Partnership Between Head Start and Vision Service Plan

ACYF Administration on Children, Youth and Families	U.S. DEPARTMENT OF HEALTH AND HUMAN SERVICES Administration for Children and Families
	1. Log No. ACYF-IM-HS-98-11	2. Issuance Date: 08/21/98
	3. Originating Office: Head Start Bureau
	4. Key Word: Vision Screening

INFORMATION MEMORANDUM [See Attachments at the bottom]

TO: All Head Start Grantee and Delegate Agencies

SUBJECT: Partnership between Head Start and Vision Service Plan

BACKGROUND: In 1997, Vision Service Plan (VSP), a nationwide network of licensed optometrists, ophthalmologists and laboratories participated in the President's Summit for America's Future and pledged to provide eye exams and eye glasses for needy children throughout the nation. As a result, VSP proposed to the Head Start Bureau a collaborative partnership where VSP would provide eyecare services, at no charge, to 7,000 Head Start children not covered by any form of health insurance who are in need of further examination and eyeglasses. This collaborative partnership is part of VSP's "Sight for Students" program founded several years ago.

INFORMATION: This memorandum supercedes ACYF-IM-HS-97-12, dated October 10, 1997.
VSP has informed the Head Start Bureau of its commitment to continue its Sight for Students Program and partnership with the Head Start through August, 1999. Details regarding how to participate remain basically the same as last year, and are found below. However, there is one change in the process that should be noted. This year, benefit forms are valid for six months only. This means that programs should make every effort to give benefits forms to families as soon as they receive them from VSP, and that they should follow through with families to ensure they have contacted and received services from their community VSP provider.

Participation in this program is voluntary and services will be awarded on a first come, first serve basis. Attached to this memorandum (ATTACHMENT A) is information that describes the steps necessary to participate in this program and the benefits covered, along with an order form (ATTACHMENT B). Head Start programs wishing to participate in this effort are toidentify children (including siblings up to the age of eighteen) who failed their vision screening and, due to financial reasons, are unable to obtain follow-up diagnosis and treatment. Children enrolled in Medicaid are not eligible to participate.

Head Start staff, are to complete a Sights for Student Application (ATTACHMENT B) are submit it to VSP. As supplies last, Head Start programs will be sent a benefit form from VSP for each student, along with a listing of VSP providers in their area. After the forms are received, Head Start programs will work with families to select providers and give them with a benefits form for their child. Selected providers will provide the service and submit the claim form to VSP.
VSP is asking that programs provide them with stories of children who were positively affected by this program (ATTACHMENT C). VSP is not, however, asking for the names of these children.

Also attached to this memorandum is a Fact Sheet on Vision Testing that can be found in the soon to be published Head Start Training Guide for the Learning Community entitled "Well-Child Health Care" (ATTACHMENT D). This fact sheet briefly describes the key features of vision testing and why it is important for young children.

/S/
Helen H. Taylor
Associate Commissioner
Head Start Bureau

Attachments:

ATTACHMENT A: Sights for Students Information [See below]
ATTACHMENT B: Sights for Students Order Form
ATTACHMENT C: Stories of Success
ATTACHMENT D: Fact Sheet: Vision Testing [See below]

Attachment A

We are delighted to announce a collaborative partnership between Head Start and and Vision Service Plan (VSP), a national healthcare leader in the area of eyecare services. VSP pledged to provide eye exams and eye glasses for needy children throughout the nation at the recent President's Summit for America's Future.

