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1 Vision Screening and the Voucher Program Brenda Dunn Program Manager Bryson McCool Secretary/Treasurer NM Lions Operation KidSight, Inc.

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Page 1: Vision Screening and the Voucher Program · Why Screen Young Children Children need to see well to learn. Refraction errors change as the child’s eye ball grows/develops (birth

1

Vision Screening and

the Voucher Program

Brenda Dunn

Program Manager

Bryson McCool

Secretary/Treasurer

NM Lions Operation KidSight, Inc.

Page 2: Vision Screening and the Voucher Program · Why Screen Young Children Children need to see well to learn. Refraction errors change as the child’s eye ball grows/develops (birth

Topics

Introduction

Why Screen Young Children?

What Is Amblyopia?

Vision Screening Program Background

Overview of NM Lions Operation KidSight Program

NMLOKS, Inc., Screening Programs

Screening Results to Date

Vision Screening Equipment and Procedures

Vision Screening Process

Vision Screening Referral Certificate

Referral Follow Up Reporting

The Voucher Program

The Save Our Children Sight Fund

Soliciting Eye Professionals & Glasses Providers For the Program

NMLOKS/SOCSF Voucher Process

NMLOKS/SOCSF Vouchers – English & Spanish

Voucher Program Results to Date

2

Page 3: Vision Screening and the Voucher Program · Why Screen Young Children Children need to see well to learn. Refraction errors change as the child’s eye ball grows/develops (birth

Why Screen Young Children

Children need to see well to learn.

Refraction errors change as the child’s eye ball

grows/develops (birth to 7-8 years).

Vision disorders don't hurt.

Parents can't tell if their child has a vision disorder.

Vision disorders can lead to amblyopia if not addressed at an

early age.

Children with a vision disorder think their limited

vision is normal.

3

Page 4: Vision Screening and the Voucher Program · Why Screen Young Children Children need to see well to learn. Refraction errors change as the child’s eye ball grows/develops (birth

Anything that interferes with clear vision in either eye (near sightedness, far

sightedness, astigmatism, strabismus and other eye problems) from birth to 7-

8 years can result in amblyopia.

If one eye sees a blur, the brain will inhibit vision with that eye resulting in

the pathways from the eye to the brain not maturing normally.

Since amblyopia usually occurs in one eye only, many parents and children

may be unaware of the condition.

The eye is completely developed by the age of seven or eight. Vision

deficiencies caused by amblyopia will be difficult to treat after vision

development is completed.

If not detected and treated early in life, amblyopia can cause a

permanent loss of vision with associated loss of two eyed depth

perception.

4

What is Amblyopia?

Page 5: Vision Screening and the Voucher Program · Why Screen Young Children Children need to see well to learn. Refraction errors change as the child’s eye ball grows/develops (birth

5

Overview of NM Lions Operation KidSight Program

NMLOKS, Inc. 501c3 Organization

3 Executive Directors 9 Directors Sec./Treas.

Medical Advisors

NMLOKS, Inc., Central Office

Program Manager – Ms. Brenda Dunn

Las Cruces, NM

24 Lions Screening Teams

Save Our Children’s Sight Fund

Screen 3-7 year old children for amblyogenic risk factors

Currently servicing public schools, Head Starts, private/charter schools, child

care centers, and health fairs across NM

Provide eye exams/glasses for 3-7 year old students not covered by Medicaid

or insurance

Provide eye exams/glasses for 8-19 year old students not

covered by Medicaid or insurance

Page 6: Vision Screening and the Voucher Program · Why Screen Young Children Children need to see well to learn. Refraction errors change as the child’s eye ball grows/develops (birth

6

NMLOKS, Inc., Screening Teams

Note that the NMLOKS Program Manager can conduct

screenings in rural communities not currently covered

by Lions screening teams.

- Future Program

Window Rock

Lions Club

Taos Lions ClubGreater Las Vegas Lions Club

Moriarty Lions Club

Ruidoso Noon Lions Club

Lea CountyLions Clubs

Carlsbad Downtown Lions ClubAlamogordo

Breakfast Lions Club

Dona Ana CountyLions Clubs

DemingLions Club

Silver City Lions Club & Women’s Club

SocorroLions Club

Alb. Rio Grande & NortheastLions Clubs

GallupLions Club

Santa Fe Capital City Lions Club

Los Alamos Lions Club

Farmington Evening Lions Club

Rio Rancho HostLions Club

Roswell

Lions

Clubs

Clovis EveningLions Club

Raton Lions Club

X

X

Artesia Downtown Lions Club

T or CLions Club

Page 7: Vision Screening and the Voucher Program · Why Screen Young Children Children need to see well to learn. Refraction errors change as the child’s eye ball grows/develops (birth

7

NMLOKS, Inc., Screening Results 1 Aug 2015 – 31 Mar 2016

0

1000

2000

3000

4000

5000

6000

7000

# Screened # Referred

Total Screened 33,593

Total Referred 6,151

Referral Rate 18.3%

Page 8: Vision Screening and the Voucher Program · Why Screen Young Children Children need to see well to learn. Refraction errors change as the child’s eye ball grows/develops (birth

8

Vision Screening Process

Both eyes are measured simultaneously.

