BULLETIN NO. 045-17 SE&S

Page 2

July 20, 2017

July 20, 2017 ( x ) Action Required

( )Informational

BULLETIN NO. 045-17 STUDENT ENGAGEMENT AND SUPPORT

TO:Educational Service District Superintendents

School District Superintendents

School Business Managers

School Building Principals

School Nurses

FROM: Chris Reykdal, Superintendent of Public Instruction

RE:Visual Screening Requirements for School Districts

CONTACT:Nicole Klein, Health Services Program

360-725-6040,

During the 2016 Legislative session, Senate Bill 6245 added near vision screening as a mandatory vision screening requirement in addition to the existing requirement for distance vision screening in all Washington state schools. This legislation amended RCW 28A.210.020.

Background

Pursuant to RCW 28A.210.020, the Washington State Board of Health (WSBOH) has the authority to adopt rules (WAC) for visual screening in schools. In collaboration with the Office of Superintendent of Public Instruction (OSPI), the Washington State Department of Health (WSDOH), school nurses in Washington state, the OSPI School Nurse Corps, and other key stakeholders, WSBOH revised Chapter246-760 WAC AUDITORY AND VISUAL STANDARDS—SCHOOL DISTRICTS which was approved by it’s board on November 9, 2016. The new rule for school-based vision screening takes effect in the 2017–18 school year. The WAC change adds the tools for mandatory near vision screening and changes the required tools for distance vision screening.

Notable Rule Changes

  • Near vision acuity screening of children in kindergarten, 1st grade, 2nd grade, 3rd grade, 5th grade, and 7th grade is required beginning in the 2017–18 school year. These are the same grades required to be screened for distance visual acuity.
  • Schools will need to purchase new tools to be in compliance with the new rule. For example, the prior rule required use of Snellen screening charts which are no longer evidence-based vision screening tools. Instead, Sloan letters and other tools indicated in the table below need to be used in order to comply with the new rule. In addition, the new near vision screening component of the rule requires schools to purchase tools

that can accurately test for near vision acuity. Schools can use instrument-based vision screening devices (such as photoscreening devices) in lieu of the charts. If the device does not generate a result for a student, a school must rescreen the studentwith an optotype tool outlined in the table below. A vendor is working with school nurses in Washington to develop vision screening kits that comply with the new rule and that meet the unique needs of school districts.Training for school nurses and for OSPI School Nurse Corps Administrators will be conducted to ensure that nurses know how to use the new tools/instruments and vision screening devices.

  • The rule now explicitly permits schools to expand visual screening to any other grades, and allows schools to conduct optional vision screenings in addition to near and far vision acuity at any grade using evidence-based screening tools and techniques; examples would be stereo-acuity and color vision screening.
  • Schools shall conduct all vision screening using tools and procedures that are linguistically, developmentally and age-appropriate. For distance vision and near vision acuity screening, schools shall use screening tools identified in WAC 246-760-071. Please refer to the table below for requirements pertaining to screening tools as well as the rescreening and referral criteria.
  • A school is not required to screen a student who has already had a comprehensive vision examination by a licensed vision care professional within the previous 12 months. To waive the screening, schools must have a report or form signed by a licensed vision care professional indicating such, and the school must place this report/form in the student’s health record.
  • Supervision, training, reporting, and referral of vision screening shall be the responsibility of the school nurse, or the school principal or his/her designee. The principal or his/her designee must demonstrate his/her competence in vision screening through supervised training by a competent school public health nurse or a licensed vision care professional, the principal or his/her designee must also have supervisory ability and experience, and have the ability to work well with school staff and lay persons.

Purpose of Screening / Grade / Screening Tools / Rescreening and Referral Criteria
Distance Vision / Kindergarten / LEA* vision test: Single LEA symbol (at 5 feet), or HOTV** letter / Visual acuity worse than 20/40 in either eye
Distance Vision / First Grade / LEA vision test: Single LEA symbol (at 5 feet), orHOTV letter / Visual acuity worse than 20/32 in either eye
Distance Vision / Second Grade and above / LEA vision test: LEA symbols or numbers, or HOTV letters, or Sloan letters / Visual acuity worse than 20/32 in either eye
Near Vision Acuity / Kindergarten / LEA vision test: LEA symbols near vision, HOTV, or Sloan letters / Visual acuity worse than 20/40 in either eye
Near Vision Acuity / First Grade and above / LEA vision test: LEA symbols near vision, HOTV, or Sloan letters / Visual acuity worse than 20/32 in either eye

*LEA vision test(s)is a test used to measure visual acuity using specific symbols or numbers, designed for those who do not know how to read the letters of the alphabet. (WAC 246-760-010).

**HOTV letters is a test using the letters H, O, T, and V calibrated of a certain size used to assess visual acuity (WAC 246-760-010).

The new vision screening rule can be read in its entirety at: (chapter 246-760 WAC).

OSPI will continue to work with school nurses and administrators, as capacity permits, to assist districts in implementing the new law by providing support and guidance through educational opportunities for nurses.

If you have questions about the content of this bulletin, please contact Nicole Klein, Health Services Program, 360-725-6040 or by email . The OSPI TTY line is 360-664-3631.

Information is available on OSPI’s website at

Michaela W. Miller, Ed.D., NBCT

Deputy Superintendent

Martin Mueller

Assistant Superintendent

Student Engagement and Support

Mona Johnson, Ed.D.

Director

Student Engagement and Support

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OSPI provides equal access to all programs and services without discrimination based on sex, race, creed, religion, color, national origin, age, honorably discharged veteran or military status, sexual orientation, gender expression, gender identity, disability, or the use of a trained dog guide or service animal by a person with a disability. Questions and complaints of alleged discrimination should be directed to the Equity and Civil Rights Director at 360-725-6162/TTY: 360-664-3631; or P.O. Box 47200, Olympia, WA 98504-7200; or.