HB 5271

relating to the screening of, services for, and educational
programs for children with visual impairments; authorizing an
BE IT ENACTED BY THE LEGISLATURE OF THE STATE OF TEXAS:
SECTION 1.  This Act may be cited as Zach's Law.
SECTION 2.  Chapter 29, Education Code, is amended by adding
Subchapter J to read as follows:
SUBCHAPTER J.  PROGRAMS FOR CHILDREN AND STUDENTS WITH
Sec. 29.331.  DEFINITIONS.  In this subchapter, "early
intervention services," "expanded core curriculum," "functional
vision assessment," "screening," and "visual impairment" have the
meanings assigned by Section 36A.001, Health and Safety Code.
Sec. 29.332.  PROGRAM REQUIRED.  In addition to a special
education program under Subchapter A, a school district and
open-enrollment charter school shall provide a program for
appropriate interventions from birth, including age-appropriate
instruction in all areas of an expanded core curriculum, to a child
(1)  is referred to the district or school under
Chapter 36A, Health and Safety Code; and
(2)  has a visual impairment, as determined by a
screening or functional vision assessment conducted under Chapter
36A, Health and Safety Code, or through a formal diagnosis of a
physician or health care provider.
Sec. 29.333.  PROGRAM CONTENTS.  A program provided under
(1)  expanded core curriculum instruction areas,
including age-appropriate instruction in:
(B)  social interaction skills;
(C)  independent living skills;
(F)  sensory efficiency skills;
(H)  compensatory or access skills; and
(2)  early intervention services, including:
(B)  developmental support; and
(C)  access to assistive technologies to support
the child's development and learning.
Sec. 29.334.  COMPENSATORY SERVICES FOR LATE
IDENTIFICATION.  (a)  The agency by rule shall require school
districts and open-enrollment charter schools to provide a student
with a visual impairment who is identified after third grade with
additional instruction and support commensurate with the student's
needs to address developmental delays and the education loss of
specific visual impairment instruction under the expanded core
curriculum, caused by the delayed identification for visual
(b)  The agency shall require school districts and
open-enrollment charter schools in conducting admission, review,
and dismissal processes to develop individualized plans to address
and remedy the delayed identification described by Subsection (a)
and provide the necessary compensatory instruction, including
additional instruction for relevant skills development and
opportunities for the student to learn and successfully complete
(c)  If consensus is not reached between a parent or adult
student and a school district or open-enrollment charter school for
compensatory services provided under this section, the parent or
adult student may pursue all administrative remedies available
under the Individuals with Disabilities Education Act (20 U.S.C.
SECTION 3.  Subtitle B, Title 2, Health and Safety Code, is
amended by adding Chapter 36A to read as follows:
CHAPTER 36A.  EARLY VISION SCREENING, IDENTIFICATION, AND REFERRAL
FOR YOUNG CHILDREN WITH VISUAL IMPAIRMENTS
SUBCHAPTER A.  GENERAL PROVISIONS
Sec. 36A.001.  DEFINITIONS.  In this chapter:
(1)  "Agency" means the Texas Education Agency.
(2)  "Certified orientation and mobility specialist"
means an individual who satisfies agency established requirements
and holds a certification issued by the Academy for Certification
of Vision Rehabilitation and Education Professionals.
(3)  "Certified teacher" means a teacher who teaches
students with visual impairments and who has:
(A)  a bachelor's degree from an accredited
(B)  an initial teaching certification in
elementary or secondary general or special education.
(4)  "Cortical vision impairment" means a disorder
caused by damage to areas of the brain that process vision and in
which the eyes remain healthy but the brain has difficulty
processing and understanding visual information.
(5)  "Early intervention services" means the early
intervention services described in Part C, Individuals with
Disabilities Education Act (20 U.S.C. Sections 1431-1443).
