It has been said that two things you should never watch being made are hotdogs and laws. What happened to our Vision Screening bill this year is an example of why laws are included.
When I learned about the issue of binary vision disorders and how dramatically they impacted the life of so many children in school, I decided to propose a bill that could help. My goals were to do the most good at the lease expense to taxpayers.
Starting with the incredible efforts and research done by the mother who brought this issue to me, listening to feedback in the hearings, and consulting with virtually every stakeholder possibly involved, we boiled the bill down to the following two parts:
To “do the most good,” we determined that identifying children with binary visual impairments was most significant – because that condition wasn’t being identified.
To control costs, we eliminated potential legislation that was desirable, but not critical, such as training teachers to recognize the condition, and addressing insurance coverage.
My bill became HB 458 and Senator Gail Bates, who agreed to cross-file the bill in the Senate, sponsored SB 604.
The Tale of Two Chambers
The House. My bill was heard first, on February 14th, before the House Ways & Means Committee (which deals with education). This is where we apparently made our first mis-step. In preparing the testimony, we tried to keep the number of witnesses pared down. However, there were just a lot of people who wanted to tell the Committee their stories. I went first to set the stage, and in my enthusiasm, probably spoke too long. I say that because I got a text from the Chair of the Committee that although Delegates were given as much time as they want their "testimony shouldn't take more than three minutes."
Unfortunately, the day of our hearing turned out to be one of the busiest for Ways & Means. They had 91 people signed up to testify on 17 different bills. I, of course, did not really consider 91 witnesses as unusually excessive, since in my Judiciary Committee, we had hearings this session with over 300 witnesses. Nonetheless, we probably didn’t get started off on the best foot with Ways & Means..
What happens after a committee has a hearing is – you wait. In Ways & Means, the bill goes to a subcommittee for adjudication (our bill went to the Education Subcommittee). It can: (1) approve the bill as is and send it to the whole committee for a vote, (2) amend the bill and send it to the whole committee for a vote, or (3) ignore the bill. Until the last week of the session, the Ways & Means Education Subcommittee chose “Door Number 3.”
The Senate. The Senate Education, Health, and Environmental Affairs held a hearing on SB 604 on February 22nd.
Shortly thereafter, the Committee voted unanimously, to approve the bill.
Shortly thereafter, the whole Senate voted, unanimously, to approve the bill.
The rest of the process. When one chamber passes a bill, it must then send the bill to the other chamber for a hearing and approval. The Senate passed SB 604 on March 10th and sent it to the House on the same day. It was assigned to the House Ways & Means Committee . . . where it had a hearing on March 13.th Thereafter, SB 604 took its place alongside HB 478, to languish within the Education Subcimmittee of Ways & Means.
Almost one month later – on April 10th – the very last day of session – SB 604 was voted out of Committee. . . AS AMENDED!
Many amendments are simple; some amendments make substantial changes. And then there are the amendments such as the one made to SB 604 in which the entire bill is stricken and in place of the requisite vision screening, the provides some training for "school health services program coordinators, and orders the creation and distribution of pamphlets about binary vision disorders.
The End. According to unwritten Legislative protocol, the fact a committee votes a sponsor’s bill out of committee at all is supposed to be a good thing for the sponsor. I am still trying very hard to determine what it is that I am appreciating. Granted, I could be at least pleased that something was going to be done, if the pamphlet version of the bill passed. But that was never a possibility.
The revised, pamphlet version of SB 604 was brought up for a vote on the floor of the House around 10:45 pm on Sine Die. If you are unfamiliar with Sine Die, it is the term used for the last day of the session, and each chamber remains in session all day long, until midnight of that day. At the stroke of midnight, all activity ends, and even bills that were up for a vote will die if the vote has not been “taken” before midnight.
With the House vote approving SB 604 occuring with just about one hour left in the 2017 session, there was no way in H*** that it could be sent back to the Senate for a determination by its committee to accept the House amendments, and then voted on by the full Senate. Besides which, Senator Bates had made it abundantly clear well in advance of these votes, that the Senate was not about to accept an amendment that totally gutted the bill. And so, our bills died.
Now you know. This is how it happens -- or doesn’t happen. The more interesting question is, why? Look for that article in the next update.
Floor Speech to Save SB 604
Below is the speech I gave on the floor of the House setting the stage to pass the bill next year.
Colleagues, what this amendment does is to restore the critical visual screening provisions to SB 604.
I urge the members of this chamber to adopt this amendment
Today in Maryland more than 25% of our children have some kind of binary vision problem, from lazy eye to double vision, convergence insufficiency, strabismus, etc., etc.
When this condition is present in children, it can have a dramatically negative effect on their ability to succeed in school.
Reading, for these children becomes torture, causing headaches, dizziness and fatigue.
And because children have no idea that their eyes are seeing differently from their friends, they feel they “aren’t smart,” and become discouraged.
Despite numerous studies, starting as far back as 1949, showing the devastating effect of visual impairments on children, we have not yet taken this issue seriously.
This bill merely adds to the vision screenings that are already done in our schools that they shall “include the administration of a computerized screening that is designed to detect possible symptoms of visual impairments.”
And the reason it is so critical to detect is because VISION THERAY CAN CORRECT THIS CONDITION IN 70 PERCENT TO 85 PERCENT OF THE CHILDREN WITH THE MOST COMMON TYPE IMPAIRMENT.
