SUBJECT
AUTHORIZE ACCEPTANCE OF CALIFORNIA DEPARTMENT OF PUBLIC HEALTH FUNDING FOR CHILDHOOD LEAD POISONING PREVENTION SERVICES, AND AUTHORIZE APPLICATION FOR FUTURE FUNDING OPPORTUNITIES (DISTRICTS: ALL)
Body
OVERVIEW
Lead is extremely toxic to humans and can lead to numerous health issues, particularly in young children. Sources of lead exposure can include, but are not limited to, time spent outside of the United States, chipping or peeling paint in homes or buildings built before 1978, water from lead pipes, soil near airports, highways, or factories, as well as certain imported products like spices, cosmetics, candy, toys, pottery, and jewelry. The County of San Diego (County) has provided services to lead poisoned children since 1987, when California State (State) law mandated this condition reportable. In 1991, the Childhood Lead Poisoning Prevention Act declared childhood lead exposure the most significant childhood environmental health problem in California. In 1993, State funding became available for case management of lead poisoned children and education services for high-risk families. For the past 33 years, the San Diego County Board of Supervisors (Board) has authorized grant applications and revenue agreements between the County Health and Human Services Agency (HHSA) and the California Department of Public Health (CDPH) Childhood Lead Poisoning Prevention Program.
On May 2, 2023 (8), the Board authorized a new revenue agreement with CDPH for Fiscal Year (FY) 2023-24 through FY 2025-26 and authorized HHSA to apply for additional funding opportunities. Today’s action requests the Board authorize a two-year Childhood Lead Poisoning Prevention Services revenue agreement with CDPH for the anticipated period of July 1, 2026, through June 30, 2028. Today’s action, if approved, would also authorize the application of future funding opportunities to support childhood lead poisoning prevention services efforts.
This item supports the County vision of a just, sustainable, and resilient future for all, specifically those communities and populations in San Diego County that have been historically left behind, as well as the ongoing commitment to the regional Live Well San Diego vision of healthy, safe, and thriving communities. This will be accomplished by increasing childhood lead poisoning awareness, thereby reducing the risk of poor health outcomes associated with lead poisoning.
RECOMMENDATION(S)
CHIEF ADMINISTRATIVE OFFICER
1. Waive Board Policy B-29 Fees, Grants, Revenue Contracts - Department Responsibility for Cost Recovery, which requires prior approval of grant applications and full-cost recovery for grants,
2. Authorize the acceptance of $3,488,932 from the California Department of Public Health, for the period of July 1, 2026 through June 30, 2028 for childhood lead poisoning prevention services, and authorize the Chief Administrative Officer, or designee, to execute all required documents, upon receipt, including any annual extensions, amendments, and/or revisions thereto that do not materially impact or alter the services or funding level.
3. Authorize the Chief Administrative Officer, or designee, to apply for additional funding opportunity announcements, if available, to support childhood lead poisoning prevention services efforts.
EQUITY IMPACT STATEMENT
The County of San Diego (County) Health and Human Services Agency (HHSA), Public Health Services Childhood Lead Poisoning Prevention Program (CLPPP) provides case management services for children in San Diego County identified as having elevated blood lead levels (BLLs), with the goal of reducing these BLLs to safe levels and preventing negative health and developmental outcomes associated with lead poisoning.
To maximize equitable outcomes, the County CLPPP conducts outreach to educate at-risk populations about the dangers of lead poisoning and helps identify potential sources of lead in their homes. These outreach activities are created for at-risk populations and materials are translated into the County threshold languages and beyond. The County CLPPP will continue to address the inequitable distribution of childhood lead poisoning cases by formulating a plan to implement a proactive approach to identify lead hazards in high-risk areas, focusing on preventing lead exposure. The CLPPP will also reach Medi-Cal recipients by enhancing provider outreach, building a stronger peer-to-peer connection, and offering more training for frontline clinic staff.
SUSTAINABILITY IMPACT STATEMENT
The proposed action to accept California Department of Public Health grant funding for the Childhood Lead Poisoning Prevention Program (CLPPP) contributes to the County of San Diego (County) Sustainability Goal #4 of protecting health and well-being through the remediation of environmental lead for communities that have been disproportionately impacted. The County CLPPP provides education to families on how to avoid lead poisoning exposures and County staff and contractors identify environmental lead hazards in and around the home and provide guidance and requirements for remediation to property owners. The County CLPPP’s focus on hazard mitigation through the removal of environmental sources of lead poisoning also aligns with the climate sustainability initiative in the Fiscal Year 2025-26 Operational Plan by creating a safer environment for children within San Diego County.
FISCAL IMPACT
Funds for this request are included in the Fiscal Year (FY) 2026-28 CAO Recommended Operational Plan in the Health and Human Services Agency. If approved, this request will result in estimated costs of $1,784,371 and estimated revenue of $1,744,466 in FY 2026-27 and estimated costs of $1,784,435 and estimated revenue of $1,744,466 in FY 2027-28. The funding source is the California Department of Public Health. A waiver of Board Policy B-29 is requested because the funding does not offset all costs. These unrecovered costs are estimated to be $39,905 in FY 2026-27 and $39,968 in FY 2027-28, for a total of $79,873. The funding source for these costs will be existing Realignment. The public benefit for providing these services far outweighs the B-29 unrecoverable costs. There will be no change in net General Fund costs and no additional staff years.
