Zach’s Law Screens Texas Newborns And Toddlers For Vision Problems

The text as introduced · 2,592 words

89R11608 KRM-F

By: González of El Paso
H.B. No. 5271

A BILL TO BE ENTITLED

AN ACT

relating to the screening of, services for, and educational

programs for children with visual impairments; authorizing an

administrative penalty.

BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:

SECTION 1. This Act may be cited as Zach's Law.

SECTION 2. Chapter 29, Education Code, is amended by adding

Subchapter J to read as follows:

SUBCHAPTER J. PROGRAMS FOR CHILDREN AND STUDENTS WITH

VISUAL IMPAIRMENT

Sec. 29.331. DEFINITIONS. In this subchapter, "early

intervention services," "expanded core curriculum," "functional

vision assessment," "screening," and "visual impairment" have the

meanings assigned by Section 36A.001, Health and Safety Code.

Sec. 29.332. PROGRAM REQUIRED. In addition to a special

education program under Subchapter A, a school district and

open-enrollment charter school shall provide a program for

appropriate interventions from birth, including age-appropriate

instruction in all areas of an expanded core curriculum, to a child

who:

(1) is referred to the district or school under

Chapter 36A, Health and Safety Code; and

(2) has a visual impairment, as determined by a

screening or functional vision assessment conducted under Chapter

36A, Health and Safety Code, or through a formal diagnosis of a

physician or health care provider.

Sec. 29.333. PROGRAM CONTENTS. A program provided under

this subchapter must contain:

(1) expanded core curriculum instruction areas,

including age-appropriate instruction in:

(A) orientation and mobility;

(B) social interaction skills;

(C) independent living skills;

(D) assistive technology;

(E) self determination;

(F) sensory efficiency skills;

(G) recreation and leisure;

(H) compensatory or access skills; and

(I) career education; and

(2) early intervention services, including:

(A) vision therapy;

(B) developmental support; and

(C) access to assistive technologies to support

the child's development and learning.

Sec. 29.334. COMPENSATORY SERVICES FOR LATE

IDENTIFICATION. (a) The agency by rule shall require school

districts and open-enrollment charter schools to provide a student

with a visual impairment who is identified after third grade with

additional instruction and support commensurate with the student's

needs to address developmental delays and the education loss of

specific visual impairment instruction under the expanded core

curriculum, caused by the delayed identification for visual

impairment.

(b) The agency shall require school districts and

open-enrollment charter schools in conducting admission, review,

and dismissal processes to develop individualized plans to address

and remedy the delayed identification described by Subsection (a)

and provide the necessary compensatory instruction, including

additional instruction for relevant skills development and

opportunities for the student to learn and successfully complete

the expanded core curriculum.

(c) If consensus is not reached between a parent or adult

student and a school district or open-enrollment charter school for

compensatory services provided under this section, the parent or

adult student may pursue all administrative remedies available

under the Individuals with Disabilities Education Act (20 U.S.C.

Section 1400 et seq.).

SECTION 3. Subtitle B, Title 2, Health and Safety Code, is

amended by adding Chapter 36A to read as follows:

CHAPTER 36A. EARLY VISION SCREENING, IDENTIFICATION, AND REFERRAL

FOR YOUNG CHILDREN WITH VISUAL IMPAIRMENTS

SUBCHAPTER A. GENERAL PROVISIONS

Sec. 36A.001. DEFINITIONS. In this chapter:

(1) "Agency" means the Texas Education Agency.

(2) "Certified orientation and mobility specialist"

means an individual who satisfies agency established requirements

and holds a certification issued by the Academy for Certification

of Vision Rehabilitation and Education Professionals.

(3) "Certified teacher" means a teacher who teaches

students with visual impairments and who has:

(A) a bachelor's degree from an accredited

university; and

(B) an initial teaching certification in

elementary or secondary general or special education.

(4) "Cortical vision impairment" means a disorder

caused by damage to areas of the brain that process vision and in

which the eyes remain healthy but the brain has difficulty

processing and understanding visual information.

(5) "Early intervention services" means the early

intervention services described in Part C, Individuals with

Disabilities Education Act (20 U.S.C. Sections 1431-1443).

(6) "Expanded core curriculum" means the set of skills

and concepts that are provided to children with a visual impairment

to compensate for visual limitations, specialized instruction,

including orientation and mobility skills, social interaction

skills, and independent living skills, and use of assistive

technology.

(7) "Functional vision assessment" is an evaluation of

a child's ability to use vision in daily activities, regardless of

any formal diagnosis.

(8) "Health care provider" means an individual or

facility licensed, certified, or otherwise authorized to

administer health care, for profit or otherwise, in the ordinary

course of business or professional practice, including a physician

or a hospital or birthing center.

(9) "Local education agency" means a school district

or an open-enrollment charter school.

(10) "Newborn" means a child less than 30 days old.

(11) "Physician" means a person licensed to practice

medicine in this state under Subtitle B, Title 3, Occupations Code.

