BILL ANALYSIS                                                                                                                                                                                                    �



                                                                  AB 1840
                                                                  Page  1

          Date of Hearing:   May 21, 2014

                        ASSEMBLY COMMITTEE ON APPROPRIATIONS
                                  Mike Gatto, Chair

                     AB 1840 (Campos) - As Amended:  May 8, 2014 

          Policy Committee:                              HealthVote:15-4

          Urgency:     No                   State Mandated Local Program:  
          No     Reimbursable:              No

           SUMMARY  

          This bill authorizes the use of an eye chart or any other  
          scientifically validated screening when appraising a child's  
          vision in school.  Adds a trained individual who meets  
          requirements established by the California Department of  
          Education (CDE) to the list of people authorized to provide  
          gross external observation of a child's eyes, visual performance  
          and perception. 

           FISCAL EFFECT   

          Minor absorbable costs to the CDE to develop or update  
          guidelines.  Workload could be absorbed by the School Health  
          Education Consultant in CDE.

           COMMENTS  :

           1)Purpose  . According to the author, while eye charts are a  
            long-standing and proven method, technology has advanced and  
            portable camera-like equipment has been invented that can  
            provide comprehensive and reliable analysis in seconds.  These  
            types of technologies can be used by any trained individual  
            and can provide a quick, mobile and accurate screening.  

           2)Background  . 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. Gross external observation of the child's eyes, visual  
            performance, and perception are to be done by the school nurse  
            and the classroom teacher. This bill also authorizes a trained  
            individual who meets requirements established by the  








                                                                  AB 1840
                                                                  Page  2

            California Department of Education (CDE) to provide the gross  
            external observation.

            The Healthier Kids Foundation of Santa Clara County  
            (Foundation) supports this bill and writes that one of the  
            most important visual skills for reading is the ability to  
            coordinate the two eyes together and that an eye chart helps  
            to test vision for distance but not how the eyes team  
            together.  Alabama, Florida, and parts of New York, for  
            example, have replaced eye charts with photo optic scan  
            cameras in school settings, which the Foundation state are  
            quick, efficient, reliable, and do not require medical  
            professionals to complete screenings.
             
          3)Opposition  . The California School Nurses Organization (CSNO)  
            expressed opposition to the previous version of the bill that  
            specifically allowed for screenings done by "scientifically  
            valid technology."  According to the American Academy of  
            Ophthalmology Instrument-Based Pediatric Vision Screening  
            Policy, evidence-based practice does not support the use of  
            instrument based screening in children older than five years  
            of age.  CSNO further states that photoscreening has not been  
            shown to be superior or inferior to visual acuity testing with  
            the use of vision charts.  CSNO further states that existing  
            law permits the use of alternative tests with children who,  
            because of age or special needs, are not able to be tested  
            with an optotype test. 


           Analysis Prepared by  :    Misty Feusahrens / APPR. / (916)  
          319-2081