BILL ANALYSIS                                                                                                                                                                                                    Ó




                   Senate Appropriations Committee Fiscal Summary
                            Senator Kevin de León, Chair


          SB 1172 (Steinberg) - Pupil Health: Vision Appraisals
          
          Amended: April 23, 2014         Policy Vote: Education
          Urgency: No                     Mandate: Yes
          Hearing Date: May 12, 2014      Consultant: Jacqueline  
          Wong-Hernandez
          
          This bill meets the criteria for referral to the Suspense File. 
          
          Bill Summary: SB 1172 requires school vision appraisals to  
          include tests for near vision, and expands current requirements  
          (in scope and frequency) 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.

          Fiscal Impact: 
              Vision testing requirements: Potentially substantial  
              reimbursable mandate to increase the number of required  
              vision tests, and the scope of those tests.
              Continual monitoring: The requirement for "continual and  
              regular observation of the pupil's eyes" by teachers and  
              school nurses could result in significant local costs, and  
              could be an additional reimbursable mandate to the extent  
              that costs could be proven. 

          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 (COE) 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)

          Non-medical certificated employees of a school district or COE  
          may be authorized to give vision tests if the employee meets  
          specified requirements.








          SB 1172 (Steinberg)
          Page 1



          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  
          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)

          A report must 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)
          Proposed Law: 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.  
          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.

          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, and grades 2, 5 and 8.  

          4)   Requires the California Department of Education (CDE) to  
               adopt guidelines to implement this bill, including training  
               requirements and a method of testing for near vision.

          Related Legislation: SB 430 (Wright) requires a pupil to receive  
          a vision examination from a physician, optometrist, or  








          SB 1172 (Steinberg)
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          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.

          Staff Comments: This bill expands vision testing requirements,  
          including an increased minimum number of screenings, likely  
          resulting in a significant reimbursable state mandate on school  
          districts. Current law requires specified personnel to  
          administer vision screenings upon a student's enrollment, and  
          then at least every third year through 8th grade. For a student  
          who enrolls in kindergarten, the screening requirement would be,  
          minimally: kindergarten, 3rd grade, and 6th grade, for a total  
          of 3 administrations. This bill requires screenings "during the  
          kindergarten year or upon first enrollment or entry in a  
          California school district of a pupil?and in grades 2, 5, and  
          8," which (for any student enrolling before 2nd grade) would  
          require a minimum of 4 administrations. This bill also expands  
          the scope of the vision screenings to include near vision. If  
          each of the more than 1,000 school districts statewide claimed  
          even the $1,000 minimum mandate claim to conduct additional (and  
          more extensive) vision screenings, state costs would exceed $1  
          million.

          This bill also requires "continual and regular observation of  
          the pupil's eyes" by teachers and school nurses. What  
          constitutes continual and regular observation is unclear, but it  
          is reasonable to consider that to be more than once in a school  
          year. This creates cost pressure to employ additional school  
          nurses to observe pupils' eyes, as well as pressure on a  
          teacher's time. To the extent that costs could be proven, this  
          requirement could constitute an additional reimbursable mandate.