Recognizing the important role that vision plays in the educational process, VSP founded the Sight for Students Program several years ago to help low income children obtain vision care. We have agreed to provide assistance in rolling out the program to the youth we serve. The following information is for your use in successfully implementing the program locally. Here are the key points:

VSP's ROLE: VSP provides eyecare services at no charge to qualifying students whose families' income is up to 200% of the federal poverty level. The services will include an eye exam from one of VSP's participating doctors, as well as glasses should they be prescribed. There will be no cost to families unless they choose to purchase a cosmetic option or other extra (see attached benefit summary for a complete coverage listing).
YOUR ROLE: Head Start grantees are asked to identify qualified students in your area of service who appear to require eyecare services (see Attachment D). After identifying the students, we also ask you to work directly with the families to go over necessary paperwork and to help them access the services, if necessary. VSP will provide services to 7,000 students served by Head Start nationwide. Services will be awarded on a first come, first served basis.
ECONOMIC SELECTION CRITERIA: VSP has targeted the "gap kids" for these services, since their families usually cannot obtain insurance at work and they are not eligible for government programs. These families earn up to 200% of the poverty level. Children who are below the poverty level usually qualify for Medicaid services. These families should be encouraged to obtain eyecare services that they are entitled to receive through Medicaid. The VSP Sight for Students program is not available for recipients of Medicaid. Students are eligible to participate up to age 18, or graduation from high school.
AWARD PROCESS: If your local organization would like to participate, please fill out the attached form titled "Easy as 1, 2, 3!" (Attachment B) and send it to the address noted on the document. Once received, the benefit forms that entitle the students to the free eye exams and materials will be created and sent to you, along with listings of VSP doctors in the local area. Note that benefit forms will be valid for six (6) months and will then expire. Please share this information with the families and, using the doctor listing, help them select a doctor in their area and schedule the exam. Finally, please ask them to bring the benefit form to the appointment. The doctor will provide the eye exam and, if glasses are prescribed, will help the family choose the appropriate materials and order and dispense the eye glasses.
SUCCESS STORIES: We would like you to report back on students who were positively affected by the program. A form for your use is included. We will share the success stories with your organization and VSP's staff and doctors (see Attachment Q.

If you have any questions, please call Mary Kearney, VSP Sight for Students Coordinator, at (800) 8527600, Ext. 5156. Thanks for helping to make Sight for Students a success.

BENEFIT COVERAGE

Elective Contact Lens - N
Necessary Contact Lens - R
Oversize Lens - Y
Blended Bifocals - N
Progressive Multifocal - N
Polycarbonate - Y
High Index - Y
Photochromic - Y
Polarized/Laminated - N
Ultra Violet Protection - N
Plano - N
Solid Tints and Dyes - Y
Plastic Gradient Dye - Y
Scratch Resistant Coating - Y
Anti-Reflective Coating - N
Color Coating - Y
Mirror and Ski Type Coating - N
Edge Treatments - Y
Vision Therapy - R
Low Vision - Y

Y - Yes, the item. or benefit is provided under the patient's coverage

N - Not a benefit under the patient's plan. If this item is provided, the patient benefit for lenses and frames will not be covered.

R - Requires prior authorization; the item or service must be medically
necessary for the patient's visual welfare.

Attachment D

Appendix B: Well- Child Health Care Fact Sheets Vision Testing

What is vision testing?

Vision testing checks how well a child can see and how well the eyes move together.

How is vision testing done?

Vision testing is done by a health professional or trained staff parent, or volunteer. It involves:

Having the child identify letters, shapes or figures on a standard eye chart
Observing the child's eye movements ("strabismus testing")
Observing for other eye abnormalities (e.g., redness, swelling, discharge)

What might I observe?

Eyes that cross or point outward
Frequent blinking, squinting, or rubbing eyes
Difficulty picking up small objects, catching balls, or seeing distant objects
Holding books and objects unusually close
Short attention for visual activities
Frequent complaints of eye discomfort, headaches, or dizziness

Follow-up to vision testing:

A child "fails" the vision test if:

She is unable to identify more than half the symbols on the 20/40 line
There is more than a two-line difference in vision between one eye
and the other, even if the worse eye is 20/40 or better.

The child should be retested. If she fails again, she should be referred to her health care provider for evaluation and treatment. Children with eye infections should be retested after treatment.

Treatment may include:

Antibiotics to treat eye infections
Eye patch
Eyeglasses
Eye muscle surgery
Special education or early intervention services