1     
PUBLIC EDUCATION VISION SCREENING

2     
2019 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Luz Escamilla

5     
House Sponsor: Brad M. Daw

6     

7     LONG TITLE
8     General Description:
9          This bill modifies provisions regarding public education vision screening.
10     Highlighted Provisions:
11          This bill:
12          ▸     defines terms;
13          ▸     recodifies existing provisions regarding vision screening in public schools and
14     repeals outdated provisions;
15          ▸     gives the Department of Health oversight over public education vision screening;
16          ▸     requires local education agencies to conduct certain free vision screening clinics;
17          ▸     requires the Department of Health to provide for higher-level individual vision
18     screening within the local education agency framework;
19          ▸     modifies provisions regarding volunteers at local education agency free vision
20     screening clinics;
21          ▸     makes technical and conforming changes; and
22          ▸     gives rulemaking authority.
23     Money Appropriated in this Bill:
24          None
25     Other Special Clauses:
26          None
27     Utah Code Sections Affected:
28     AMENDS:
29          26-1-30, as last amended by Laws of Utah 2018, Chapters 35 and 200

30          35A-13-403, as last amended by Laws of Utah 2018, Chapter 415
31          53E-9-301, as last amended by Laws of Utah 2018, Chapters 304, 389 and renumbered
32     and amended by Laws of Utah 2018, Chapter 1
33     REPEALS AND REENACTS:
34          53G-9-404, as renumbered and amended by Laws of Utah 2018, Chapter 3
35     

36     Be it enacted by the Legislature of the state of Utah:
37          Section 1. Section 26-1-30 is amended to read:
38          26-1-30. Powers and duties of department.
39          The department shall exercise the following powers and duties, in addition to other
40     powers and duties established in this chapter:
41          (1) enter into cooperative agreements with the Department of Environmental Quality to
42     delineate specific responsibilities to assure that assessment and management of risk to human
43     health from the environment are properly administered;
44          (2) consult with the Department of Environmental Quality and enter into cooperative
45     agreements, as needed, to ensure efficient use of resources and effective response to potential
46     health and safety threats from the environment, and to prevent gaps in protection from potential
47     risks from the environment to specific individuals or population groups;
48          (3) promote and protect the health and wellness of the people within the state;
49          (4) establish, maintain, and enforce rules necessary or desirable to carry out the
50     provisions and purposes of this title to promote and protect the public health or to prevent
51     disease and illness;
52          (5) investigate and control the causes of epidemic, infectious, communicable, and other
53     diseases affecting the public health;
54          (6) provide for the detection, reporting, prevention, and control of communicable,
55     infectious, acute, chronic, or any other disease or health hazard which the department considers
56     to be dangerous, important, or likely to affect the public health;
57          (7) collect and report information on causes of injury, sickness, death, and disability

58     and the risk factors that contribute to the causes of injury, sickness, death, and disability within
59     the state;
60          (8) collect, prepare, publish, and disseminate information to inform the public
61     concerning the health and wellness of the population, specific hazards, and risks that may affect
62     the health and wellness of the population and specific activities which may promote and protect
63     the health and wellness of the population;
64          (9) establish and operate programs necessary or desirable for the promotion or
65     protection of the public health and the control of disease or which may be necessary to
66     ameliorate the major causes of injury, sickness, death, and disability in the state, except that the
67     programs may not be established if adequate programs exist in the private sector;
68          (10) establish, maintain, and enforce isolation and quarantine, and for this purpose
69     only, exercise physical control over property and individuals as the department finds necessary
70     for the protection of the public health;
71          (11) close theaters, schools, and other public places and forbid gatherings of people
72     when necessary to protect the public health;
73          (12) abate nuisances when necessary to eliminate sources of filth and infectious and
74     communicable diseases affecting the public health;
75          (13) make necessary sanitary and health investigations and inspections in cooperation
76     with local health departments as to any matters affecting the public health;
77          (14) establish laboratory services necessary to support public health programs and
78     medical services in the state;
79          (15) establish and enforce standards for laboratory services which are provided by any
80     laboratory in the state when the purpose of the services is to protect the public health;
81          (16) cooperate with the Labor Commission to conduct studies of occupational health
82     hazards and occupational diseases arising in and out of employment in industry, and make
83     recommendations for elimination or reduction of the hazards;
84          (17) cooperate with the local health departments, the Department of Corrections, the
85     Administrative Office of the Courts, the Division of Juvenile Justice Services, and the Crime