(6)  "Expanded core curriculum" means the set of skills
and concepts that are provided to children with a visual impairment
to compensate for visual limitations, specialized instruction,
including orientation and mobility skills, social interaction
skills, and independent living skills, and use of assistive
(7)  "Functional vision assessment" is an evaluation of
a child's ability to use vision in daily activities, regardless of
(8)  "Health care provider" means an individual or
facility licensed, certified, or otherwise authorized to
administer health care, for profit or otherwise, in the ordinary
course of business or professional practice, including a physician
or a hospital or birthing center.
(9)  "Local education agency" means a school district
or an open-enrollment charter school.
(10)  "Newborn" means a child less than 30 days old.
(11)  "Physician" means a person licensed to practice
medicine in this state under Subtitle B, Title 3, Occupations Code.
(12)  "Risk factors" means criteria or factors
identifying an infant or child as susceptible to a visual
(A)  a premature birth of less than 32 weeks;
(B)  in vitro alcohol or substance abuse;
(E)  a history of a neurological disorder;
(F)  a diagnosis of a seizure disorder, cerebral
palsy, intrauterine stroke, hydrocephalus, cerebral dysplasia such
as schizencephaly, cranial dysplasia such as Apert syndrome,
meningitis, encephalitis, a brain tumor, or a traumatic brain
(G)  a genetic predisposition, including rare
(H)  a family history of congenital visual
(I)  a family history of autism spectrum disorder
or a diagnosis of autism spectrum disorder;
(J)  a history of metabolic disorders, including
hypoglycemia, methylmalonic acidemia or propionic acidemia, Refsum
disease, mucopolysaccharidosis, neuronal ceroid lipofuscinosis,
disorders of glycosylation, or Tay-Sachs disease;
(K)  a history of malnourishment, sensory
processing disorder, or malabsorption syndromes; or
(L)  parent or caregiver concerns regarding
(13)  "Screening" means a test or battery of tests
administered to rapidly determine the need for a professional
(14)  "Visual impairment" means a loss of vision
resulting from a disorder of the ocular system or disorder of the
visual pathways and visual centers in the brain, including the
pathways serving visual perception, cognition, and visual guidance
of movement of any type or degree.
Sec. 36A.002.  RULES.  The executive commissioner may adopt
rules to implement this chapter.
SUBCHAPTER B.  SCREENING, EVALUATION, AND REFERRAL SERVICES
Sec. 36A.051.  SUSCEPTIBILITY QUESTIONNAIRE.  (a)  The
department shall develop a susceptibility questionnaire based on
the risk factors indicating potential visual impairment in infants
and provide the questionnaire to hospitals and other birthing
(b)  The executive commissioner by rule shall require a
physician attending a newborn or another health care provider
attending the delivery of the newborn to:
(1)  complete and submit the susceptibility
questionnaire to the department before the physician or health care
provider may discharge the newborn from the hospital or birthing
(2)  provide a copy of the completed susceptibility
questionnaire to the newborn's parent, legal guardian, or managing
conservator and, if known, the newborn's primary care physician and
(c)  The department shall record the information provided in
the completed susceptibility questionnaire in the database
established under Subchapter C and report the data to the
commission and applicable local education agency.
Sec. 36A.052.  SCREENING AND REFERRAL.  (a)  The executive
commissioner by rule shall require screening of newborns and
infants born in this state at regular intervals within the first 36
months of life to detect visual impairment that is based on ocular
and neurological disorders, including cortical vision impairment.
(1)  health care providers to conduct vision screenings
at well-child visits when the child is 3 months, 6 months, 12
months, 24 months, 30 months, and 36 months of age;
(2)  a health care provider attending a newborn to
conduct a vision screening for a newborn who exhibits a risk factor;
(3)  a health care provider to conduct a vision
screening focused on identifying neurological visual impairments,
including cortical vision impairment, and refer for a functional
vision assessment and learning media assessment any child younger
than five years of age who exhibits a risk factor, regardless of
whether the child received a formal diagnosis of a visual
(c)  A health care provider who conducts a screening under
Subsection (b) and detects a visual impairment or an indication of
(1)  refer the child's parent, legal guardian, or
managing conservator to the applicable local education agency for
early intervention services, including a functional vision
(2)  provide the child's parent, legal guardian, or
managing conservator with information on locations at which the
child may receive a medical follow-up for a formal diagnosis.
