[Congressional Record Volume 154, Number 150 (Monday, September 22, 2008)]
[Senate]
[Pages S9210-S9212]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. DODD (for himself and Mr. Voinovich):
  S. 3534. A bill to provide for the expansion of Federal programs to 
prevent and manage vision loss, and for other purposes; to the 
Committee on Health, Education, Labor, and Pensions.
  Mr. DODD. Mr. President, I rise today to introduce the Vision 
Preservation Act of 2008 with my colleague Sen. George Voinovich. The 
goal of this legislation is to help Americans avoid the personal 
tragedy of unnecessary, preventable vision loss. This important 
legislation is supported by Prevent Blindness America, the American 
Foundation for the Blind, the American Academy of Ophthalmology, and 
the American Optometric Association
  Right now there are an estimated 80 million Americans suffering from 
potentially blinding eye disease. Three million more Americans struggle 
with low vision. 1.1 million more are legally blind. Glaucoma, diabetic 
retinopathy, cataract and age-related macular degeneration, AMD, and 
other vision problems are costing tens of thousands of people in the 
United States their ability to see each year. With the aging baby boom 
generation moving toward retirement age, these numbers are expected to 
grow considerably. It is estimated that by 2030, the number of blind 
and visually impaired people will double if nothing is done.
  Unsurprisingly, ``The Economic Impact of Vision Problems: The Toll of 
Major Adult Eye Disorders, Visual Impairment, and Blindness on the U.S. 
Economy,'' a study conducted by Prevent Blindness America, reveals that 
vision loss carries significant cost to individuals, private insurers, 
health care providers, and the Federal government. The study indicates 
that the direct and indirect costs of vision loss among adults are 
$51.4 billion. And over a lifetime, the cost for just one

[[Page S9211]]

person dealing with this terrible condition is $566,000. The lifetime 
costs associated with just those Americans born with vision loss in 
2000 is $2.5 billion.
  But what makes vision loss even more tragic is that half of all 
blindness is preventable if action is taken soon enough. There are many 
health and financial challenges our nation is facing that we may just 
have to weather. But here is one we can do something about--and we 
should. That is why Sen. Voinovich and I are introducing the Vision 
Preservation Act. This legislation would improve and strengthen 
important public health programs at the Centers for Disease Control and 
Prevention, the National Institutes of Health, and the Health Resources 
and Services Administration, HRSA. Specifically, it would expand 
existing public education and awareness efforts to empower Americans to 
do what is necessary to protect their own vision. This legislation 
would also incorporate vision screening, prevention, and rehabilitation 
into the Maternal and Child Health Block Grants and the Community 
Health Centers so low income Americans who are most likely to go 
without needed prevention and screening can be alerted to the early 
warning signs of vision loss. It would improve the training and 
education of health professionals so that they are better prepared to 
help their patients identify and deal with conditions that could lead 
to vision loss.
  These are simple steps that we in the Senate can take to help make 
sure that millions of Americans can live without fear of losing their 
sight. I urge my colleagues to join us in supporting this legislation.
  Mr. President, I ask unanimous consent that the text of the bill and 
a letter of support be printed in the Record.
  There being no objection, the material was ordered to be printed in 
the Record, as follows:

                                S. 3534

       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 Preservation Act of 
     2008''.

     SEC. 2. FINDINGS; SENSE OF CONGRESS.

