WSR 02-15-163

PROPOSED RULES

DEPARTMENT OF HEALTH


[ Filed July 23, 2002, 2:22 p.m. ]

Original Notice.

Preproposal statement of inquiry was filed as WSR 99-11-030.

Title of Rule: Chapter 246-760 WAC, Auditory and visual standards -- School districts.

Purpose: These rules require public schools to screen all students for loss of auditory and visual acuity in grades kindergarten, one, two, three, five and seven, and when a student is referred for screening. Screening program requirements are established for program personnel, screening standards, record keeping and notification of parents/guardians.

Other Identifying Information: These rules have been reviewed in conformance with Executive Order 97-02, regulatory improvement. The State Board of Health delegated the adoption of these rules to the department at its October 2001 board meeting.

Statutory Authority for Adoption: RCW 28A.210.200.

Statute Being Implemented: RCW 28A.210.200.

Summary: The proposed changes are limited to housekeeping. Language is updated to be consistent with current standards of rule writing. No changes are proposed in the frequency of screening or screening tests.

Reasons Supporting Proposal: The proposed changes are consistent with the requirements of Executive Order 97-02, regulatory improvement.

Name of Agency Personnel Responsible for Drafting: Frank Chestnut, Department of Health, Mailstop 47880, Olympia, Washington 98504-7880, (360) 236-3574; Implementation and Enforcement: Gayle Thronson, Office of Superintendent of Public Instruction, Mailstop 47200, Olympia, Washington 98504-7200, (360) 725-6040.

Name of Proponent: Department of Health, governmental.

Rule is not necessitated by federal law, federal or state court decision.

Explanation of Rule, its Purpose, and Anticipated Effects: The proposal rule changes are housekeeping in nature. The changes improve clarity and readability.

Proposal Changes the Following Existing Rules: Editorial changes are made throughout the chapter, improve the clarity of the rules and do not change the substance of the regulation.

No small business economic impact statement has been prepared under chapter 19.85 RCW. The agency has not completed a small business economic impact statement under RCW 19.85.030. The proposed rule makes changes that are only housekeeping in nature and does not impose additional costs on small businesses.

RCW 34.05.328 does not apply to this rule adoption. The proposed rule makes changes that are only housekeeping in nature. The proposal does not impose penalties, does not set qualifications for licensure or permits, and does not significantly alter policy or regulatory programs.

Hearing Location: Department of Health, CenterPoint Office, 20435 72nd Avenue South, Suite 200, Large Conference Room 1, Kent, WA 98032, on August 27, 2002, at 10:30 a.m.

Assistance for Persons with Disabilities: Contact Frank Chestnut, by August 9, 2002, so arrangements can be made, TDD (800) 833-6388, or (360) 236-3574.

Submit Written Comments to: Frank Chestnut, Office of Maternal and Child Health, Department of Health, Mailstop 47880, Olympia, Washington 98504, fax (360) 586-7868, by August 27, 2002.

Date of Intended Adoption: September 3, 2002.

July 19, 2002

M. C. Selecky

Secretary

OTS-5374.4


AMENDATORY SECTION(Amending Order 225B, filed 12/23/91, effective 1/23/92)

WAC 246-760-001   ((Purpose.)) What is the purpose of these rules?   ((The following regulations are adopted pursuant to)) These rules implement chapter 32, Laws of 1971((, wherein is contained the legislative mandate that)). Under this chapter, each board of school directors in the state shall provide for and require screening of the auditory and visual acuity of children attending schools in their districts to ((ascertain)) determine if any ((of such)) children (("))have defects sufficient to retard them in their studies.((" It is the purpose of such screening procedures to identify those children who are likely to have visual or auditory defects. In addition to the requirements of these regulations, the need for appropriate educational services as provided in chapter 28A.210 RCW must be recognized and arranged for those children whose visual or auditory handicaps warrant special facilities or educational methods.)) Each board of school directors shall establish procedures to implement these rules.

[Statutory Authority: RCW 43.20.050 and 28A.210.020. 92-02-019 (Order 225B), 246-760-001, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.20.050. 91-02-051 (Order 124B), recodified as 246-760-001, filed 12/27/90, effective 1/31/91; Order 63, 248-144-010 (codified as WAC 248-148-010), filed 11/1/71.]


AMENDATORY SECTION(Amending Order 124B, filed 12/27/90, effective 1/31/91)

WAC 246-760-020   ((Criteria for selection of children for screening.)) How frequently must schools screen children?   ((Boards of)) Schools ((directors)) shall ((require)) conduct auditory and visual screening of children ((as follows)):

(1) ((Schools shall screen all children)) In kindergarten and grades one, two, three, five, and seven((.)); and

(2) ((Schools shall promptly screen all children having a)) For any child showing symptoms of possible loss in auditory or visual acuity referred to the district by parents, guardians, or school staff.