86     Victim Reparations Board to conduct testing for HIV infection of alleged sexual offenders,
87     convicted sexual offenders, and any victims of a sexual offense;
88          (18) investigate the causes of maternal and infant mortality;
89          (19) establish, maintain, and enforce a procedure requiring the blood of adult
90     pedestrians and drivers of motor vehicles killed in highway accidents be examined for the
91     presence and concentration of alcohol;
92          (20) provide the Commissioner of Public Safety with monthly statistics reflecting the
93     results of the examinations provided for in Subsection (19) and provide safeguards so that
94     information derived from the examinations is not used for a purpose other than the compilation
95     of statistics authorized in this Subsection (20);
96          (21) establish qualifications for individuals permitted to draw blood pursuant to
97     Subsection 41-6a-523(1)(a)(vi), 53-10-405(2)(a)(vi), 72-10-502(5)(a)(vi), or
98     77-23-213(3)(a)(vi), and to issue permits to individuals it finds qualified, which permits may
99     be terminated or revoked by the department;
100          (22) establish a uniform public health program throughout the state which includes
101     continuous service, employment of qualified employees, and a basic program of disease
102     control, vital and health statistics, sanitation, public health nursing, and other preventive health
103     programs necessary or desirable for the protection of public health;
104          (23) adopt rules and enforce minimum sanitary standards for the operation and
105     maintenance of:
106          (a) orphanages;
107          (b) boarding homes;
108          (c) summer camps for children;
109          (d) lodging houses;
110          (e) hotels;
111          (f) restaurants and all other places where food is handled for commercial purposes,
112     sold, or served to the public;
113          (g) tourist and trailer camps;

114          (h) service stations;
115          (i) public conveyances and stations;
116          (j) public and private schools;
117          (k) factories;
118          (l) private sanatoria;
119          (m) barber shops;
120          (n) beauty shops;
121          (o) physician offices;
122          (p) dentist offices;
123          (q) workshops;
124          (r) industrial, labor, or construction camps;
125          (s) recreational resorts and camps;
126          (t) swimming pools, public baths, and bathing beaches;
127          (u) state, county, or municipal institutions, including hospitals and other buildings,
128     centers, and places used for public gatherings; and
129          (v) any other facilities in public buildings or on public grounds;
130          (24) conduct health planning for the state;
131          (25) monitor the costs of health care in the state and foster price competition in the
132     health care delivery system;
133          (26) adopt rules for the licensure of health facilities within the state pursuant to Title
134     26, Chapter 21, Health Care Facility Licensing and Inspection Act;
135          (27) license the provision of child care;
136          (28) accept contributions to and administer the funds contained in the Organ Donation
137     Contribution Fund created in Section 26-18b-101;
138          (29) serve as the collecting agent, on behalf of the state, for the nursing care facility
139     assessment fee imposed under Title 26, Chapter 35a, Nursing Care Facility Assessment Act,
140     and adopt rules for the enforcement and administration of the nursing facility assessment
141     consistent with the provisions of Title 26, Chapter 35a, Nursing Care Facility Assessment Act;

