[Congressional Record Volume 153, Number 155 (Monday, October 15, 2007)]
[House]
[Pages H11527-H11530]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              {time}  1730
                    VISION CARE FOR KIDS ACT OF 2007

  Ms. BALDWIN. Madam Speaker, I move to suspend the rules and pass the 
bill (H.R. 507) to establish a grant program to provide vision care to 
children, and for other purposes, as amended.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                                H.R. 507

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Vision Care for Kids Act of 
     2007''.

     SEC. 2. FINDINGS.

       Congress makes the following findings:
       (1) Millions of children in the United States suffer from 
     vision problems, many of which go undetected. Because 
     children with vision problems can struggle developmentally, 
     resulting in physical, emotional, and social consequences, 
     good vision is essential for proper physical development and 
     educational progress.
       (2) Vision problems in children range from common 
     conditions such as refractive errors, amblyopia, strabismus, 
     ocular trauma, and infections, to rare but potentially life- 
     or sight-threatening problems such as retinoblastoma, 
     infantile cataracts, congenital glaucoma, and genetic or 
     metabolic diseases of the eye.
       (3) Since many serious ocular conditions are treatable if 
     identified in the preschool and early school-age years, early 
     detection provides the best opportunity for effective 
     treatment and can have far-reaching implications for vision.
       (4) Various identification methods, including vision 
     screening and comprehensive eye examinations required by 
     State laws, can be helpful in identifying children needing 
     services. A child identified as needing services through 
     vision screening should receive a comprehensive eye 
     examination followed by subsequent treatment as needed. Any 
     child identified as needing services should have access to 
     subsequent treatment as needed.
       (5) There is a need to increase public awareness about the 
     prevalence and devastating consequences of vision disorders 
     in children and to educate the public and health care 
     providers about the warning signs and symptoms of ocular and 
     vision disorders and the benefits of early detection, 
     evaluation, and treatment.

     SEC. 3. GRANTS REGARDING VISION CARE FOR CHILDREN.

       (a) In General.--The Secretary of Health and Human Services 
     (referred to in this section as the ``Secretary''), acting 
     through the Director of the Centers for Disease Control and 
     Prevention, may award grants to States on the basis of an 
     established review process for the purpose of complementing 
     existing State efforts for--
       (1) providing comprehensive eye examinations by a licensed 
     optometrist or ophthalmologist for children who have been 
     previously identified through a vision screening or eye 
     examination by a licensed health care provider or vision 
     screener as needing such services, with priority given to 
     children who are under the age of 9 years;
       (2) providing treatment or services, subsequent to the 
     examinations described in paragraph (1), necessary to correct 
     vision problems; and
       (3) developing and disseminating, to parents, teachers, and 
     health care practitioners, educational materials on 
     recognizing signs of visual impairment in children.
       (b) Criteria and Coordination.--
       (1) Criteria.--The Secretary, in consultation with 
     appropriate professional and patient organizations including 
     individuals with knowledge of age appropriate vision 
     services, shall develop criteria--
       (A) governing the operation of the grant program under 
     subsection (a); and
       (B) for the collection of data related to vision assessment 
     and the utilization of follow-up services.
       (2) Coordination.--The Secretary shall, as appropriate, 
     coordinate the program under subsection (a) with the program 
     under section 330 of the Public Health Service Act (relating 
     to health centers) (42 U.S.C. 254b), the program under title 
     XIX of the Social Security Act (relating to the Medicaid 
     program) (42 U.S.C. 1396 et

[[Page H11528]]

