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F I S C A L I M P A C T R E P O R T
SPONSOR Sandoval
ORIGINAL DATE
LAST UPDATED
02/17/07
03/13/07 HB 1283/aHAFC/aSFC
SHORT TITLE Driver Contributions to Children’s Sight Fund
SB
ANALYST Hanika Ortiz
REVENUE (dollars in thousands)
Estimated Revenue
Recurring
or Non-Rec
Fund
Affected
FY07
FY08
FY09
$0.1
see narrative Children’s Sight
Fund
(Parenthesis ( ) Indicate Revenue Decreases)
ESTIMATED ADDITIONAL OPERATING BUDGET IMPACT (dollars in thousands)
FY07
FY08
FY09 3 Year
Total Cost
Recurring
or Non-Rec
Fund
Affected
Total
$15.2
$7.5
Recurring General
fund
(Parenthesis ( ) Indicate Expenditure Decreases)
SOURCES OF INFORMATION
LFC Files
Responses Received From
Public Education Department (PED)
Department of Health (DOH)
SUMMARY
Synopsis of SFC Amendment
The Senate Finance Committee Amendment removes the requirement that the vision testing
occur annually.
Synopsis of HAFC Amendment
The House Appropriations and Finance Committee Amendment allows a school nurse or the
nurse’s designee, a primary care health provider or a lay eye screener to conduct vision
screenings; provides a vision test only for students enrolled in PK, K 1
st
and 3
rd
grades; removes
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House Bill 1283/aHAFC/aSFC – Page
2
the requirement that any parent notification be only by mail; allows eyeglasses purchased from
the fund to not necessarily be the least expensive; disallows using monies from the fund to
provide replacement insurance for ruined contact lenses; and, includes the appointment of a
school administrator to the advisory committee.
Synopsis of Original Bill
House Bill 1283 amends the public school code and adds new sections to Chapters 24 and 66-
Article 6 NMSA 1978 to require an elementary school nurse administer an annual vision screen
for enrolled students unless the parent refuses the screening. In addition, it will establish a “save
our children’s sight fund" in the state treasury administratively attached to the DOH. The fund
will be used for the purpose of developing and implementing a vision screening program with
follow-up comprehensive examinations for children regardless of family income. A temporary
provision will require the Secretary of Health to appoint an advisory committee to establish the
standards for an appropriate vision screen. The DOH will also be required to promulgate rules
for appropriate vision screening test standards.
SIGNIFICANT ISSUES
The bill is unclear if a “lay eye screener" needs specific training or prior qualifications to
conduct vision screenings on children.
AMENDMENTS
Pg 2, line 8, insert “developmentally appropriate" between “annual" and “vision screening test"
to help address the needs of PK; non-verbal children with disabilities; and, children with hearing
impairments.
FISCAL IMPLICATIONS
Children’s Medical Services within the DOH pays for diagnostic evaluations for children, but
only those children diagnosed with severe problems receive continued vision services. Children
found to have only mild visual acuity are not covered. In those cases, families must pay out-of-
pocket for glasses and follow-up care.
The bill establishes a non-reverting “Save Our Children’s Sight Fund" administered by DOH for
development and implementation of a vision screening program to be administered annually in
the state’s elementary schools. The fund will support the costs associated with follow-up exams
as needed, contact lenses or polycarbonate lenses and replacement insurance for lost or broken
lenses or ruined contact lenses. Funds will come from voluntary contributions from drivers who
have checked-off an option to contribute to the fund for a $1.00 or $5.00 fee. Other funds may
come from grants, appropriations, contributions and statutory revenues directed to the fund.
Expenditures will be by warrants of the secretary of finance and administration pursuant to
vouchers signed by the secretary of health or the secretary’s authorized representative
.
This bill creates a new fund and provides for continuing appropriations. The LFC has concerns
with including continuing appropriation language in the statutory provisions for newly created
funds, as earmarking reduces the ability of the legislature to establish spending priorities.
