I 
109TH CONGRESS 
1ST SESSION H. R. 2671
To provide for the expansion of Federal programs to prevent and manage 
vision loss, and for other purposes. 
IN THE HOUSE OF REPRESENTATIVES 
MAY 26, 2005
Mr. GENE GREEN of Texas (for himself, Ms. ROS-LEHTINEN, Mr. PRICE of 
North Carolina, and Mr. TIBERI) introduced the following bill; which was 
referred to the Committee on Energy and Commerce, and in addition to 
the Committee on Ways and Means, for a period to be subsequently de-
termined by the Speaker, in each case for consideration of such provisions 
as fall within the jurisdiction of the committee concerned 
A BILL 
To provide for the expansion of Federal programs to prevent 
and manage vision loss, and for other purposes.
Be it enacted by the Senate and House of Representa-
tives of the United States of America in Congress assembled, 
SECTION 1. SHORT TITLE. 
This Act may be cited as the ‘‘Vision Preservation 
Act of 2005’’. 
SEC. 2. FINDINGS. 
The Congress finds as follows:
(1) An estimated 80 million Americans have a 
potentially blinding eye disease. Three million Amer-
icans have low vision, 1.1 million Americans are le-
gally blind, and 200,000 Americans are more se-
verely visually impaired. Visual impairment is one of 
the 10 more frequent causes of disability in the 
United States. 
(2) While it is believed that half of all blindness 
can be prevented, the number of Americans who are 
blind or visually impaired is expected to double by 
2030. 
(3) Vision is critical to conducting activities of 
daily living and affects developmental learning, com-
municating, working, health, and quality of life. 
(4) Vision problems affect 1 in 20 preschoolers 
and, if untreated, can affect learning ability, person-
ality, and adjustment in school. 
(5) It is estimated that blindness and visual im-
pairment cost the Federal Government more than $4 
billion annually in benefits and lost taxable income. 
(6) The four leading eye diseases affecting older 
Americans are age-related macular degeneration, 
cataract, diabetic retinopathy, and glaucoma. 
(7) Age-related macular degeneration is the 
most common cause of low vision and legal blindness
in older Americans. More than 1.6 million Ameri-
cans age 50 and older live with late stage age-re-
lated macular degeneration. It is recommended that 
individuals age 60 or older have their eyes examined 
at least once a year to detect age-related macular 
degeneration. 
(8) The Federal Government spends more than 
$3.4 billion each year treating cataract through the 
Medicare program. Cataract affects nearly 20.5 mil-
lion Americans age 40 and over. By age 80, more 
than half of all Americans have cataract. 
(9) Diabetic retinopathy affects over 5.3 million 
Americans age 18 or older and can affect anyone 
with diabetes. The Centers for Disease Control and 
Prevention estimate that 10.3 million Americans 
have diagnosed diabetes, while an additional 5.4 mil-
lion have undiagnosed diabetes. Because the number 
of Americans with diabetes is expected to grow sig-
nificantly as the number of older Americans con-
tinues to increase, more people will be at risk for di-
abetic retinopathy. 
(10) Glaucoma affects more than 2.2 million 
Americans age 40 and older. Glaucoma cannot be 
prevented, but most cases can be controlled and vi-
sion loss slowed or halted with treatment. Glaucoma
disproportionately affects minorities, affecting more 
than 10 percent of Black men and Hispanic women 
age 80 or older. 
(11) Vision rehabilitation helps people with a 
serious vision loss learn to safely navigate within 
their home environs, avoid medication errors, cook 
and use kitchen implements safely, and avoid burns, 
falls, and other injuries. Vision rehabilitation pro-
motes safety and independence for the vision-im-
paired elderly, and prevents injuries and further dis-
abilities. 
(12) Recognizing that the Nation requires a 
public health approach to visual impairment, the De-
partment of Health and Human Services dedicated 
a portion of its Healthy People 2010 initiative to vi-
sion. The initiative set out as a goal the improve-
ment of the Nation’s visual health through preven-
tion, early detection, treatment, and rehabilitation. 
(13) Greater efforts must be made at the Fed-
eral, State, and local levels to increase awareness of 
vision problems, their impact, the importance of 
early diagnosis, treatment, and rehabilitation, and 
effective prevention strategies. It is the sense of the 
Congress that the Nation must have a full-scale pub-
lic health effort on vision problems that includes the 
following: 
(A) Communication and education. 