     seq.), the program under title XXI of such Act (relating to 
     the State children's health insurance program) (42 U.S.C. 
     1397aa et seq.), and with other Federal or State programs 
     that provide services to children.
       (c) Application.--To be eligible to receive a grant under 
     subsection (a), a State shall submit to the Secretary an 
     application in such form, made in such manner, and containing 
     such information as the Secretary may require, including--
       (1) information on existing Federal, Federal-State, or 
     State-funded children's vision programs;
       (2) a plan for the use of grant funds, including how funds 
     will be used to complement existing State efforts (including 
     possible partnerships with non-profit entities);
       (3) a plan to determine if a grant eligible child has been 
     identified as provided for in subsection (a); and
       (4) a description of how funds will be used to provide 
     items or services, only as a secondary payer--
       (A) for an eligible child, to the extent that the child is 
     not covered for the items or services under any State 
     compensation program, under an insurance policy, or under any 
     Federal or State health benefits program; or
       (B) for an eligible child, to the extent that the child 
     receives the items or services from an entity that provides 
     health services on a prepaid basis.
       (d) Evaluations.--To be eligible to receive a grant under 
     subsection (a), a State shall agree that, not later than 1 
     year after the date on which amounts under the grant are 
     first received by the State, and annually thereafter while 
     receiving amounts under the grant, the State will submit to 
     the Secretary an evaluation of the operations and activities 
     carried out under the grant, including--
       (1) an assessment of the utilization of vision services and 
     the status of children receiving these services as a result 
     of the activities carried out under the grant;
       (2) the collection, analysis, and reporting of children's 
     vision data according to guidelines prescribed by the 
     Secretary; and
       (3) such other information as the Secretary may require.
       (e) Limitations in Expenditure of Grant.--A grant may be 
     made under subsection (a) only if the State involved agrees 
     that the State will not expend more than 20 percent of the 
     amount received under the grant to carry out the purpose 
     described in paragraph (3) of such subsection.
       (f) Matching Funds.--
       (1) In general.--With respect to the costs of the 
     activities to be carried out with a grant under subsection 
     (a), a condition for the receipt of the grant is that the 
     State involved agrees to make available (directly or through 
     donations from public or private entities) non-Federal 
     contributions toward such costs in an amount that is not less 
     than 25 percent of such costs.
       (2) Determination of amount contributed.--Non-Federal 
     contributions required in paragraph (1) may be in cash or in 
     kind, fairly evaluated, including plant, equipment, or 
     services. Amounts provided by the Federal Government, or 
     services assisted or subsidized to any significant extent by 
     the Federal Government, may not be included in determining 
     the amount of such non-Federal contributions.
       (g) Definition.--For purposes of this section, the term 
     ``comprehensive eye examination'' includes an assessment of a 
     patient's history, general medical observation, external and 
     ophthalmoscopic examination, visual acuity, ocular alignment 
     and motility, refraction, and as appropriate, binocular 
     vision or gross visual fields, performed by an optometrist or 
     an ophthalmologist.
       (h) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there is authorized to be 
     appropriated $65,000,000 for the period of fiscal years 2009 
     through 2013.
  The SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from 
Wisconsin (Ms. Baldwin) and the gentleman from New York (Mr. Fossella) 
each will control 20 minutes.
  The Chair recognizes the gentlewoman from Wisconsin.