142          (30) establish methods or measures for health care providers, public health entities, and
143     health care insurers to coordinate among themselves to verify the identity of the individuals
144     they serve;
145          (31) (a) designate Alzheimer's disease and related dementia as a public health issue
146     and, within budgetary limitations, implement a state plan for Alzheimer's disease and related
147     dementia by incorporating the plan into the department's strategic planning and budgetary
148     process; and
149          (b) coordinate with other state agencies and other organizations to implement the state
150     plan for Alzheimer's disease and related dementia; [and]
151          (32) ensure that any training or certification required of a public official or public
152     employee, as those terms are defined in Section 63G-22-102, complies with Title 63G, Chapter
153     22, State Training and Certification Requirements, if the training or certification is required:
154          (a) under this title;
155          (b) by the department; or
156          (c) by an agency or division within the department; and
157          (33) oversee public education vision screening as described in Section 53G-9-404.
158          Section 2. Section 35A-13-403 is amended to read:
159          35A-13-403. Services provided by the division.
160          The division may:
161          (1) provide:
162          (a) a business enterprise program;
163          (b) workshops, employment, and training; and
164          (c) vocational rehabilitation, training and adjustment, sight conservation, prevention of
165     blindness, low vision lenses, and recreational services;
166          [(2) assist public education officials in the discharge of their duties towards children
167     who are blind or have visual impairments, and perform services related to vision screening
168     under Section 53G-9-404;]
169          [(3) maintain a register of individuals who are blind or have visual impairments,

170     including such facts as the office considers necessary for proper planning, administration, and
171     operations, but protecting against unwarranted invasions of privacy;]
172          [(4)] (2) establish and operate community service centers, rehabilitation facilities, and
173     workshops; and
174          [(5)] (3) perform other duties assigned by the director or the executive director.
175          Section 3. Section 53E-9-301 is amended to read:
176          53E-9-301. Definitions.
177          As used in this part:
178          (1) "Adult student" means a student who:
179          (a) is at least 18 years old;
180          (b) is an emancipated student; or
181          (c) qualifies under the McKinney-Vento Homeless Education Assistance
182     Improvements Act of 2001, 42 U.S.C. Sec. 11431 et seq.
183          (2) "Aggregate data" means data that:
184          (a) are totaled and reported at the group, cohort, school, school district, region, or state
185     level with at least 10 individuals in the level;
186          (b) do not reveal personally identifiable student data; and
187          (c) are collected in accordance with board rule.
188          (3) (a) "Biometric identifier" means a:
189          (i) retina or iris scan;
190          (ii) fingerprint;
191          (iii) human biological sample used for valid scientific testing or screening; or
192          (iv) scan of hand or face geometry.
193          (b) "Biometric identifier" does not include:
194          (i) a writing sample;
195          (ii) a written signature;
196          (iii) a voiceprint;
197          (iv) a photograph;

198          (v) demographic data; or
199          (vi) a physical description, such as height, weight, hair color, or eye color.
200          (4) "Biometric information" means information, regardless of how the information is
201     collected, converted, stored, or shared:
202          (a) based on an individual's biometric identifier; and
203          (b) used to identify the individual.
204          (5) "Board" means the State Board of Education.
205          (6) "Data breach" means an unauthorized release of or unauthorized access to
206     personally identifiable student data that is maintained by an education entity.
207          (7) "Data governance plan" means an education entity's comprehensive plan for
208     managing education data that:
209          (a) incorporates reasonable data industry best practices to maintain and protect student
210     data and other education-related data;
211          (b) describes the role, responsibility, and authority of an education entity data
212     governance staff member;
213          (c) provides for necessary technical assistance, training, support, and auditing;
214          (d) describes the process for sharing student data between an education entity and
215     another person;
216          (e) describes the education entity's data expungement process, including how to
217     respond to requests for expungement;
218          (f) describes the data breach response process; and
219          (g) is published annually and available on the education entity's website.
220          (8) "Education entity" means:
221          (a) the board;
222          (b) a local school board;
223          (c) a charter school governing board;
224          (d) a school district;
225          (e) a charter school;

