BILL ANALYSIS �
AB 1840
Page 1
ASSEMBLY THIRD READING
AB 1840 (Campos)
As Amended May 8, 2014
Majority vote
HEALTH 15-4 APPROPRIATIONS 13-4
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|Ayes:|Pan, Maienschein, |Ayes:|Gatto, Bocanegra, |
| |Ammiano, Gordon, Bonilla, | |Bradford, |
| |Bonta, Chesbro, Gomez, | |Ian Calderon, Campos, |
| |Gonzalez, Roger | |Eggman, Gomez, Holden, |
| |Hern�ndez, Lowenthal, | |Linder, Pan, Quirk, |
| |Waldron, Nazarian, | |Ridley-Thomas, Weber |
| |Ridley-Thomas, Wieckowski | | |
| | | | |
|-----+--------------------------+-----+--------------------------|
|Nays:|Ch�vez, Nestande, |Nays:|Bigelow, Donnelly, Jones, |
| |Patterson, Wagner | |Wagner |
| | | | |
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SUMMARY : Authorizes the use of an eye chart or any other
scientifically validated test to be used for pupil vision
screening performed in schools.
EXISTING LAW requires, upon first enrollment in a California
school district of a child at an elementary school, and at least
every third year thereafter until the child has completed the
eighth grade, the child's vision to be appraised by the school
nurse or other authorized person, as specified, and requires
results of the appraisal to be entered in the health record of
the pupil.
FISCAL EFFECT : According to the Assembly Appropriations
Committee, minor absorbable costs to the California Department
of Education (CDE) to develop or update guidelines. Workload
could be absorbed by the School Health Education Consultant in
CDE.
COMMENTS : According to the author, childhood vision disorders
are a prevalent and significant public health problem, yet there
is a significant lack of public awareness about the importance
of eye care in children and the inability of children to
recognize their own vision problems. The author asserts these
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problems are heightened in families from economically
disadvantaged backgrounds by financial hardship and lack of
access to appropriate medical care. The author states that this
bill will help broaden the accessibility to vision screenings
because any trained individual can utilize digital technology to
screen students, the results are immediate and digital, and the
results indicate whether or not a child would need a follow up
eye exam. More students in low-income, urban, and rural areas
would have access to this new digital technology to provide
accurate and quick results.
Photoscreening. According to the American Academy of Pediatrics
(AAP) policy statement, Use of Photoscreening for Children's
Vision Screening, photoscreening is a vision screening technique
used to screen for amblyogenic factors such as strabismus (lazy
eye) and significant refractive errors in one or both eyes in
children. Using a camera or video system, images of the
pupillary reflexes (reflections) are obtained. Other than
having to fixate on the appropriate target long enough for the
photoscreening, little cooperation is needed from the child.
Data is then analyzed by the evaluator. Children who do not
pass the test may be referred for a complete eye examination.
Photoscreening does not represent a single technique or piece of
equipment. Different optical systems can be used for
photoscreening. Each photoscreening system may have its own
advantages and disadvantages, and it appears that results
published in the literature for one system are not necessarily
valid for others. Studies performed by different investigators
using the same photoscreening apparatus may yield a wide range
of results. Likewise, it is not certain that data gathered
about different groups of children or different settings can be
extrapolated to other groups or settings. The AAP favors
additional research of the efficacy and cost-effectiveness of
photoscreening as a vision screening tool.
Vision screening in California's schools. A guide developed by
the CDE titled, "A Guide for Vision Testing in California Public
Schools," states that the only people authorized to conduct
vision tests include the following:
1)Medical practitioners, including a nurse, physician,
ophthalmologist, or optometrist who holds both a license from
the appropriate California board or agency, and a health and
development credential, a standard designated service
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credential with a specialization in health, a health services
credential as a school nurse, or a school nurse services
credential;
2)Certificated school district or county employees who hold a
teaching credential and are qualified by training, including
satisfactory completion of six hours of vision testing, or an
accredited college or university course in vision testing of
at least one semester unit; or,
3)Contracting agents who have met the training requirements
specified above and who have been authorized by the county
superintendent of schools in which the district is located to
perform the tests.
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. The Foundation
further argues that a few states, including Alabama, Florida,
and parts of New York have replaced eye charts with photo optic
scan cameras in school settings, which are quick, efficient,
reliable, and don't require medical professionals to complete
screenings.
The California School Nurses Organization (CSNO) opposes this
bill and writes that 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 argues that while children younger than four
years can benefit from instrument-based screening, for children
four to five years of age, photoscreening has not been shown to
be superior or inferior to visual acuity testing with the use of
vision charts. Finally, CSNO states that current law already
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 : Paula Villescaz / HEALTH / (916)
319-2097
AB 1840
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FN: 0003543