                             General Leave

  Ms. BALDWIN. Madam Speaker, I ask unanimous consent that all Members 
have 5 legislative days to revise and extend their remarks and include 
extraneous material on the bill under consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from Wisconsin?
  There was no objection.
  Ms. BALDWIN. Madam Speaker, I yield myself such time as I may 
consume.
  Madam Speaker, I rise in support of H.R. 507, the Vision Care for 
Kids Act of 2007.
  A small but significant portion of children have visual impairments. 
It is estimated that vision impairment affects approximately 1.2 out of 
every 1,000 8-year-olds. When detected early, many childhood vision 
abnormalities are treatable, but the potential for correction and 
normal visual development diminishes with age. Vision problems can 
occur at any point during a lifetime, but tend to be particularly 
damaging to school-age children.
  Impaired vision can result in adverse physical, emotional, and social 
consequences. For instance, a child may miss learning opportunities by 
failing to explore his or her environment. Additionally, if a child is 
visually impaired, he or she may be unable to imitate social behavior 
or understand nonverbal cues.
  Early recognition of eye disease results in more effective treatment 
and that can be sight saving and sometimes even life saving. Yet, many 
children under the age of five do not receive any vision screening at 
all.
  The Vision Care for Kids Act of 2007 would authorize a grant program 
to provide comprehensive eye exams for uninsured children with vision 
disorders, with priority for children under the age of 9. Funds would 
be used for treatment and services to correct vision disorders 
identified through eye exams and to increase public awareness of visual 
impairment in children. H.R. 507 would require States receiving funds 
to contribute a 25 percent match of funds for each Federal dollar 
obtained through the program.
  The bill before us today makes great strides in providing access to 
an array of vision-related services, including vision screening 
services that can help uninsured children in low- to moderate-income 
families.
  I want to thank my colleagues for their commitment and strong support 
of this legislation, and particularly commend my dear friend and 
colleague, Representative Gene Green, for his unwavering dedication to 
this issue.
  I urge my colleagues to support this vital and important legislation.
  Madam Speaker, I reserve the balance of my time.
  Mr. FOSSELLA. Madam Speaker, I rise in support of H.R. 507, the 
Vision Care for Kids Act, and join my colleague in asking for its 
adoption.
  And at the outset, let me thank a few individuals for bringing this 
bill to the floor: of course, Chairman Dingell and Ranking Member 
Barton. I'd also like to thank Representatives Green, Sullivan, and 
Engel for their leadership and support in bringing the Vision Care for 
Kids Act to the floor, and Mr. Pascrell, who's been very, very 
passionate about this issue for many years. I've had the privilege and 
pleasure of working with him, and I know how passionate he is, like so 
many of us, to get quality vision care for kids who need it.
  We've been working on this bill for about 6 years; and after 
countless modifications, negotiations and compromise, I'm proud to say 
we have a bill that is unanimously supported by the entire vision 
community.
  And my colleague from Wisconsin put it very simply: there are many 
kids today who have problems with their eyes; who have an inability to 
see properly; who, if left untreated, obviously, leads to negative 
consequence in social interaction, not to mention their poor 
performance in school and academic achievement because of their 
inability to see, and not to mention the fact that they're not getting 
the appropriate care that in some cases leads to greater illnesses and 
in some cases leads to death.
  The legislation we hope to pass today represents the kind of quality, 
sound public policy that can only come about through the bipartisan 
cooperation and a willingness to compromise by many interested parties.
  H.R. 507 represents a responsible and sensible approach to public 
health. It's well documented that without the adequate access to vision 
screening and treatment for eye disorders, a child's entire learning 
and development can be adversely affected. And we say that for children 
who do not qualify for a public program and did not have health 
insurance, our assisting in catching potentially eye disorders is 
critical.
  The bill strikes an effective balance with a shared relationship 
between Federal and State governments. Once States have identified, 
through the screening mechanism of their choice, that a child may have 
an eye disorder, this legislation will provide Federal funding for 
follow-up comprehensive eye exam and the necessary treatment.
  By incorporating a three-to-one Federal-State match, we maintain 
incentives for States to run their programs efficiently, providing 
additional assurances to taxpayers that we're maximizing the use of 
each dollar spent.
  I'd like to thank the American Academy of Ophthalmology, the Vision 
Council of America, Prevent Blindness

[[Page H11529]]

