89R11608 KRM-F
	By: González of El Paso	H.B. No. 5271

	A BILL TO BE ENTITLED
	AN ACT
	relating to the screening of, services for, and educational
	programs for children with visual impairments; authorizing an
	administrative penalty.
	BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
	SECTION 1.  This Act may be cited as Zach's Law.
	SECTION 2.  Chapter 29, Education Code, is amended by adding
	Subchapter J to read as follows:
	SUBCHAPTER J. PROGRAMS FOR CHILDREN AND STUDENTS WITH
	VISUAL IMPAIRMENT
	Sec. 29.331.  DEFINITIONS. In this subchapter, "early
	intervention services," "expanded core curriculum," "functional
	vision assessment," "screening," and "visual impairment" have the
	meanings assigned by Section 36A.001, Health and Safety Code.
	Sec. 29.332.  PROGRAM REQUIRED. In addition to a special
	education program under Subchapter A, a school district and
	open-enrollment charter school shall provide a program for
	appropriate interventions from birth, including age-appropriate
	instruction in all areas of an expanded core curriculum, to a child
	who:
	(1)  is referred to the district or school under
	Chapter 36A, Health and Safety Code; and
	(2)  has a visual impairment, as determined by a
	screening or functional vision assessment conducted under Chapter
	36A, Health and Safety Code, or through a formal diagnosis of a
	physician or health care provider.
	Sec. 29.333.  PROGRAM CONTENTS. A program provided under
	this subchapter must contain:
	(1)  expanded core curriculum instruction areas,
	including age-appropriate instruction in:
	(A)  orientation and mobility;
	(B)  social interaction skills;
	(C)  independent living skills;
	(D)  assistive technology;
	(E)  self determination;
	(F)  sensory efficiency skills;
	(G)  recreation and leisure;
	(H)  compensatory or access skills; and
	(I)  career education; and
	(2)  early intervention services, including:
	(A)  vision therapy;
	(B)  developmental support; and
	(C)  access to assistive technologies to support
	the child's development and learning.
	Sec. 29.334.  COMPENSATORY SERVICES FOR LATE
	IDENTIFICATION. (a) The agency by rule shall require school
	districts and open-enrollment charter schools to provide a student
	with a visual impairment who is identified after third grade with
	additional instruction and support commensurate with the student's
	needs to address developmental delays and the education loss of
	specific visual impairment instruction under the expanded core
	curriculum, caused by the delayed identification for visual
	impairment.
	(b)  The agency shall require school districts and
	open-enrollment charter schools in conducting admission, review,
	and dismissal processes to develop individualized plans to address
	and remedy the delayed identification described by Subsection (a)
	and provide the necessary compensatory instruction, including
	additional instruction for relevant skills development and
	opportunities for the student to learn and successfully complete
	the expanded core curriculum.
	(c)  If consensus is not reached between a parent or adult
	student and a school district or open-enrollment charter school for
	compensatory services provided under this section, the parent or
	adult student may pursue all administrative remedies available
	under the Individuals with Disabilities Education Act (20 U.S.C.
	Section 1400 et seq.).
	SECTION 3.  Subtitle B, Title 2, Health and Safety Code, is
	amended by adding Chapter 36A to read as follows:
	CHAPTER 36A. EARLY VISION SCREENING, IDENTIFICATION, AND REFERRAL
	FOR YOUNG CHILDREN WITH VISUAL IMPAIRMENTS
	SUBCHAPTER A. GENERAL PROVISIONS
	Sec. 36A.001.  DEFINITIONS. In this chapter:
	(1)  "Agency" means the Texas Education Agency.
	(2)  "Certified orientation and mobility specialist"
	means an individual who satisfies agency established requirements
	and holds a certification issued by the Academy for Certification
	of Vision Rehabilitation and Education Professionals.
	(3)  "Certified teacher" means a teacher who teaches
	students with visual impairments and who has:
	(A)  a bachelor's degree from an accredited
	university; and
	(B)  an initial teaching certification in
	elementary or secondary general or special education.
