Bill
A 4848
NJ A4848 requires prenatal care providers to screen pregnant persons for lead when risk factors exist, enabling early detection and protection for fetuses and young children.
Status and procedural history
- Bill number: A 4848
- Introduced: September 23, 2024
- Assembly passage: Passed Assembly 72–0–0 (December 19, 2024)
- Senate action: Received in Senate 01/14/2025; referred to Senate Health, Human Services & Senior Citizens Committee; reported out with amendments (3/3/2025, 2nd reading). Referred to Transportation 02/06/2025 and listed as “Held for consideration in Transportation” (05/28/2025).
- Companion: S3616 (identical as amended)
- Statutory placement: Supplements P.L.1995, c.328 (C.26:2-137.2 et seq.)
- Effective date (if enacted): first day of the third month after enactment; Commissioner of Health to adopt implementing regulations.
Purpose / intent
- To improve detection of lead exposure during pregnancy by requiring prenatal care providers to screen pregnant persons for lead exposure risk factors and to perform lead screening when indicated by the most recent CDC and ACOG guidance. The bill aims to identify elevated maternal blood lead levels early so that clinicians and public health authorities can intervene to protect the pregnancy and household members (especially children under age six).
Key provisions (as amended)
- Covered providers: requires licensed health care professionals who provide prenatal maternity care to assess pregnant persons. The scope (per Senate amendments) explicitly includes:
- licensed physicians
- licensed physician assistants
- certified advanced practice nurses
- certified nurse midwives
- certified professional midwives
- certified midwives
- Risk assessment and screening trigger:
- Providers must assess each pregnant person for possible risk factors for lead exposure and elevated blood lead levels using the most recent CDC and American College of Obstetricians and Gynecologists (ACOG) guidance.
- If the assessment identifies at least one risk factor, the provider must perform (or arrange for) lead screening. (Earlier Assembly committee amendments had required screening in the first and third trimesters when risk factors were present; the Senate committee amendment replaced the fixed schedule with assessment based on current CDC/ACOG guidance.)
- Referral option: If the provider cannot perform the screening, they may refer the patient to another qualified provider who can.
- Patient refusal: A provider is not required to conduct lead screening if the patient objects in writing. Under Senate amendments, a provider is also not required to re-run screening if another provider has already completed the required screening.
- Elevated results — provider duties: If a provider receives laboratory results indicating an elevated maternal blood lead level, the provider must:
- notify the patient of the results;
- explain the significance of lead poisoning (in plain language); and
- ensure that any children or other household members under age six are, or have been, screened for lead exposure.
- Laboratory reporting requirements:
- Laboratories performing the lead screening must report test results to the New Jersey Department of Health (DOH), the local health department where the pregnant person resides, and the submitting provider within five business days of obtaining the result.
- Data collection and confidentiality:
- Records of screenings must be included in the DOH central lead database maintained under P.L.1995, c.328.
- Information compiled by DOH is confidential; DOH may publish statistical reports excluding personal identifying information.
- Technical and compliance provisions:
- Providers must comply with existing statutory blood sample collection requirements (section 4 of P.L.1995, c.328).
- The Commissioner of Health will adopt implementing rules and regulations.
Who is affected
- Primary: pregnant persons receiving prenatal care in New Jersey, particularly those with risk factors for lead exposure.
- Health care providers: prenatal care clinicians listed above will need to perform risk assessments and arrange screenings when indicated.
- Laboratories: required to report results promptly (within 5 business days) to DOH, local health departments, and submitting providers.
- Public health agencies: DOH and local health departments will receive data on pregnancy-related lead screenings and manage confidentiality and statistical reporting.
- Households with children under six: providers must ensure young children in the household are screened if the pregnant person has an elevated level.
Potential impacts and considerations
- Public health benefit: likely increased detection of maternal lead exposure, enabling clinical intervention and remediation to reduce risks to fetuses and young children.
- Administrative effects: additional assessment, documentation, referrals, and reporting duties for providers and labs; DOH will receive added data and must maintain confidentiality safeguards.
- Flexibility: the bill ties screening to current CDC/ACOG guidance rather than a fixed schedule (as amended), allowing standards to evolve with science and practice.
- Patient autonomy: preserves the right of pregnant persons to decline testing in writing.
Sponsor(s) and support
- Sponsors listed on the reprint: Assemblywoman Shanique Speight, Assemblyman Reginald W. Atkins, Assemblywoman Luanne M. Peterpaul; several co-sponsors (see bill text). (Note: earlier header listing a different name appears to be an error in the provided metadata.)
For more detail
- See the full bill text and committee statements for exact statutory language, amendment history, and the definitions (e.g., the bill defines “lead screening” as the application of a detection technique to measure blood lead level).
Compiled from official sources — confirm details with the bill’s official record.
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