[Congressional Record Volume 155, Number 53 (Monday, March 30, 2009)]
[House]
[Pages H4090-H4093]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    VISION CARE FOR KIDS ACT OF 2009

  Mr. PALLONE. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 577) 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. 577

       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 
     2009''.

     SEC. 2. GRANTS REGARDING VISION CARE FOR CHILDREN.

       Part Q of title III of the Public Health Service Act (42 
     U.S.C. 280h et seq.) is amended by adding at the end the 
     following:

     ``SEC. 399Z-1. GRANTS REGARDING VISION CARE FOR CHILDREN.

       ``(a) In General.--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 (as defined 
     in subsection (i)) by a licensed optometrist or 
     ophthalmologist for eligible children (as defined in 
     subsection (b)) 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;

[[Page H4091]]

       ``(2) providing treatment or services to such children, 
     subsequent to the examinations described in paragraph (1), 
     that are 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) Eligible Children.--
       ``(1) In general.--For purposes of this section, the term 
     `eligible child' means, with respect to an examination 
     described in paragraph (1) of subsection (a) or a treatment 
     or service described in paragraph (2) of such subsection and 
     with respect to a State, a child who is a low-income child 
     (as defined by the State) and who--
       ``(A) is not eligible for medical assistance under the 
     State plan under title XIX of such Act;
       ``(B) subject to paragraph (2)(A), is not eligible for 
     child health assistance under the State child health plan 
     under title XXI of the Social Security Act;
       ``(C) subject to paragraph (2)(B), does not have health 
     insurance coverage (as defined in section 2791) in the group 
     market or in the individual market (as such terms are defined 
     in such section) and is not a beneficiary or participant 
     under a group health plan (as defined in such section); and
       ``(D) is not receiving assistance under any State health 
     compensation program or under any other Federal or State 
     health benefits program for such examination, treatment, or 
     service, respectively.
       ``(2) Inclusion of certain low-income children with health 
     benefits.--With respect to an examination described in 
     paragraph (1) of subsection (a) or a treatment or service 
     described in paragraph (2) of such subsection and with 
     respect to a State--
       ``(A) paragraph (1)(B) shall not apply to a child who is 
     eligible for child health assistance under the State child 
     health plan under title XXI of the Social Security Act 
     (whether or not such child is enrolled under such plan), if 
     such plan does not provide for coverage of such examination, 
     treatment, or service, respectively; and
       ``(B) paragraph (1)(C) shall not apply to a child described 
     in such paragraph if no amount is payable under the coverage 
     or plan described in such paragraph for such examination, 
     treatment, or service, respectively.
       ``(c) Criteria.--The Secretary, in consultation with 
     appropriate professional and patient organizations including 
     individuals with knowledge of age appropriate vision 
     services, shall develop criteria--
       ``(1) governing the operation of the grant program under 
     subsection (a); and
       ``(2) for the collection of data related to vision 
     assessment and the utilization of follow-up services.
       ``(d) 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 an eligible child has been 
     identified as provided for in subsection (a);
       ``(4) an assurance that funds will be used consistent with 
     this section;
       ``(5) a description of how funds will be used to provide 
     examinations, treatments, and services, consistent with this 
     section; and
       ``(6) an assurance that, in providing examinations, 
     treatments, and services through use of such grant, the State 
     will give priority to eligible children with the lowest 
     income.
       ``(e) 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.
       ``(f) Limitations in Expenditure of Grant.--A grant may be 
     made under subsection (a) only if the State involved agrees 
     that the State will expend amounts received under such grant 
     as follows:
       ``(1) The State will expend at least 80 percent of such 
     amounts for the purposes described in paragraphs (1) and (2) 
     of such subsection.
       ``(2) The State will not expend more than 10 percent of 
     such amounts to carry out the purpose described in paragraph 
     (3) of such subsection.
       ``(3) The State will not expend more than 10 percent of 
     such amounts for administrative purposes.
       ``(g) 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.
       ``(h) Supplement Not Supplant.--A State that receives a 
     grant under this section shall ensure that amounts received 
     under such grant will be used to supplement, and not 
     supplant, any other Federal, State, or local funds available 
     to carry out activities of the type carried out under the 
     grant.
       ``(i) Definitions.--For purposes of this section:
       ``(1) Child.--The term `child' means an individual who--
       ``(A) has not attained 18 years of age; or
       ``(B) has not attained 19 years of age and is a full-time 
     student in a secondary school (or in the equivalent level of 
     vocational or technical training).
       ``(2) Comprehensive eye examination.--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.
       ``(j) Authorization of Appropriations.--For the purpose of 
     carrying out this section, there are authorized to be 
     appropriated--
       ``(1) $10,000,000 for fiscal year 2010;
       ``(2) $13,000,000 for fiscal year 2011; and
       ``(3) $14,000,000 for each of the fiscal years 2012 through 
     2014.''.