Very quick - acquisition time is 0.8 seconds.

Can refract through glasses to check present

prescriptions.

Can facilitate vision screening in children who are difficult to deal with.

Children who do not pass the screening are referred for a comprehensive eye examination.

Page 9: Vision Screening and the Voucher Program · Why Screen Young Children Children need to see well to learn. Refraction errors change as the child’s eye ball grows/develops (birth

9

Vision Screening Referral Certificate

Specifies possible vision problem(s).

Printed on site.

Provided to the school nurse or Head Start administrator after screening session.

A copy of the measurement report is given to the parents when school nurse notifies them their child should get a complete eye exam.

Page 10: Vision Screening and the Voucher Program · Why Screen Young Children Children need to see well to learn. Refraction errors change as the child’s eye ball grows/develops (birth

10

Referral Follow Up Reporting

Worksheet below shows referral follow-up information required by NMLOKS and NMDOH.

After a screening, the screening team fills in the site and date of the screening, the name of the referred child, the child’s age, and the reason(s) the camera specified why the child was referred. The sheet is then given to the school nurse.

Once the school nurse has filled in whether the referred child saw an eye professional and if they did, whether glasses or other treatment were needed on the worksheet, she/he sends it to the NMLOKS Program Manager.

Information from the worksheet will be used to develop required statistics such as the % of children screened that were referred, the % of referred children who saw an eye professional, the false positive rate (i.e., % of referred children who saw an eye professional and did not need any treatment).

Vision Problem Code: A – Astigmatism M – Myopia H - Hyperopia AN – Anisometropia AC – AnisocoriaS – Corneal Reflex (Strabismus) NM – No measurement

(Please print legibly)

PLEASE RETURN TO:

BRENDA DUNN, Program ManagerNM Lions Operation KidSight, Inc. 1501 N. Solano Dr. Las Cruces, NM 88001

[email protected] FAX: 575-524-1699

To be filled out by screening team

School & Date of

Screening Referred Child's Name or ID Age

Vision

Problem

Identified

by Camera

(See code

below)

Seen by

Eye

Doctor.

(Yes/No)

If child saw Eye

Doctor, did child

receive glasses or other

treatment? (Yes/No)

To be filled out by School Nurse

Page 11: Vision Screening and the Voucher Program · Why Screen Young Children Children need to see well to learn. Refraction errors change as the child’s eye ball grows/develops (birth

11

Save Our Children Sight Fund

Began 1 Jan 2008 based on New Mexico Statute Authority 666.3. Save Our Children's

Sight Fund (SOCSF) option.

NM residents can donate $1 or $5 to the Fund when renewing vehicle registration.

Money in the fund is appropriated to NMDOH, which shall administer the fund for the purpose of

development and implementation of a vision screening program making vision screenings and follow-up

comprehensive examinations available to New Mexico children regardless of family income.

Contract between NMDOH and NMLOKS, Inc., initially signed January 2015 to administer the SOCSF. A

follow up contract was issued for 2015-16 fiscal year. NMDOH will go out with an RFP for 2016-17 which

will expenses to exceed $50K if needed.

NM Save

Our Children’s

Sight Fund

NMLOKS, Inc., Program Manager coordinates with school

nurses to identify 3-18 year students who have been

referred by nurse’s or KidSight screenings and who are not

covered by Medicaid or other insurance.

NMLOKS will cover 3-7 year old students while SOCSF will

cover 8-19 year olds.

NMLOKS, Inc., Program Manager will coordinate with school

nurse to set up exam and provide glasses, if needed.

NM Save

Our Children’s

Sight Fund

Please make a donation to the Save Our

Children Sight Fund when paying for

your vehicle registration renewals.

Your $1 or $5 donation will help pay for

an eye exam and glasses (if needed) for

any student, age 3 – 19 years old, who is

not covered by Medicaid or insurance.