(12) "Risk factors" means criteria or factors

identifying an infant or child as susceptible to a visual

impairment, including:

(A) a premature birth of less than 32 weeks;

(B) in vitro alcohol or substance abuse;

(C) birth complications;

(D) congenital infections;

(E) a history of a neurological disorder;

(F) a diagnosis of a seizure disorder, cerebral

palsy, intrauterine stroke, hydrocephalus, cerebral dysplasia such

as schizencephaly, cranial dysplasia such as Apert syndrome,

meningitis, encephalitis, a brain tumor, or a traumatic brain

injury;

(G) a genetic predisposition, including rare

chromosomal abnormalities;

(H) a family history of congenital visual

impairment or vision loss;

(I) a family history of autism spectrum disorder

or a diagnosis of autism spectrum disorder;

(J) a history of metabolic disorders, including

hypoglycemia, methylmalonic acidemia or propionic acidemia, Refsum

disease, mucopolysaccharidosis, neuronal ceroid lipofuscinosis,

disorders of glycosylation, or Tay-Sachs disease;

(K) a history of malnourishment, sensory

processing disorder, or malabsorption syndromes; or

(L) parent or caregiver concerns regarding

developmental vision delays.

(13) "Screening" means a test or battery of tests

administered to rapidly determine the need for a professional

examination.

(14) "Visual impairment" means a loss of vision

resulting from a disorder of the ocular system or disorder of the

visual pathways and visual centers in the brain, including the

pathways serving visual perception, cognition, and visual guidance

of movement of any type or degree.

Sec. 36A.002. RULES. The executive commissioner may adopt

rules to implement this chapter.

SUBCHAPTER B. SCREENING, EVALUATION, AND REFERRAL SERVICES

Sec. 36A.051. SUSCEPTIBILITY QUESTIONNAIRE. (a) The

department shall develop a susceptibility questionnaire based on

the risk factors indicating potential visual impairment in infants

and provide the questionnaire to hospitals and other birthing

facilities.

(b) The executive commissioner by rule shall require a

physician attending a newborn or another health care provider

attending the delivery of the newborn to:

(1) complete and submit the susceptibility

questionnaire to the department before the physician or health care

provider may discharge the newborn from the hospital or birthing

facility; and

(2) provide a copy of the completed susceptibility

questionnaire to the newborn's parent, legal guardian, or managing

conservator and, if known, the newborn's primary care physician and

vision service provider.

(c) The department shall record the information provided in

the completed susceptibility questionnaire in the database

established under Subchapter C and report the data to the

commission and applicable local education agency.

Sec. 36A.052. SCREENING AND REFERRAL. (a) The executive

commissioner by rule shall require screening of newborns and

infants born in this state at regular intervals within the first 36

months of life to detect visual impairment that is based on ocular

and neurological disorders, including cortical vision impairment.

(b) The rules must require:

(1) health care providers to conduct vision screenings

at well-child visits when the child is 3 months, 6 months, 12

months, 24 months, 30 months, and 36 months of age;

(2) a health care provider attending a newborn to

conduct a vision screening for a newborn who exhibits a risk factor;

and

(3) a health care provider to conduct a vision

screening focused on identifying neurological visual impairments,

including cortical vision impairment, and refer for a functional

vision assessment and learning media assessment any child younger

than five years of age who exhibits a risk factor, regardless of

whether the child received a formal diagnosis of a visual

impairment.

(c) A health care provider who conducts a screening under

Subsection (b) and detects a visual impairment or an indication of

associated risk factors shall:

(1) refer the child's parent, legal guardian, or

managing conservator to the applicable local education agency for

early intervention services, including a functional vision

assessment; and

(2) provide the child's parent, legal guardian, or

managing conservator with information on locations at which the

child may receive a medical follow-up for a formal diagnosis.

(d) As soon as practicable after receiving a referral, the

local education agency shall conduct a functional vision assessment

and provide any applicable early intervention services.

Sec. 36A.053. FUNCTIONAL VISION ASSESSMENT. (a) A parent,

legal guardian, managing conservator, or health care provider may

request a local education agency to conduct a functional vision

assessment if a routine vision screening or other evaluation

indicates a potential visual impairment.

(b) If a susceptibility questionnaire completed under

Section 36A.051 indicates a child has a risk factor or a screening

conducted under Section 36A.052 indicates a child may have a visual

impairment, the applicable local education agency shall conduct a

functional vision assessment for the child as soon as practicable.

The local education agency shall provide the child's parent, legal

guardian, or managing conservator with written information on

locations at which the assessment may be performed.

(c) A functional vision assessment must assess the manner in

which the child uses vision to perform tasks in daily life

activities by considering both ocular and neurological factors that

may impact vision, including a cortical vision impairment.

(d) A certified teacher, certified orientation and mobility

specialist, health care provider, or local education agency that

conducts a functional vision assessment indicating a child has a

visual impairment or does not sufficiently use vision to

appropriately access developmental or educational materials or

settings shall inform the child's parent, legal guardian, or

managing conservator the child may be eligible, regardless of a

formal diagnosis, under the Individuals with Disabilities

Education Act (20 U.S.C. Section 1400 et seq.) to receive early

intervention services from the applicable local education agency,

including access to an expanded core curriculum.