FEDERAL AND STATE MANDATE
The fact is, we are already required to address this issue by the federal government
Indeed, pursuant to individual complaints, the Maryland Department of Education has found Howard, Harford, Anne Arundel, and Prince Georges counties to be out of compliance with the Individuals with Disabilities Education Act (the “IDEA”)
In a Response Letter, the Maryland Department of Education said, “Any impairment in vision, regardless of severity, is covered, provided that such impairment . . . adversely affects a child’s educational performance.” The Department found that the non-compliant counties were required to recognize such impairments and to “collect sufficient data” to determine if a child has a vision impairment.”
THIS IS EXACTLY WHAT HB458/SB604 DID – before the House amendment stripping the bill of all content except the instruction that schools issue pamphlets about the conditions.
Colleagues, this amendment creates the means by which our schools can COLLECT THE DATA to determine if a child has a vision impairment. The amendment puts back into the bill the simple requirement that schools expand their vision tests to COVER these types of binary vision disorders.
Pamphlets don’t diagnose vision conditions.
IMPACT ON JUVENILE JUSTICE
Perhaps even more problematic, particularly for me, as a member of the Judiciary Committee, is the fact that studies all over the country have found a clear link between vision and anti-social behavior, including juvenile delinquency.
One Maryland study found that up to 98% of the juveniles incarcerated in the Hickey School suffered from vision impairments – almost none of which were caused by poor acuity.
If you think about it, this makes sense.
Just imagine the damage it does to the self-esteem of an already at-risk student to go to school and find that he or she can’t get through the reading or understand what she/he has read – while others do.
The National Correctional Education Association taught its correctional officers how to look for and recognize these conditions inside prison and jail schools. One of the subject matter experts for the training was responsible for a 29% reduction in recidivism at the San Bernardino Juvenile Hall for a 11 years in a row by properly identifying and addressing visual impairments.
In FY 2014, Maryland had 1,196 juveniles committed, and another 4,805 detained awaiting disposition.
It costs the State $38,360 to house a juvenile inmate for a year.
For 1,196 juveniles at $38,360 each, the State spends $45.9 million a year, just to house those who have been committed.
If we are able to keep just 25% of those 11 hundred children out of the system, the State saves $11.5 million a year.
If proper identification eliminates 10% of that population, we save $4.5 million.
If we can improve the vision screening to properly identify these children and keep just 1% of those children out of jail, the state saves half a million dollars.
And the savings in children’s lives and futures is inestimable.
VALIDITY OF THE COMPUTER VISION TESTING
One of the concerns expressed by the committee was about the technology; here are the facts
This idea for this bill was brought to me by a Mom, by the name of Catherine Carter whose whole family has been affected by this condition and by the school system’s lack of knowledge about it.
The efforts and the research she put into working for this bill are almost unbelievable. Not only educate most of the legislature about the significant details of the entire issue, but she sought out vendors capable of providing the services so that we would have a precise estimate of what it would cost! One of those vendors is RightEye, a three-year-old Maryland company that has created computer-based programs that screen for all sorts of vision issues as well as other conditions. (NOTE: vendors who helped us identify costs are clearly aware that the ultimate awarding of a contract must go through the procurement process).
The science behind the computerized technology offered by RightEye (and possibly others) is backed by over 40 years of studies. Right now, the Veterans Administration is using computer vision screening developed with RightEye to test their soldiers for Parkinson disease
And for you baseball fans, RightEye has recently signed a contract with Major League Baseball for vision testing of its players.
The American Academy of Pediatrics, in 2016 issued a policy statement on visual system assessments in infants, children and young adults in which they stated, “Instrument-based screening devices for vision screening are available commercially and have extensive validation.
The science is sound
The need is great
Federal and State law demands we test for these vision conditions
And children are suffering.
Please join with me in voting for this amendment.
HB 458 - Vision screening for binary eye disorders
Bill whose time has come
This year, I am introducing a bill to expand the scope of vision testing in schools. The current test only ascertains whether your child can see at 20-20 acuity.
But "acuity" is not the only relevant measure. Approximately 12% of the population has a vision impairment in which the eyes don't coordinate with each other. The condition may be binary vision disorder or vision processing disorder, but the effect of these disorders can cause serious issues for our children.
What is a Visual Processing Disorder?
People with this disorder, see words on a page very differently. And children with the disorder have no way of knowing that there is a problem with their vision!
Children with this disorder have difficulty focusing and reading, and often get headaches as they try to concentrate on understanding what they're seeing.
The result is obvious -- school can become torture for these children, and they don't know why.
If the disorder is sufficiently severe, the child may be diagnosed as having a disability. The school will creat an IEP (individual education plan) for the child -- which will have no effect since the plan doesn't address the actual problem. The school suffers the added expense of processing the IEP, and
the child will not be helped.
The Condition is CURABLE
The most horrifying part of not identifying this condition early, is that it is curable! There is no need for these children to suffer through years and years of pain and failure and self-doubt when a quick and simple test can identify the existence of such a visual impairment, allowing the children to get treatment.
Thanks to a wonderful constituent -- Catherine Carter -- who brought this issue to my attention, we are going to introduce a bill to have the vision screening already being done by schools to include screening for this type of visual impairment. The cost to add such screening is minimal, and the value of identifying this condition before a child is asked to learn to read, is definitely worth it.