[House Report 111-46]
[From the U.S. Government Publishing Office]



111th Congress                                                   Report
                        HOUSE OF REPRESENTATIVES
 1st Session                                                     111-46
======================================================================
 
                    VISION CARE FOR KIDS ACT OF 2009

                                _______
                                

 March 23, 2009.--Committed to the Committee of the Whole House on the 
              State of the Union and ordered to be printed

                                _______
                                

 Mr. Waxman, from the Committee on Energy and Commerce, submitted the 
                               following


                              R E P O R T

                        [To accompany H.R. 577]

      [Including cost estimate of the Congressional Budget Office]

  The Committee on Energy and Commerce, to whom was referred 
the bill (H.R. 577) to establish a grant program to provide 
vision care to children, and for other purposes, having 
considered the same, report favorably thereon with an amendment 
and recommend that the bill as amended do pass.

                                CONTENTS

                                                                   Page
Purpose and Summary..............................................     3
Background and Need for Legislation..............................     4
Hearings.........................................................     4
Committee Consideration..........................................     4
Committee Votes..................................................     4
Committee Oversight Findings.....................................     5
Statement of General Performance Goals and Objectives............     5
New Budget Authority, Entitlement Authority, and Tax Expenditures     5
Earmarks and Tax and Tariff Benefits.............................     5
Committee Cost Estimate..........................................     5
Congressional Budget Office Estimate.............................     5
Federal Mandates Statement.......................................     7
Advisory Committee Statement.....................................     7
Constitutional Authority Statement...............................     7
Applicability to Legislative Branch..............................     7
Section-by-Section Analysis of the Legislation...................     7
Explanation of Amendments........................................     8
Changes in Existing Law Made by the Bill, As Reported............     8

    The amendment is as follows:
    Strike all after the enacting clause and insert the 
following:

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;
          ``(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.''.

                          Purpose and Summary

    The purpose of H.R. 577, the ``Vision Care for Kids Act of 
2009'', is to establish a grant program to provide care for 
children with visual impairment. The bill authorizes the 
Secretary of Health and Human Services to award grants to 
states to provide comprehensive eye examinations and corrective 
treatment services to children identified by a vision screening 
as needing such services. The bill authorizes the appropriation 
of $10 million in FY 2010 and $51 million over the 5-year 
period FY 2010 through 2014 for this grant program, which would 
be administered through the Centers for Disease Control and 
Prevention.

                  Background and Need for Legislation

    Vision impairment affects approximately 1.2 out of every 
1,000 8-year-old children. Vision problems can occur at any 
point during a lifetime, but tend to be particularly damaging 
to school-age children because developmental struggles may 
result in 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.
    In addition to the psychological costs, the economic costs 
for people with impaired vision are very high. It is estimated 
that the lifetime costs for all people with vision impairment 
who were born in 2000 will total $2.5 billion. These costs 
include both direct and indirect costs. Direct medical costs 
include doctor visits, prescription drugs, and inpatient 
hospital stays; direct non-medical expenses can include home 
modifications and special education. Indirect costs account for 
the majority of costs, and include the value of lost wages when 
a person dies early, cannot work, or is limited in the amount 
or type of work he or she can perform.
    The ``Health Vision 2010'' component of the national 
Healthy People 2010 initiative to establish national health 
objectives underscores the need for correcting children's 
vision problems at a young age. Healthy Vision 2010 recommends 
that all children receive a vision-screening exam from their 
healthcare provider before they reach the age of 5. Early 
recognition of eye disease results in more effective treatment 
that can be sight-saving or even life-saving. Yet, in 2002, 36% 
of children under the age of 5 did not receive any vision 
screening.

                                Hearings

    The Committee on Energy and Commerce did not hold hearings 
on the legislation.

                        Committee Consideration

    The Committee on Energy and Commerce met in open markup 
session on Wednesday, March 4, 2009, and, pursuant to a motion 
by Mr. Waxman, agreed by unanimous consent to consider and 
approve H.R. 577 and several other bills en bloc. H.R. 577 was 
ordered favorably reported, amended, to the House by a voice 
vote. An amendment in the nature of a substitute to H.R. 577 
offered by Mr. Waxman was adopted by unanimous consent.

                            Committee Votes

    Clause 3(b) of rule XIII of the Rules of the House of 
Representatives requires the Committee to list the record votes 
on the motion to report legislation and amendments thereto. 
There were no recorded votes taken during consideration or 
ordering H.R. 577 reported to the House.

