Since the onset of the coronavirus pandemic, deferred care and increased use of telemedicine have negatively impacted aspects of pediatric preventive care that require in-person visits, including immunizations and blood lead testing. The pandemic has also resulted in children spending more time at home, which increases the risk of exposure for children living in homes with lead contamination.

Surveillance data collected by the Michigan Department of Health and Human Services Childhood Lead Poisoning Prevention Program (CLPPP) reveals that 65,590 children had blood lead testing between March and July 2019, but only 32,692 were tested between March and July 2020. Given that approximately 3% of Michigan children who are tested for blood lead have a level that is ≥ 5µg/dL, nearly 1,000 children with elevated blood lead levels have gone undetected related to the decrease in testing. Preliminary data from August 2020 show that testing rates remain lower than previous years, so this number is growing. Without testing, children will continue to be exposed to lead, a neurotoxin with irreversible effects, including children with lead levels ≥ 45µg/dL who require chelation therapy.

The Bright Futures/AAP Periodicity Schedule recommends risk assessment for lead exposure at the following well child exams: 6, 9, 12, 18 and 24 months and at 3, 4, 5 and 6 years. Patients with a positive risk assessment should have blood lead testing. Additionally, children with Medicaid are required to have a blood lead test at 12 and 24 months or once between 36 and 72 months if they have not previously been tested.

As your practice works to catch up on deferred preventive care, including vaccines, MIAAP and CLPPP encourage you prioritize lead screening. Because most children with lead exposure are asymptomatic, your careful attention to this preventive service is an essential piece of identifying and mitigating the negative impacts of lead.

A quick reference for primary care providers, including screening questions, can be found at https://miclppp.org/wp-content/uploads/BLL-Quick-Reference_2019R.pdf.

CLPPP also offers a Childhood Lead Poisoning Prevention for Primary Care Providers course, which can be found at https://courses.mihealth.org/public. Continuing medical education (CME)/continuing education unit (CEU) credit is available.

For more information feel free to contact us at MDHHS-CLPPP@michigan.gov.

PHOTO: Marco Verch

For Same Day Assistance keep reading…

For those of you who dream of having quick access to a child psychiatrist and adolescent psychiatrist (CAP) to discuss a case, dream no more! Michigan Medicine created a robust, same day, free phone consultation service within the U-M Department of Child and Adolescent Psychiatry. The Michigan Child Collaborative Care or MC3 program is supported by funds from the Centers for Medicare and Medicaid Services through the Michigan Department of Health and Human Services. MC3 connects you with a psychiatric colleague SAME DAY for case discussion and recommendations. It gets better. MC3 is now offering Telepsychiatry for direct patient consultation that is billed to the patient’s insurance for those insurances accepted by Michigan Medicine Department of Psychiatry including several Medicaid Health Plans.

The MC3 CAPs are an amazing group of clinicians who are eager to help pediatricians, nurse practitioners, PA’s, family medicine providers and obstetricians caring for patients up to age 26 and pregnant and postpartum women of any age up to a year postpartum.

So what’s a consultation look like?

Once you sign up you have access to webinars, psychotropic medication quick reference cards, and can even arrange a lunch and learn with one of the child psychiatrists. It’s just that easy.

For complex cases that need a higher level of care, a telepsychiatry visit can be set up for the patient to have a virtual consultation. Recommendations are provided to you and the psychiatrist can walk you through the plan.

This program has been a game changer for me. My prescribing practice completely changed, and I have gained confidence and skills in managing mental health concerns knowing that a child psychiatrist is just a call away.

To sign up: https://mc3.depessioncenter.org/

And please feel free to reach out to me if you have questions at gagginol@yahoo.com or 269.271.9301.

PHOTO: Welcome Mind

The MIAAP is excited to participate in a pediatric dental health grant program through the American Academy of Pediatrics and DentaQuest, a non-profit partnership that promotes and writes grants for oral health projects. The MIAAP will work with the Michigan Department of Health and Human Services on this program. Under the program, called “Varnish! Michigan,” pediatricians apply fluoride varnish to children’s teeth to prevent tooth decay.

Physicians see children, especially toddlers, in their offices earlier and more often than do dentists. Varnish! Michigan takes advantage of that access by giving children a head start on preventive dental care.

Participating physicians will work with MDHHS to directly contact local dentists to connect patients with nearby dental care resources.

Participating pediatricians and staff members undergo two CME training sessions in preparation for the program, for which they receive 1 CME credit.

Varnish! Michigan will also incorporate the AAP's current “Brush, Book, Bed” program that supplies dental supplies and reading materials to children and families.

By participating in this project, clinics will receive training on how to fit varnish into their workflow. They will also receive bags of supplies for their patients, which will include toothbrushes, toothpaste, and books for children to read.

The project is a great opportunity for collaboration between the MIAAP and MDHHS to help provide more incentive for pediatricians and other medical providers to increase their oral health services to the families they serve.

demmings@michigan.gov

jared.burkhart@miaap.org

PHOTO: N A I T

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For an online application and payment, click here.

November 2020

Volume XXVIII, Issue11

Reminder:

Screen For Lead

Adolescent Psychiatry Access

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Varnish! Michigan

Stay The Course On COVID-19

Michigan, along with most of the country, is facing a renewed surge and record numbers of COVID-19 cases as we head into the holiday season. The daily record-breaking numbers of new cases come at a time when many in the northern part of the country will spend increasing time indoors. The next couple of months are also time of year that traditionally features holiday celebrations, with large groups of people congregating in closed spaces.

As “coronavirus fatigue,” sets in and long-term abstinence from favorite activities and celebrations—even everyday events such as lunch at a restaurant with a colleague or hugs and handshakes among friends and family—it is more important than ever to observe preventive measures recommended by the CDC and widely accepted within the public health community.

I thought I would review the CDC recommendations for the upcoming holiday celebrations that typically include large gatherings of families and friends, crowded parties, and travel that may put people at increased risk for COVID-19.