	(4)  "Cortical vision impairment" means a disorder
	caused by damage to areas of the brain that process vision and in
	which the eyes remain healthy but the brain has difficulty
	processing and understanding visual information.
	(5)  "Early intervention services" means the early
	intervention services described in Part C, Individuals with
	Disabilities Education Act (20 U.S.C. Sections 1431-1443).
	(6)  "Expanded core curriculum" means the set of skills
	and concepts that are provided to children with a visual impairment
	to compensate for visual limitations, specialized instruction,
	including orientation and mobility skills, social interaction
	skills, and independent living skills, and use of assistive
	technology.
	(7)  "Functional vision assessment" is an evaluation of
	a child's ability to use vision in daily activities, regardless of
	any formal diagnosis.
	(8)  "Health care provider" means an individual or
	facility licensed, certified, or otherwise authorized to
	administer health care, for profit or otherwise, in the ordinary
	course of business or professional practice, including a physician
	or a hospital or birthing center.
	(9)  "Local education agency" means a school district
	or an open-enrollment charter school.
	(10)  "Newborn" means a child less than 30 days old.
	(11)  "Physician" means a person licensed to practice
	medicine in this state under Subtitle B, Title 3, Occupations Code.
	(12)  "Risk factors" means criteria or factors
	identifying an infant or child as susceptible to a visual
	impairment, including:
	(A)  a premature birth of less than 32 weeks;
	(B)  in vitro alcohol or substance abuse;
	(C)  birth complications;
	(D)  congenital infections;
	(E)  a history of a neurological disorder;
	(F)  a diagnosis of a seizure disorder, cerebral
	palsy, intrauterine stroke, hydrocephalus, cerebral dysplasia such
	as schizencephaly, cranial dysplasia such as Apert syndrome,
	meningitis, encephalitis, a brain tumor, or a traumatic brain
	injury;
	(G)  a genetic predisposition, including rare
	chromosomal abnormalities;
	(H)  a family history of congenital visual
	impairment or vision loss;
	(I)  a family history of autism spectrum disorder
	or a diagnosis of autism spectrum disorder;
	(J)  a history of metabolic disorders, including
	hypoglycemia, methylmalonic acidemia or propionic acidemia, Refsum
	disease, mucopolysaccharidosis, neuronal ceroid lipofuscinosis,
	disorders of glycosylation, or Tay-Sachs disease;
	(K)  a history of malnourishment, sensory
	processing disorder, or malabsorption syndromes; or
	(L)  parent or caregiver concerns regarding
	developmental vision delays.
	(13)  "Screening" means a test or battery of tests
	administered to rapidly determine the need for a professional
	examination.
	(14)  "Visual impairment" means a loss of vision
	resulting from a disorder of the ocular system or disorder of the
	visual pathways and visual centers in the brain, including the
	pathways serving visual perception, cognition, and visual guidance
	of movement of any type or degree.
	Sec. 36A.002.  RULES. The executive commissioner may adopt
	rules to implement this chapter.
	SUBCHAPTER B. SCREENING, EVALUATION, AND REFERRAL SERVICES
	Sec. 36A.051.  SUSCEPTIBILITY QUESTIONNAIRE. (a) The
	department shall develop a susceptibility questionnaire based on
	the risk factors indicating potential visual impairment in infants
	and provide the questionnaire to hospitals and other birthing
	facilities.
	(b)  The executive commissioner by rule shall require a
	physician attending a newborn or another health care provider
	attending the delivery of the newborn to:
	(1)  complete and submit the susceptibility
	questionnaire to the department before the physician or health care
	provider may discharge the newborn from the hospital or birthing
	facility; and
	(2)  provide a copy of the completed susceptibility
	questionnaire to the newborn's parent, legal guardian, or managing
	conservator and, if known, the newborn's primary care physician and
	vision service provider.
	(c)  The department shall record the information provided in
	the completed susceptibility questionnaire in the database
	established under Subchapter C and report the data to the
	commission and applicable local education agency.
