It seemed like a good idea when it was signed into law last fall: All North Carolina children must have an eye exam before entering kindergarten.
But with the policy scheduled to go into effect at the beginning of the 2006-07 school year, school officials, doctors, and parents are stepping up their protests against the exams, which they call onerous and expensive for families.
North Carolina Speaker of the House James A. Black, a Democrat and the lead sponsor of the measure, has responded to the critics by announcing that he would seek amendments to the statute when state lawmakers meet in May.
“There’s always unintended consequences,” said Angie M. Whitener, a spokeswoman for Rep. Black. “Certainly, we don’t want to turn anyone away from school.”
Critics, however, say they want nothing less than a complete repeal of the law.
The policy, which was included in the state budget last August at the request of Mr. Black, who is an optometrist, requires all North Carolina children to have a complete eye exam from an optometrist or ophthalmologist before entering kindergarten, beginning this coming fall.
The exam would be in addition to the basic vision screening that children typically receive during visits to pediatricians. While the law requires the exams to take place no more than six months before school starts, it includes a grace period of 60 days after school begins.
According to Rep. Black’s office, the intent of the law is to make sure students’ vision problems do not go unnoticed or misdiagnosed as attention disorders or learning disabilities. The legislation appropriated $2 million for families who could not afford the exams or whose insurance would not cover them.
Pediatricians Question Measure
Controversy arose almost as soon as the law was passed.
School officials did not want to turn away students simply because they had not received the eye exam. Parents complained that it would be a hardship to get the exams for their children in addition to annual checkups.
Other critics argued that the $2 million appropriated by the state wouldn’t be enough to cover all the families who did not qualify for Medicaid or other financial assistance but could not easily afford the exams.
“That’s not how they want to spend their money,” said Leanne E. Winner, the government-relations director for the North Carolina School Boards Association.
Many pediatricians also deemed the exams unnecessary. In a letter from the North Carolina Pediatric Society that is posted on the school boards association Web site, the society’s president, Peter J. Morris, writes: “Best practice dictates that all children entering kindergarten have their vision screened and only those who fail should be referred for a comprehensive eye exam.”
Eye doctors are also scarce in North Carolina’s rural areas, critics add. According to Ms. Winner, six of the state’s 100 counties do not have certified optometrists or ophthalmologists. Further, some doctors don’t accept Medicaid or patients younger than 5. And parents cannot take their children to out-of-state doctors for the exams because the law requires the doctor to be in North Carolina.
In response to the controversy, Rep. Black wants to amend the law. He is proposing to extend the grace period from 60 to 180 days after the start of school, change the time span for getting the exam from six months to one year before school starts, and accept eye exams from out-of-state eye doctors.
“They are not sufficient,” Ms. Winner said of the proposed changes. “It delays the inevitable. [Schools will have to] tell a child who hasn’t had an exam that they can’t come to school, whether it’s August or February.”