of America, the American Optometric Association for their support of 
the legislation, that of my colleague, and know full well that if this 
bill does become law, there will be children who currently don't have 
access to quality treatment that will get the treatment they deserve 
and need so that they can live a more full and healthy and happy life.
  Madam Speaker, I reserve the balance of my time.
  Ms. BALDWIN. Madam Speaker, I am delighted to yield 5 minutes to the 
gentleman from New Jersey (Mr. Pascrell), a passionate advocate of this 
legislation.
  Mr. PASCRELL. Madam Speaker, I want to thank the gentlelady from 
Wisconsin (Ms. Baldwin), who is a model of sensitivity to the needs of 
all of our children.
  I want to thank Congressman Fossella, who's been at the forefront of 
this.
  Madam Speaker, I rise today regarding an issue that has long been 
near to my heart. I've been listening to these other bills that have 
been put forth in bipartisan fashion. This is a good example of what we 
can do together when it comes to our children, their health care and 
their education. This is critical. This is important. So anybody who 
says we can't do it is not listening today.
  I also want to thank Chairman Dingell, Chairman Pallone for their 
thoughtful consideration and support for preventive vision care for 
children. Many a kid has been put in the back of the class or sent out 
of the room because it was misinterpreted, misunderstood, and many 
times, that child had a problem with vision, with seeing and was too 
embarrassed to say so, or couldn't recognize it within himself. So 
preventive vision care is critically important to avoid vision loss and 
blindness in our Nation's children.
  Untreated vision problems can affect a child's physical, educational, 
and emotional development. That is why for many years, as my good 
friend from Staten Island has pointed out, we have fought for 
legislation to set up a grant program to provide comprehensive eye 
exams and the necessary follow-up care for children whose families do 
not have the resources or access to such care.
  The Center for Disease Control states that approximately 1.8 million 
children under the age of 18 are blind or have some form of visual 
impairment. Fortunately, vision loss can be avoided with early 
diagnosis and treatment. That is not so revealing, is it? On any such 
disease, early vision, early problems affecting vision, early problems 
affecting hearing, early problems of detection of teeth, et cetera, et 
cetera, many of these visual deficits are caught only after they have 
impaired the child's early and most critical education. That's the rub.
  Eye health has a direct impact on learning and achievement. That's 
the core of the fight that we have waged. It is a national disgrace, 
Madam Speaker, that only one in three children receive preventive 
vision care before they are enrolled in elementary school. That's not 
acceptable.
  So I'm pleased to introduce this, along with Congressman Gene Green, 
and there are many others that we need to salute here who have fought 
this fight with us, and that is Representative Ileana Ros-Lehtinen, 
Representative John Boozman. Senator Kit Bond on the other side of the 
building has waged that fight over there. A truly bipartisan effort.
  It's so easy. I know it's difficult for us as Congressmen to 
understand that, including myself. But it's so easy that we can come 
together when the problem is defined and we can work together, together 
on a solution.
  Here's a perfect example. The seven bills, the eight bills that we 
just have gone through, Commerce, these affect people's lives. They're 
not esoteric. They're not up in the sky someplace. These affect people.
  H.R. 507 will establish a Federal grant program to provide for timely 
diagnostic examination, treatment and follow-up vision care for 
children.
  This legislation will complement existing State programs and allow 
eye exams for a vulnerable pediatric population that does not qualify 
for Medicaid and does not qualify for SCHIP and do not have access to 
private health insurance. Critical that we understand this. Very 
important here. Very significant for those families.
  Better eye care will significantly mitigate the effects of visual 
impairment. So it's important to act now, Madam Speaker. The prevention 
is more than half the battle.
  Madam Speaker, I urge my colleagues to vote in favor of the Vision 
Care for Kids Act. Kids out there are waiting for us in all 50 States 
to act on this.
  Thank you, Mr. Fossella. Thank you to my good friend, the gentlelady 
from Wisconsin. And I think that we've hit a home run here for the last 
hour and a half, thanks to you both.
  Mr. FOSSELLA. Madam Speaker, I continue to reserve the balance of my 
time.
  Ms. BALDWIN. Madam Speaker, I am pleased to yield 4 minutes to the 
lead author of this bill, the gentleman from Texas (Mr. Gene Green).
  Mr. GENE GREEN of Texas. Madam Speaker, I'd like to thank my 
colleague on our Energy and Commerce Committee and Health Subcommittee 
for allowing me to rush in from the airport to be able to put a 
statement on this bill.
  I rise, obviously, in support of H.R. 507, the Vision Care for Kids 
Act. This bill has been crafted in a very bipartisan fashion with the 
leadership of my colleagues, Mr. Fossella, Mr. Pascrell, Mr. Sullivan, 
Mr. Engel, and Ms. Ros-Lehtinen. I'd like to thank them for their 
dedication to children's vision issues in this legislation in 
particular.
  The Vision Care for Kids Act establishes a much-needed grant program 
to provide follow-up vision care to uninsured children with vision 
disorders. As we tried to target the program to the children most in 
need, we learned very quickly that a child's access to vision screening 
and comprehensive vision care varies widely depending on individual 
State laws. For example, some States have no vision screening 
requirements, whereas 30 States currently mandate vision screening. 
Twenty-eight of these States with screening mandates, however, do not 
have or offer any guarantee that children who fail the screening will 
receive a follow-up eye exam.
  On a nationwide basis, as many as 80 percent of the children who fail 
a vision screening do not get the follow-up care they need. Among the 
parents of these children, 25 percent cite financial constraints as a 
primary reason their child does not receive important follow-up care 
more than any other factor influencing their lack of care.
  This lack of vision care jeopardizes a child's development and can 
unfortunately lead to lifelong vision impairment. These children 
deserve a healthy start to their educational and social development, 
yet the reality is that nearly two of three children entering 
elementary school have never received preventive vision care. 
Unfortunately, the lack of health experience presents a barrier to the 
delivery of appropriate vision care in this country. For many children 
who are lucky enough to have health insurance for medical care, their 
policy doesn't cover vision coverage. This is precisely why this bill 
is necessary.