	Sec. 36A.052.  SCREENING AND REFERRAL. (a) The executive
	commissioner by rule shall require screening of newborns and
	infants born in this state at regular intervals within the first 36
	months of life to detect visual impairment that is based on ocular
	and neurological disorders, including cortical vision impairment.
	(b)  The rules must require:
	(1)  health care providers to conduct vision screenings
	at well-child visits when the child is 3 months, 6 months, 12
	months, 24 months, 30 months, and 36 months of age;
	(2)  a health care provider attending a newborn to
	conduct a vision screening for a newborn who exhibits a risk factor;
	and
	(3)  a health care provider to conduct a vision
	screening focused on identifying neurological visual impairments,
	including cortical vision impairment, and refer for a functional
	vision assessment and learning media assessment any child younger
	than five years of age who exhibits a risk factor, regardless of
	whether the child received a formal diagnosis of a visual
	impairment.
	(c)  A health care provider who conducts a screening under
	Subsection (b) and detects a visual impairment or an indication of
	associated risk factors shall:
	(1)  refer the child's parent, legal guardian, or
	managing conservator to the applicable local education agency for
	early intervention services, including a functional vision
	assessment; and
	(2)  provide the child's parent, legal guardian, or
	managing conservator with information on locations at which the
	child may receive a medical follow-up for a formal diagnosis.
	(d)  As soon as practicable after receiving a referral, the
	local education agency shall conduct a functional vision assessment
	and provide any applicable early intervention services.
	Sec. 36A.053.  FUNCTIONAL VISION ASSESSMENT. (a) A parent,
	legal guardian, managing conservator, or health care provider may
	request a local education agency to conduct a functional vision
	assessment if a routine vision screening or other evaluation
	indicates a potential visual impairment.
	(b)  If a susceptibility questionnaire completed under
	Section 36A.051 indicates a child has a risk factor or a screening
	conducted under Section 36A.052 indicates a child may have a visual
	impairment, the applicable local education agency shall conduct a
	functional vision assessment for the child as soon as practicable.
	The local education agency shall provide the child's parent, legal
	guardian, or managing conservator with written information on
	locations at which the assessment may be performed.
	(c)  A functional vision assessment must assess the manner in
	which the child uses vision to perform tasks in daily life
	activities by considering both ocular and neurological factors that
	may impact vision, including a cortical vision impairment.
	(d)  A certified teacher, certified orientation and mobility
	specialist, health care provider, or local education agency that
	conducts a functional vision assessment indicating a child has a
	visual impairment or does not sufficiently use vision to
	appropriately access developmental or educational materials or
	settings shall inform the child's parent, legal guardian, or
	managing conservator the child may be eligible, regardless of a
	formal diagnosis, under the Individuals with Disabilities
	Education Act (20 U.S.C. Section 1400 et seq.) to receive early
	intervention services from the applicable local education agency,
	including access to an expanded core curriculum.
	Sec. 36A.054.  REFERRAL FOR DIAGNOSTIC SERVICES. A
	certified teacher, certified orientation and mobility specialist,
	health care provider, or local education agency that conducts a
	vision screening or functional vision assessment and determines a
	child may have a visual impairment shall use the database developed
	under Subchapter C and refer the child to:
	(1)  a pediatric ophthalmologist, optometrist, or
	pediatric neurologist, as appropriate;
	(2)  the applicable local education agency for a
	functional vision assessment and learning media assessment if those
	assessments have not been conducted; and
	(3)  the Blind Children's Vocational Discovery and
	Development Program administered by the commission for further
	support and services.
	Sec. 36A.055.  EARLY INTERVENTION SERVICES. (a) The
	department, commission, and agency and local education agencies
	shall coordinate to ensure certified teachers, certified
	orientation and mobility specialists, health care providers, and
	local education agencies that detect or diagnose a child with a
	visual impairment, regardless of the child's age, provide
	information on and refer the child to:
	(1)  the Division for Early Childhood Intervention
	Services of the commission;
	(2)  the applicable local education agency responsible
	for delivering early intervention services; and
	(3)  any other appropriate services the department
	requires or recommends.
