Michigan: What you need to know about the universal lead testing mandate for children

Michigan has taken a bold step in protecting children’s health. As of April 30, 2025, the state requires universal blood lead testing for all children younger than age 6. This new policy aligns with updated HEDIS® measures and aims detect lead exposure early so kids can get the help they need.

This policy change is a critical opportunity to improve health outcomes for Michigan’s children. By following the new guidelines, you’ll help protect young patients from the lifelong effects of lead exposure.

What’s changed under the new policy

• All children must be tested at 12 and 24 months of age
• Children, ages 24–72 months, must be tested if no prior documentation exists
• Additional testing is required for children in high-risk environments (e.g., older housing, known exposure)

This shift from risk-based screening to universal testing reflects growing evidence that lead exposure can occur in any setting, not just traditionally high-risk areas.

HEDIS measure alignment

The Lead Screening in Children (LSC) HEDIS measure now tracks the percentage of children who receive a lead test by age 2. This is part of the Child Core Set used for Medicaid quality reporting. Pediatricians must ensure:

• Timely testing and documentation
• Accurate reporting through Michigan Care Improvement Registry (MCIR)
• Follow-up for elevated results (≥ 3.5 µg/dL)

Next steps for health care providers

1. Update clinical protocols

• Integrate lead testing into well-child visits at 12 and 24 months
• Include catch-up testing for children up to age 6

2. Train staff

• Ensure all team members understand the new requirements
• Provide guidance on documenting parental opt-outs

3. Use MCIR for reporting

• Enter all blood lead test results into MCIR
• Confirm results appear on immunization certificates

4. Educate families

• Share the importance of early lead detection
• Address concerns about testing and follow-up care

5. Monitor HEDIS compliance

• Track lead screening rates in your practice
• Use EHR tools to flag missing tests and follow-ups

Helpful resources

• Michigan Public Health Code – Lead testing
• MDHHS universal lead testing rule draft
• HEDIS MY 2025 measure descriptions
• MCIR