226          (f) the Utah Schools for the Deaf and the Blind; or
227          (g) for purposes of implementing the School Readiness Initiative described in Title
228     53F, Chapter 6, Part 3, School Readiness Initiative, the School Readiness Board created in
229     Section 35A-3-209.
230          (9) "Expunge" means to seal or permanently delete data, as described in board rule
231     made under Section 53E-9-306.
232          (10) "General audience application" means an Internet website, online service, online
233     application, mobile application, or software program that:
234          (a) is not specifically intended for use by an audience member that attends kindergarten
235     or a grade from 1 to 12, although an audience member may attend kindergarten or a grade from
236     1 to 12; and
237          (b) is not subject to a contract between an education entity and a third-party contractor.
238          (11) "Higher education outreach student data" means the following student data for a
239     student:
240          (a) name;
241          (b) parent name;
242          (c) grade;
243          (d) school and school district; and
244          (e) contact information, including:
245          (i) primary phone number;
246          (ii) email address; and
247          (iii) physical address.
248          (12) "Individualized education program" or "IEP" means a written statement:
249          (a) for a student with a disability; and
250          (b) that is developed, reviewed, and revised in accordance with the Individuals with
251     Disabilities Education Act, 20 U.S.C. Sec. 1400 et seq.
252          (13) "Local education agency" or "LEA" means:
253          (a) a school district;

254          (b) a charter school;
255          (c) the Utah Schools for the Deaf and the Blind; or
256          (d) for purposes of implementing the School Readiness Initiative described in Title
257     53F, Chapter 6, Part 3, School Readiness Initiative, the School Readiness Board created in
258     Section 35A-3-209.
259          (14) "Metadata dictionary" means a record that:
260          (a) defines and discloses all personally identifiable student data collected and shared by
261     the education entity;
262          (b) comprehensively lists all recipients with whom the education entity has shared
263     personally identifiable student data, including:
264          (i) the purpose for sharing the data with the recipient;
265          (ii) the justification for sharing the data, including whether sharing the data was
266     required by federal law, state law, or a local directive; and
267          (iii) how sharing the data is permitted under federal or state law; and
268          (c) without disclosing personally identifiable student data, is displayed on the
269     education entity's website.
270          (15) "Necessary student data" means data required by state statute or federal law to
271     conduct the regular activities of an education entity, including:
272          (a) name;
273          (b) date of birth;
274          (c) sex;
275          (d) parent contact information;
276          (e) custodial parent information;
277          (f) contact information;
278          (g) a student identification number;
279          (h) local, state, and national assessment results or an exception from taking a local,
280     state, or national assessment;
281          (i) courses taken and completed, credits earned, and other transcript information;

282          (j) course grades and grade point average;
283          (k) grade level and expected graduation date or graduation cohort;
284          (l) degree, diploma, credential attainment, and other school exit information;
285          (m) attendance and mobility;
286          (n) drop-out data;
287          (o) immunization record or an exception from an immunization record;
288          (p) race;
289          (q) ethnicity;
290          (r) tribal affiliation;
291          (s) remediation efforts;
292          (t) an exception from a vision screening required under Section 53G-9-404 or
293     information collected from a vision screening [required under] described in Section
294     53G-9-404;
295          (u) information related to the Utah Registry of Autism and Developmental Disabilities,
296     described in Section 26-7-4;
297          (v) student injury information;
298          (w) a disciplinary record created and maintained as described in Section 53E-9-306;
299          (x) juvenile delinquency records;
300          (y) English language learner status; and
301          (z) child find and special education evaluation data related to initiation of an IEP.
302          (16) (a) "Optional student data" means student data that is not:
303          (i) necessary student data; or
304          (ii) student data that an education entity may not collect under Section 53E-9-305.
305          (b) "Optional student data" includes:
306          (i) information that is:
307          (A) related to an IEP or needed to provide special needs services; and
308          (B) not necessary student data;
309          (ii) biometric information; and

