consequently, the Centers for Disease Control and Prevention (CDC) and the American Academy of Pediatrics have revised their 1991 guidelines, which recommended universal BPb screening of preschooaged children, to target instead high-risk groups.2'3 However, even when universal screening was the national guideline, a General Accounting Office study found that only 19% of children receiving Medicaid were screened.4 Similarly, a 1994 CDC telephone survey found that only 24% of parents reported that their young children had been screened for lead poisoning through blood testing.5 In New York City, a 1993 review of charts of children receiving Medicaid found that only 20.4% were screened for lead poisoning.6 For screened children with BPb levels of 0.48 nmol/L (10 )/dL) or higher, the CDC in 1991 developed recommendations for fol- low-up actions. These included repeat venous BPb testing in 3 to 4 months or less, depend- ing on the severity ofthe lead poisoning.7 Given the low rates of screening, we questioned whether primary care providers were complying with the 1991 CDC recom- mendations for follow-up.