                      Committee Oversight Findings

    Regarding clause 3(c)(1) of rule XIII of the Rules of the 
House of Representatives, the oversight findings of the 
Committee are reflected in this report.

         Statement of General Performance Goals and Objectives

    H.R. 577 would allow the Secretary of Health and Human 
Services, acting through the Director of the Centers for 
Disease Control and Prevention (CDC), to award grants to states 
to: (1) provide comprehensive eye examinations by a licensed 
optometrist or ophthalmologist for children identified by a 
licensed healthcare provider or vision screener, with priority 
to children under age 9; (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.

   New Budget Authority, Entitlement Authority, and Tax Expenditures

    In compliance with clause 3(c)(2) of rule XIII of the Rules 
of the House of Representatives, the Committee finds that H.R. 
577 would result in no new or increased budget authority, 
entitlement authority, or tax expenditures.

                  Earmarks and Tax and Tariff Benefits

    In compliance with clause 9 of rule XXI of the Rules of the 
House of Representatives, H.R. 577 does not contain any 
congressional earmarks, limited tax benefits, or limited tariff 
benefits as defined in clause 9(d), 9(e), or 9(f) of rule XXI.

                        Committee Cost Estimate

    The Committee adopts as its own the cost estimate on H.R. 
577 prepared by the Director of the Congressional Budget Office 
pursuant to section 402 of the Congressional Budget Act of 
1974.

                  Congressional Budget Office Estimate

    Pursuant to clause 3(c)(3) of rule XIII of the Rules of the 
House of Representatives, the following is the cost estimate on 
H.R. 577 provided by the Congressional Budget Office pursuant 
to section 402 of the Congressional Budget Act of 1974:

                                     U.S. Congress,
                               Congressional Budget Office,
                                    Washington, DC, March 20, 2009.
Hon. Henry A. Waxman,
Chairman, Committee on Energy and Commerce,
House of Representatives, Washington, DC.
    Dear Mr. Chairman: The Congressional Budget Office has 
prepared the enclosed cost estimate for H.R. 577, the Vision 
Care for Kids Act of 2009.
    If you wish further details on this estimate, we will be 
pleased to provide them. The CBO staff contact is Stephanie 
Cameron.
            Sincerely,
                                              Douglas W. Elmendorf.
    Enclosure.

H.R. 577--Vision Care for Kids Act of 2009

    Summary: H.R. 577 would amend the Public Health Service Act 
to authorize the Director of the Centers for Disease Control 
and Prevention (CDC) to administer grants to states to increase 
examinations of children for vision problems, provide treatment 
of any problems detected, and develop and disseminate 
educational materials to promote the detection of vision 
disorders in children. The bill would authorize the 
appropriation of $65 million for those purposes over the 2010-
2014 period. CBO estimates that implementing H.R. 577 would 
cost $4 million in 2010 and $54 million over the 2010-2014 
period, assuming appropriation of the specified amounts. 
Enacting H.R. 577 would not affect direct spending or revenues.
    H.R. 577 contains no intergovernmental or private-sector 
mandates as defined in the Unfunded Mandates Reform Act (UMRA) 
and would impose no costs on state, local, or tribal 
governments.
    Estimated cost to the Federal Government: The estimated 
budgetary impact of H.R. 577 is shown in the following table. 
The costs of this legislation fall within budget function 550 
(health).

----------------------------------------------------------------------------------------------------------------
                                                               By fiscal year, in millions of dollars--
                                                     -----------------------------------------------------------
                                                                                                          2010-
                                                        2010      2011      2012      2013      2014      2014
----------------------------------------------------------------------------------------------------------------
                                  CHANGES IN SPENDING SUBJECT TO APPROPRIATION

Authorization Level.................................        10        13        14        14        14        65
Estimated Outlays...................................         4        10        12        14        14        54
----------------------------------------------------------------------------------------------------------------