(3) If ((manpower)) resources permit, schools shall annually screen children at other grade levels.

[Statutory Authority: RCW 43.20.050. 91-02-051 (Order 124B), recodified as 246-760-020, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 28A.31.030. 87-22-010 (Order 306), 248-148-021, filed 10/26/87.]


AMENDATORY SECTION(Amending Order 124B, filed 12/27/90, effective 1/31/91)

WAC 246-760-030   What are the auditory acuity screening standards(( -- )) for screening equipment and procedures((.))?   (1) Schools shall use auditory screening equipment providing tonal stimuli at frequencies at one thousand, two thousand, and four thousand herz (Hz) at hearing levels of twenty ((or twenty-five)) decibels (dB), as measured at the earphones, in reference to American National Standards Institute (ANSI) ((1969)) 1996 standards.

(2) Qualified persons ((shall)) will check the calibration of ((said)) frequencies and intensity at least every twelve months, at the earphones, using equipment designed for audiometer calibration.

[Statutory Authority: RCW 43.20.050. 91-02-051 (Order 124B), recodified as 246-760-030, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 28A.31.030. 87-22-010 (Order 306), 248-148-031, filed 10/26/87.]


AMENDATORY SECTION(Amending Order 225B, filed 12/23/91, effective 1/23/92)

WAC 246-760-040   What are the procedures for auditory acuity screening ((procedures.))?   (1) Schools shall screen all children referenced in WAC 246-760-020 on an individual basis at one thousand, two thousand, and four thousand Hz.

(2) The screener shall:

(a) Present each of the tonal stimuli at a hearing level of twenty ((or twenty-five)) dB based on the ANSI ((1969)) 1996 standards;

(b) Conduct screenings in an environment free of extraneous noise;

(c) If at all possible, complete screening within the first semester of each school year;

(d) Place the results of screenings, any referrals, and referral results ((of such referrals)) in each student's health and/or school record; and

(e) Forward the results to the student's new school if the student transfers.

[Statutory Authority: RCW 43.20.050 and 28A.210.020. 92-02-019 (Order 225B), 246-760-040, filed 12/23/91, effective 1/23/92. Statutory Authority: RCW 43.20.050. 91-02-051 (Order 124B), recodified as 246-760-040, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 28A.31.030. 87-22-010 (Order 306), 248-148-035, filed 10/26/87.]


AMENDATORY SECTION(Amending Order 124B, filed 12/27/90, effective 1/31/91)

WAC 246-760-050   What are the auditory acuity screening ((failure -- )) referral procedures((.))?   ((Boards of school directors shall establish procedures requiring school districts:

(1) Rescreen students not responding to one or more frequencies in either ear in three to six weeks after the initial screening, and)) (1) If a child does not respond to one or more frequencies in either ear:

(a) The school must rescreen the child within six weeks; and

(b) Notify their teachers of the need for preferential positioning in class because of the possibility of decreased hearing((.)); and

(((2))) (c) Notify the parents or legal guardian of the need for audiological evaluation if the student fails the second screening.

(((3))) (2) Schools shall notify parents or legal guardian of the need for medical evaluation if:

(a) Indicated by audiological evaluation((,)); or

(b) Audiological evaluation is not available.

[Statutory Authority: RCW 43.20.050. 91-02-051 (Order 124B), recodified as 246-760-050, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 28A.31.030. 87-22-010 (Order 306), 248-148-091, filed 10/26/87.]


AMENDATORY SECTION(Amending Order 124B, filed 12/27/90, effective 1/31/91)

WAC 246-760-060   What are the auditory acuity screening(( -- )) qualifications ((of)) for personnel((.))?   Each school district shall designate a district audiologist or district staff member having:

(1) Responsibility for ((the administration of)) administering the auditory screening program ((in conformity with these regulations,)); and

(2) Training and experience ((appropriate)) to:

(a) Develop an administrative plan for conducting auditory screening in cooperation with the appropriate school personnel ((in order)) to ensure the program ((can be)) is carried out efficiently and effectively;

(b) Obtain the necessary instrumentation for carrying out the screening program, and ensuring the equipment is in proper working order and calibration; and

(c) Secure appropriate personnel for carrying out the screening program, if ((such)) assistance is necessary, and for assuring ((such)) these personnel are sufficiently trained to:

(i) Understand the purposes and regulations involved in the auditory screening programs; and

(ii) Utilize the screening equipment ((in an appropriate manner)) to ensure maximum accuracy((.));

(d) Ensure records are made and distributed as appropriate; and

(e) Disseminate information to other school personnel ((acquainting)) familiarizing them with aspects of a child's behavior ((denoting)) indicating the need for referral for auditory screening.

