Follow-Up and Case Coordination

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Laboratory Services

Providers who use DSHS Laboratory Services may sign up for a Remote Data Systems account. Remote Data Systems allows access to DSHS Laboratory testing results for a variety of tests, including lead. Visit their website to learn how to sign-up and access blood lead test results.


If a child's capillary screening sample comes out positive for 3.5 µg/dL or more, there must be a confirmatory venous sample. It is important to get this venous sample as soon as possible. DSHS recommends following this schedule for venous samples. You can also find a copy of this table in the Reference for Blood Lead Retesting and Medical Case Management (Pb-109).

Environmental Lead Investigations

An Environmental Lead Investigation (ELI) is a service for children who have elevated blood lead levels. Physicians (MD, DO), Physician Assistants (PA), Nurse Practitioners (NP), or Clinical Nurse Specialists (CNS) can request an ELI for their patient. A child must meet the following criteria to qualify for an ELI:

  • One venous blood lead test at 20 µg/dL or higher, OR
  • Two venous blood lead tests at least 12 weeks apart at 10-19 µg/dL

Providers can request an ELI using the Request for Environmental Investigation Form (Pb-101). Information about requesting an ELI is provided in the Texas Medicaid Provider Procedures Manual from the Texas Medicaid & Healthcare Partnership (TMHP).

Providers must submit the request for an ELI within 30 days of the qualifying venous blood lead level. Providers must supply the parent's or guardian's most current telephone number. This information is needed to schedule an ELI. Incorrect or missing information may delay scheduling and may result in more calls to the provider's office for additional information.

Please use these talking points to explain what an ELI is to a parent or guardian:

  1. A DSHS Risk Assessor is an expert licensed by the state of Texas to find lead hazards
  2. A Risk Assessor will visit your home to find out if there are lead hazards that could be a danger to your child
  3. Parent or Guardian must be present at the time of the environmental lead investigations to answer questions. Since you need to be there to answer questions, the Risk Assessor will call you to schedule a day to visit your child's home to conduct the assessment
  4. The visit could take anywhere from a few hours to one day.
  5. The Risk Assessor will test areas where your child sleeps, plays, and eats to see if there are items that may be contributing to the lead exposure. 
  6. The Risk Assessor will use equipment to see if there is lead in your home.
  7. The Risk Assessor may take dust, paint, soil, or other samples to send to a certified laboratory for testing.
  8. The Risk Assessor will send a letter with the results of the ELI to the parent and the healthcare provider. The letter will explain the results of the visit and offer recommendations to remove lead hazards. If the home is a rental property, the ELI findings as they relate to the property will be sent to the home owner. No information about the child will be disclosed to the property owner.

Last updated February 16, 2024.