Save Our Children Sight Fund/NM Lions Operation KidSight

Central Office

The Lions Club Community Center

1501 N. Solano

Las Cruces, NM 88001

Page 12: Vision Screening and the Voucher Program · Why Screen Young Children Children need to see well to learn. Refraction errors change as the child’s eye ball grows/develops (birth

12

Solicit Process for NMLOKS/SOCSF Eye Doctor & Glasses Providers

The State of New Mexico has been listening to our community and school representatives who are concerned about access to vision services for children. We know many students lack vision care. We are partnering with NM Lions Operation KidSight (NMLOKS), Inc., to assist you in ensuring that each student with less than optimal vision in the state of New Mexico is afforded an opportunity to take full advantage of their schools academic programs.

Through two outreach initiatives, NMLOKS’ goal to provide vision screenings to NM students and the "Save Our Children's Sight Fund" Program, a comprehensive eye examination and eyeglasses will be provided to any Pre-K through 12th grade student in need who does not have vision insurance.

We are currently seeking the assistance of all eye care providers and eyeglasses providers to be a part of this statewide program and to complete the following registration form and fax it back to the NMLOK central office to begin receiving referrals.

Compensation for your services will be as follows:

Reimbursement for Dilated Comprehensive Eye Exam…$100.00

Reimbursement for 1 Pair of Polycarbonate Lenses & Frames…$75.00

Please submit all invoices and visit notes via fax or US Mail upon completion of services and when the product becomes available for the patient pick up. Please send the documents to the NMLOKS Central Office at fax number 575-524-1699 or 1501 North Solano Drive, Las Cruces, New Mexico 88001. Payments will be mailed within a maximum of 30 days upon submission. Our goal is to issue payment much faster though.

An added value when joining the network is also that each student’s parent will be getting a list of our network preferred providers whether or not they qualify for the assistance program or not so additional business may come your way just by joining.

Thank you in advance for your participation in the New Mexico Lions Operation Kidsight and the Save Our Children’s Sight Fund initiatives.

NM Lions Operation Kidsight, Inc./Save Our Children’s Sight Fund Central Office

Registration Form

Save Our Children’s Sight Fund

Eye Care & Eyeglasses Referral Network For New Mexico Students (Pre-K – up to 19 years of age)

Business Name: _________________________________________________________

Business Address: ______________________________________________________

Mailing Address: _______________________________________________________

City: _____________________________ State: _________ Zip Code: ____________

Phone number: ____________________________ Fax: _______________________

Email address: __________________________________________________________

Business Hours of Operation: _________________________________________

Business License Number: ____________________________________________

Name(s) of Practitioner(s) who will see our referrals:

1. _______________________________________________________________

2. _______________________________________________________________

3. _______________________________________________________________

4. _______________________________________________________________

Services Provided:

Dilated Eye Exams: __________ Glasses: __________

Other: ______________________________________________

Please sign and date below as acknowledgment and understanding of the process:

⇨ We agree to follow the guidelines set forth by the American Association for Pediatric

Ophthalmology and Strabismus (AAPOS) when conducting an eye examination on a student

referred by the New Mexico Lions Operation Kidsight, Inc. (NMLOKS) program.

⇨ We agree to provide the eye examination results and treatment plan of each student referred

by NMLOKS via fax or mail within 48 hours of the referral appointment.

Note: The parents of the referred student have signed a waiver for you to release the above

information to NMLOKS.

________________________________________ __________________________________________ ________________________ Signature Printed Name Date

Please return this form to: Brenda Dunn, Program Manager 1501 North Solano Drive New Mexico Lions Operation KidSight Las Cruces, New Mexico 88001 www.NMLionsKidSight.com Phone: 575-525-5631 / Fax: 575-524-1699

Page 13: Vision Screening and the Voucher Program · Why Screen Young Children Children need to see well to learn. Refraction errors change as the child’s eye ball grows/develops (birth

13

NMLOKS/SOCSF Voucher Process

Referral from school nurse’s acuity screening

School nurse notes whether referred student got to see an eye doctor or not and if they did, what was the prognosis and treatment if needed.

NMLOKS Program Manager initiates a voucher for the referred student and determines nearest eye exam and glasses providers who are alerted the student will be coming in.

School nurse contacts referred student’s parents to inform them their child has a vision problem and needs an eye exam. She determines if they have Medicaid or other means to pay for eye exam and glasses, if needed.

School nurse contacts NMLOKS Program Manager to provide referred student’s information.

