IN THE SENATE OF THE UNITED STATES
September 22 (legislative day, September 17), 2008
Mr. Dodd (for himself and Mr. Voinovich) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions
To provide for the expansion of Federal programs to prevent and manage vision loss, and for other purposes.
This Act may be cited as the
Vision Preservation Act of
Findings; sense of Congress
The Congress finds as follows:
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.
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.
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.
One in twenty preschoolers experience visual impairment which, if unaddressed, can affect learning ability, personality, and adjustment in school.
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 nonmedical costs, and indirect costs such as lost productivity and wages.
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.
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.
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.
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:
Communication and education.
Surveillance, epidemiology, and prevention research.
Programs, policies, and systems change.
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:
Preventive health measures with respect to vision loss
Communication and Education
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—
the impact of vision problems; and
the importance of early diagnosis, management, and effective prevention and rehabilitation strategies.
In carrying out this subsection, the Secretary may—
conduct public service announcements and education campaigns;
enter into partnerships with eye-health professional organizations and other vision-related organizations;
conduct community disease prevention campaigns;
conduct testing, evaluation, and model training for vision screeners based on scientific studies; and
evaluate strategies to reduce barriers to access to treatment by optometrists and ophthalmologists.
In carrying out this subsection, the Secretary shall—
establish appropriate measurements for public awareness of vision problems;
establish appropriate measurements to determine the effectiveness of existing campaigns to increase awareness of vision problems;
establish quantitative benchmarks for determining the effectiveness of activities carried out under this subsection; and
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.
Surveillance, Epidemiology, and Health Services research
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.
In carrying out this subsection, the Secretary may—
create a national ongoing surveillance system;
identify and test screening modalities;
evaluate strategies to reduce barriers to access to treatment by optometrists, ophthalmologists, and other vision rehabilitation professionals;
evaluate the efficacy and cost-effectiveness of current and future interventions and community strategies;
update and improve knowledge about the true costs of vision problems and related disabilities; and
require the Surgeon General to assess the state of vision care and vision rehabilitation in the United States.
Programs, Policies, and Systems
The Secretary shall expand and intensify research within the Centers for Disease Control and Prevention on the prevention and management of vision loss.
In carrying out this subsection, the Secretary may—
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;
work with health care systems to better address vision problems and associated disabilities; and
award grants for community outreach regarding vision loss to health care institutions and national vision organizations with broad community presence.
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—
and at the end of subparagraph (E);
by striking the
period at the end of subparagraph (F) and inserting
by adding at the end the following new subparagraph:
introduce core performance measures on eye health by incorporating vision screening and examination standards into State programs under this title, based on scientific studies.
Prevention and Treatment for Underserved, Minority, and Other Populations
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
Vision care services at community health centers receiving assistance under section 330 of the Public Health Service Act (42 U.S.C. 254b).
Vision rehabilitation programs at vision rehabilitation agencies, eye clinics, and hospitals.
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.
Vision Rehabilitation Professional Development Grants
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
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:
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—
geriatrics among vision rehabilitation professionals, including professionals in the vision rehabilitation therapy, orientation and mobility, and low vision therapy fields; and
vision rehabilitation among occupational therapists and others in related rehabilitation and health disciplines.
Conducting, and disseminating the findings and conclusions of, research on the effectiveness of preparatory and continuing education training under paragraph (1).
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.
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.
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—
offers or coordinates education or training activities among professionals described in subsection (b)(1); or
agrees to use the grant to expand its capacity to coordinate such activities.
Distribution of grants
In awarding grants under this section, the Secretary shall ensure that grantees offer or coordinate training for current and emerging professionals—
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
serving a variety of populations of older individuals with vision loss, including racial and ethnic minorities, low-income individuals, and other underserved populations.
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.