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Minutes for HB2346 - Committee on Education

Short Title

Relating to standards for school-administered vision screenings.

Minutes Content for Tue, Mar 10, 2020

Chairperson Baumgardner opened the hearing.

Staff gave an overview of the bill.

Chairperson Baumgardner asked what the difference between a committee and a commission is. Staff responded that you can probably call it anything you want . Typically, you think of a committee having a group of legislators on it, and a commission, the state board would select members according to the criteria.

Todd Fleisher, Executive Director of the Kansas Optometric Association and the Kansas Vision Coalition Task Force (KVC), expressed the importance of vision in a child’s learning. It is estimated that more than 40 percent of the brain is devoted to visual function and 80 percent of learning is a result of visual processing. In 2017, Envision, Inc. spearheaded the organization of a Vision Summit to bring together a group of interested organizations from various disciplines and areas of the state, to discuss current screening practices, sharing best practices, challenges and shortcomings of these screenings. They identified gaps in care that needed to be addressed as well as duplicate initiatives. KVC was formed to provide direction and advocacy out of an Ad Hoc committee that was formed, the Kansas Vision Screening Guidelines were updated, evidence-based practice regarding vision screenings was changed significantly, and shortcomings in current Kansas Vision Screening Laws and Regulations were addressed. The coalition believes these minor changes to the statutes relating to school-administered vision screening will help make sure screenings are standardized in how and when they are provided allowing for more frequent review and revision. (Attachment 1)

Mae Claxton, ADN, RN, appeared before the Committee representing herself and Cindy Galemore, RN. They support the proposed changes to the current statutes and reported on a survey conducted among Kansas School Nurses by KDHE, Bureau of Health Promotion and Bureau of Family Health with 78.7% of school districts participating. The survey showed inconsistencies in grade levels being screened across the state but the majority of schools screen preschool age students. The school nurse is the most common job category conducting vision screenings, though 22% are being done by other types of personnel including volunteers. Only 55% of schools state all their vision screeners have completed training. It is concerning that of the 11,557 students referred to a health care provider, only 2,262 or 19.6% were seen. Revision to the current vision screen statutes are necessary to provide evidence-based guidance, emphasize the importance of referrals and follow-ups, establish consistency in grade levels being screened, establish the important role of the school nurse, require screening annually for children participating in early childhood IDEA part B programs, establish specific grade levels for screening versus the current “every 2 years” and to establish a commission to periodically revise guidelines, provide oversight, and monitor progress. (Attachment 2)

Proponent written testimony was submitted by Sharon A. Morris, MS, RN, KSNO Representative to NASN (Attachment 3)

Opponent written testimony was submitted by Jill Freisberg, RN, School Nurse (Attachment 4)

Senator Bollier asked about the data collection, the necessity of doing it every year, and what would be changing over time. Mr. Fleisher replied they are looking at the number of children who are being referred and how many of those receive care. Some schools are able to get 75% of the children examined or follow-up care given but the average is closer to 19%. They are trying to get children in earlier so if there is something that needs to be addressed it will be done more quickly rather than waiting another five or ten years to be reviewed again. Senator Bollier asked if that includes things like having access to insurance so they can get seen. Mr. Fleisher responded yes and identified programs available like the See to Learn program that has free assessment for three-year olds. Senator Bollier asked about the schools that had to cut their school nurse, and who administers the screening. Mr. Fleisher said they are either using volunteers that have been trained or the local Lions Club steps up to do the screenings. Senator Bollier asked if the volunteers would be reporting the data. Mr. Fleisher said the volunteers would report to the school and the school would report it to the state

Senator Sykes, asked ofthe Advocacy Committee members, are the same makeup as the Commission or are there some that are missing? Mr. Fleischer said it is generally the same, they did make sure there will be an ophthalmologist and optometrist on the Commission.

Seeing no further questions, Chairperson Baumgardner closed the hearing on HB2346.