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Lead-Safe Wisconsin: Local Health Department Responsibilities and Resources

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Local health departments (LHDs) contract with DHS' Childhood Lead Poisoning Prevention Program (CLPPP) each year to deliver childhood lead poisoning prevention services. When a child meets the definition of an elevated blood lead level (EBLL), the LHD is responsible for two concurrent responses:

  • Nursing case management for the child and family.
  • An environmental investigation of the child's home.

This page breaks down what is expected on each track and links to the tools LHDs need to get the work done.

All standards for the Childhood Lead Poisoning Prevention Program are laid out in the CLPPP Handbook, P-0066:

Nursing case management

The public health nurse (PHN) is responsible for coordinating a child's care from diagnosis through case closure.

Assess the child

PHNs shall assess the child's:

  • Health status.
  • Development and behavior.
  • Nutritional intake.
  • Other risk factors.

Educate the caregiver

Caregivers shall be educated on:

  • The child's blood lead level (BLL) and what it means.
  • Potential sources of exposure.
  • What to expect during the environmental investigation.
  • Interim exposure mitigation measures.
  • The follow-up testing schedule.
  • The importance of sibling/parental testing.

Develop and document a plan of care

Once a plan of care is developed, the PHN must complete the Nursing Case Management Report, F-44771A (PDF) and upload it into HHLPSS. The plan of care should cover:

  • Environmental hazard reduction.
  • Nutrition.
  • Caregiver education.
  • Medical follow-up and referrals.

Coordinate with a multidisciplinary team

As needed, PHNs may convene case conferences with:

  • The risk assessor.
  • WIC.
  • Early childhood programs.
  • Social services.
  • The child's physician.

Evaluate and close the case

The following documents are required to be completed when a nurse does a home visit:

The following documents are not required to be completed during case management, but may be used to support the work of the PHN:

For more information about case management, visit:

Environmental investigations

Wisconsin law requires an environmental investigation for every child under age 6 with an elevated blood lead level (EBLL). Additionally, all local health departments under contract with DHS must completed a lead hazard investigation for all children under age 16 with an EBLL.

For more information about childhood lead poisoning environmental investigation responsibilities, visit:

Investigate the property

Environmental investigators shall complete:

  1. Pre-investigation preparation.
  2. An interview of the family and property owner about the child's habits, potential non-paint exposures, and other properties the child visits.
  3. A visual assessment of painted and varnished surfaces, friction and impact points, and other hazards.
  4. Collection of samples, such as XRF readings, paint chips, and dust-wipe samples from floors and windowsills in every room a child under 6 can access.
  5. An assessment of non-paint hazards, such as take-home lead, traditional medicines or cosmetics, imported spices, or old cookware.
  6. Deliver a written report to the owner and tenant within 10 working days of the investigation or lab results, using the risk assessment report template (Word).

Write and enforce work orders

Local health departments (LHDs) decide whether to require permanent abatement with a certified lead abatement contractor or interim controls with a certified lead-safe renovator. If an owner doesn't comply, LHDs can post a hazard notice, pursue local ordinance enforcement, or refer the case to the county district attorney under Wis. Stat. § 254.30.

Hazard typeDeadline for correction
Imminent5 days
Non-imminent30 days
Non-imminent, exterior, ordered Oct 1 - May 1No earlier than the following June 1

Monitor and clear the property

Once work is reported complete, the Risk Assessor/Lead Hazard Investigator must conduct a visual clearance and collect clearance dust-wipe samples against Wisconsin's dust standards. If a property fails, they should order more cleaning and re-sample.

Document everything in HHLPSS

Health department staff are expected to:

The following documents are required to be completed when completing an environmental lead investigation:

The following documents are not specifically required to be completed during environmental investigations, but a version still must be uploaded into HHLPSS along with the previous reports. These templates were designed to make completing these reports easier:

DHS also offers templates for health departments looking to write up work orders:

Make sure your reports are complete and meet rule requirements by using these checklists. For a combination Lead Inspection and Risk Assessment (LIRA), use both Lead Inspection and Risk Assessment checklists:

Additionally, the following webpages can be referenced for more information:

The consolidated contract

Local Health Department partners deliver these services under an annual consolidated contract with DHS. Funding is distributed using a risk-based formula that looks at:

  • Pre-1950s housing stock
  • Medicaid-enrolled children under 6
  • Local BLL/EBLL history

Each health department selects a scope of work built around DHS's program quality criteria and boundary statement, and end-of-year reports are due to CLPPP by February 1 of the following contract year.

Need help?

The Childhood Lead Poisoning Prevention Program is here to help local public health departments with their response to lead poisoning cases. Reach out at:

  Email: DHSLeadPoisoningPrevention@dhs.wisconsin.gov

  Phone (voicemail): 608-266-5817

CLPPP webinars

The Childhood Lead Poisoning Prevention Program hosts monthly webinars about all things lead. Sign up here:

Glossary

 
Last revised October 7, 2026