  The SPEAKER pro tempore. Pursuant to the rule, the gentleman from New 
Jersey (Mr. Pallone) and the gentleman from Louisiana (Mr. Scalise) 
each will control 20 minutes.
  The Chair recognizes the gentleman from New Jersey.


                             General Leave

  Mr. PALLONE. I ask unanimous consent that all Members may have 5 
legislative days in which to revise and extend their remarks.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentleman from New Jersey?
  There was no objection.
  Mr. PALLONE. I yield myself such time as I may consume.
  I rise in support of H.R. 577, the Vision Care for Kids Act of 2009. 
Vision problems are particularly challenging for children because they 
can cause developmental struggles which can lead to physical, emotional 
and social consequences. Vision impairment can cause a child to miss 
learning opportunities, for example, and vision-impaired children often 
have an inability to understand nonverbal cues, leading to difficulties 
with social interactions.
  Correcting vision problems at a young age, however, can improve 
outcomes. The Vision Care for Kids Act would address these problems by 
improving access to vision services for children. The bill amends the 
Public Health Services Act to give the Secretary of Health and Human 
Services the authority to award grants to States for first, 
comprehensive eye examinations for children previously identified as 
needing these services, second, treatment or services to correct vision 
problems, and third, development and dissemination of educational 
materials on recognizing signs of visual impairment.

                              {time}  1615

  I'd like to thank my colleague, Representative Green, for his 
sponsorship and again his hard work on this issue.
  I ask my colleagues to support the bill, and I reserve the balance of 
my time.
  Mr. SCALISE. Mr. Speaker, I rise today in support of H.R. 577, the 
Vision Care for Kids Act. This bipartisan legislation provides eye 
examinations and follow-up care for children who have been identified 
as needing vision care services. This legislation builds on State 
programs currently in place with a focus on helping low-income 
children.
  Undiagnosed and untreated vision problems can pose learning problems 
for children. Vision problems can have effects on a child's emotional, 
educational and physical development.
  A majority of children entering school never have received a vision 
test and, for those who do receive a vision test and do not pass, many 
do not receive the recommended follow-up care. This legislation will 
enable more children to receive testing and the follow-up care, if 
necessary.
  We need to continue to work towards a system by which roadblocks to a 
formative education for our children are eliminated. I stand in support 
of this legislation, and hope that my colleagues will join in.

[[Page H4092]]

