HOUSE BILL REPORT

HB 1865

As Passed House:

March 4, 2015

Title: An act relating to visual screening in schools.

Brief Description: Concerning visual screening in schools.

Sponsors: Representatives Magendanz, Ortiz-Self, McCaslin, Hayes and Pollet.

Brief History:

Committee Activity:

Education: 2/10/15, 2/19/15 [DP];

Appropriations: 2/27/15 [DP].

Floor Activity:

Passed House: 3/4/15, 93-3.

Majority Report: Do pass. Signed by 21 members: Representatives Santos, Chair; Ortiz-Self, Vice Chair; Reykdal, Vice Chair; Magendanz, Ranking Minority Member; Muri, Assistant Ranking Minority Member; Stambaugh, Assistant Ranking Minority Member; Bergquist, Caldier, Fagan, Gregory, Griffey, Hargrove, Hayes, S. Hunt, Kilduff, Klippert, Lytton, McCaslin, Orwall, Pollet and Springer.

Staff: Cece Clynch (786-7195).

Majority Report: Do pass. Signed by 31 members: Representatives Hunter, Chair; Ormsby, Vice Chair; Chandler, Ranking Minority Member; Parker, Assistant Ranking Minority Member; Wilcox, Assistant Ranking Minority Member; Buys, Carlyle, Cody, Condotta, Dent, Dunshee, Fagan, Haler, Hansen, Hudgins, S. Hunt, Jinkins, Kagi, Lytton, MacEwen, Magendanz, Pettigrew, Sawyer, Schmick, Senn, Springer, Stokesbary, Sullivan, Tharinger, Van Werven and Walkinshaw.

Minority Report: Do not pass. Signed by 2 members: Representatives G. Hunt and Taylor.

Staff: Jessica Harrell (786-7349).

Background:

Every board of school directors has the duty to provide for and require screening for the visual and auditory acuity of all children attending schools in their districts. The screening must be made in accordance with procedures and standards adopted by rule of the Board of Health (BOH). Prior to the adoption or revision of rules, the BOH must seek the recommendations of the Superintendent of Public Instruction regarding administration of the screening and the qualifications of persons competent to administer the screening.

The BOH rules regarding visual screening are as follows:

• Schools must conduct screening in kindergarten, and in grades 1, 2, 3, and 7. In addition, schools must conduct screening for any child showing symptoms of possible loss in visual acuity referred to the district by parents, guardians, or school staff. If resources permit, schools must annually screen children at other grade levels.

• Personnel conducting the screening must use a properly illuminated and glare free Snellen test chart, or an approved alternative, for screening for distance central vision acuity. Students having a visual acuity of 20/40 or less in either eye as determined by the Snellen test must be rescreened within two weeks or as soon as possible after the original screening. Schools must inform parents or guardians of students failing the second screening of the need and importance for the child to receive professional care.

• Schools must screen children with corrective lenses for distance viewing with their corrective lenses on.

• If school personnel observe a child with other signs or symptoms related to eye problems and if the signs or symptoms negatively influence the child in his or her studies, school personnel must refer the child to the parents or guardians for professional care.

• Screening must be performed by persons competent to administer screening procedures as a function of their professional training and background or special training and demonstrated competence under supervision. Technicians and nonprofessional volunteers must have adequate preparation and a thorough understanding of the tests as demonstrated by their performance under supervision. Supervision, training, reporting, and referral must be the responsibility of a professional person, designated by the school administration, who may be a school nurse, or public health nurse, a special educator, teacher, or administer who possesses basic knowledge of the objectives and methods of visual acuity screening.

The rules do not require routine screening for near visual acuity.

Summary of Bill:

Every board of school directors has the duty to provide for and require screening for both distance and near visual acuity.

Appropriation: None.

Fiscal Note: Available.

Effective Date: The bill takes effect 90 days after adjournment of the session in which the bill is passed.

Staff Summary of Public Testimony (Education):

(In support) Distance vision is not everything. Many people have to print their notes bigger and bigger as they age. Children, too, have near-vision problems. Up to 40 percent of eye problems are missed when only distance vision is tested, for example, far sightedness, lazy eye, and astigmatism. This is an equity issue. In lower economic areas, students fail visual screenings at a rate of 38 percent compared to a rate of 24 percent for the general population. About 25 percent of students cannot read due to visual issues, 66 percent of illiterate adults, 70 percent of juvenile delinquents, and 90 percent of prison inmates. The National Institute for Literacy estimates this is costing $60 billion per year. Since 2007 some teachers have been asking why the state does not check to see if students can see their textbooks. There are lots of reasons that students are not meeting academic benchmarks, so parents and teachers do not usually think that the student's eyes are the problem. When schools do routine screening for distance acuity, parents get a note that their child's vision is okay. Pediatricians also just check for distance. The only opportunity to check for near vision issues is when students go to the eye doctor, which does not happen very often for low-income students.

No one reads text books at 20 feet away. The law requires students to be screened at this distance. Some teachers estimate that 25 percent of the children they work with cannot read. Some students cannot read and report that when they try to read the words move around the page and some letters are darker and some are lighter. Many parents and teachers do not think about the fact that students do not do their reading at 20 feet away. Some students tilt their heads or press on their faces to adjust their eyes and make it easier to see. Students who cannot read are often behind their grade level. When students get glasses they can move out of remediation classes, which are more expensive. The King County Jail pilot found out that 80 percent of the jail population could not see properly. These children should be able to see and be successful.

Optometrists found that 80 percent of juveniles examined at the King County Jail were farsighted, have astigmatism, or other eye movement problems that are correctable. For about 73 percent of those children, glasses helped them immediately. Kids learn mostly by what they see. This state needs to move into a digital age in the way it tests visual problems. The positive results of glasses improve student's grades and attitudes. Some optometrists find that the parents of children who are behind grade level in reading do not believe that the problem could be the child's eyes. Many eye problems cannot be detected with distance vision tests. Due to the Affordable Care Act many eye exams would be available for free or low cost to all children under age 18. The detection and correction of visual problems should be available. It is important to do these exams while students are in school to catch the problems early.

(Opposed) None.

Staff Summary of Public Testimony (Appropriations):

(In support) Testing distance vision came about in the day of the chalkboard.  Forty percent of vision problems are not detected by testing for distance vision only. Distance vision is tested at 20 feet, while near vision is tested at 16 inches.  The problem of not detecting and correcting visual acuity issues early, further impairs vision.  Seventy percent of persons in juvenile detention have vision problems and the figure is 90 percent in prisons.  The cost is modest to the state.  Under current law, districts are required to screen for visual acuity.  One can argue that they already have the duty to screen for near vision problems, and this means there is a risk of lawsuits for not doing so.  This should not take significant resources.  This bill is good for teachers as well as students.  A teacher may wonder whether a student has a vision issue, but when the teacher talks to the parent, the parent responds that the child has been screened at school and no problem was detected.  Currently, testing for distance vision takes about three and one-half to four minutes per student.  Testing for near vision acuity would take another three and one-half to four minutes per student.

(Opposed) None.

Persons Testifying (Education): Representative Magendanz, prime sponsor; Jene Jones, League of Education Voters; Katie Johnson; Kathy Lambert and Edward Jones, King County Council; Joanna Haws; and Brad Tower, Optometric Physicians of Washington.

Persons Testifying (Appropriations): Representative Magendanz, prime sponsor; Brad Tower, Optomatric Physicians of Washington; and Katherine Johnson.

Persons Signed In To Testify But Not Testifying (Education): None.

Persons Signed In To Testify But Not Testifying (Appropriations): None.