Community-based lead screening, testing, outreach & education

Outcome 1: Decrease disparities in blood lead levels by socioeconomic status and
improve blood lead testing and reporting rates for children less than 6 years of age at risk
for lead exposure.
Expand community-based lead screening/testing for young children. Subrecipient will provide lead
screening/testing for children ages 6 months through 6 years at mobile clinics, preschools, pediatric
offices, FQHC/community clinic sites, shelters, and community events.
Support confirmatory testing and follow-up. Subrecipient will coordinate with DOH PHNs and other
partners to support families who require confirmatory venous blood draws or follow-up but face barriers
to accessing a laboratory or care setting.
Strengthen FQHC and community clinic capacity. Subrecipient will train FQHCs, pediatric practices,
community clinics, and partner sites to develop or expand lead screening/testing, reporting, referral, and
family education workflows.
Identify children and pregnant people who may be missed by traditional systems. Subrecipient will
prioritize outreach to families facing barriers to care and those served in nontraditional or community-
based settings.
Outcome 2: Decrease number of children living in environments at high risk of lead
exposure and improve rates of children less than 6 years of age with elevated blood lead
levels linked to recommended services.
Include pregnant people in lead screening/testing and prevention outreach. Subrecipient will
incorporate lead exposure education, risk screening, testing when appropriate, and referral support for
pregnant people served through Subrecipient -child health programs, and
community outreach.

Support DOH-led investigation and response. When elevated blood lead levels are identified,
Subrecipient will support DOH with family engagement, education, outreach, linkage to care, and
additional screening/testing events when requested.
Provide point-of-care capillary lead screening/testing for children ages 6 months through 6 years using
approved field-based testing processes and aligned with DOH/HI-CLPPP guidance.
Conduct screening/testing at Subrecipient mobile clinic events, preschools, pediatric offices, FQHCs
and community clinics, shelters and transitional housing programs, community fairs, family events,
outreach sites, and other DOH-identified priority locations.
Provide pre-test education, consent support, fingerstick testing, on-site results counseling, referral
guidance, and documentation/reporting support.
Integrate lead exposure education, risk screening, and testing into maternal-child health outreach,
mobile clinic encounters, prenatal/postpartum support, and community-based navigation.
Provide point-of-care testing when appropriate and aligned with DOH guidance.
Refer pregnant people for confirmatory venous testing, prenatal care, pediatric care, Public Health
Nursing, DOH/HI-CLPPP follow-up, and other support services when indicated.
Develop or adapt culturally responsive, family-friendly educational materials for children, caregivers,
pregnant people, and partner organizations.
Distribute materials through mobile clinics, preschools, pediatric offices, shelters, FQHCs, community
clinics, WIC/community partner events, and DOH/PHN outreach activities.
Provide education on sources of lead exposure, why testing matters, lead risks during pregnancy,
household prevention strategies, nutrition and developmental health messaging, confirmatory testing,
and follow-up pathways.
Coordinate lead testing events with selected preschools, pediatric offices, shelters, FQHCs, community
clinics, and community partners.
Bring testing directly into familiar, trusted environments to reduce transportation, scheduling, language,
and access barriers.
Use a workflow that includes education, fingerstick testing, on-site results and counseling,
referral/reporting, and linkage to confirmatory testing and PHN/DOH follow-up when indicated.
Train FQHCs, community clinics, pediatric offices, and other interested partners to establish or
strengthen lead screening and testing programs.
Provide technical assistance on pediatric and family care workflows, Lead Care II or other approved field
testing processes, staffing models for community/mobile settings, family engagement and consent
workflows, documentation, reporting, referral pathways, confirmatory testing protocols, and
education/outreach strategies.
Share lessons learned from Subrecipient -based testing model to support sustainable lead
screening/testing infrastructure across Hawaiis community health system.

Coordinate with DOH PHNs when children, pregnant people, or families require confirmatory venous
testing or follow-up blood draws but face barriers to accessing a laboratory.
When feasible and appropriate, dispatch Subrecipient mobile clinic capacity or arrange a community-
based follow-up encounter to help close the loop between initial testing and confirmatory testing.
Support families experiencing transportation barriers, scheduling challenges, language access needs,
housing instability, shelter placement, disability, or geographic isolation.
Support DOH-led investigation and response efforts for homes, shelters, transitional housing sites, or
community settings where children or pregnant people may have been exposed.
Assist with family engagement and communication, access coordination, education during DOH-led
investigations, helping families understand next steps, and linkage to PHNs, pediatric providers, prenatal
care, and social supports.
Return to shelters or community sites for additional screening/testing if DOH identifies a cluster or
concern, and support outreach to other potentially exposed children, pregnant people, or household
members.
Community-based lead screening/testing for children ages 6 months through 6 years.
Lead education, risk screening, and testing support for pregnant people.
Screening/testing events at Subrecipient mobile clinics, preschools, pediatric offices, shelters, FQHCs,
community clinics, and community events.
Family education materials for children, caregivers, and pregnant people.
Outreach materials for partner sites, preschools, shelters, and clinics.
Training and technical assistance for FQHCs, pediatric offices, community clinics, and
shelter/community partners.
Coordination with DOH PHNs for families needing confirmatory testing or follow-up blood draws.
Mobile clinic deployment support when families face barriers to accessing laboratory follow-up.
Community outreach support for DOH-led home, shelter, or site investigations related to elevated lead
levels.
Documentation of number of individuals screened, age groups, pregnancy status when applicable, event
locations, referrals made, and partner sites engaged.
Regular reporting to DOH/HI-CLPPP.
Project summary of outcomes, lessons learned, equity gaps, and recommendations for sustaining the
model.
Phase Key Activities
Phase 1: Start-Up and Coordination Finalize workplan with DOH/HI-CLPPP; confirm
testing and reporting expectations; coordinate with
PHNs; update educational materials; identify
priority communities; schedule initial testing sites.
Phase 2: Community Screening/Testing and Deploy mobile clinic and outreach teams to provide
Pregnant People Outreach lead screening/testing and education at preschools,
pediatric offices, shelters, community clinics,
FQHCs, mobile clinics, and community events.

Phase Key Activities
Phase 3: PHN Follow-Up and Mobile Clinic Coordinate with DOH PHNs when families with
Dispatch elevated or concerning results need confirmatory
venous testing but face barriers to accessing a lab;
support follow-up coordination and mobile clinic
deployment when feasible.
Phase 4: Clinic and FQHC Capacity Building Train FQHCs, pediatric offices, and community
clinics to implement or improve lead screening and
testing workflows.
Phase 5: DOH Investigation and Community When elevated lead levels indicate possible
Response Support exposure in homes, shelters, or community
settings, support DOH with family engagement,
additional outreach, education, and repeat or
expanded screening/testing events.
Phase 6: Evaluation and Sustainability Planning Summarize screening/testing volume,
demographics, pregnancy-related outreach,
elevated results, referral completion, PHN
coordination, clinic training outcomes, lessons
learned, and recommendations for continued
statewide implementation.