Follow up information on referred student submitted to NMLOKS Central Office

Referral from KidSight screening

Has Medicaid/Insurance Does Not Have Medicaid/Insurance

Referral from school nurse for student

identified with a vision problem

NMLOKS Program Manager enters referral follow up information into database NMLOKS Program Manager arranges

payment to eye doctor and glasses provider. Eye Doctor provides eye exam report to NMLOKS Program Manager.

School nurses are surveyed to evaluate performance of NMLOKS Program Manager

Page 14: Vision Screening and the Voucher Program · Why Screen Young Children Children need to see well to learn. Refraction errors change as the child’s eye ball grows/develops (birth

14

NMLOKS/SOCSF Voucher

VOUCHER #: ________________

DATE ISSUED: _______________

TO BE FILLED OUT BY SCHOOL NURSE (please print)

Student’s Name: _______________________________________________Sex (Circle): M F D.O.B._______________

Address: _________________________________________ City: _________________________ Zip Code: __________

Home Phone #: ______________________________________ Cell #: _______________________________________

School Name: __________________________________________ School District: _____________________________

School Nurse’s Name: ___________________________________ Phone #: __________________________________

It has been verified from a vision screening that the student needs an eye exam.

It has been verified that student is not covered by Medicaid or insurance.

I have contacted and sent this completed voucher to the student’s parent/guardian for signature.

I have coordinated with the NM Lions Operation KidSight Central Office Program Manager

The phone number to activate this voucher is 575-525-5631 and fax number 575-524-1699 or scan to email

[email protected] for submission of completed form

__________________________________ _____________________________________________ _______________

School Nurse’s Signature Email Address Date

Parents/Guardians

1. Once this voucher form is complete and returned to the school nurse she/he will send us the form and request

the eye care providers contact information from the NM Lions Operation KidSight Program Manager. This

information will be given to you in writing to call and schedule an appointment for your child.

2. If the eye exam results show the need for glasses, NM Lions Operation KidSight/Save Our Children’s Sight Fund

will provide the medically necessary eye glasses for your child which will include a fashion frame and a basic pair of

polycarbonate lenses. Any options, upgrades, add-on, or treatments will not be covered.

3. The voucher should be surrendered at the time of service. Note that this voucher is non-transferable and only

valid for the person whose name is written above. Copies or Facsimiles cannot be combined with any other offer or

promotion.

4. Please read and sign the agreement below:

By signing this form you understand and consent to the following:

I, the parent or legal guardian, acknowledge that my child is not covered by Medicaid or private insurance that would

cover the cost of an eye exam and treatment if needed.

Initial here if covered by Medicaid but funds are unavailable____ Medicaid Number: ___________________________

I, the parent or legal guardian, give my permission for the attending eye professional and treatment provider to

furnish the NM Lions Operation KidSight Central Office with the eye exam results to facilitate the payment for the

eye exam and treatment. I understand all HIPPA privacy regulations will be followed.

I understand this voucher expires 60 days from the date of issued.

______________________________ ______________________________________________ _______________

Print Parent/Guardian Name Parent’s/Guardian’s Signature Date

TO BE FILLED OUT BY SCHOOL NURSE (please print) VOUCHER #: ________________

DATE ISSUED: _______________

Student’s Name: ___________________________________________ Sex (Circle): M F D.O.B._____________

Address: _______________________________________ City: ______________________ Zip Code: __________

Home Phone #: _____________________________ Cell #: ____________________________________________

School Name: ______________________________________ School District: _____________________________

School Nurse’s Name: ________________________________________ Phone #: _________________________

It has been verified from a vision screening that the student needs an eye exam.

It has been verified that student is not covered by Medicaid or insurance.

I have contacted and sent this completed voucher to the student’s parent/guardian for signature.

I have coordinated with the NM Lions Operation KidSight Central Office Program Manager

The phone number to activate this voucher is 575-525-5631 and fax number 575-524-1699 or scan to email

[email protected] for submission of completed form

__________________________________ __________________________________ _________________

School Nurse’s Signature Email Address Date

Padres/Tutores

1) El/la enfermera de la escuela rellena esta forma que indica que su hijo necesita un examen completo de los ojos

provisto de un optometrista u oftamólogo. El/la enfermera le da a Usted (padres/tutor) una lista de

proveedores de cuidado ocular. Usted necesita llamar a una de esas oficinas para hacer una cita para un

examen de los ojos para su hijo. Dile a la oficina que el examen estará pagado por NM Lions Operation KidSight.

2) Si el examen de optometrista u oftamólogo indica que necesita espejuelos el fondo de NM Operation

KidSight/Operation Save Our Children’s Sight paga por una montura de moda y también lentes básicos hecho de

policarbonata (lo que usa para todos los niños bajo de 19 años). Cualquier mejora, como lentes transiciones o

ahumados NO está incluído.

