[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.
____________________