  Mr. Speaker, I reserve the balance of my time.
  Mr. PALLONE. Mr. Speaker, I yield 5 minutes to the sponsor, Mr. Gene 
Green of Texas.
  Mr. GENE GREEN of Texas. Mr. Speaker, I thank my colleague, the Chair 
of our Health Subcommittee, for yielding to me.
  I rise in support of H.R. 577, the Vision Care for Kids Act. The 
Vision Care For Kids Act creates a much needed grant program to provide 
follow-up vision care for children with vision disorders who do not 
have access to these services.
  States have taken steps to identify children for potential vision 
disorders through mandatory vision screenings. However, most States do 
not mandate follow-up eye exams or treatment for children who fail 
these vision screenings.
  Of the 36 States that require vision screenings, 26 of them do not 
require children who failed the screening to receive a follow-up exam. 
This lack of vision care jeopardizes a child's development and can, 
unfortunately, lead to lifelong vision impairment.
  The Vision Care for Kids Act seeks to remedy this problem by 
authorizing a new grant program to complement State efforts to provide 
comprehensive eye exams for children who have been identified, through 
vision screenings or other eye exams, as having a potential vision 
disorder. The grant funding authorized under this bill can be used for 
specific treatments and services to correct the vision disorders 
identified through the eye exams.
  Unless caught early and appropriately treated, vision disorders can 
lead to irreversible damage that can hinder a child's normal growth, 
development and opportunity to succeed. These children deserve a 
healthy start to their educational and social development. Yet the 
reality is that nearly two out of three children entering elementary 
school have never received preventive vision care.
  Unfortunately, lack of health insurance presents a barrier to the 
delivery of appropriate vision care in this country. And for many 
children who are lucky to have health insurance for medical care, their 
policy doesn't cover vision coverage. This is precisely why this bill 
is necessary.
  By targeting the program towards children who are school-aged, who do 
not have vision coverage for the services they require, and are at risk 
for vision disorders, the bill is designed to spend scarce health care 
dollars in the wisest manner.
  A portion of the grant funds may also be used to increase education 
awareness of vision disorders, so that warning signs can be recognized 
and any problems can be detected in a timely fashion.
  This bill has been crafted in a bipartisan manner with my colleague 
from Oklahoma (Mr. Sullivan), our leader on the Republican side. And 
I'd also like to thank Representative Eliot Engel, Representative Bill 
Pascrell and Representative Ros-Lehtinen for their continued support of 
this legislation.
  I'd also like to thank the Congressional Vision Caucus for their 
support of the legislation. In 2003 I was joined by our colleagues, 
Congressman Price, Congresswoman Ros-Lehtinen and Congressman Tiberi, 
in establishing the Congressional Vision Caucus. As a founding member 
of the Caucus, I'm particularly pleased to see this bill on the floor 
today, and consider it a milestone for our young caucus.
  Today the Vision Caucus is comprised of more than 100 Members of 
Congress, both Republicans and Democrats, House Members and Senators. 
While our initial goal was to raise the awareness of vision disorders 
in Congress, the Caucus has developed and endorsed key pieces of vision 
legislation, including this bill, the Vision Care for Kids Act before 
us today.
  I'd also like to thank Chairman Waxman, Ranking Member Barton of the 
Energy and Commerce Committee, as well as the Chair and ranking member 
of the Health Subcommittee, Mr. Pallone and Mr. Deal, for their 
support.
  With that, I encourage my colleagues to join me in passing this 
important bill to improve vision care for America's children.
  Mr. SCALISE. Mr. Speaker, I yield 5 minutes to the gentleman from 
Oklahoma (Mr. Sullivan).
  Mr. SULLIVAN. Mr. Speaker, I rise in strong support of H.R. 577, the 
