II 

110TH CONGRESS 

2D SESSION S. 3534 

To provide for the expansion of Federal programs to prevent and manage 

vision loss, and for other purposes. 

IN THE SENATE OF THE UNITED STATES 

SEPTEMBER 22 (legislative day, SEPTEMBER 17), 2008 

Mr. DODD (for himself and Mr. VOINOVICH) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL 

To provide for the expansion of Federal programs to prevent 

and manage vision loss, and for other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Vision Preservation 

5 Act of 2008’’. 

6 SEC. 2. FINDINGS; SENSE OF CONGRESS. 

7 (a) FINDINGS.—The Congress finds as follows: 

8 (1) An estimated 80 million Americans have a 

9 potentially blinding eye disease, and more than 19.1 

10 million Americans report trouble seeing, even with 


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1 eye glasses or contacts. At least 1.1 million Ameri2 cans are legally blind, and 200,000 Americans expe3 rience profound vision loss. Refractive errors affect 

4 approximately one third of persons 40 years or older 

5 in the United States. Visual impairment is one of 

6 the 10 more frequent causes of disability in the 

7 United States. 

8 (2) While it is believed that half of all blindness 

9 can be prevented, the number of Americans who are 

10 blind or visually impaired is expected to double by 

11 2030. 

12 (3) Vision loss can, especially without appro13 priate rehabilitation and skills training, significantly 

14 impact an individual’s ability to conduct activities of 

15 daily living, as well as developmental learning, com16 municating, working, health, and quality of life. 

17 (4) One in twenty preschoolers experience visual 

18 impairment which, if unaddressed, can affect learn19 ing ability, personality, and adjustment in school. 

20 (5) It is estimated that blindness and visual im21 pairment cost the Federal Government more than $4 

22 billion annually in benefits and lost taxable income, 

23 and cost the United States economy approximately 

24 $51.4 billion annually in direct medical costs, direct 


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1 nonmedical costs, and indirect costs such as lost pro2 ductivity and wages. 

3 (6) Vision rehabilitation helps people with vi4 sion loss to live safely and independently at home 

5 and in the community, reduce medication errors, 

6 cook and perform other daily activities reliably, and 

7 avoid accidents which may lead to injury or even the 

8 onset of additional disabilities, especially among 

9 older persons living with vision loss. 

10 (7) Recognizing that the Nation requires a pub11 lic health approach to visual impairment, the De12 partment of Health and Human Services dedicated 

13 a portion of its Healthy People 2010 initiative to vi14 sion. The initiative set out as a goal the improve15 ment of the Nation’s visual health through preven16 tion, early detection, treatment, and rehabilitation. 

17 (8) Greater efforts must be made at the Fed18 eral, State, and local levels to increase awareness of 

19 vision loss and its causes, its impact, the importance 

20 of early diagnosis, treatment, and rehabilitation, and 

21 effective prevention strategies. 

22 (b) SENSE OF CONGRESS.—It is the sense of the 

23 Congress that the Nation must have a full-scale integrated 

24 public health strategy to comprehensively address vision 


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1 loss and its causes that, at a minimum, includes the fol2 lowing: 

3 (1) Communication and education. 

4 (2) Surveillance, epidemiology, and prevention 

5 research. 

6 (3) Programs, policies, and systems change. 

7 SEC. 3. VISION LOSS PREVENTION. 

8 Part B of title III of the Public Health Service Act 

9 (42 U.S.C. 243 et seq.) is amended by inserting after sec10 tion 317S the following: 

11 ‘‘SEC. 317T. PREVENTIVE HEALTH MEASURES WITH RE12 SPECT TO VISION LOSS. 

13 ‘‘(a) COMMUNICATION AND EDUCATION.— 

14 ‘‘(1) IN GENERAL.—The Secretary, acting 

15 through the Centers for Disease Control and Preven16 tion, the Health Resources and Services Administra17 tion, and the National Institutes of Health, shall ex18 pand and intensify programs to increase awareness 

19 of vision problems, including awareness of— 

20 ‘‘(A) the impact of vision problems; and 

21 ‘‘(B) the importance of early diagnosis, 

22 management, and effective prevention and reha23 bilitation strategies. 

