PHILIPSBURG, Mont. — On a recent day in this 19th-century mining town turned tourist hot spot, students made their way into the Granite High School lobby and past a new filtered water bottle fill station.

Water samples taken from the drinking fountain the station replaced had a lead concentration of 10 parts per billion — twice Montana’s legal limit for schools of 5 parts per billion for the toxic metal.

Thomas Gates, the principal and superintendent of the small Philipsburg School District, worries the new faucets, sinks, and filters the district installed for roughly 30 water sources are temporary fixes. The high school, built in 1912, is likely laced with aged pipes and other infrastructure, like so much of this historic town.

“If we change faucets or whatever, lead is still getting pushed in,” Gates said.

The school in Philipsburg is one of hundreds in Montana grappling with how to remove lead from their water after state officials mandated schools test for it. So far, 74% of schools that submitted samples found at least one faucet or drinking fountain with high lead levels. Many of those schools are still trying to trace the source of the problem and find the money for long-term fixes.

In his Feb. 7 State of the Union address, President Joe Biden said the infrastructure bill he championed in 2021 will help fund the replacement of lead pipes that serve “400,000 schools and child care centers, so every child in America can drink clean water.”

However, as of mid-February, states were still waiting to hear how much infrastructure money they’ll receive, and when. And schools are trying to figure out how to respond to toxic levels of lead now. The federal government hasn’t required schools and child care centers to test for lead, though it has awarded grants to states for voluntary testing.

During the past decade, nationwide unease has been stirred by news of unsafe drinking water in places like Flint, Michigan. Politicians have promised to increase checks in schools where kids — who are especially vulnerable to lead poisoning — drink water daily. Lead poisoning slows children’s development, causing learning, speech, and behavioral challenges. The metal can cause organ and nervous system damage.

A new report by advocacy group Environment America Research & Policy Center showed that most states fall short in providing oversight for lead in schools. And the testing that has happened to this point shows widespread contamination from rural towns to major cities.

At least 19 states require schools to test for lead in drinking water. A 2022 law in Colorado requires child care providers and schools that serve any kids from preschool through fifth grade to test their drinking water by May 31 and, if needed, make repairs. Meanwhile, California leaders, who mandated lead testing in schools in 2017, are considering requiring districts to install filters on water sources with high levels of lead.

As states boost scrutiny, schools are left with complicated and expensive fixes.

As it passed the infrastructure bill, Congress set aside $15 billion to replace lead pipes, and $200 million for lead testing and remediation in schools.

White House spokesperson Abdullah Hasan didn’t provide the source of the 400,000 figure Biden cited as the number of schools and child care centers slated for pipe replacement. Several clean-water advocacy organizations didn’t know where the number came from, either.

Part of the issue is that no one knows how many lead pipes are funneling drinking water into schools.

The Environmental Protection Agency estimates between 6 million and 10 million lead service lines are in use nationwide. Those are the small pipes that connect water mains to plumbing systems in buildings. Other organizations say there could be as many as 13 million.

But the problem goes beyond those pipes, said John Rumpler, senior director for the Clean Water for America Campaign at Environment America.

Typically lead pipes connected to public water systems are too small to serve larger schools. Water contamination in those buildings is more likely to come from old faucets, fountains, and internal plumbing.

“Lead is contaminating schools’ drinking water” when there aren’t lead pipes connecting to a municipal water source, Rumpler said. Because of their complex plumbing systems, schools have “more places along the way where lead can be in contact with water.”

Montana has collected more data on lead-contaminated school water than most other states. But gaps remain. Of the state’s 591 schools, 149 haven’t submitted samples to the state, despite an initial 2021 deadline.

Jon Ebelt, spokesperson with the Montana Department of Public Health and Human Services, said the state made its deadline flexible due to the covid-19 pandemic and is working with schools that need to finish testing.

Greg Montgomery, who runs Montana’s lead monitoring program, said sometimes testing stalled when school districts ran into staff turnover. Some smaller districts have one custodian to make sure testing happens. Larger districts may have maintenance teams for the work, but also have a lot more ground to cover.