3) Tiene que dar esta forma al optometrista que hace el examen de los ojos en el momento del examen. Esta

forma no se puede transferar o usar por otra persona sino cuyo nombre está escrito encima. Copias o fax no se

puede combinar con otra oferta o promoción.

4) Por favor, lea y firma el acuerdo abajo:

___ Yo, el padre o tutor legal, admito que mi hijo no está cubierto por Medicaid ni seguro privado que cubriría el

precio de un examen ocular y el tratamiento (como espejuelos) si sea necesario.

Firmar con las iniciales si tiene seguro pero ya lo usó para este año y no hay fondos en este momento. _____

Numero Medicaid: ___________________________________________________________________________

___ Yo, el padre o tutor legal, doy permisión al/a la optometrista para dar los resultados del examen ocular a

NM Lions Operation KidSight Central Office para facilitar el pago del examen y espejuelos. Entiendo que las

regulaciones de la privacidad de HIPPA estará seguido.

___ Entiendo que este cupón expira 60 días de la fecha emitido.

Nombre o padre/tutor Firma de padre/tutor Fecha

Page 15: Vision Screening and the Voucher Program · Why Screen Young Children Children need to see well to learn. Refraction errors change as the child’s eye ball grows/develops (birth

15

NMLOKS/SOCSF Voucher Approval Form

VOUCHER #: _______________

Save Our Children’s Sight Fund

New Mexico Lions Operation Kidsight, Inc.

Brenda Dunn, Program Manager

1501 North Solano Drive, Las Cruces, NM 88001

575-525-5631 Fax: 575-524-1699

[email protected]

www.nmlionskidsight.com

Approval for Eye Exam/Glasses

To:

This is to notify you that _______________________ has been

recommended for a dilated eye exam and glasses based on a

previous screening. SOCSF/NMLOKS has approved this

request. Please bill us accordingly.

Thank you.

Program Manager, NMLOKS, Inc.

Page 16: Vision Screening and the Voucher Program · Why Screen Young Children Children need to see well to learn. Refraction errors change as the child’s eye ball grows/develops (birth

16

NMLOKS/SOCSF Voucher Program Results

- 1 Jul 2015 To Date -

33%

34%

26%

7%

Distribution of Students Serviced By Age Group

3-7 Years 8-12 Years 13-16 Years 17-19 Years

Page 17: Vision Screening and the Voucher Program · Why Screen Young Children Children need to see well to learn. Refraction errors change as the child’s eye ball grows/develops (birth

17

NMLOKS/SOCSF Voucher Program Results

- # of Students Who Received an Eye Exam and/or Glasses by Community -

0

10

20

30

40

50

60

70

13

5

9

1

53

30

39

4 4

26

10

52

4

11

15

1

69

40

2

7

1

Total # Students 351

Covered by SOCSF 236

Covered by KidSight 115

Page 18: Vision Screening and the Voucher Program · Why Screen Young Children Children need to see well to learn. Refraction errors change as the child’s eye ball grows/develops (birth

18

NMLOKS/SOCSF Voucher Program Results

- # of Students by Age Group Who Received an

Eye Exam and/or Glasses by Community -

0

5

10

15

20

25

30

35

3-7 Years 8-12 Years 13-16 Years 17-19 Years

Page 19: Vision Screening and the Voucher Program · Why Screen Young Children Children need to see well to learn. Refraction errors change as the child’s eye ball grows/develops (birth

19

NMLOKS/SOCSF Voucher Program Results

- SOCSF and KidSight Funds Expended For Eye

Exams and Glasses by Community -

$0

$1,000

$2,000

$3,000

$4,000

$5,000

$6,000

$7,000

$8,000

$9,000

$10,000

KidSight SOCSF

$ for Total # Students $51,834

SOCSF $ $35,602

KidSight $ $16,232

Page 20: Vision Screening and the Voucher Program · Why Screen Young Children Children need to see well to learn. Refraction errors change as the child’s eye ball grows/develops (birth

20

NMLOKS, Inc., Contact Information

Brenda Dunn, Program Manager

NMLOKS, Inc., Central Office

1501 North Solano Drive

Las Cruces, New Mexico 88001

Phone: 575-525-5631

Fax: 575-524-1699

email: [email protected]

Bryson McCool, Secretary/Treasurer

5557 Red Fox Rd.

Las Cruces, NM 88007

Phone: 575-652-4029 575-973-0732 (c)

Fax: 575-571-4165

email: [email protected]