West Virginia WIC Policy & Procedure 2.21 2.21 Lead Screening and Referral Effective Date: 11/21/2022 POLICY: All infants, age six (6) months and older, and children will be provided a lead screening (questionnaire); when necessary, a referral will be sent to the healthcare provider. PROCEDURE: A. Lead Screening – On the Crossroads Dietary Assessment Screen 1. Infants, age six (6) months and older a. At the one (1) year certification appointment, between twelve (12) and thirteen (13) months of age, the Nutritionist/Nutrition Associate (CPA) must complete the Lead Screening Question on the Crossroads Dietary Assessment Screen with the parent, guardian or caretaker: “Has your infant/child had a blood test for lead within the past 12 months?” i. Utilize medical documentation (electronic or hard copy) from the healthcare provider, when available. b. If the parent, guardian or caretaker answers “no” or “unknown”, a referral to the healthcare provider is required. i. Document the referral on the Crossroads Referral Program Screen. ii. The Nutritionist/Nutrition Associate (CPA) will follow-up on the referral at the infant/child’s mid-certification follow-up appointment. 2. Child: a. At every child certification appointment (age 2 – 5 years old), the Nutritionist/Nutrition Associate (CPA) must complete the Lead Screening Question on the Crossroads Dietary Assessment Screen with the parent, guardian or caretaker: “Has your infant/child had a blood test for lead within the past 12 months?” i. Utilize medical documentation (electronic or hard copy) from the healthcare provider, when available. b. If the parent, guardian or caretaker answers “no” or “unknown”, a referral to the healthcare provider is required. i. Document the referral on the Crossroads Referral Program Screen. ii. The Nutritionist/Nutrition Associate (CPA) will follow-up on the referral at the child’s mid-certification follow-up appointment. B. Nutrition Education and Counseling 1 of 2

West Virginia WIC Policy & Procedure 2.21 2.21 Lead Screening and Referral Effective Date: 11/21/2022 1. Encourage all participants, including women participants, to speak with their healthcare provider about getting a lead test, especially if they reside in an area with a known lead issue. 2. Encourage the WIC food package which provides key nutrients that contribute to decreased lead absorption. a. Calcium – milk, yogurt and cheese b. Vitamin C – fresh, frozen and/or canned: citrus, strawberries, broccoli, brussels sprouts, potatoes and peppers. c. Vitamin D – egg yolks, some fortified cereals d. Vitamin E – spinach, broccoli, butternut squash e. Zinc – whole grains, milk, yogurt, cheese f. Iron – beans (dried or canned), WIC cereals, spinach, tuna 3. Offer a lead safety pamphlet or at a minimum summarize the information in the pamphlet. REFERENCES: 1. WIC Final Policy Memorandum 2001- 1, WIC Allowable Costs – Clarification of WIC’s FY 2001, Appropriations Act Provision Regarding Blood Lead Screening 2. Revised/Reissued Policy Memorandum 93-3A, WIC’s Role in Screening for Childhood Lead Poisoning 3. CDC Lead Poisoning Prevention Program 4. West Virginia Childhood Lead Poisoning Prevention Program 2 of 2