Suit says District ignores lead tests

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The D.C. government has been failing to comply with a federal court order to screen thousands of low-income children for lead poisoning, according to lawyers in the case.

"As was obvious to the court in 2003, it is still obvious today that the children of the District of Columbia are not receiving the blood-lead tests they are entitled to receive," lawyers in a nearly decade-old class-action lawsuit recently said.

"Defendants' failure to provide the required blood-lead testing is even more egregious considering the high presence of lead in the drinking water in the District of Columbia," said attorneys from the D.C.-based law firm Terris, Pravlik & Millan, which represents city Medicaid recipients in the suit.

Elevated levels of lead were found in the city's water supply in 2003, but D.C. Water and Sewer Authority officials last year said the water supply now meets federal safety requirements. Lead is toxic and at high levels can cause learning and behavioral problems.

Still, the District has failed to meet federal requirements that Medicaid-eligible children from infancy to 5 get blood lead testing at regular intervals, the lawyers said. In addition, they say, the city is failing to provide accurate and reliable data about lead testing.

D.C. officials sharply dispute the claims, saying there is no evidence to suggest doctors fail to provide the screenings.

The D.C. Office of the Attorney General argued in court filings this week that "the District's physicians in fact do know their jobs and do order blood tests when required."

However, city attorneys acknowledge record-keeping problems have affected the city's ability to report accurate data on lead screening. One problem is the ongoing difficulty merging information in the city's lead-testing database with the District's Medicaid-enrollment list.

The disagreement marks the latest development in the class-action suit filed in federal court in the District in 1993, called Salazar v. D.C. The suit accused the city of failing to provide adequate health care for low-income children. Under a court settlement, the District is supposed to be providing periodic lead screening to children starting in infancy.

D.C. attorneys dispute that too few children are getting tested, saying that's impossible to tell because of flawed data reported by the District to the federal Centers for Medicare and Medicaid Services.

D.C. government attorney Robert C. Utiger, senior counsel to the deputy for civil litigation, said the problem is "one of data collection, not provision of services."

According to legal papers submitted by Mr. Utiger this week, the District reviewed 100 files for children 12 months to 24 months old and found 98 percent of the time lead tests were performed or ordered.

In addition, a review of more than 10,000 records showed that of children 1 to 5, 86 percent had blood-test results or tests ordered, Mr. Utiger said.

But Michael G. Shaw, one of the attorneys representing plaintiffs in the case, argued in court papers earlier this summer that less than half of 12- to 24-month-olds received lead screening.

"Children who should be receiving blood-lead testing services are still not receiving them," he said.

Similar issues arose in 2002 when the same law firm filed a motion stating the District was failing to provide lead tests. At the time, city officials responded by stating the record-keeping problems were hampering their data-reporting efforts.

Leila Abrar, a spokeswoman for the D.C. Department of Health, said the District provides blood-lead tests to all children under 6 and targeted screening to pregnant woman and children deemed to be at a high risk of lead exposure.