Ohio cracks down on prematurely closed cases

CLEVELAND — The Ohio Department of Health warns it will no longer accept the “high number” of lead poisoning cases statewide that are never investigated because local health officials fail to contact a child’s family.

The department, which delegates its authority to investigate lead poisoning cases to local health departments, sent letters last month warning lead programs across the state that it expects them to do more to reach parents or guardians.

Cases that are closed due to “no contact” leave poisoned children without any intervention and leave potentially hazardous homes free to harm more families.

But some local lead programs say the the state is unfairly changing the rules on them.

And worse, they claim, is that the state is retroactively applying new rules to cases that go back more than five years.

By law, lead investigations are required when a child’s blood test results reach 10 micrograms per deciliter of lead or above.

Health department guidelines have long required at least three attempts to reach a family before a case can be closed.

Now, the state appears to be tightening up when it will allow these “no contact” closures, outlining steps it says the local health departments, called delegated authorities, need to document they’ve taken to find poisoned children.

“The [public health lead investigation protocol] manual states that the investigator shall contact the primary health care provider, Healthchek Coordinator, case manager, or other sources to obtain contact information,” the letter reads. If that doesn’t work, the letter also says the property owner should be contacted.

But the state’s manual doesn’t in fact say that. It says investigators “may” contact these sources. It’s a subtle difference, but one that local lead program officials say is important.

“Frankly they changed the criteria as to what constitutes evidence to close a case,” said John Sobolewski, supervisor of Cuyahoga County’s lead program, which investigates cases outside the city of Cleveland. “It’s a little overwhelming to try and go back to every case you think you’ve already addressed and then provide additional information that wasn’t required at the time, when we thought they were closed.”