A. In this chapter, the following terms have the meanings indicated.
B. Terms Defined.
(1) "Administer a blood test for lead poisoning" means to:
(a) Draw a blood specimen, by either venous or capillary methodology, and:
(i) Send the specimen to a medical laboratory for blood lead analysis; or
(ii) Conduct a blood lead analysis at a health care provider's office subject to licensing, certification, and approval by the Laboratories Administration of the Department; or
(b) Order a blood specimen to be drawn by a third-party health care provider, by either venous or capillary methodology, and sent to a medical laboratory for blood lead analysis.
(2) “At-risk area” means, effective March 28, 2016, any geographic area within the State that has been designated by the Department as at-risk for lead exposure:
(a) For individuals born on January 1, 2015 or later in the 2015 Targeting Plan for Areas at Risk for Childhood Lead Poisoning; or
(b) For individuals born before January 1, 2015 in the 2004 Targeting Plan for Areas at Risk for Childhood Lead Poisoning.
(3) "Blood lead analysis" means the analysis and determination by a medical laboratory of the blood lead level in a blood specimen.
(4) "CDC" means the federal Centers for Disease Control and Prevention.
(5) "Child" means an individual younger than 18 years old.
(6) “Child at high-risk” means a child who resides, or has previously resided, in an area within the State that has been designated as high-risk for lead poisoning by the Department in the 2015 Targeting Plan.
(7) "Department" means the Maryland Department of Health.
(8) "Elevated blood lead level" means:
(a) A blood lead level of 10 micrograms per deciliter or greater; or
(b) A blood lead level of 5 micrograms per deciliter or greater for a blood test performed after March 28, 2016.
(9) "EPSDT" means the Early and Periodic Screening Diagnosis and Treatment program governed by COMAR 10.09.23.
(10) "Health care provider" means a person who is licensed, certified, or otherwise authorized to provide health care services under the Health Occupations Article, Annotated Code of Maryland.
(11) “High-risk area” is an area within the State that has been designated by the Department as high-risk for lead poisoning according to the 2015 Targeting Plan.
(12) "Immunization registry" means an immunization registry established and maintained by the Department.
(13) "Lead exposure risk questionnaire" means the set of questions used to determine an individual's risk for lead exposure and lead poisoning, as approved by the Department and based on the recommendations from the CDC.
(14) "Local health officer" means the county health officer in each of the 23 counties of Maryland and the Commissioner of Health in Baltimore City, or their designated representative.
(15) "Medical laboratory" means a licensed medical laboratory as defined by Health-General Article, §17-201(b), Annotated Code of Maryland.
(16) "Nonprimary care" means health care that:
(a) Is given or recommended by a health care provider that is not the individual's primary care provider; and
(b) Includes but is not limited to episodic health care for acute illness or injury or health care that is given in an emergency room or other urgent care setting.
(17) Prekindergarten Program.
(a) "Prekindergarten program" means a public educational or public early intervention program that enrolls or serves children below the level of kindergarten.
(b) "Prekindergarten program" includes:
(i) Programs that operate within a school and those that operate outside of a school;
(ii) Preschool special education programs governed by COMAR 13A.05.01;
(iii) Extended Elementary Education Programs governed by COMAR 13A.06.02.01;
(iv) Local Infant and Toddler Programs as defined in COMAR 13A.13.01;
(v) Head Start and Early Head Start Programs as authorized under the Head Start Act, 42 U.S.C. §9801 et seq.;
(vi) Judith P. Hoyer Early Child Care and Education Centers established by Education Article, 5-217, Annotated Code of Maryland; and
(vii) Any other educational or early intervention program as determined by the Department.
(18) "Primary care" means health care that:
(a) Is continuous, comprehensive and coordinated;
(b) Emphasizes prevention of illness and injury; and
(c) Includes but is not limited to the following services;
(i) Age appropriate screenings;
(ii) Diagnosis and treatment of acute and chronic disorders;
(iii) Growth and developmental assessments;
(iv) Health care supervision;
(vi) Patient and parent health and psychosocial counseling;
(vii) Physical examinations; and
(viii) Referrals to specialty health care providers.
(19) "Primary care provider" means a health care provider that provides primary care.
(20) “Targeting Plan” means the 2015 Targeting Plan for Areas at Risk for Childhood Lead Poisoning developed by the Department that includes but is not limited to:
(a) Methodology for determining levels of risk for childhood lead poisoning;
(b) Maps of the State designating at-risk areas;
(c) Zip code and census tract lists indicating each zip code and census tract's designated level of risk; and
(d) Recommendations regarding the prevention of childhood lead poisoning.
(21) "12-month visit" means a well-child evaluation by a health care provider that occurs when a child is between 12 months old and 14 months old.
(22) "24-month visit" means a well-child evaluation by a health care provider that occurs when the child is between 24 months old and 26 months old.
(23) "Well-child evaluation" means a periodic primary care assessment of a child by a primary care provider in accordance with the:
(a) American Academy of Pediatrics' guidelines; or
(b) Periodicity schedule established under EPSDT requirements.