Vision Exam Program Requirement Moves Through Missouri General Legislation

Legislation is moving through the Missouri General Assembly that would remove an expiration date for a program prompting children in elementary and middle school to receive a vision exam.

Under Missouri law, every child enrolling in kindergarten or first grade in a public elementary school in this state must receive “a comprehensive vision examination performed by a state licensed optometrist or physician.” As it stands now, the requirement is set to expire on June 30, 2012.

Legislation sponsored by Sen. David Pearce, R-Warrensburg, in the Senate and Rep. Don Wells, R-Cabool, in the House would approve that expiration date, effectively making the program permanent.

In an interview, Pearce said he believes the program has been successful. “And I think it’s proven itself,” he said. “And that’s why we can take the sunset off and just have a permanent program.”

The law, however, stipulates children can opt out if a parent or guardian submits to a school administrator a written request that the child be excused from taking a vision examination. Kristi Lanham, a nurse at Oakville Elementary School, said that many parents decide to go that route.

“I have to tell you honestly, myself, I don’t have an opinion one way or the other. It’s just something I have to deal with, so I deal with it,” Lanham said. “But I know a lot of parents think it’s kind of crazy and they choose to opt out of it. The parents that do send me the exams, over half of those kids are children who are already identified with a vision problem, so they already have a doctor that they see on a regular basis for their eyes. And most of those kids are already wearing glasses.”

The vision exam law, Lanham said, is different from immunizations requirement. In that provision, children could be excused from school if the procedures aren’t followed. With this situation, she said, parents could take no action whatsoever and face no consequences.

“Immunizations are required, but you can go to the county health department and them at a reduced price,” Lantham said. “The way it was explained was because there’s not really any state funding supplied for the vision exams … they can’t make it mandatory and the parents have to have the choice to opt out of it.”

“For the parents who choose not to do the exam and not to bother filling in the opt out form, there’s nothing that happens, there’s no consequence,” Lantham added. “It’s just ‘oh well, they didn’t return anything.’”

Pearce said the opt-out was put in place to prevent the program from becoming an unfunded mandate. He added there are a number of ways to pay for the exam.

“We do have the Blindness Trust Fund for when people renew their driver’s license—there’s money in there, and there’s [probably] about $100,000 in there,” Pearce said. “We’ve never even come close to spending all that money. So there’s plenty of money in there. Plus, a lot of the kids are covered with their private insurance or through Medicaid. Many, many eye doctors back home, they do these services for free. So really financing’s never been a problem for it.”

Wells’ version of the measure passed the House earlier this year 146-2, with Rep. Marsha Haefner, R-Oakville, voting affirmatively. She said in an interview that she is supportive of the legislation, calling it “another safety net for children.”

Pearce—who handled legislation creating the program when he was in the Missouri House—said the measure is one of the best bills he’s carried in his legislative career.

“About three months ago, a woman came up to me and said ‘are you responsible for that eye exam bill that passed a few years ago?’” Pearce said, adding that the tone of her voice seemed ‘fairly negative.’ “I said ‘yeah, I passed it in the House.’”

“And she said ‘I want to thank you, because my son can see. If it wasn’t for an eye exam that he had, he would be blind today,’” Pearce added. “And so, you hear stories like that and you think it’s worthwhile.”