We conclude that universal screening with appropriate follow-up is an important public health goal that has not been met in the borough of the Bronx of New York City, despite federal, state, and local mandates. Furthermore, federal guidelines for scheduled
follow-up ofchildren with elevated BPb levels have not been successfully implemented in the satellite clinics of an institution with an established and comprehensive lead screening program, a program that includes substantive efforts toward community
outreach and education.