BILL ANALYSIS Ó
SENATE COMMITTEE ON EDUCATION
Carol Liu, Chair
2013-2014 Regular Session
BILL NO: SB 1172
AUTHOR: Steinberg
AMENDED: April 23, 2014
FISCAL COMM: Yes HEARING DATE: April 30, 2014
URGENCY: No CONSULTANT: Lynn Lorber
SUBJECT : Vision appraisal.
SUMMARY
This bill requires school vision appraisals to include
tests for near vision, and expands current requirements for
school nurses and teachers to observe student's eyes to
also include observation of the appearance and behavior of
student's eyes, and requires observation to be continual
and regular.
BACKGROUND
Current law:
1) 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.
d) Accredited schools or colleges or optometry,
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osteopathic medicine, or medicine. (Education
Code § 49452)
2) Provides that non-medical certificated employees of a
school district or county office of education may be
authorized to give vision tests if the employee has
one of the following documents:
a) A statement from a qualified supervisor of
health that the employee has satisfactorily
completed an acceptable course of in-service in
techniques and procedures in vision testing of at
least six hours, and that the employee is
qualified to administer vision tests to students.
b) A transcript from an accredited college or
university evidencing that the employee has
successfully completed an acceptable course in
vision testing of at least one semester unit.
(California Code of Regulations, Title 5, § 591)
3) 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 classroom teacher.
The evaluation may be waived if the parents present a
certificate from a physician and surgeon, a physician
assistant or an optometrist, and parents may opt-out
based on religious beliefs. (EC § 49455)
4) Requires a report to be made to the parent when a
visual or other defect has been noted by the
supervisor of health or his/her assistant.
(EC § 49456)
ANALYSIS
This bill requires school vision appraisals to include
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tests for near vision, and expands current requirements for
school nurses and teachers to observe student's eyes to
also include observation of the appearance and behavior of
student's eyes, and requires observation to be continual
and regular. Specifically, this bill:
1) Adds appraisal of near vision to currently-required
tests for visual acuity and color vision.
2) Adds the observation of the appearance and behavior of
student's eyes, and specifies that this observation is
to be continual and regular, to the current
requirement that school nurses and classroom teachers
observe student's eyes, visual performance, and
perception. This bill also provides that observations
of these eye functions may indicate vision
difficulties.
3) Modifies the frequency of vision appraisals from upon
first enrollment and at least every third year
thereafter until the student has completed grade 8, to
kindergarten or upon first enrollment, grades 2, 5 and
8. This bill provides that a student whose first
enrollment occurs in grade 4 or 7 is not required to
be appraised in the following year.
4) Requires the California Department of Education to
adopt guidelines to implement this bill, including
training requirements and a method of testing for near
vision.
STAFF COMMENTS
1) Visual acuity . Existing regulations provide that
vision appraisals are tests for visual acuity at the
far point, and are to be conducted by means of an
optotype test. Regulations define test failure as
follows:
a) For children under six years of age: Visual
acuity of 20/50 or worse. The designation 20/50
or worse indicates the inability to identify
accurately the majority of letters or symbols on
the 20-foot line of the test chart at a distance
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of 10 feet.
b) For children six years of age or older:
Visual acuity of 20/40 or worse. This means the
inability to identify the majority of letters or
symbols on the 15-foot line of the test chart at
a distance of 10 feet.
c) For all children: A difference of visual
acuity between the two eyes of two lines or more
on the optotype chart. (California Code of
Regulations, Title 5, § 594)
This bill requires tests for visual acuity to include
near vision, which is recommended but not required as
an additional procedure in the California Department
of Education's (CDE) Guide for Vision Testing in
California Public Schools. CDE's guidance
specifically recommends and describes a Hyperopia
test, which is used for assessing near-distance vision
at least once, preferably in kindergarten or first
grade. This bill requires the CDE to adopt guidelines
to implement this bill, including a method of testing
for near vision.
http://www.cde.ca.gov/ls/he/hn/documents/visionreport.p
df
2) Training . School nurses and classroom teachers are
currently required to observe student's eyes, visual
performance, and perception. This bill adds the
requirement that nurses and teachers also observe the
appearance and behavior of student's eyes, which is
recommended in existing CDE guidance. Some may
question whether teachers who are not trained to
conduct vision appraisals know how to make these
observations. As noted, current law already requires
observation; this bill adds observation of appearance
and behavior of student's eyes. Further, this bill
requires the CDE to adopt guidelines to implement this
bill, including training requirements.
3) Failure of vision appraisal . Current law requires a
report to be made to the parent when a visual or other
defect has been noted by the supervisor of health or
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his/her assistant. Current regulations require a
re-evaluation of a student who failed a vision test,
prior to a report being made to the student's parents.
(Education Code § 49456 and California Code of
Regulations, Title 5, § 594)
4) Guidelines . Recommendations included in the
California Department of Education's (CDE) Guide for
Vision Testing in California Public Schools that would
be required by this bill include:
a) Vision testing may be done in kindergarten
or first grade and in grades two, five, and
eight, as well as on enrollment and referral at
any grade level.
b) Have teachers make continual observations of
students' appearance and behavior that may
indicate vision difficulties.
c) Conduct vision testing of students whose
school performance indicates a vision problem.
5) Fiscal impact . This bill creates a mandate by
expanding the duties of school nurses and teachers to
include a test of near vision, adding observation of
the appearance and behavior of student's eyes, and
requiring that this observation is to be continual and
regular.
6) Related legislation . SB 430 (Wright) requires a pupil
to receive a vision examination from a physician,
optometrist, or ophthalmologist and requires that
screening to include a test for binocular function,
refraction, and eye health. SB 430 is pending in the
Assembly Health Committee.
AB 1840 (Campos) authorizes a child's vision to be
appraised by using an eye chart or any other
scientifically valid technology, as specified. AB
1840 is pending in the Assembly Health Committee.
7) Prior legislation . AB 1095 (Wright, 2001) would have
required every student, within 90 days of entering
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grade 1, to undergo a comprehensive eye exam that
includes, in addition to ocular health and distance
and near visual acuity, additional evaluations of
visual skills such as eye teaming, focusing and
tracking that may impact a child's ability to read.
AB 1095 was held in the Senate Appropriations
Committee's suspense file.
AB 1096 (Wright, 2001) would have established a pilot
program for schools scoring in the bottom 20% on state
achievement tests, to administer to poor readers a
comprehensive eye screening and remedial vision
training. AB 1096 died on the Senate Floor's inactive
file.
SB 606 (Vasconcellos, 2001) would have required the
existing student eye examination to include screening
for binocular function, ocular alignment, ocular
motility, and near visual acuity. SB 606 was held on
the Assembly Appropriations Committee's suspense file.
SUPPORT
California Academy of Eye Physicians & Surgeons
OPPOSITION
None on file.