Vision Care for Kids Act of 2009. I want to thank my colleague, 
Congressman Gene Green, the lead sponsor of this important legislation, 
and I am proud to be the lead Energy and Commerce Committee Republican 
on this bill.
  This legislation will help complement existing State efforts by 
providing grants for eye examinations and follow-up treatment for 
uninsured children who fail a vision screening. It does this by 
authorizing $65 million over 5 years in Federal grant funds.
  Millions of children in the United States suffer from vision 
problems, many of which go undetected because of lack of access to 
affordable and proper eye care. This legislation will bridge a chief 
gap in vision care, children who face undetected vision problems versus 
children who are able to receive treatment for their vision problems 
before it's too late.
  Vision problems in children range from common conditions, such as 
lazy eye and cross eye, to more serious conditions such as infantile 
cataracts. Also, many serious eye conditions are treatable if 
identified in preschool and early school-aged years. Early detection 
provides the best opportunity for effective treatment and lower public 
health care costs for the future.
  According to the Center for Disease Control and Prevention, 
approximately 1.8 million children under the age of 18 are blind or 
have some form of visual impairment. Also, nearly two in three children 
do not receive any preventive vision care before starting elementary 
school. Children who have undiagnosed vision problems can have 
difficulties in school and be wrongly labeled with learning disorders. 
The Vision Care for Kids Act seeks to change that, and provide all kids 
the vision care they need.
  Again, I encourage quick adoption of this bill today.
  Mr. PALLONE. I have no additional speakers. I don't know if my 
colleague does.
  Mr. SCALISE. Mr. Speaker, at this time I yield 5 minutes to the 
gentleman from Georgia (Mr. Gingrey).
  Mr. GINGREY of Georgia. Mr. Speaker, I thank the gentleman for 
yielding, and I'm a very proud supporter of H.R. 577, the Vision Care 
for Kids Act of 2009. I want to commend Representative Green from Texas 
and Representative Sullivan from Oklahoma for bringing forward this 
bill.
  The reason why I'm here, Mr. Speaker, speaking on this issue as a 
physician Member of the House, is because it's very personal to me.
  My granddaughters, my oldest grandchildren, are now 11 years old. 
They are identical twin girls, Ali and Hannah Manning. And, Mr. 
Speaker, they were born prematurely. In fact, they were born 
immaturely, so premature at 26 weeks, that each of them weighed 1 
pound, 12 ounces. And I thank God, Mr. Speaker, for the blessing, the 
double miracles of life and health. And really, they've done fine, 
except they had problems with vision. And that's because these young, 
premature, immature infants, need, Mr. Speaker, to receive so much 
oxygen therapy in their first weeks of life that it can damage the 
retina, and, in fact, that's what happened with our twin 
granddaughters. And they had to have multiple surgeries, laser 
surgeries. In fact, little Ali learned how to put a contact lens in her 
eye when she was only 5 years old. She could put it in and take it out.
  And again, we are so blessed. Their parents are blessed. My daughter 
and son-in-law, and the grandparents, the Mannings, and we Gingreys are 
so thankful.
  But we think every day about other children who cannot afford the 
care, maybe cannot afford to have vision screening. And if they do, Mr. 
Speaker, and if they're found to have limited vision, Mr. Sullivan 
talked about all the difficulties in school, both emotionally and 
physically and educationally that they have. If they can't afford then 
to have something done about their visual problem, what a shame that 
is.
  So, for us to have a bill, a program where Federal grants are given 
through the CDC, working with the States to make sure that each and 
every child, not just those privileged few that happen to have good 
coverage, could get the care that they need so they could become good, 
strong students and