Outside Burley McWilliams’ Missoula County Public Schools office, about 75 miles northwest of Philipsburg, sit dozens of water samples in small plastic bottles for a second round of lead testing. Director of operations and maintenance for the district of roughly 10,000 students, McWilliams said lead has become a weekly topic of discussion with his schools’ principals, who have heard concerns from parents and employees.

Several of the district’s schools had drinking fountains and classroom sinks blocked off with bags taped over faucets, signs of the work left to do.

The district spent an estimated $30,000 on initial fixes for key water sources by replacing parts like faucets and sinks. The school received federal covid money to buy water bottle stations to replace some old infrastructure. But if the new parts don’t fix the problem, the district will likely need to replace pipes — which isn’t in the budget.

The state initially set aside $40,000 for schools’ lead mitigation, which McWilliams said translated to about $1,000 for his district.

“That’s the one frustration that I had with this process: There’s no additional funding for it,” McWilliams said. He hopes state or federal dollars come through soon. He expects the latest round of testing to be done in March.

Montgomery said Feb. 14 that he expects to hear “any day now” what federal funding the state will receive to help reimburse schools for lead mitigation.

Back in Philipsburg, Chris Cornelius, the schools’ head custodian, has a handwritten list on his desk of all the water sources with high lead levels. The sink in the corner of his office has a new sign saying in bold letters that “the water is not safe to drink.”

According to state data, half the 55 faucets in the high school building had lead concentrations high enough to need to be fixed, replaced, or shut off.

Cornelius worked to fix problem spots: new sinks in the gym locker rooms, new faucets and inlet pipes on every fixture that tested high, water bottle fill stations with built-in filtration systems like the one in the school’s lobby.

Samples from many fixtures tested safe. But some got worse, meaning in parts of the building, the source of the problem goes deeper.

Cornelius was preparing to test a third time. He plans to run the water 12 to 14 hours before the test and remove faucet filters that seem to catch grime coming from below. He hopes that will lessen the concentration enough to pass the state’s thresholds.

The EPA recommends collecting water samples for testing at least eight hours after the fixtures were last used, which “maximizes the likelihood that the highest concentrations of lead will be found.”

If the water sources’ lead concentrations come back high again, Cornelius doesn’t know what else to do.

“I have exhausted possibilities at this point,” Cornelius said. “My last step is to put up more signs or shut it off.”

KHN correspondent Rachana Pradhan contributed to this report.

BIGFORK, Mont. — On a recent afternoon, it was a crisp 70 degrees on the football field at the high school in this northwestern Montana community less than 200 miles south of the U.S.-Canada border.

Vikings head coach Jim Benn was running his team through drills in the pristine fall weather, without much interruption. Just a couple of weeks earlier, though, players needed frequent water breaks as they sweated through temperatures in the low to mid-90s, about 15 degrees higher than average for the time of year.

Although temperatures have started to drop now that autumn is underway, Montana and many other states in the northern U.S. are getting hotter — and staying hot for longer. August is when many high school sports ramp up, and this year’s was either the hottest on record or close to it for many communities across Montana, according to the National Weather Service and other meteorologists. The heat wave stretched into September, and at least six Montana cities broke the 100-degree mark during the first half of the month.

This August was the hottest on record for the nearby states of Idaho, Washington, and Oregon. Nationwide, this summer was the third-hottest on record, according to the National Oceanic and Atmospheric Association.

Health experts and researchers say states — especially the states in the northern U.S., such as Idaho, Maine, Montana, and North Dakota — aren’t adapting fast enough to keep high school athletes safe. Students and their families have sued schools, accusing them of not doing enough to protect athletes. Many states that have taken action did so only after an athlete died.

“Between high school and college, we’re losing roughly six athletes each year to exertional heatstroke, and the majority of those are high school athletes,” said Rebecca Stearns, chief operating officer at the University of Connecticut’s Korey Stringer Institute, which is named after a Minnesota Vikings player who died from heatstroke in 2001. The institute studies and tries to prevent the condition.

The true number of heat-related deaths could be higher, she said, because death certificates aren’t always accurately filled out. Exertional heat illness is the second-leading cause of death for high school and college athletes, behind cardiac arrest, she said.

In Bigfork, Benn said he hadn’t seen one of his athletes experience an exertional heat illness — such as heat exhaustion or heatstroke, which can cause fainting, vomiting, and even death — during his nearly 30-year coaching career in Montana until last year. An athlete became overheated at an early summer football camp during the record-shattering 2021 heat wave.