                              {time}  1745

  By targeting the program toward children who are school age, 
uninsured, and at risk for vision disorders, the bill is designed to 
spend scarce health care dollars in the wisest manner possible. A 
portion of the grant funds will also be used to increase education and 
awareness of vision disorders so that the warning signs can be 
recognized and any problems can be detected in a timely fashion.
  During the committee consideration of this legislation, we made 
several changes in the underlying bill. Specifically, we clarified that 
the Secretary should consult with professional and patient 
organizations when developing the criteria associated with the grant 
program's operations and data collection. This amendment also specifies 
an authorization level of $65 million over 5 years and includes a 
State-matching requirement of 25 percent.
  The compromise could not have been developed without the dedication 
of key members of the vision community, including the American Academy 
of Ophthalmology, the American Optometric Association, the Vision 
Council of America, and Prevent Blindness America.

[[Page H11530]]

  As a founding member of the Congressional Vision Caucus, I am 
particularly pleased to see this bill on the House floor today and 
consider it a milestone for our very young caucus. In 2003, I joined my 
colleagues David Price, Ileana Ros-Lehtinen, and Pat Tiberi in 
establishing the Congressional Vision Caucus. Today the Vision Caucus 
is comprised of more than 100 Members of the House, both Republican and 
Democrat, House Members and Senators. While our initial goal was to 
raise the awareness of vision disorders in Congress, the caucus has 
developed and endorsed two key pieces of vision legislation, including 
the Vision Care for Kids Act before us today.
  It is particularly gratifying to see our efforts result in 
legislative success, and I thank the members of the Vision Caucus and 
the 152 cosponsors of this legislation for their support. I would also 
like to thank Chairman Dingell and Ranking Member Barton of the Energy 
and Commerce Committee, as well as the chairman and ranking member of 
the Health Subcommittee, Mr. Pallone and Mr. Deal, for their support of 
this legislation.
  And I would also like to thank John Ford and William Garner of the 
committee's majority staff for their expertise, as well as Ryan Long 
and Katherine Martin of the minority staff for their willingness to 
work with us in a bipartisan fashion on this legislation.
  With that, I encourage my colleagues to join us in passing this 
important bill to improve vision care for America's children.
  Mr. FOSSELLA. Madam Speaker, let me again, in closing, thank the 
sponsors, Mr. Green and, of course, Mr. Pascrell for really helping us 
to get to this point. I failed to mention Ms. Ros-Lehtinen before. She 
was instrumental as well, and Mr. Sullivan and Mr. Engel. Let me 
commend and thank my colleague Ms. Baldwin for her eloquence in 
shepherding all these bills to the floor.
  As it relates to this bill, early detection, early diagnosis, and 
early treatment, we know that those are the magical things that have to 
happen in order for a child to lead a more forward, healthy life. 
Without the access to the care that a child needs, we know that that 
life is going to be compromised in some way, shape, or form.
  I think that this bill helps to get us to that point. I think it will 
help a lot of children who currently have no help and no access.
  I would also like to thank Ryan McKee from my office, who has worked 
on this bill for several years in our efforts.
  Madam Speaker, I yield back the balance of my time.
  Ms. BALDWIN. Madam Speaker, in closing, visual impairments can have 
lifelong consequences for children. As we have heard, this bill will 
help identify these impairments early so that our kids can live up to 
their full potential. This bill and the others that preceded it are 
prime examples of bipartisan cooperation.
  I urge my colleagues to support this bill and those that have 
preceded it. And I also thank the gentleman from New York (Mr. 
Fossella) for his assistance in expeditiously, yet comprehensively, 
managing the nine vital important and bipartisan health bills that were 
before us this afternoon.
  Mr. MURPHY of Connecticut. Madam Speaker, I rise today in strong 
support of H.R. 507, the Vision Care for Kids Act of 2007.
  This issue is simple, Madam Speaker, kids can't learn if they can't 