[[Page H4093]]

healthy and happy adults. So this is a wonderful program.
  Again, I commend the committee, Energy and Commerce Committee. I 
commend Mr. Green, Mr. Sullivan, Mr. Pallone, Mr. Deal.
  I recommend that all my colleagues, of course, support H.R. 577.
  Mr. PASCRELL. I was pleased to introduce the Vision Care for Kids Act 
with my colleagues Congressmen Green, Sullivan, and Engel and 
Congresswoman Ros-Lehtinen in both this Congress and in the previous 
Congress. This important legislation will establish a federal grant 
program to provide for timely diagnostic examination, treatment, and 
follow-up vision care for children, which will complement existing 
State programs and allow eye exams for a vulnerable pediatric 
population that do not qualify for Medicaid or SCHIP and do not have 
access to private health insurance.
  This issue has long been near to my heart. In fact, in 2003, I first 
championed legislation to create a grant program to provide 
comprehensive eye exams and necessary follow-up care for children whose 
families do not have the resources for or access to such care. 
Preventive vision care is critically important to avoid vision loss, 
and even blindness, in our nation's children, which can affect a 
child's physical, emotional, and intellectual development.
  The CDC states that approximately 1.8 million children under the age 
of 18 are blind or have some form of visual impairment. Fortunately, in 
most cases, vision loss can be avoided with early diagnosis and 
treatment. Eye health has a direct impact on learning and achievement, 
and unfortunately, many visual deficits are caught only after they have 
impaired a child's early and most critical education. Consequently, it 
is a national disgrace that only one in three children receive 
preventive vision care before they are enrolled in elementary school.
  This essential legislation will provide the tools to significantly 
mitigate the effects of visual impairment. In fact, H.R. 577 has the 
potential to open up a new world of academic and social opportunity for 
approximately half a million of our youngest children nationwide. As 
Congress continues its work to improve the health care and educational 
opportunities available to children in this country, the need to remove 
outside impediments to learning must be addressed to achieve long-term 
success.
  I would like to thank Chairman Waxman and Chairman Pallone, for their 
thoughtful consideration and support for preventive vision care for 
children, and I urge my colleagues to vote in favor of the Vision Care 
for Kids Act. Finally, I encourage the Senate to expeditiously consider 
this essential legislation to provide necessary vision care to our 
nation's most vulnerable children.
  Ms. JACKSON-LEE of Texas. Mr. Speaker, I rise in support of H.R. 577 
``Vision Care for Kids Act of 2009.'' I want to thank my colleague 
Congressman Gene Green of Texas for introducing this legislation.
  Mr. Speaker, I rise today to tell my colleagues that our nation's 
children are our future. They should be the center of all of our 
legislative efforts to improve the lives of all Americans.
  The Vision Care for Kids Act of 2009 is a necessary grant program 
aimed at bolstering children's vision initiatives in the states and 
encouraging new community-based children's vision partnerships. This 
legislation amends the Public Health Service Act to authorize the 
Secretary of Health and Human Services, acting through the Director of 
the Centers for Disease Control and Prevention (CDC), to award matching 
grants to states to complement existing state efforts to: (1) provide 
comprehensive eye examinations from 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, who do not 
otherwise have coverage for vision services, and who are low-income 
children, with priority given to children who are under the age of nine 
years; (2) provide treatment or services as necessary to correct 
identified vision problems; and (3) develop and disseminate to parents, 
teachers, and health care practitioners educational materials on 
recognizing signs of visual impairment in children.
  We used to hold our child's hands when our child takes their first 
step. However, not many help our children to learn how to use their 
eyes properly, how to see properly, and how to relax their eyes and 
protect their vision. Today's education system requires our children to 
give close attention, read many books, add or subtract numbers or 
operate a computer for hours. Therefore, it is important to learn to 
guide our children to attain good child vision health at various stages 
of their development.
  Ten million children suffer from vision disorders, according to the 
National Parent Teacher Association. Vision disorders are considered 
the fourth most common disability in the United States, and they are 
one of the most prevalent handicapping conditions in childhood. 
According to data from the Making the Grade: An analysis of state and 
federal children's vision care policy research study, 32 states require 
vision screenings for students, but 29 of them do not require children 
who fail the screening to have a comprehensive eye examination. Because 
up to two-thirds of children who fail vision screenings do not comply 
with recommended eye exams, many children enter school with uncorrected 
vision problems. Undetected and untreated vision deficiencies, 
particularly in children, can take a large toll. Studies have shown 
that the costs associated with adult vision problems in the U.S. are at 
$51.4 billion.
  Undiagnosed and untreated vision problems for children are serious 
issues. Vision problems can affect a child's cognitive, emotional, 
neurological and physical development. While vision disorders are 
considered the fourth most common disability in the United States, two-
thirds of all children entering school have never received a vision 
test. For the one-third of children who do receive a vision test, 
approximately 40-67 percent who fail the test do not receive the 
recommended follow-up care.
  I urge my colleagues to support the Vision Care for Kids Act of 2009 
so that we can protect our children of America.
  Mr. SCALISE. Mr. Speaker, I yield back the balance of my time.
  Mr. PALLONE. I also yield back and ask for passage, Mr. Speaker.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentleman from New Jersey (Mr. Pallone) that the House suspend the 
rules and pass the bill, H.R. 577, as amended.
  The question was taken.
  The SPEAKER pro tempore. In the opinion of the Chair, two-thirds 
being in the affirmative, the ayes have it.
  Mr. BROUN of Georgia. Mr. Speaker, on that I demand the yeas and 
nays.
  The yeas and nays were ordered.
  The SPEAKER pro tempore. Pursuant to clause 8 of rule XX and the 
Chair's prior announcement, further proceedings on this motion will be 
postponed.

                          ____________________