(B) Surveillance, epidemiology, and preven-
tion research. 
(C) 
Programs, 
policies, 
and 
systems 
change. 
TITLE I—PUBLIC HEALTH 
PROVISIONS 
SEC. 101. VISION LOSS PREVENTION. 
Part B of title III of the Public Health Service Act 
(42 U.S.C. 243 et seq.) is amended by inserting after sec-
tion 317S the following: 
‘‘SEC. 317T. PREVENTIVE HEALTH MEASURES WITH RE-
SPECT TO VISION LOSS. 
‘‘(a) COMMUNICATION AND EDUCATION.—
‘‘(1) IN
GENERAL.—The Secretary, acting 
through the Centers for Disease Control and Preven-
tion, the Health Resources and Services Administra-
tion, and the National Institutes of Health, shall ex-
pand and intensify programs to increase awareness 
of vision problems, including awareness of—
‘‘(A) the impact of vision problems; and
‘‘(B) the importance of early diagnosis, 
management, and effective prevention and reha-
bilitation strategies. 
‘‘(2) ACTIVITIES.—In carrying out this sub-
section, the Secretary may—
‘‘(A) conduct public service announcements 
and education campaigns; 
‘‘(B) enter into partnerships with eye-
health professional organizations and other vi-
sion-related organizations; 
‘‘(C) conduct community disease preven-
tion campaigns; and 
‘‘(D) conduct testing, evaluation, and 
model training for vision screeners based on sci-
entific studies. 
‘‘(3) EVALUATION.—In carrying out this sub-
section, the Secretary shall—
‘‘(A) establish appropriate measurements 
for public awareness of vision problems; 
‘‘(B) establish appropriate measurements 
to determine the effectiveness of existing cam-
paigns to increase awareness of vision problems; 
‘‘(C) establish quantitative benchmarks for 
determining the effectiveness of activities car-
ried out under this subsection; and
‘‘(D) not later than 12 months after the 
date of the enactment of this section, submit a 
report to the Congress on the results achieved 
through such activities. 
‘‘(b) SURVEILLANCE, EPIDEMIOLOGY, AND HEALTH 
SERVICES RESEARCH.—
‘‘(1) IN GENERAL.—The Secretary shall expand 
and intensify activities to establish a solid scientific 
base of knowledge on the prevention and control of 
vision problems and related disabilities. 
‘‘(2) ACTIVITIES.—In carrying out this sub-
section, the Secretary may—
‘‘(A) create a national ongoing surveillance 
system; 
‘‘(B) identify and test screening modalities; 
‘‘(C) evaluate the efficacy and cost-effec-
tiveness of current and future interventions and 
community strategies; 
‘‘(D) update and improve knowledge about 
the true costs of vision problems and related 
disabilities; and 
‘‘(E) require the Surgeon General to assess 
the state of vision care and vision rehabilitation 
in the United States. 
‘‘(c) PROGRAMS, POLICIES, AND SYSTEMS.—
‘‘(1) IN GENERAL.—The Secretary shall expand 
and intensify research within the Centers for Dis-
ease Control and Prevention on the prevention and 
management of vision loss. 
‘‘(2) ACTIVITIES.—In carrying out this sub-
section, the Secretary may—
‘‘(A) build partnerships with voluntary 
health organizations, nonprofit vision rehabilita-
tion agencies, Federal, State, and local public 
health agencies, eye health professional organi-
zations, and organizations with an interest in 
vision issues; 
‘‘(B) work with health care systems to bet-
ter address vision problems and associated dis-
abilities; and 
‘‘(C) award grants for community outreach 
regarding vision loss to national vision organi-
zations with broad community presence.’’. 
SEC. 102. EXPANSION OF VISION PROGRAMS UNDER THE 
MATERNAL AND CHILD HEALTH SERVICE 
BLOCK GRANT PROGRAM. 
Section 501(a)(3) of the Social Security Act (42 
U.S.C. 701(a)(3)) is amended—
(1) by striking ‘‘and’’ at the end of subpara-
graph (E);
(2) by striking the period at the end of sub-
paragraph (F) and inserting ‘‘, and’’; and 
(3) by adding at the end the following new sub-
paragraph: 
‘‘(G) introduce core performance measures 
on eye health by incorporating vision screening 
standards into State programs under this title, 
based on scientific studies.’’. 