310          (iii) information that is not necessary student data and that is required for a student to
311     participate in a federal or other program.
312          (17) "Parent" means:
313          (a) a student's parent;
314          (b) a student's legal guardian; or
315          (c) an individual who has written authorization from a student's parent or legal
316     guardian to act as a parent or legal guardian on behalf of the student.
317          (18) (a) "Personally identifiable student data" means student data that identifies or is
318     used by the holder to identify a student.
319          (b) "Personally identifiable student data" includes:
320          (i) a student's first and last name;
321          (ii) the first and last name of a student's family member;
322          (iii) a student's or a student's family's home or physical address;
323          (iv) a student's email address or other online contact information;
324          (v) a student's telephone number;
325          (vi) a student's social security number;
326          (vii) a student's biometric identifier;
327          (viii) a student's health or disability data;
328          (ix) a student's education entity student identification number;
329          (x) a student's social media user name and password or alias;
330          (xi) if associated with personally identifiable student data, the student's persistent
331     identifier, including:
332          (A) a customer number held in a cookie; or
333          (B) a processor serial number;
334          (xii) a combination of a student's last name or photograph with other information that
335     together permits a person to contact the student online;
336          (xiii) information about a student or a student's family that a person collects online and
337     combines with other personally identifiable student data to identify the student; and

338          (xiv) information that, alone or in combination, is linked or linkable to a specific
339     student that would allow a reasonable person in the school community, who does not have
340     personal knowledge of the relevant circumstances, to identify the student with reasonable
341     certainty.
342          (19) "School official" means an employee or agent of an education entity, if the
343     education entity has authorized the employee or agent to request or receive student data on
344     behalf of the education entity.
345          (20) (a) "Student data" means information about a student at the individual student
346     level.
347          (b) "Student data" does not include aggregate or de-identified data.
348          (21) "Student data manager" means:
349          (a) the state student data officer; or
350          (b) an individual designated as a student data manager by an education entity under
351     Section 53E-9-303, who fulfills the duties described in Section 53E-9-308.
352          (22) (a) "Targeted advertising" means presenting advertisements to a student where the
353     advertisement is selected based on information obtained or inferred over time from that
354     student's online behavior, usage of applications, or student data.
355          (b) "Targeted advertising" does not include advertising to a student:
356          (i) at an online location based upon that student's current visit to that location; or
357          (ii) in response to that student's request for information or feedback, without retention
358     of that student's online activities or requests over time for the purpose of targeting subsequent
359     ads.
360          (23) "Third-party contractor" means a person who:
361          (a) is not an education entity; and
362          (b) pursuant to a contract with an education entity, collects or receives student data in
363     order to provide a product or service, as described in the contract, if the product or service is
364     not related to school photography, yearbooks, graduation announcements, or a similar product
365     or service.

366          (24) "Written consent" means written authorization to collect or share a student's
367     student data, from:
368          (a) the student's parent, if the student is not an adult student; or
369          (b) the student, if the student is an adult student.
370          Section 4. Section 53G-9-404 is repealed and reenacted to read:
371          53G-9-404. Public education vision screening.
372          (1) As used in this section:
373          (a) "Health care professional" means an individual licensed under:
374          (i) Title 58, Chapter 16a, Utah Optometry Practice Act;
375          (ii) Title 58, Chapter 31b, Nurse Practice Act, if the individual is licensed for the
376     practice of advance practice registered nursing, as defined in Section 58-31b-102;
377          (iii) Title 58, Chapter 42a, Occupational Therapy Practice Act;
378          (iv) Title 58, Chapter 67, Utah Medical Practice Act;
379          (v) Title 58, Chapter 68, Utah Osteopathic Medical Practice Act; or
380          (vi) Title 58, Chapter 70a, Physician Assistant Act.
381          (b) "Qualifying child" means a child who:
382          (i) attends an LEA;
383          (ii) is at least three years old; and
384          (iii) is not yet 16 years old.
385          (c) "Tier one vision screening" means a lower-level evaluation of an individual's
386     vision, as determined by Department of Health rule.
387          (d) "Tier two vision screening" means an individual, higher-level evaluation of an
388     individual's vision, as determined by Department of Health rule.
389          (2) The Department of Health shall oversee public education vision screening, as
390     described in this section.
391          (3) A child who is less than nine years old and has not yet attended public school in the
392     state shall, before attending a public school in the state, provide:
393          (a) a completed vision screening form, described in Subsection (5)(a)(i), that is signed