24 ‘‘(2) ACTIVITIES.—In carrying out this sub25 section, the Secretary may— 


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1 ‘‘(A) conduct public service announcements 

2 and education campaigns; 

3 ‘‘(B) enter into partnerships with eye4 health professional organizations and other vi5 sion-related organizations; 

6 ‘‘(C) conduct community disease preven7 tion campaigns; 

8 ‘‘(D) conduct testing, evaluation, and 

9 model training for vision screeners based on sci10 entific studies; and 

11 ‘‘(E) evaluate strategies to reduce barriers 

12 to access to treatment by optometrists and oph13 thalmologists. 

14 ‘‘(3) EVALUATION.—In carrying out this sub15 section, the Secretary shall— 

16 ‘‘(A) establish appropriate measurements 

17 for public awareness of vision problems; 

18 ‘‘(B) establish appropriate measurements 

19 to determine the effectiveness of existing cam20 paigns to increase awareness of vision problems; 

21 ‘‘(C) establish quantitative benchmarks for 

22 determining the effectiveness of activities car23 ried out under this subsection; and 

24 ‘‘(D) not later than 12 months after the 

25 date of the enactment of this section, submit a 


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1 report to the Congress on the results achieved 

2 through such activities. 

3 ‘‘(b) SURVEILLANCE, EPIDEMIOLOGY, AND HEALTH

4 SERVICES RESEARCH.— 

5 ‘‘(1) IN GENERAL.—The Secretary shall expand 

6 and intensify activities to establish a solid scientific 

7 base of knowledge on the prevention, control, and re8 habilitation of vision problems and related disabil9 ities. 

10 ‘‘(2) ACTIVITIES.—In carrying out this sub11 section, the Secretary may— 

12 ‘‘(A) create a national ongoing surveillance 

13 system; 

14 ‘‘(B) identify and test screening modalities; 

15 ‘‘(C) evaluate strategies to reduce barriers 

16 to access to treatment by optometrists, ophthal17 mologists, and other vision rehabilitation pro18 fessionals; 

19 ‘‘(D) evaluate the efficacy and cost-effec20 tiveness of current and future interventions and 

21 community strategies; 

22 ‘‘(E) update and improve knowledge about 

23 the true costs of vision problems and related 

24 disabilities; and 


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1 ‘‘(F) require the Surgeon General to assess 

2 the state of vision care and vision rehabilitation 

3 in the United States. 

4 ‘‘(c) PROGRAMS, POLICIES, AND SYSTEMS.— 

5 ‘‘(1) IN GENERAL.—The Secretary shall expand 

6 and intensify research within the Centers for Dis7 ease Control and Prevention on the prevention and 

8 management of vision loss. 

9 ‘‘(2) ACTIVITIES.—In carrying out this sub10 section, the Secretary may— 

11 ‘‘(A) build partnerships with voluntary 

12 health organizations, nonprofit vision rehabilita13 tion agencies, Federal, State, and local public 

14 health agencies, eye-health professional organi15 zations, and organizations with an interest in 

16 vision issues; 

17 ‘‘(B) work with health care systems to bet18 ter address vision problems and associated dis19 abilities; and 

20 ‘‘(C) award grants for community outreach 

21 regarding vision loss to health care institutions 

22 and national vision organizations with broad 

23 community presence.’’. 


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1 SEC. 4. EXPANSION OF VISION PROGRAMS UNDER THE MA2 TERNAL AND CHILD HEALTH SERVICE BLOCK 

3 GRANT PROGRAM. 

4 Section 501(a)(3) of the Social Security Act (42 

5 U.S.C. 701(a)(3)) is amended— 

6 (1) by striking ‘‘and’’ at the end of subpara7 graph (E); 

8 (2) by striking the period at the end of sub9 paragraph (F) and inserting ‘‘, and’’; and 

10 (3) by adding at the end the following new sub11 paragraph: 

12 ‘‘(G) introduce core performance measures 

13 on eye health by incorporating vision screening 

14 and examination standards into State programs 

15 under this title, based on scientific studies.’’. 