       (a) Findings.--The Congress finds as follows:
       (1) An estimated 80 million Americans have a potentially 
     blinding eye disease, and more than 19.1 million Americans 
     report trouble seeing, even with eye glasses or contacts. At 
     least 1.1 million Americans are legally blind, and 200,000 
     Americans experience profound vision loss. Refractive errors 
     affect approximately one third of persons 40 years or older 
     in the United States. Visual impairment is one of the 10 more 
     frequent causes of disability in the United States.
       (2) While it is believed that half of all blindness can be 
     prevented, the number of Americans who are blind or visually 
     impaired is expected to double by 2030.
       (3) Vision loss can, especially without appropriate 
     rehabilitation and skills training, significantly impact an 
     individual's ability to conduct activities of daily living, 
     as well as developmental learning, communicating, working, 
     health, and quality of life.
       (4) One in twenty preschoolers experience visual impairment 
     which, if unaddressed, can affect learning ability, 
     personality, and adjustment in school.
       (5) It is estimated that blindness and visual impairment 
     cost the Federal Government more than $4 billion annually in 
     benefits and lost taxable income, and cost the United States 
     economy approximately $51.4 billion annually in direct 
     medical costs, direct non medical costs, and indirect costs 
     such as lost productivity and wages.
       (6) Vision rehabilitation helps people with vision loss to 
     live safely and independently at home and in the community, 
     reduce medication errors, cook and perform other daily 
     activities reliably, and avoid accidents which may lead to 
     injury or even the onset of additional disabilities, 
     especially among older persons living with vision loss.
       (7) Recognizing that the Nation requires a public health 
     approach to visual impairment, the Department of Health and 
     Human Services dedicated a portion of its Healthy People 2010 
     initiative to vision. The initiative set out as a goal the 
     improvement of the Nation's visual health through prevention, 
     early detection, treatment, and rehabilitation.
       (8) Greater efforts must be made at the Federal, State, and 
     local levels to increase awareness of vision loss and its 
     causes, its impact, the importance of early diagnosis, 
     treatment, and rehabilitation, and effective prevention 
     strategies.
       (b) Sense of Congress.--It is the sense of the Congress 
     that the Nation must have a full-scale integrated public 
     health strategy to comprehensively address vision loss and 
     its causes that, at a minimum, includes the following:
       (1) Communication and education.
       (2) Surveillance, epidemiology, and prevention research.
       (3) Programs, policies, and systems change.

     SEC. 3. VISION LOSS PREVENTION.

       Part B of title III of the Public Health Service Act (42 
     U.S.C. 243 et seq.) is amended by inserting after section 
     317S the following:

     ``SEC. 317T. PREVENTIVE HEALTH MEASURES WITH RESPECT TO 
                   VISION LOSS.

       ``(a) Communication and Education.--
       ``(1) In general.--The Secretary, acting through the 
     Centers for Disease Control and Prevention, the Health 
     Resources and Services Administration, and the National 
     Institutes of Health, shall expand and intensify programs to 
     increase awareness of vision problems, including awareness 
     of--
       ``(A) the impact of vision problems; and
       ``(B) the importance of early diagnosis, management, and 
     effective prevention and rehabilitation strategies.
       ``(2) Activities.--In carrying out this subsection, the 
     Secretary may--
       ``(A) conduct public service announcements and education 
     campaigns;
       ``(B) enter into partnerships with eye-health professional 
     organizations and other vision-related organizations;
       ``(C) conduct community disease prevention campaigns;
       ``(D) conduct testing, evaluation, and model training for 
     vision screeners based on scientific studies; and
       ``(E) evaluate strategies to reduce barriers to access to 
     treatment by optometrists and ophthalmologists.
       ``(3) Evaluation.--In carrying out this subsection, the 
     Secretary shall--
       ``(A) establish appropriate measurements for public 
     awareness of vision problems;
       ``(B) establish appropriate measurements to determine the 
     effectiveness of existing campaigns to increase awareness of 
     vision problems;
       ``(C) establish quantitative benchmarks for determining the 
     effectiveness of activities carried out under this 
     subsection; and
       ``(D) not later than 12 months after the date of the 
     enactment of this section, submit a report to the Congress on 
     the results achieved through such activities.
       ``(b) Surveillance, Epidemiology, and Health Services 
     Research.--
       ``(1) In general.--The Secretary shall expand and intensify 
     activities to establish a solid scientific base of knowledge 
     on the prevention, control, and rehabilitation of vision 
     problems and related disabilities.
       ``(2) Activities.--In carrying out this subsection, the 
     Secretary may--
       ``(A) create a national ongoing surveillance system;
       ``(B) identify and test screening modalities;
       ``(C) evaluate strategies to reduce barriers to access to 
     treatment by optometrists, ophthalmologists, and other vision 
     rehabilitation professionals;
       ``(D) evaluate the efficacy and cost-effectiveness of 
     current and future interventions and community strategies;
       ``(E) update and improve knowledge about the true costs of 
     vision problems and related disabilities; and
       ``(F) require the Surgeon General to assess the state of 
     vision care and vision rehabilitation in the United States.
       ``(c) Programs, Policies, and Systems.--
       ``(1) In general.--The Secretary shall expand and intensify 
     research within the Centers for Disease Control and 
     Prevention on the prevention and management of vision loss.
       ``(2) Activities.--In carrying out this subsection, the 
     Secretary may--
       ``(A) build partnerships with voluntary health 
     organizations, nonprofit vision rehabilitation agencies, 
     Federal, State, and local public health agencies, eye health 
     professional organizations, and organizations with an 
     interest in vision issues;
       ``(B) work with health care systems to better address 
     vision problems and associated disabilities; and
       ``(C) award grants for community outreach regarding vision 
     loss to health care institutions and national vision 
     organizations with broad community presence.''.