394     by a health care professional; or
395          (b) a written statement signed by a parent that the child will not be screened before
396     attending public school in the state.
397          (4) The Department of Health shall prepare and provide:
398          (a) training for a school nurse who supervises an LEA tier one vision screening clinic;
399     and
400          (b) an online training module for a potential volunteer for an LEA tier one vision
401     screening clinic.
402          (5) (a) The Department of Health shall provide a template for:
403          (i) a form for use by a health care professional under Subsection (3)(a) to certify that a
404     child has received an adequate vision screening; and
405          (ii) a referral form used for the referral and follow up of a qualifying child after a tier
406     one or tier two vision screening.
407          (b) A template described in Subsection (5)(a) shall include the following statement: "A
408     screening is not a substitute for a complete eye exam and vision evaluation by an eye doctor."
409          (6) The Department of Health shall make rules to:
410          (a) generally provide for and require the administration of tier one vision screening in
411     accordance with this section, including an opt-out process;
412          (b) describe standards and procedures for tier one vision screening, including referral
413     and follow up protocols and reporting a student's significant vision impairment results to the
414     Utah Schools for the Deaf and the Blind;
415          (c) outline the qualifications of and parameters for the use of an outside entity to
416     supervise an LEA tier one vision screening clinic when an LEA does not have a school nurse to
417     supervise an LEA tier one vision screening clinic;
418          (d) determine when a potential volunteer at an LEA tier one vision screening clinic has
419     a conflict of interest, including if the potential volunteer could profit financially from
420     volunteering;
421          (e) determine the regularity of tier one vision screening in order to ensure that a

422     qualifying child receives tier one vision screening at particular intervals; and
423          (f) provide for tier two vision screening for a qualifying child, including:
424          (i) in coordination with the state board, determining mandatory and optional tier two
425     vision screening for a qualifying child;
426          (ii) identification of and training for an individual who provides tier two vision
427     screening;
428          (iii) (A) the creation of a symptoms questionnaire that includes questions for a
429     nonprofessionally trained individual to identify an eye focusing or tracking problem as well as
430     convergence insufficiency of a qualifying child; and
431          (B) protocol on how to administer the symptoms questionnaire in coordination with
432     tier two vision screening;
433          (iv) general standards, procedures, referral, and follow up protocol; and
434          (v) aggregate reporting requirements.
435          (7) (a) In accordance with Department of Health oversight and rule and Subsection
436     (7)(b), an LEA shall conduct free tier one vision screening clinics for all qualifying children
437     who attend the LEA or a school within the LEA.
438          (b) If the parent of a qualifying child requests that the qualifying child not participate in
439     a tier one or tier two vision screening, an LEA may not require the qualifying child to receive
440     the tier one or tier two vision screening.
441          (8) (a) Except as provided in Subsection (8)(b), a school nurse shall supervise an LEA
442     tier one vision screening clinic as well as provide referral and followup services.
443          (b) If an LEA does not have a school nurse to supervise an LEA tier one vision
444     screening clinic, an LEA may, in accordance with Department of Health rule, use an outside
445     entity to supervise an LEA tier one vision screening clinic.
446          (9) (a) An LEA shall ensure that a volunteer who assists with an LEA tier one vision
447     screening clinic:
448          (i) (A) is trained by a school nurse; or
449          (B) demonstrates successful completion of the training module described in Subsection

450     (4)(b);
451          (ii) complies with the requirements of Subsection (9)(c); and
452          (iii) is supervised by a school nurse or, in accordance with Subsection (8)(b), an
453     outside entity.
454          (b) In accordance with Department of Health rule, an LEA may exclude a person from
455     volunteering at an LEA tier one vision screening clinic if the person has a conflict of interest,
456     including if the person could profit financially from volunteering.
457          (c) A volunteer who assists with an LEA tier one vision screening clinic may not
458     market, advertise, or promote a business in connection with assisting at the LEA tier one vision
459     screening clinic.
460          (d) A volunteer who assists with an LEA tier one vision screening clinic is not liable
461     for damages that result from an act or omission related to the LEA tier one vision screening
462     clinic, if the act or omission is not willful or grossly negligent.