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House Bill 1283/aHAFC/aSFC – Page
3
The bill is not part of the FY08 Governor’s Executive Budget request for the DOH. The budget
impact to DOH is reported at 0.25 FTE at an estimated cost of $15,250 for salary, benefits, and
start-up costs for the first year. There is no provision within the bill for a percentage of the
revenue from the fund be set aside for administrative costs.
SIGNIFICANT ISSUES
Pre-kindergarten public school students are required to have a vision screening. The current
practice in New Mexico is that vision screening occurs in kindergarten, first grade, third grade
and fifth grade. Early screening requires screening for vision problems such as amblyopia, which
needs treatment as early as possible for the best possible outcome.
The bill presents an innovative financing mechanism to help cover the cost of vision diagnosis
and treatment for student who do not have insurance coverage. It is not clear if this mechanism
of the vehicle registration check-off box will adequately fund such an effort. The bill will require
the parents to be notified by mail if a child’s vision screen indicates the need for follow-up.
Information regarding the availability of funds from the Save Our Children’s Sight Fund must be
enclosed.
PERFORMANCE IMPLICATIONS
Vision screening is recommended by the American Academies of Pediatrics, Family Physicians
and Ophthalmologists.
PED comments that providing early vision screening and possible funds to support follow-up
costs and treatment can lead to improved vision. As there is a link between health and academic
success, this can assist in closing the achievement gap and lead to improved reading and math
scores. However, there is currently no requirement for annual vision screening for all elementary
students; and, as there are 177,419 students enrolled in New Mexico in grades pre-K through 6
an annual screening may be difficult for the current number of elementary school nurses to
accomplish.
ADMINISTRATIVE IMPLICATIONS
DOH notes that the bill creates a new revenue stream to support specialty medical needs for
children without insurance coverage; and, until the revenue stream can be determined it is
impossible to identify the extent to which services will be provided. DOH further notes the need
to develop rules and establish a mechanism to disburse these funds to eligible families and to
evaluate efficiency and effectiveness of vision screening, follow-up referral and treatment
.
CONFLICT, DUPLICATION, COMPANIONSHIP, RELATIONSHIP
Duplicates SB 1149
TECHNICAL ISSUES
Vision screening protocols are already established and used in New Mexico public schools, so
that the recommendation for an “advisory committee to establish the standard for appropriate
vision screening" may be a duplication of efforts.
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House Bill 1283/aHAFC/aSFC – Page
4
OTHER SUBSTANTIVE ISSUES
DOH has the following comments:
Not all children in New Mexico are receiving the vision care that they need. A recent national
report from the Centers for Disease Control highlights the lack of appropriate screening for
children 0-6 years of age who are from poor and or minority families. The report goes on to state
that for many children, their visual impairment only becomes obvious when they enter school. A
significant proportion of children with visual impairments do improve with appropriate treatment
if it is provided early.
School nurses in New Mexico public schools perform vision screening on elementary age
students, however there is no requirement or established standard for when a child should be
screened and or how often a screen is necessary. Even if these children are screened in school,
uninsured or underinsured children may not receive needed vision services or glasses. They may
attend school, yet not achieve up to their potential due to vision problems.
POSSIBLE QUESTIONS
The earlier vision impairment is identified and treated, the better the outcome for the child.
Is their a reason why the bill does not specifically include pre-school.
AMENDMENTS
The Departments suggest the following:
On page 2, line 7, strike “An elementary" and insert in lieu thereof of “A".
On page 2, line 8 after the word “nurse", insert “or their designee".
On page 2, line 8 after the word administer, strike the words “an annual" and insert the
word “a"
On page 2, line 9 after the word “students", insert “in grades pre-kindergarten,
kindergarten, first grade, third grade and fifth grade".
On page 2, line 10 after students, insert “in identified grades".
On page 2, line 19 after parent, strike “by mail and enclose" and insert in lieu thereof “of
that need and provide"
On page 3, line 21 after “a practicing school nurse," insert “a school administrator,"
AHO/nt