     SEC. 4. EXPANSION OF VISION PROGRAMS UNDER THE MATERNAL AND 
                   CHILD HEALTH SERVICE BLOCK GRANT PROGRAM.

       Section 501(a)(3) of the Social Security Act (42 U.S.C. 
     701(a)(3)) is amended--
       (1) by striking ``and'' at the end of subparagraph (E);
       (2) by striking the period at the end of subparagraph (F) 
     and inserting ``, and''; and
       (3) by adding at the end the following new subparagraph:
       ``(G) introduce core performance measures on eye health by 
     incorporating vision screening and examination standards into 
     State programs under this title, based on scientific 
     studies.''.

     SEC. 5. PREVENTION AND TREATMENT FOR UNDERSERVED, MINORITY, 
                   AND OTHER POPULATIONS.

       (a) Expansion and Intensification of Vision Programs.--The 
     Secretary of Health and Human Services (in this section 
     referred to as the ``Secretary'') shall expand and intensify 
     programs targeted to prevent vision loss, treat eye and 
     vision conditions, and rehabilitate people of all ages who 
     are blind or partially sighted in underserved and minority 
     communities, including the following:
       (1) Vision care services at community health centers 
     receiving assistance under section 330 of the Public Health 
     Service Act (42 U.S.C. 254b).
       (2) Vision rehabilitation programs at vision rehabilitation 
     agencies, eye clinics, and hospitals.

[[Page S9212]]

       (b) Voluntary Guidelines for Vision Screening.--The 
     Secretary, in consultation with eye-health professional 
     organizations and other vision-related organizations, shall 
     develop voluntary guidelines to ensure the quality of vision 
     screening and appropriate referral for comprehensive eye 
     examinations and subsequent vision rehabilitation services.

     SEC. 6. VISION REHABILITATION PROFESSIONAL DEVELOPMENT 
                   GRANTS.

