BILL ANALYSIS                                                                                                                                                                                                    Ó




                   Senate Appropriations Committee Fiscal Summary
                            Senator Kevin de León, Chair


          SB 430 (Wright) - Vision Appraisals: Binocular Vision
          
          Amended: April 18, 2013         Policy Vote: Education 9-0;  
          Health 9-0
          Urgency: No                     Mandate: Yes
          Hearing Date: May 23, 2013      Consultant: Jacqueline  
          Wong-Hernandez
          
          SUSPENSE FILE.

          
          Bill Summary: SB 430 requires the current vision appraisal of  
          students to also include tests for binocular function, beginning  
          in grade 3.

          Fiscal Impact: This bill could result in a significant new  
          mandate on local educational agencies (LEAs), whereby the state  
          may have to reimburse LEAs for every screening exam performed in  
          compliance with this bill, and any related staffing or training  
          costs.

          Background: Existing law requires school districts to provide  
          for the testing of the sight and hearing of each student  
          enrolled in the district. The test is to be given only by: a)  
          duly qualified supervisors of health employed by the district;  
          b) certificated employees of the district or county office of  
          education who possess the qualifications prescribed by the  
          Commission on Teacher Credentialing; c) contract with an agency  
          duly authorized to perform those services by the county  
          superintendent of schools, under guidelines established by the  
          State Board of Education; or, d) accredited schools or colleges  
          or optometry, osteopathic medicine, or medicine.  (Education  
          Code § 49452)

          Existing law requires, upon first enrollment in an elementary  
          school, and at least every third year thereafter until the child  
          has completed grade 8, the vision of students to be appraised by  
          the school nurse or other authorized person. The evaluation must  
          include tests for visual acuity and color vision, however, color  
          vision is to be appraised once and only on male students. Gross  
          external observation of the child's eyes, visual performance,  
          and perception are to be done by the school nurse and the  








          SB 430 (Wright)
          Page 1


          classroom teacher. The evaluation may be waived if the parents  
          present a certificate from a physician and surgeon, a physician  
          assistant or an optometrist.  (EC § 49455)

          Related Legislation: AB 1095 (Wright) 2001 would have required  
          every student, within 90 days of entering grade 1, to undergo a  
          comprehensive eye exam that includes evaluations of visual  
          skills such as eye teaming, focusing and tracking that may  
          impact a child's ability to read. That bill was held under  
          submission in this Committee.

          Proposed Law: SB 430 requires the current vision appraisal of  
          students to also include screening tests for binocular function.  
          Specifically, this bill:

             1)   Adds binocular function to the list of tests included in  
               the existing vision appraisal given to students every three  
               years until the student completes grade 8.

             2)   Specifies that binocular function appraisals need not  
               begin until the student has reached grade 3.

             3)   Authorizes the binocular function appraisal to include a  
               validated symptom survey developed during a National  
               Institute of Health clinical trial and published for use in  
               the public domain.

             4)   Adds binocular function to the list of appraisals that  
               may be completed by a physician and surgeon, a physician  
               assistant or an optometrist in lieu of the appraisals  
               completed at school.

          Staff Comments: This bill would expand an existing requirement  
          on LEAs, by requiring the current vision appraisal of students  
          to also include screening tests for binocular function, in  
          grades 3 and 6. While the current vision screenings are mandated  
          in state law, LEAs are not currently reimbursed for those costs,  
          because that statutory requirement existed before the adoption  
          of California Constitution Article 13B requiring state  
          reimbursement for new duties and higher levels of service  
          imposed on local entities.  

          If a test claim were filed for the new mandate imposed by this  
          bill, it would likely be found by the Commission on State  








          SB 430 (Wright)
          Page 2


          Mandates to be reimbursable, since it is clearly a higher level  
          of service than what is required under existing law. Even a  
          minor cost to each additional screening would result in  
          significant statewide reimbursement of the hundreds of school  
          districts serving pupils in grades 3 and 6. 

          Staff notes that to the extent that binocular function screening  
          results in eye conditions being diagnosed and corrected or  
          mitigated earlier in a pupil's academic career, pupils are  
          likely to learn more easily and to avoid misdiagnoses that could  
          result in more expensive, unneeded educational services.