BUSINESS IMPACT STATEMENT
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Details
ADVISORY BOARD STATEMENT
The Health Services Advisory Board will receive a presentation on this item at its meeting on May 5, 2026.
BACKGROUND
The County of San Diego (County) has provided services to lead poisoned children since 1987, when California State (State) law mandated this condition reportable. In 1991, the Childhood Lead Poisoning Prevention Act declared childhood lead exposure the most significant childhood environmental health problem in California. In 1993, State funding became available for case management of lead poisoned children and education services for high-risk families. Sources of lead exposure can include, but are not limited to, chipping or peeling paint in homes or buildings built before 1978, water from lead pipes, soil near airports, highways, or factories, as well as some imported products like toys and jewelry.
Lead is extremely toxic to humans and can lead to numerous health issues, particularly in young children. Small amounts, as low as 3.5 micrograms of lead per deciliter of blood, can cause serious, irreversible health problems including learning disabilities and developmental delays, and have been linked to lower IQ levels. Large amounts, of 70 or more micrograms of lead per deciliter of blood, and/or the accumulation of lead in the body over time can lead to death. Healthcare providers and the California Department of Public Health (CDPH) Childhood Lead Poisoning Prevention Branch refer lead poisoned children to local health departments for nurse case management and environmental investigations.
Community outreach and education to parents and caregivers of small children are key components of preventing lead poisoning. These prevention messages include awareness of potential childhood lead poisoning sources, ways to prevent children from becoming lead poisoned, and the importance of families and medical providers working together to screen children for lead poisoning. Community outreach and education presentations are coordinated at various venues such as resource centers; community health centers; Women, Infants, and Children programs; community-based organizations; and health fairs. These presentations provide education on lead poisoning in children, awareness of lead poisoning, and information on prevention. In accordance with the 1991 Childhood Lead Poisoning Prevention Act, State regulations specify health care providers must counsel, evaluate, and screen young children for lead poisoning and take certain actions when a child is found to be poisoned, including referring the child to the local health jurisdiction or local Childhood Lead Poisoning Prevention Program (CLPPP).
On May 2, 2023 (8), the San Diego County Board of Supervisors (Board) authorized acceptance of the Childhood Lead Poisoning Prevention Services grant from the CDPH. In Fiscal Year 2024-25, the County Health and Human Services Agency (HHSA), Public Health Services provided the following childhood lead poisoning prevention services with the assistance of CDPH CLPPP funding:
• Public Health Nurses provided case management services, aimed at removing potential sources of lead exposure to 111 children with blood lead levels over 9.5 mcg/dL (the threshold for which the Centers for Disease Control and Prevention recommend more frequent follow-up) throughout San Diego County.
• Information to reduce lead poisoning and improve child health provided to families of 951 children in San Diego County with a blood lead level of 3.5-9.4 mcg/dL.
• Staff collaboration via a Memorandum of Understanding with the County Department of Environmental Health and Quality to conduct 42 environmental investigations for lead hazards, during Fiscal Year 2024-25, and assist property owners to successfully complete abatement, in homes of lead poisoned children throughout San Diego County.
• Outreach to medical providers, childcare and preschool programs, and refugee services organizations to promote screening and monitoring of children at high risk for lead poisoning.
• Staff and contractor participation in over 550 health fairs and community events across San Diego County to provide information on lead poisoning prevention, screening, and resources; and
• Education and outreach on lead poisoning prevention to 662 healthcare providers.
In the 2026-2028 grant period, the County of San Diego CLPPP will continue to provide:
• Case management services to children with elevated blood lead levels,
• Education and outreach to families in partnership with providers,
• Expand outreach to local healthcare providers,
• Environmental investigations,
• Partnership with the City of San Diego to assess for lead risks in the community, and
• Enhance the processing and quality of assurance of CLPPP data.
Today’s actions request the Board authorize the acceptance of funding for Childhood Lead Poisoning Prevention services from CDPH for the term of July 1, 2026, through June 30, 2028, for approximately $3,488,932, and the pursuit of additional funding opportunities to support efforts for childhood lead poisoning prevention services.
A waiver of Board Policy B-29 is being requested because the revenues described above do not fully offset the costs for the Childhood Lead Poisoning Prevention services. The benefits of providing these services far outweigh the unrecovered costs as the services provided enhance public health through community outreach and awareness of lead poisoning and case management to children with elevated blood lead levels. The public benefit of providing these services, including case management, education and outreach, outweighs the indirect costs not offset by grant revenue.
LINKAGE TO THE COUNTY OF SAN DIEGO STRATEGIC PLAN
Today’s proposed actions support the Equity (Health) and Community (Quality of Life) initiatives in the County of San Diego 2026-2031 Strategic Plan, as well as our commitment to the regional Live Well San Diego vision of healthy, safe, and thriving communities. This is accomplished by increasing childhood lead poisoning awareness, thereby reducing the disproportionate risk of suffering disability or death due to lead poisoning among vulnerable populations.
Respectfully submitted,
ebony n. shelton
Chief Administrative Officer
ATTACHMENT(S)
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