SEC. 103. PREVENTION AND TREATMENT FOR UNDER-
SERVED, 
MINORITY, 
AND 
OTHER 
POPU-
LATIONS. 
(a) EXPANSION AND INTENSIFICATION OF VISION 
PROGRAMS.—The Secretary of Health and Human Serv-
ices (in this section referred to as the ‘‘Secretary’’) shall 
expand and intensify programs targeted to prevent vision 
loss, treat eye and vision conditions, and rehabilitate peo-
ple of all ages who are blind or partially sighted in under-
served and minority communities, including the following: 
(1) Vision care services at community health 
centers receiving assistance under section 330 of the 
Public Health Service Act (42 U.S.C. 254b). 
(2) Vision rehabilitation programs at vision re-
habilitation agencies, eye clinics, and hospitals. 
(b) VOLUNTARY GUIDELINES FOR VISION SCREEN-
ING.—The Secretary, in consultation with eye-health pro-
fessional organizations and other vision-related organiza-
tions, shall develop voluntary guidelines to ensure the 
quality of vision screening. 
SEC. 104. NATIONAL INSTITUTES OF HEALTH. 
(a) IN GENERAL.—The Director of the National In-
stitutes of Health (in this section referred to as the ‘‘Di-
rector’’) shall expand, intensify, and coordinate programs 
for the conduct and support of research with respect to 
vision loss prevention and vision rehabilitation. 
(b) COORDINATION.—The Director shall coordinate 
vision-related activities in consultation with Federal offi-
cials, voluntary health organizations, medical professional 
societies, and private entities as appropriate. 
(c) RESEARCH.—In carrying out this section, the Di-
rector shall expand the following research activities: 
(1) translational research within the National 
Eye Institute; 
(2) diabetes and glaucoma related programs of 
the National Eye Institute; 
(3) creation of an age-related macular degen-
eration public education program within the Na-
tional Eye Institute to—
(A) increase awareness of age-related 
macular degeneration in selected high-risk tar-
get audiences in the United States;
(B) increase awareness of the importance 
of early detection of age-related macular degen-
eration in preventing vision loss; 
(C) increase health care providers’ aware-
ness of the need for regular comprehensive di-
lated eye examinations for those at risk for age-
related macular degeneration and other eye dis-
eases, with the ultimate goal of early detection 
of eye disease and the linkage of patients to ap-
propriate medical treatment and rehabilitation 
services; and 
(D) encourage at-risk populations to take 
appropriate action based on their increased 
awareness. 
TITLE II—MEDICARE 
PROVISIONS 
SEC. 201. IMPROVEMENT OF OUTPATIENT VISION SERV-
ICES UNDER PART B. 
(a) COVERAGE UNDER PART B.—Section 1861(s)(2) 
of the Social Security Act (42 U.S.C. 1395x(s)(2)) is 
amended—
(1) in subparagraph (Y), by striking ‘‘and’’ 
after the semicolon at the end; 
(2) in subparagraph (Z), by adding ‘‘and’’ after 
the semicolon at the end; and
(3) by adding at the end the following new sub-
paragraph: 
‘‘(AA) vision rehabilitation services (as defined 
in subsection (bbb)(1));’’. 
(b) SERVICES DESCRIBED.—Section 1861 of the So-
cial Security Act (42 U.S.C. 1395x) is amended by adding 
at the end the following new subsection: 
‘‘Vision Rehabilitation Services: Vision Rehabilitation 
Professional 
‘‘(bbb)(1)(A) The term ‘vision rehabilitation services’ 
means rehabilitative services (as determined by the Sec-
retary in regulations) furnished—
‘‘(i) to an individual diagnosed with a vision im-
pairment (as defined in paragraph (6)); 
‘‘(ii) pursuant to a plan of care established by 
a qualified physician (as defined in subparagraph 
(C)) or by a qualified occupational therapist that is 
periodically reviewed by a qualified physician; 
‘‘(iii) in an appropriate setting (including the 
home of the individual receiving such services if 
specified in the plan of care); and 
‘‘(iv) by any of the following individuals: 
‘‘(I) A qualified physician. 
‘‘(II) An occupational therapist.