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.