16 SEC. 5. PREVENTION AND TREATMENT FOR UNDER17 SERVED, MINORITY, AND OTHER POPU18 LATIONS. 

19 (a) EXPANSION AND INTENSIFICATION OF VISION

20 PROGRAMS.—The Secretary of Health and Human Serv21 ices (in this section referred to as the ‘‘Secretary’’) shall 

22 expand and intensify programs targeted to prevent vision 

23 loss, treat eye and vision conditions, and rehabilitate peo24 ple of all ages who are blind or partially sighted in under25 served and minority communities, including the following: 


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1 (1) Vision care services at community health 

2 centers receiving assistance under section 330 of the 

3 Public Health Service Act (42 U.S.C. 254b). 

4 (2) Vision rehabilitation programs at vision re5 habilitation agencies, eye clinics, and hospitals. 

6 (b) VOLUNTARY GUIDELINES FOR VISION SCREEN7 ING.—The Secretary, in consultation with eye-health pro8 fessional organizations and other vision-related organiza9 tions, shall develop voluntary guidelines to ensure the 

10 quality of vision screening and appropriate referral for 

11 comprehensive eye examinations and subsequent vision re12 habilitation services. 

13 SEC. 6. VISION REHABILITATION PROFESSIONAL DEVELOP14 MENT GRANTS. 

15 (a) AUTHORITY.—The Secretary of Health and 

16 Human Services (in this section referred to as the ‘‘Sec17 retary’’) may make grants to eligible institutions of higher 

18 education or nonprofit organizations for the purpose of ac19 tivities described in subsection (b) relating to vision reha20 bilitation professional development. 

21 (b) USE OF FUNDS.—The Secretary may not make 

22 a grant to an institution of higher education or a nonprofit 

23 organization under this section unless the institution or 

24 organization agrees to use the grant for the following: 


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1 (1) Developing and offering preparatory and 

2 continuing education training opportunities (incor3 porating state-of-the-art approaches, technologies, 

4 and therapies to meet the unique needs of older 

5 adults with vision loss) in— 

6 (A) geriatrics among vision rehabilitation 

7 professionals, including professionals in the vi8 sion rehabilitation therapy, orientation and mo9 bility, and low vision therapy fields; and 

10 (B) vision rehabilitation among occupa11 tional therapists and others in related rehabili12 tation and health disciplines. 

13 (2) Conducting, and disseminating the findings 

14 and conclusions of, research on the effectiveness of 

15 preparatory and continuing education training under 

16 paragraph (1). 

17 (3) Developing and disseminating interdiscipli18 nary course curricula for use in the preparation of 

19 new professionals in vision rehabilitation, occupa20 tional therapy, and related rehabilitation and health 

21 disciplines. 

22 (4) Educating physicians, nurses, and other 

23 health care providers about the value of vision reha24 bilitation, to increase appropriate referral by such 

25 professionals for the full range of vision rehabilitaVerDate Aug 31 2005 05:34 Sep 23, 2008 Jkt 069200 PO 00000 Frm 00010 Fmt 6652 Sfmt 6201 E:\BILLS\S3534.IS S3534

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1 tion services available to older individuals with vision 

2 loss. 

3 (c) ELIGIBILITY.—To be eligible to receive a grant 

4 under this section, an entity shall be a university, aca5 demic medical center, national or regional nonprofit orga6 nization, community rehabilitation provider, or allied 

7 health education program, or a consortium of such enti8 ties, that— 

9 (1) offers or coordinates education or training 

10 activities among professionals described in sub11 section (b)(1); or 

12 (2) agrees to use the grant to expand its capac13 ity to coordinate such activities. 

14 (d) DISTRIBUTION OF GRANTS.—In awarding grants 

15 under this section, the Secretary shall ensure that grant16 ees offer or coordinate training for current and emerging 

17 professionals— 

18 (1) from a variety of geographic regions and a 

19 range of different types and sizes of settings and fa20 cilities, including settings and facilities located in 

21 rural, urban, and suburban areas; and 

22 (2) serving a variety of populations of older in23 dividuals with vision loss, including racial and ethnic 

24 minorities, low-income individuals, and other under25 served populations. 


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1 (e) APPLICATION.—To seek a grant under this sec2 tion, an entity shall submit to the Secretary an application 

3 at such time, in such manner, and containing such infor4 mation as the Secretary may require. 

Æ 


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