	(b)  The department, commission, and agency and local
	education agencies shall coordinate to ensure a child who is
	determined to have a visual impairment through a screening,
	diagnosis, or functional vision assessment receives all
	appropriate early intervention services, including instruction in
	all areas of the expanded core curriculum.
	SUBCHAPTER C. STATE AGENCY POWERS AND DUTIES
	Sec. 36A.101.  EDUCATIONAL MATERIALS. (a) The department
	shall develop written educational materials on visual impairments
	under this chapter. The materials shall include information on:
	(1)  visual impairments;
	(2)  the risk factors associated with visual
	impairments;
	(3)  vision screening requirements;
	(4)  early intervention services provided by local
	education agencies;
	(5)  referral and reporting requirements; and
	(6)  any other material the department considers
	necessary.
	(b)  The department shall provide the materials developed
	under this section to hospitals, birthing facilities, and primary
	care providers and require a health care provider to provide a copy
	of the materials to the parent, legal guardian, or managing
	conservator of a newborn.
	(c)  The department in collaboration with the agency shall
	develop a plan to coordinate early intervention services for
	children who are identified with risk factors or diagnosed with a
	visual impairment. The department and agency may not require a
	formal diagnosis of a visual impairment before a child is eligible
	for early intervention services.
	Sec. 36A.102.  TRAINING. (a) The department, in
	collaboration with medical schools and other health care
	organizations, shall develop a training program for health care
	providers to ensure knowledge of and provide necessary skills for
	detecting visual impairments and associated risk factors, with a
	focus on both ocular and neurological forms of visual impairment.
	(b)  Health care providers and certified teachers shall
	complete the training course developed under this section to
	identify signs and symptoms of a visual impairment, risk factors,
	or any other indicator that may necessitate a functional vision
	assessment with or without a formal diagnosis.
	Sec. 36A.103.  PUBLIC AWARENESS CAMPAIGN. (a) The
	department shall establish a public awareness campaign to educate
	parents, legal guardians, managing conservators, and health care
	providers on:
	(1)  types of visual impairments, including cortical
	vision impairment;
	(2)  the importance of early screening;
	(3)  the developmental history and risk factors
	associated with visual impairment;
	(4)  mandatory screening and referral requirements;
	and
	(5)  available resources for children with visual
	impairments.
	(b)  The department shall provide educational materials and
	support for parents, legal guardians, and managing conservators,
	including information on methods of advocating for their child's
	needs and navigating the early intervention system specifically
	designed for blind and visually impaired children.
	Sec. 36A.104.  STATEWIDE VISION DATABASE; REPORT. (a) To
	ensure children with visual impairments receive timely diagnosis
	and treatment, the department shall establish and maintain a secure
	statewide database to monitor and track children who have a risk
	factor for or are diagnosed with a visual impairment. The database
	must track and record:
	(1)  screening and functional assessment outcomes,
	including:
	(A)  the number of children screened; and
	(B)  the number of children diagnosed with or
	identified as having a visual impairment or risk factors;
	(2)  diagnostic follow-up appointments; and
	(3)  early intervention services provided, including
	the number of children receiving early intervention services for a
	visual impairment.
	(b)  Not later than December 1 of each year, the department
	shall provide a written report to the legislature summarizing the
	information collected under Subsection (a) and providing
	recommendations for legislative or other action.
	(c)  The report shall include recommendations for improving
	the program's effectiveness, equity, and accessibility.
	Sec. 36A.105.  FUNDING. From money appropriated or
	otherwise available for this purpose, the department and commission
	shall allocate money to support the implementation of this chapter.
	Sec. 36A.106.  ENFORCEMENT. The department or commission
	may impose an administrative penalty in an amount determined by an
	administrative law judge to be appropriate based on the seriousness
	of the conduct or order a corrective action for a violation of the
	screening and referral requirements under this chapter.
	SECTION 4.  As soon as practicable after the effective date
	of this Act, the executive commissioner of the Health and Human
	Services Commission and the Texas Education Agency shall adopt
	rules necessary to implement the changes in law made by this Act.
	SECTION 5.  This Act takes effect September 1, 2025.