[Statutory Authority: RCW 43.20.050. 91-02-051 (Order 124B), recodified as 246-760-060, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 28A.31.030. 87-22-010 (Order 306), 248-148-101, filed 10/26/87.]


AMENDATORY SECTION(Amending Order 124B, filed 12/27/90, effective 1/31/91)

WAC 246-760-070   What visual acuity screening equipment((.)) must be used?   ((Boards of school districts shall require)) Personnel conducting the screening must use a Snellen test chart for screening for distance central vision acuity((: Provided, That)). Either the Snellen E chart or the standard Snellen distance acuity chart may be used as appropriate to the child's age and abilities. The test chart ((shall)) must be properly illuminated and glare free.

Other screening procedures equivalent to the Snellen test may be used only if approved by the state board of health.

[Statutory Authority: RCW 43.20.050. 91-02-051 (Order 124B), recodified as 246-760-070, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 28A.31.030. 87-22-010 (Order 306), 248-148-121, filed 10/26/87.]


AMENDATORY SECTION(Amending Order 124B, filed 12/27/90, effective 1/31/91)

WAC 246-760-080   What are the visual acuity screening procedures((.))?   (1) Schools shall:

(a) Screen children ((wearing glasses)) with corrective lenses for distance viewing with their ((glasses)) corrective lenses on;

(b) Place the results of screening, any referrals, and referral results ((of such referrals)) in each student's health and/or school record; and

(c) Forward the results to the student's new school if the student transfers.

(2) ((When a child is observed by)) If school personnel ((to demonstrate)) observe a child with other signs or symptoms related to eye problems ((to the extent such)) and if the signs or symptoms negatively influence the child in his or her studies, school personnel shall refer the child to the parents or guardians for professional care.

[Statutory Authority: RCW 43.20.050. 91-02-051 (Order 124B), recodified as 246-760-080, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 28A.31.030. 87-22-010 (Order 306), 248-148-123, filed 10/26/87.]


AMENDATORY SECTION(Amending Order 124B, filed 12/27/90, effective 1/31/91)

WAC 246-760-090   What are the visual acuity screening ((failure -- )) referral procedures((.))?   ((Boards of school directors shall require)) Schools shall rescreen students having a visual acuity of 20/40 or less in either eye as determined by the Snellen test or its approved equivalent within two weeks or as soon as possible after the original screening. Failure is indicated by the inability to identify the majority of letters or symbols on the thirty foot line of the test chart at a distance of twenty feet.

Schools shall inform parents or guardians of students failing the second screening, in writing, of the need and importance ((of)) for the child ((receiving)) to receive professional care.

[Statutory Authority: RCW 43.20.050. 91-02-051 (Order 124B), recodified as 246-760-090, filed 12/27/90, effective 1/31/91. Statutory Authority: RCW 28A.31.030. 87-22-010 (Order 306), 248-148-131, filed 10/26/87.]


AMENDATORY SECTION(Amending Order 124B, filed 12/27/90, effective 1/31/91)

WAC 246-760-100   What are the qualifications ((of)) for visual screening personnel((.))?   (1) Screening ((shall)) must be performed by persons competent to administer ((such)) screening procedures as a function of their professional training and background ((and/))or special training and demonstrated competence under supervision.

(2) Technicians and nonprofessional volunteers ((shall)) must have adequate preparation and thorough understanding of the tests as demonstrated by their performance under supervision.

(3) Supervision, training, reporting and referral shall be the responsibility of a professional person specifically designated by the school administration. He or she may be a school nurse or public health nurse, a special educator, teacher or administrator who possesses basic knowledge of the objectives and methods of visual acuity screening, supervisory experience and ability, demonstrated ability to teach others and demonstrated capacity to work well with people.

(4) Screening ((will)) may not be performed by ((opthamologists)) ophthalmologists, optometrists, or opticians or any individuals ((where)) who may have a conflict of interest ((might occur)).

[Statutory Authority: RCW 43.20.050. 91-02-051 (Order 124B), recodified as 246-760-100, filed 12/27/90, effective 1/31/91; Order 63, 248-144-150 (codified as WAC 248-148-150), filed 11/1/71.]

Washington State Code Reviser's Office