Sec. 36A.054. REFERRAL FOR DIAGNOSTIC SERVICES. A

certified teacher, certified orientation and mobility specialist,

health care provider, or local education agency that conducts a

vision screening or functional vision assessment and determines a

child may have a visual impairment shall use the database developed

under Subchapter C and refer the child to:

(1) a pediatric ophthalmologist, optometrist, or

pediatric neurologist, as appropriate;

(2) the applicable local education agency for a

functional vision assessment and learning media assessment if those

assessments have not been conducted; and

(3) the Blind Children's Vocational Discovery and

Development Program administered by the commission for further

support and services.

Sec. 36A.055. EARLY INTERVENTION SERVICES. (a) The

department, commission, and agency and local education agencies

shall coordinate to ensure certified teachers, certified

orientation and mobility specialists, health care providers, and

local education agencies that detect or diagnose a child with a

visual impairment, regardless of the child's age, provide

information on and refer the child to:

(1) the Division for Early Childhood Intervention

Services of the commission;

(2) the applicable local education agency responsible

for delivering early intervention services; and

(3) any other appropriate services the department

requires or recommends.

(b) The department, commission, and agency and local

education agencies shall coordinate to ensure a child who is

determined to have a visual impairment through a screening,

diagnosis, or functional vision assessment receives all

appropriate early intervention services, including instruction in

all areas of the expanded core curriculum.

SUBCHAPTER C. STATE AGENCY POWERS AND DUTIES

Sec. 36A.101. EDUCATIONAL MATERIALS. (a) The department

shall develop written educational materials on visual impairments

under this chapter. The materials shall include information on:

(1) visual impairments;

(2) the risk factors associated with visual

impairments;

(3) vision screening requirements;

(4) early intervention services provided by local

education agencies;

(5) referral and reporting requirements; and

(6) any other material the department considers

necessary.

(b) The department shall provide the materials developed

under this section to hospitals, birthing facilities, and primary

care providers and require a health care provider to provide a copy

of the materials to the parent, legal guardian, or managing

conservator of a newborn.

(c) The department in collaboration with the agency shall

develop a plan to coordinate early intervention services for

children who are identified with risk factors or diagnosed with a

visual impairment. The department and agency may not require a

formal diagnosis of a visual impairment before a child is eligible

for early intervention services.

Sec. 36A.102. TRAINING. (a) The department, in

collaboration with medical schools and other health care

organizations, shall develop a training program for health care

providers to ensure knowledge of and provide necessary skills for

detecting visual impairments and associated risk factors, with a

focus on both ocular and neurological forms of visual impairment.

(b) Health care providers and certified teachers shall

complete the training course developed under this section to

identify signs and symptoms of a visual impairment, risk factors,

or any other indicator that may necessitate a functional vision

assessment with or without a formal diagnosis.

Sec. 36A.103. PUBLIC AWARENESS CAMPAIGN. (a) The

department shall establish a public awareness campaign to educate

parents, legal guardians, managing conservators, and health care

providers on:

(1) types of visual impairments, including cortical

vision impairment;

(2) the importance of early screening;

(3) the developmental history and risk factors

associated with visual impairment;

(4) mandatory screening and referral requirements;

and

(5) available resources for children with visual

impairments.

(b) The department shall provide educational materials and

support for parents, legal guardians, and managing conservators,

including information on methods of advocating for their child's

needs and navigating the early intervention system specifically

designed for blind and visually impaired children.

Sec. 36A.104. STATEWIDE VISION DATABASE; REPORT. (a) To

ensure children with visual impairments receive timely diagnosis

and treatment, the department shall establish and maintain a secure

statewide database to monitor and track children who have a risk

factor for or are diagnosed with a visual impairment. The database

must track and record:

(1) screening and functional assessment outcomes,

including:

(A) the number of children screened; and

(B) the number of children diagnosed with or

identified as having a visual impairment or risk factors;

(2) diagnostic follow-up appointments; and

(3) early intervention services provided, including

the number of children receiving early intervention services for a

visual impairment.

(b) Not later than December 1 of each year, the department

shall provide a written report to the legislature summarizing the

information collected under Subsection (a) and providing

recommendations for legislative or other action.

(c) The report shall include recommendations for improving

the program's effectiveness, equity, and accessibility.

Sec. 36A.105. FUNDING. From money appropriated or

otherwise available for this purpose, the department and commission

shall allocate money to support the implementation of this chapter.

Sec. 36A.106. ENFORCEMENT. The department or commission

may impose an administrative penalty in an amount determined by an

administrative law judge to be appropriate based on the seriousness

of the conduct or order a corrective action for a violation of the

screening and referral requirements under this chapter.

SECTION 4. As soon as practicable after the effective date

of this Act, the executive commissioner of the Health and Human

Services Commission and the Texas Education Agency shall adopt

rules necessary to implement the changes in law made by this Act.

SECTION 5. This Act takes effect September 1, 2025.