California's expanded childhood lead screening requirements now in effect
November 9,
2026By Physicians for a Healthy California General
As California observes National Lead Poisoning Prevention Week (October 25–31), physicians are encouraged to review expanded childhood lead screening regulations that took effect July 6, 2026. The regulations expand testing requirements and update clinical follow-up protocols to improve early identification of lead exposure among children, with nearly all California ZIP codes now considered high risk.
Under the updated regulations, all children enrolled in Medi-Cal or other publicly funded programs for low-income families must receive blood lead testing at 12 and 24 months of age. For other children, testing is required at those ages if, in the professional judgement of the health care provider, the child is at risk of lead poisoning based on any of the specified risk criteria, including where they live. Child, for purposes of the regulations, is defined as a person under 21 years of age. Because CDPH identifies 99.3% of California ZIP codes as high risk for lead exposure, nearly all children qualify for testing based on their ZIP code alone, without additional risk assessment questions.
Other risk factors that trigger testing include:
- Living or spending time in a home, school or other building constructed before 1978
- Having a household member involved in lead-related work or activities
- Pica behavior
- Residence in or travel to another country
- Close contact with someone who has an elevated blood lead level
- Exposure to certain pottery, dishware, traditional remedies, foods or spices that may contain lead
When a parent or guardian refuses screening, clinicians must provide oral or written guidance about lead exposure and document the reason screening was not performed in the child's medical record.
The regulations also establish updated requirements for catch-up testing, educating parents about lead exposure risks and follow-up care for children with elevated blood lead levels.
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