Proposed Template for Legislative Text

Prevent Blindness suggests the following textual template be used for the development of state legislation to support healthy vision in children, modified as necessary to fit into the state’s existing body of laws.

Section 1. School-readiness vision health requirements

Upon entering [insert here the first year of required school within the state – kindergarten or first grade] or within 30 days of the start of the school year, the parent or guardian of each child shall present to school health personnel certification that the child within the previous 12 months has passed a vision screening conducted by an authorized vision screener trained in vision screening techniques approved by the [insert here an appropriate oversight body]. Medical professionals conducting vision screenings for purposes of school entry must also follow the approved techniques. Such techniques must follow nationally recognized vision screening protocol, and at minimum include the following:

a) Observation (ABCs: Appearance signs, Behavior signs, Complaint signs)
b) Recognition distance visual acuity screening (utilizing either HOTV or Lea Symbols, or vision screening instruments demonstrating a scientific evidence base and deemed as best- or acceptable-practice by the Advisory Committee of the National Center for Children’s Vision and Eye Health)
c) Appropriate follow-up and data collection procedures

Children who fit into one of the following categories must provide proof of a comprehensive eye examination performed by a licensed optometrist or physician trained in the provision of comprehensive eye care chosen by the child’s parent or guardian indicating any pertinent diagnosis, treatment, prognosis, recommendation and evidence of follow-up treatment, if necessary:

— Children who fail to pass the vision screening
— Children with readily recognized eye abnormalities
— Children with systemic diseases or using medications known to cause eye disorders
— Children with a family history of a first-degree relative with strabismus or amblyopia
— Children born prematurely at less than 32 completed weeks of gestation
— Children with a diagnosed with neurodevelopmental delay

Documentation of a comprehensive eye exam within the previous twelve months shall waive the requirement of a vision screening.

Any person who conducts an eye examination of a child in response to such child having failed an eye examination given in accordance with the provisions of this section shall forward a written report of the results of the examination to the school health personnel and a copy of said report to a parent or guardian of such child. Said report shall include, but not be limited to, the following:

a) Date of the report
b) Name, phone number, and address of the child
c) Name of the child’s school
d) Type of examination
e) A summary of significant findings, including diagnoses, treatment, prognosis, whether or not a return visit is recommended and, if so, when
f) Recommended educational adjustments for the child, if any, which may include the following: preferential seating in the classroom, eyeglasses for full-time use in school, eyeglasses for part-time use in school or any other recommendations
g) Name, phone number, address and signature of the examiner

For all students who do not have documentation of a screening performed by an authorized screener or documentation of an eye examination performed within the previous twelve months, the school shall be responsible for providing an authorized vision screening, conducted within [insert here a reasonable time as determined by the state]. For those children who fail the required vision screening, a comprehensive eye examination, performed by a licensed optometrist or physician trained in the provision of comprehensive eye care, shall be required to be obtained by the child’s family.

All families of children shall be notified in both written and verbal formats of the results from the school-based vision screening and their responsibilities to provide a follow-up comprehensive eye examination via the school’s established parental communication mechanism. Schools providing notification should attempt to provide all communication in a culturally and linguistically appropriate manner.

The family of the child must provide a copy of the comprehensive eye examination report to the school health personnel within [insert here a reasonable time as determined by the state].

For families unable to financially provide a comprehensive eye examination for the child… [Insert here a statement regarding state funding designated for families of children who are unable to afford them].

[The following section should be included where an appropriate oversight body does not exist.]

Section 2. State Children’s Vision Health and School Readiness Commission

A State Children’s Vision Health and School Readiness Commission (hereinafter referred to as “Commission”) should be established to ensure the enactment of this state requirement.

The Commission shall be appointed by the governor and be comprised of one optometrist, one ophthalmologist, one pediatrician or family practice physician, one representative of a nonprofit voluntary health organization dedicated to preventing blindness, one representative of the state department of education, one representative of the state department of public health, one school nurse, one public health nurse, one school superintendent, one local health commissioner, and other members as determined appropriate by the governor.

The Commission shall:

a) provide linguistically and culturally appropriate materials to be used in vision screening forms, notifications, and other communications among the school, parents/guardians, and licensed optometrists/physicians trained in the provision of comprehensive eye care;
b) pursue opportunities to offer free or low-cost eye exams, using a sliding scale, to students who fail vision screenings and are unable to afford an exam on their own;
c) pursue opportunities to provide geographically accessible opportunities for such examinations;
d) designate an agency to collect data from school health personnel concerning the results of the original screenings, the reports from the comprehensive eye exam, the outreach letters to unresponsive families, and referrals to child protective agencies, and submit the data to the Commission annually;
e) issue an annual report to the secretary of the department of health, the secretary of the department of education, the governor, and the state legislature, with the key findings, including evaluation of cost effectiveness, of the collected data and recommendations for possible modifications to the program;
f) perform other related tasks, as assigned by the governor.