“We immediately got water on him, got him cooled down,” he said.

The player recovered after he was sprayed with a hose. Benn said he didn’t have an immersion tub filled with ice water on hand, which is what Stearns said is the recommended treatment.

“It is exactly why we need standard policies that have medical best practices incorporated,” Stearns said.

The Korey Stringer Institute ranks all 50 states and Washington, D.C., based on how well they follow best practices for preventing and responding to exertional heat illness among high school athletes, as well as other health risks such as cardiac arrest. Montana is 48th on the list, followed by Minnesota, Maine, and California.

California is last, according to the institute’s report, because it’s the only state that doesn’t regulate high school athletic trainers, which are generally responsible for the health and safety of athletes. Stearns said the institute is working with California sports officials who are pushing for laws that require licensing of athletic trainers.

States in the northern U.S. dominate the bottom third of the institute’s rankings. Stearns said many states the institute has approached about improving heat safety think it isn’t an issue or resist some policies because implementing them could come with a hefty price tag.

But some of the efforts don’t cost a penny, she said. At Bigfork High School, for example, Benn has implemented a three-day acclimatization period, without football pads, when his players return to the field in early August. “That’s really low-hanging fruit, in my perspective,” Stearns said.

Stearns added that most heat-related illnesses occur during the first days of practice, which are typically the hottest and when athletes are not accustomed to exerting themselves in the heat. But she said the state’s high school sports association should mandate acclimatization periods.

Montana and many other states also don’t have a system dictating when practices need to be modified — for example, by removing pads or reducing the length and the number of workouts — or canceled altogether, said Stearns. Policies that require an emergency plan for responding to an exertional heat illness are lacking in many northern states, as well.

Stearns and other researchers, such as Bud Cooper at the University of Georgia, said states should use what’s known as the “wet bulb globe temperature” — which accounts for air temperature, humidity, and radiant heat from surfaces such as turf that absorb sunlight — to make those determinations, rather than the heat index. The heat index doesn’t account for radiant heat, which increases the risk of developing heat illness. The foundation of the National Federation of State High School Associations said in February that it was sending 5,000 of the special thermometers to high schools across the country.

Stearns said that research suggests acclimatization periods reduce the number of exertional heat illnesses by as much as 55% and that states that have used the wet bulb globe temperature to mandate changes to practice have seen an 80% reduction.

In Georgia, Cooper’s work documenting heat-related deaths among high school athletes led to sweeping policy changes in 2012. Since the policy shift, Georgia has gone from being the state with the highest number of heat-related deaths among high school football players to having no deaths.

Researchers such as Cooper have begun to provide regional policy guidelines based on the local average wet bulb globe temperatures to help states understand the risks for high school athletes and give them a starting point for making policy changes.

New Jersey was among the early adopters of the wet bulb system among states in the northern U.S. when it approved a law in 2020 requiring school districts to buy the thermometers. The state also requires hundreds of schools to put cold immersion tubs on-site when temperatures reach a certain level. The state is now second in the institute’s rankings of sports safety policies, behind Florida and ahead of Georgia.

In the Pacific Northwest, Oregon and Washington have policies that mandate changes to school sports practices based on the heat index, not the wet bulb globe temperature. Heat and sports safety researchers say that’s better than nothing.

The Montana High School Association, which regulates high school athletics, has implemented heat guidance that allows referees to call for extra breaks during football or soccer games, said executive director Brian Michelotti. The association also asks other sports, such as cross-country running, to schedule meets early in the day.

While Montana health officials say the state has never documented a death related to heat illness among the state’s high school athletes, the historic heat waves over the past two summers have athletic officials considering additional precautions. “It really has triggered us to have more discussions about that and really come back and revisit with some sport science committees,” Michelotti said.

He said any policy changes would have to be approved by the association’s seven-member board and wouldn’t happen until at least next year.

Heat and sports safety experts such as Stearns at the Korey Stringer Institute said adding statewide policies and mandates saves lives by ensuring that all coaches and schools are following best practices before a death happens.

“One life is too much a price for all of the games in a season,” she said.