the time a property is sold or rented.
If a local health department has questions or concerns about who can conduct risk assessments in their area, please reach out to Katie Etter at email@example.com.
Abatement vs. Renovation
Abatement is any set of measures designed to permanently eliminate lead-based paint hazards. These measures include removal of lead-based paint, enclosure, encapsulation, replacement of building components, and other permanent measures to eliminate lead-based paint hazards.
While abatement is the end goal, lead hazards can be immediately reduced through interim controls, measures designed to temporarily reduce human exposure to lead-based paint hazards. These measures include dust removal, paint film stabilization, treatment of friction and impact surfaces, covering soil, and land use controls. Interim controls are not long-term solutions to lead hazards and lead hazards should be regularly monitored and managed until abatement is possible.
Homeowners and renters may qualify for financial assistance for lead abatement in their home. More information about the program and the application can be found here. Lead abatement contractors can be searched here.
Not all work done on homes that results in the elimination of lead hazards is considered abatement. Repair, renovation and painting activities in pre-1978 homes may result in the disturbance of lead even though that is not the purpose of the activities. These non-abatement activities are regulated under EPA’s Lead RRP rule, which you can read about here. RRP workers need to use lead-safe work practices and licensed contractors can be searched here.
NBS Lead Case Management Module
The NEDSS Base System (NBS) is an electronic disease reporting and case management platform supported by the Centers for Disease Control and Prevention and functions as Indiana’s required avenue.
Lead Case Management Module Specific Resource Materials:
- Reasons for Submitting Notifications in NBS For Lead Cases – A single page Reference Document
- Local Health Department NBS Lead Case Management Training Webinar Video
- Webinar PowerPoint
- Indiana NBS Lead Case Management Module User Guide (updated 8.13.2020)
Note: The material and information covered in the Webinar listed above was accurate and current as of the date of the launch of NBS, Feb. 3, 2020. Some changes in procedures have been put in place since that time and are therefore not reflected in the discussion and presentation of the Webinar. The information found in the
“Lead Case Management User Guide ”referenced above is specific to the use of the Lead Case Management Module and should be followed when using the Module.
General Communicable Disease Resource Materials:
- Resources and Educational Materials
Printed brochures and other publications on lead and healthy homes related topics are available to be ordered by local health departments from the IDOH Lead and Healthy Homes Program, free of charge. Availability and quantities of materials may be limited.
Brochures listed below are available to print directly from this site and can be ordered already printed using the Supply Order Form.
NOTE: Blood Lead Test Kits and lab supplies are no longer provided by the Lead and Healthy Homes division. All testing supplies can be obtained through the IDOH Laboratories online program, LimsNet.
Additional Resources and Educational Tools
For Families - All documents available to print and are also available to be ordered through the Supply Order Form.
- IDOH Brochure (English and Spanish)
- IDOH Fact Sheet (English and Spanish)
- Radon: A brief guide on how to keep your home and family safe from radon
- Radon: Keep your home safe from radon
- Radon One Page Resource: Contains links to multiple publications
Pregnancy (All documents available to print and are also available to be ordered through the “Supply Order Form”)
- Prenatal Risk Evaluation Questions for Lead Exposure (English)
- Prenatal Risk Evaluation Questions for Lead Exposure (Spanish)
- Lead and Pregnancy Infographic (English)
- Lead and Pregnancy Infographic (Spanish)
- Well Fed Means Less Lead (English) (Available to be ordered through “Supply Order Form”)
- Fight Lead Poisoning with a Healthy Diet (English)
- Fight Lead Poisoning with a Healthy Diet (Spanish)
- Protect Against Lead Exposure with WIC Foods
Lead Testing Instructional Phlebotomy Videos:
This video provides guided training for capillary blood lead testing on patients.
This video provides guided training for the venipuncture blood lead collection process.
CDC Lead Testing Video: Learning How to Reduce the Risk of Contamination and Achieve Accurate Results
- General Resources
- National Center for Healthy Housing (NCHH) – Information, tools and data and resources available to support the work of the NCHH’s dedication to securing healthy housing for all.
- CDC Childhood Lead Poisoning Prevention Program – CDC’s web page is filled with lead-related resources and information for parents & caregivers, healthcare providers and public health professionals
- EPA Lead Information – United States Environmental Protection Agency (EPA) lead webpage
- HUD Healthy Homes – U.S. Department of Housing and Urban Development (HUD) Healthy Homes Program, addresses multiple childhood diseases and injuries in the home.
- Indiana Poison Control: 1-800-222-1222
- Consumer Product Safety Commission Product Recalls – Provides information on products being recalled for safety concerns related to lead
- CDC’s Milestone Tracker App – Free app available on iOS and Android devices to help track your child’s milestones from age 2 months to 5 years.
- EPA – Protect Your Family from Lead in Your Home – Real Estate Disclosure – (Available in Spanish, Vietnamese, Russian, Arabic, Somali)
- CDC Childhood Lead Poisoning Prevention: Healthcare Providers – Resources and information on lead screening, reporting, medical management, education and other lead health issues for health care providers.
- American Academy of Pediatrics (AAP) information on lead exposure – information and resources for physicians on prevention and medical management
- PEHSU Region 5 – Great Lakes Center for Children’s Environmental Health. Resource for information and physician consult.
- I-Lead New Case Entry Guide
- Lead Exposure Resource Guide
- A guide for public health agencies to assist with the processes and planning for assessing needs and coordinating a response to incidences of large-scale human exposures to lead and lead-containing products should they occur in a community.
- Laws and Code
Indiana Lead Rules
- 410 IAC 29 - Indiana Lead Rule for Reporting, Monitoring, and Preventive Procedures for an Elevated Blood Lead Level (Case Management Rule) - Final Rule
The final rule updates definitions and other important guidelines used for lead case management, including lowering the standard for an elevated blood lead level and the benchmark for beginning case management services.
- 410 IAC 32 – Indiana Lead-Based Paint Program (Lead-based Paint Rule)
Compliance with HIPAA
Questions about HIPAA?