Senate bill would fund vision care for children who fail screening, exam

The AAO, AAPOS and other vision care organizations hailed the legislation as a ‘fiscally responsible’ way to meet a critical need.

Issue: October 1, 2006

ByErin L. Boyle

Proposed legislation in the Senate would fund vision care for children who fail preschool vision screenings or exams.

The bill would allow the Department of Health and Human Services to award grants to states to provide comprehensive eye examination and treatment to children who are identified through vision screenings or eye exams, according to a draft of the bill. Children younger than 9 years would receive “top priority” for screening, the draft said.

Sen. Christopher “Kit” Bond, R-Mo., introduced the Vision Care for Kids Act of 2006 on July 19. The bill was then referred to the Committee on Health, Education, Labor and Pensions.

The bill would make diagnosing and treating vision problems in school-aged children a “national priority,” according to a draft of the bill posted on Sen. Bond’s Web site.

The American Academy of Ophthalmology, American Association for Pediatric Ophthalmology and Strabismus and other eye care organizations helped draft the bill, according to an AAO news release. The American Optometric Association and Vision Council of America also support the bill.

“The act helps close the gap for kids who fail a vision screening who are not getting the follow-up diagnosis and treatment they need,” the release from the AAO said.

“Two percent to 5% of children who fail a vision screening have significant eye problems, beyond those that can be fixed immediately with glasses,” the release said. “Many of these eye problems, if not treated early in life, can lead to permanent and irreversible visual loss. Yet, nearly 25% of parents whose children failed a vision screening did not schedule a follow-up comprehensive vision exam for their children because of a lack of financial resources.”

The bill complements the Children’s Healthy Vision Campaign, an initiative launched by the AAO, with support from AAPOS and the American Academy of Family Physicians. The initiative encourages vision screening as a “thorough yet cost-effective” way of identifying children who need more comprehensive eye exams, the AAO release said.

New state laws require vision screening for children

North Carolina and Oklahoma have both recently seen laws passed or proposed requiring vision screening for children.

The Oklahoma House and Senate passed the state’s Children’s Vision of Excellence Act in the spring, and Oklahoma Gov. Brad Henry signed it into law in June. The American Academy of Ophthalmology, American Academy of Pediatric Ophthalmology and Strabismus and Oklahoma Academy of Ophthalmology helped develop the law, according to a statement from the AAO.

“This new law requires vision screening for all school-aged children entering kindergarten, first and third grade, in an effort to identify eye and vision problems that could impede their healthy development,” the AAO release said. “Children who fail the screening are referred for further vision evaluation performed by an ophthalmologist or optometrist.”

In the release, AAO Secretary for State Affairs Cynthia Bradford, MD, said, “This is a true victory, not only for ophthalmology, but also for the children in Oklahoma. An alternative bill, which was endorsed by the optometrists, called for creating an expensive and wasteful mandate that required all children entering school to receive a full eye exam performed by an optometrist or ophthalmologist. We needed to support the children and their eye and vision health with options that were both fiscally responsible and clinically effective, which is what Oklahoma is getting.”

In North Carolina, the state House passed a bill that would require vision screening for every child entering kindergarten. The measure has moved to the state Senate for consideration.

If enacted, the bill would supersede earlier legislation that would have required a comprehensive eye exam for every child entering kindergarten starting in the 2007-2008 school year.

Children who fail a vision screening must undergo a comprehensive eye exam, according to the bill. Also, any teacher, administrator or other official who has “reason to believe” that a child enrolled in kindergarten through third grade is experiencing vision problems may recommend to a parent that the child get a comprehensive eye exam.

The law also established a 10-member Governor’s Commission on Early Childhood Vision Care. The commission will include five optometrists, three ophthalmologists, one general pediatrician and one school nurse. Members appointed by the governor will serve 2-year terms. Those appointed by the general assembly will serve one-year terms. The body will process applications, reimburse providers for services rendered to eligible participants, inform providers and the general public about the program and investigate alternative ways to serve eligible children.

Landmark cooperation

The bill is also notable because it represents a rare example of consensus between ophthalmic and optometric advocacy organizations, said Robert S. Gold, MD, OSN Pediatrics/Strabismus Section Editor.

“The bottom line is that this is the first time on a national scale that the American Academy of Ophthalmology, American Optometric Association and the Vision Council of America have supported a legislative means to help children see better, to help children be screened so that we can detect children that have vision problems,” Dr. Gold said. “They’ll need to have a vision screening before they go to school. Those children that fail the screening can be referred to the proper eye care specialist for further evaluation for a comprehensive eye exam.”

Giving every child a comprehensive eye exam before entering school is not cost-effective because only 2% to 5% have vision problems, Dr. Gold said. He noted that there has been “contention” in the past between ophthalmic organizations, on the one hand, which favor vision screenings, and optometric organizations that have advocated comprehensive eye exams for every child entering school.

“Now, it seems as though, through this legislation, everybody is agreeing,” Dr. Gold said. “The AOA had been, until recently, advocating complete examinations on almost every child prior to school and having it funded. So, obviously, funding was never available for all of these children. Now, the funding is going to be done through state grants. It’s a landmark piece of legislation.”

For more information:

Robert S. Gold, MD, can be reached at Eye Physicians of Central Florida, 225 W. State Road, 434, Suite 111, Longwood, FL 32750; 407-767-6411; fax: 407-767-8160; e-mail: rsgeye@aol.com.

Reference:

Senate Bill 3685, the Vision Care for Kids Act of 2006, introduced July 19, 2006, can be read at Sen Christopher Kit Bonds Web site: www.bond.senate.gov/atwork/legislation.cfm: Choose item 26.

Matt Hasson is an OSN Staff Writer who covers all aspects of ophthalmology. He focuses on regulatory, legislative and practice management topics.