    Basis of estimate: H.R. 577 would authorize the 
appropriation of $10 million in 2010 and a total of $65 million 
over the 2010-2014 period for the purposes of detecting and 
treating vision disorders in low-income children. In 
particular, H.R. 577 would authorize the Director of the CDC to 
administer grants to states for three purposes: (1) providing 
comprehensive eye examinations to children with potential eye 
disorders, as identified by screenings; (2) funding treatment 
of disorders identified through the comprehensive eye exam; and 
(3) developing and disseminating educational materials on 
symptoms of eye disorders to parents, teachers, and health care 
practitioners.
    Children eligible for Medicaid would not be eligible for 
vision care services provided through CDC grants. Other low-
income children with health insurance, including those enrolled 
in the Children's Health Insurance Program (CHIP), could be 
eligible for vision care services provided through CDC grants 
if the coverage of such examination, treatment, or services is 
not provided through their health insurance. Provision of those 
vision care services to children enrolled in CHIP would not 
affect direct spending because this bill would not change 
eligibility or benefits provided under CHIP.
    Based on historical spending patterns for similar programs 
at CDC, and assuming appropriation of the authorized amounts, 
CBO estimates that implementing H.R. 577 would cost $54 million 
over the 2010-2014 period.
    Intergovernmental and private-sector impact: H.R. 577 
contains no intergovernmental or private-sector mandates as 
defined in UMRA. Public institutions of higher education that 
provide education and training for health professionals in pain 
care would benefit from grant funds authorized in the bill.
    Estimate prepared by: Federal costs: Stephanie Cameron; 
Impact on state, local, and tribal governments: Lisa Ramirez-
Branum; Impact on the private sector: Kei Nakagawa.
    Estimate approved by: Peter H. Fontaine, Assistant Director 
for Budget Analysis.

                       Federal Mandates Statement

    The Committee adopts as its own the estimate of federal 
mandates regarding H.R. 577 prepared by the Director of the 
Congressional Budget Office pursuant to section 423 of the 
Unfunded Mandates Reform Act.

                      Advisory Committee Statement

    No advisory committees within the meaning of section 5(b) 
of the Federal Advisory Committee Act were created by the 
legislation.

                   Constitutional Authority Statement

    Pursuant to clause 3(d)(1) of rule XIII of the Rules of the 
House of Representatives, the Committee finds that the 
constitutional authority for H.R. 577 is provided in the 
provisions of Article I, section 8, clause 1, that relate to 
expending funds to provide for the general welfare of the 
United States.

                  Applicability to Legislative Branch

    The Committee finds that the legislation does not relate to 
the terms and conditions of employment or access to public 
services or accommodations within the meaning of section 
102(b)(3) of the Congressional Accountability Act of 1995.

             Section-by-Section Analysis of the Legislation


Section 1. Short title

    Section 1 establishes the short title of the Act as the 
``Vision Care for Kids Act of 2009''.

Section 2. Grants regarding vision care for children

    Section 2 amends Part Q of title III of the Public Health 
Service Act (42 U.S.C. 280h et seq.) to add section 399Z-1.

Section 399Z-1. Grants regarding vision care for children

    Section 399Z-1 allows the Secretary of Health and Human 
Services, acting through the Director for the Centers for 
Disease Control and Prevention, to 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 9; (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. This section prioritizes 
services for children who are under age 9. It also requires the 
Secretary to give priority to states that will provide services 
to the lowest-income eligible children. States are required to 
ensure that grant funds supplement, and not supplant, any other 
federal, state, or local funds available to carry out similar 
activities; and to coordinate grant programs under this bill 
with existing federal and state programs. States are also 
required to provide assurances that the state will not 
eliminate or otherwise reduce vision care services and that 
grant funds are expended on eligible children.
    Section 399Z-1 authorizes $10 million for FY2010, $13 
million for FY2011, and $14 million for each of fiscal years 
2012 through 2014, and it requires that at least 25% of costs 
are contributed by the state, directly or through donations.

                       Explanation of Amendments

    Mr. Waxman offered an amendment in the nature of a 
substitute to make certain changes to the bill. These included 
a clarification of eligibility requirements for children with 
regard to specific services; the requirement that up to 10% of 
funds be available for educational materials and up to 10% for 
administrative costs; and the indication of specific 
authorization amounts for each of the 5 fiscal years.

         Changes in Existing Law Made by the Bill, as Reported

  In compliance with clause 3(e) of rule XIII of the Rules of 
the House of Representatives, changes in existing law made by 
the bill, as reported, are shown as follows (new matter is 
printed in italic and existing law in which no change is 
proposed is shown in roman):

                       PUBLIC HEALTH SERVICE ACT




           *       *       *       *       *       *       *
TITLE III--GENERAL POWERS AND DUTIES OF PUBLIC HEALTH SERVICE

           *       *       *       *       *       *       *



PART Q--PROGRAMS TO IMPROVE THE HEALTH OF CHILDREN

           *       *       *       *       *       *       *


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;
          (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.

           *       *       *       *       *       *       *


                                  
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