       (a) Authority.--The Secretary of Health and Human Services 
     (in this section referred to as the ``Secretary'') may make 
     grants to eligible institutions of higher education or 
     nonprofit organizations for the purpose of activities 
     described in subsection (b) relating to vision rehabilitation 
     professional development.
       (b) Use of Funds.--The Secretary may not make a grant to an 
     institution of higher education or a nonprofit organization 
     under this section unless the institution or organization 
     agrees to use the grant for the following:
       (1) Developing and offering preparatory and continuing 
     education training opportunities (incorporating state-of-the-
     art approaches, technologies, and therapies to meet the 
     unique needs of older adults with vision loss) in--
       (A) geriatrics among vision rehabilitation professionals, 
     including professionals in the vision rehabilitation therapy, 
     orientation and mobility, and low vision therapy fields; and
       (B) vision rehabilitation among occupational therapists and 
     others in related rehabilitation and health disciplines.
       (2) Conducting, and disseminating the findings and 
     conclusions of, research on the effectiveness of preparatory 
     and continuing education training under paragraph (1).
       (3) Developing and disseminating interdisciplinary course 
     curricula for use in the preparation of new professionals in 
     vision rehabilitation, occupational therapy, and related 
     rehabilitation and health disciplines.
       (4) Educating physicians, nurses, and other health care 
     providers about the value of vision rehabilitation, to 
     increase appropriate referral by such professionals for the 
     full range of vision rehabilitation services available to 
     older individuals with vision loss.
       (c) Eligibility.--To be eligible to receive a grant under 
     this section, an entity shall be a university, academic 
     medical center, national or regional nonprofit organization, 
     community rehabilitation provider, or allied health education 
     program, or a consortium of such entities, that--
       (1) offers or coordinates education or training activities 
     among professionals described in subsection (b)(1); or
       (2) agrees to use the grant to expand its capacity to 
     coordinate such activities.
       (d) Distribution of Grants.--In awarding grants under this 
     section, the Secretary shall ensure that grantees offer or 
     coordinate training for current and emerging professionals--
       (1) from a variety of geographic regions and a range of 
     different types and sizes of settings and facilities, 
     including settings and facilities located in rural, urban, 
     and suburban areas; and
       (2) serving a variety of populations of older individuals 
     with vision loss, including racial and ethnic minorities, 
     low-income individuals, and other underserved populations.
       (e) Application.--To seek a grant under this section, an 
     entity shall submit to the Secretary an application at such 
     time, in such manner, and containing such information as the 
     Secretary may require.
                                  ____



                              American Optometric Association,

                               Alexandria, VA, September 19, 2008.
     Hon. Chris Dodd,
     U.S. Senate,
     Washington, DC.
       Dear Senator Dodd: The American Optometric Association 
     (AOA), representing over 36,000 doctors of optometry who are 
     the frontline providers of eye and vision care, optometric 
     researchers, educators and optometry students, deeply 
     appreciates your continued outstanding leadership on priority 
     eye and vision care issues before Congress.
       With that in mind, it is my pleasure to inform you that the 
     AOA wholly endorses and will be working to pass the Vision 
     Preservation Act of 2008, legislation you have crafted to 
     strengthen federal vision programs designed to prevent and 
     manage vision loss.
       Vision impairments are a growing problem in the US--
     particularly with the aging of the babyboomer generation. 
     Approximately 80 million Americans have a potentially 
     blinding eye disease such as diabetic retinopathy, glaucoma, 
     cataract, and age-related macular degeneration. If we fail to 
     take decisive action, the number of blind and visually 
     impaired Americans will double in the next 25 years, even 
     though half of all blindness is preventable.
       By introducing the Vision Preservation Act, you are 
     providing important leadership on vision-related programs and 
     policies at the federal level. This bill's focus on 
     increasing public awareness about vision problems, bolstering 
     research at the National Eye Institute, and improving access 
     to vision care at Federally-Qualified Health Centers, the 
     Maternal and Child Health Bureau, and under the Medicaid 
     program are key components that optometry and others in the 
     vision community are completely united behind.
       As the Vision Preservation Act of 2008 is considered, be 
     assured that we will continue to work with you and your 
     colleagues in Congress to place maximum emphasis on early 
     identification of those individuals at risk for vision loss 
     and need access to quality care.
       If we can be of any assistance on this legislation, or any 
     other vision related questions, please contact Alicia Kerry 
     Jones.
           Sincerely,
                                            Michele Haranin, O.D.,
                           Chair, AOA Federal Relations Committee.

     

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