see. Providing early vision screening for our nation's children will 
make sure they are all ready to learn when they enter school and the 
Vision Care for Kids Act will help provide states with the means to 
offer this important care.
  When I was in the Connecticut State Senate, I championed an 
initiative which made school-based vision screening a priority through 
the mandated reporting of pediatric vision screening on school health 
assessment forms. The passage of today's legislation will enhance my 
state's ability to enhance vision programs for children by providing a 
much needed federal stream of funding. Importantly, it will allow 
Connecticut's children to receive followup care when uninsured children 
are identified through my state's existing vision screening program.
  The passage of today's legislation is another example of how this 
Congress is actively working to provide health services to our nation's 
children. This week, as the House contemplates whether we should 
provide 10 million American children with health insurance through the 
SCHIP program, we should take today as an opportunity to affirm our 
commitment to comprehensive health screening and coverage for all 
American children.
  Madam Speaker, I urge all my colleagues to support H.R. 507 and yield 
back the balance of my time.
  Mr. CLYBURN. Madam Speaker, I rise today in strong support of H.R. 
507 Care for Kids Act of 2007. As you know, this bill would award 
grants to states to: (1) provide comprehensive eye examinations by a 
licensed optometrist or ophthalmologist for children identified by a 
licensed health care provider or vision screener, with priority to 
children under age nine; (2) provide treatment or services to correct 
vision problems of such children; and (3) develop and disseminate 
educational materials on recognizing signs of visual impairment in 
children.
  Madam Speaker, studies have shown that African-Americans were most 
likely to report that they do not have a regular eye care professional 
(21 percent). And Hispanics were least likely to have seen an eye care 
professional in the last year (43 percent).
  Madam Speaker, like many diseases, vision problems can 
disproportionately affect certain ethnic groups. For example, African-
Americans are five times more likely to have glaucoma, Hispanics are at 
the greatest risk for cataracts, and myopia or near-sightedness is much 
more common among Asians than other ethnic groups.
  But the story doesn't end there, a new study by University of 
Michigan pediatricians suggests that poor, uninsured, black and 
Hispanic children are getting the least vision care services in this 
country. In all, non-Hispanic and non-black children were 47 percent 
more likely than Hispanic children--and 59 percent more likely than 
black children--to have received eye care in the last year. In 
addition, the study showed that uninsured black or Hispanic children 
were less likely than uninsured children of other races or ethnicities 
to have corrective lenses.
  Madam speaker, we have to do better on providing care to these 
communities and giving these communities the healthcare professionals 
to deliverer such care. To date, the current enrollment percentages of 
African-American and Hispanic students in optometry school is dismal at 
best. In the United States, only 3.5 percent of currently enrolled 
optometry students are African American. Hispanics do not fare much 
better, when including the InterAmerican University of Puerto Rico, the 
enrollment of Hispanics in U.S. optometry schools and Canada is even 
lower than that of African Americans.
  So Madam Speaker while I strongly support this bill we must do more 
to address these disparities. Thus, the reason behind my outspoken wish 
to mandate vision care to the State Child Health Insurance Program 
(SCHIP) reauthorization. The lack of vision care for children can not 
be tolerated in this country and I look forward to working with the 
Congress in bringing this issue to the forefront of our debate around 
SCHIP.
  Ms. BALDWIN. Madam Speaker, I yield back the balance of my time.
  The SPEAKER pro tempore (Ms. Berkley). The question is on the motion 
offered by the gentlewoman from Wisconsin (Ms. Baldwin) that the House 
suspend the rules and pass the bill, H.R. 507, as amended.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill, as amended, was passed.
  A motion to reconsider was laid on the table.

                          ____________________