Evidence record
State Made Limited Progress In Expanding Childhood Lead Exposure Testing, Audit Finds
- Jurisdiction
- Washington
- Publishing agency
- Office of the Washington State Auditor
- Publication date
- October 13, 2026
- Source record
- Original document linked
Findings
4
Recommendations
4
Overall conclusion
The follow-up audit found limited progress by the Health Care Authority in expanding Medicaid lead exposure testing, with none of the prior recommendations fully implemented as of May 2026.
Scope
Follow-up performance audit on Medicaid lead exposure testing for children enrolled in Medicaid in Washington state, focusing on progress implementing recommendations from the 2023 audit and status through May 2026.
Findings (4)
Each finding has a stable link.
- F-1456
Washington has taken some steps to improve the number of children tested for lead exposure, but none of the prior recommendations have been fully implemented.
- F-1457
Health Care Authority partly followed some recommendations, while progress on others only began during the audit.
- F-1458
The agency did not work with the Department of Health to ensure all guidance to health care providers around Medicaid lead testing requirements is clear and consistent.
- F-1459
Two related recommendations—educating Medicaid providers about testing effectiveness in the provider's office and using health records prompts to remind providers to test—had not been addressed prior to May 2026.
Recommendations (4)
- R-1299
Follow through on prior audit recommendations to increase Medicaid lead exposure testing rates.
Related finding F-1456 - R-1300
Collaborate with the Department of Health to standardize and clarify all guidance for Medicaid lead testing.
Related finding F-1458 - R-1301
Educate Medicaid providers about the effectiveness of in-office testing for lead exposure.
Related finding F-1459 - R-1302
Implement health records prompts to remind providers to test Medicaid-enrolled children for lead exposure.
Related finding F-1459