(d)  As soon as practicable after receiving a referral, the
local education agency shall conduct a functional vision assessment
and provide any applicable early intervention services.
Sec. 36A.053.  FUNCTIONAL VISION ASSESSMENT.  (a)  A parent,
legal guardian, managing conservator, or health care provider may
request a local education agency to conduct a functional vision
assessment if a routine vision screening or other evaluation
indicates a potential visual impairment.
(b)  If a susceptibility questionnaire completed under
Section 36A.051 indicates a child has a risk factor or a screening
conducted under Section 36A.052 indicates a child may have a visual
impairment, the applicable local education agency shall conduct a
functional vision assessment for the child as soon as practicable.
The local education agency shall provide the child's parent, legal
guardian, or managing conservator with written information on
locations at which the assessment may be performed.
(c)  A functional vision assessment must assess the manner in
which the child uses vision to perform tasks in daily life
activities by considering both ocular and neurological factors that
may impact vision, including a cortical vision impairment.
(d)  A certified teacher, certified orientation and mobility
specialist, health care provider, or local education agency that
conducts a functional vision assessment indicating a child has a
visual impairment or does not sufficiently use vision to
appropriately access developmental or educational materials or
settings shall inform the child's parent, legal guardian, or
managing conservator the child may be eligible, regardless of a
formal diagnosis, under the Individuals with Disabilities
Education Act (20 U.S.C. Section 1400 et seq.) to receive early
intervention services from the applicable local education agency,
including access to an expanded core curriculum.
Sec. 36A.054.  REFERRAL FOR DIAGNOSTIC SERVICES.  A
certified teacher, certified orientation and mobility specialist,
health care provider, or local education agency that conducts a
vision screening or functional vision assessment and determines a
child may have a visual impairment shall use the database developed
under Subchapter C and refer the child to:
(1)  a pediatric ophthalmologist, optometrist, or
pediatric neurologist, as appropriate;
(2)  the applicable local education agency for a
functional vision assessment and learning media assessment if those
assessments have not been conducted; and
(3)  the Blind Children's Vocational Discovery and
Development Program administered by the commission for further
Sec. 36A.055.  EARLY INTERVENTION SERVICES.  (a)  The
department, commission, and agency and local education agencies
shall coordinate to ensure certified teachers, certified
orientation and mobility specialists, health care providers, and
local education agencies that detect or diagnose a child with a
visual impairment, regardless of the child's age, provide
information on and refer the child to:
(1)  the Division for Early Childhood Intervention
(2)  the applicable local education agency responsible
for delivering early intervention services; and
(3)  any other appropriate services the department
(b)  The department, commission, and agency and local
education agencies shall coordinate to ensure a child who is
determined to have a visual impairment through a screening,
diagnosis, or functional vision assessment receives all
appropriate early intervention services, including instruction in
all areas of the expanded core curriculum.
SUBCHAPTER C.  STATE AGENCY POWERS AND DUTIES
Sec. 36A.101.  EDUCATIONAL MATERIALS.  (a)  The department
shall develop written educational materials on visual impairments
under this chapter. The materials shall include information on:
(2)  the risk factors associated with visual
(3)  vision screening requirements;
(4)  early intervention services provided by local
(5)  referral and reporting requirements; and
(6)  any other material the department considers
(b)  The department shall provide the materials developed
under this section to hospitals, birthing facilities, and primary
care providers and require a health care provider to provide a copy
of the materials to the parent, legal guardian, or managing
(c)  The department in collaboration with the agency shall
develop a plan to coordinate early intervention services for
children who are identified with risk factors or diagnosed with a
visual impairment. The department and agency may not require a
formal diagnosis of a visual impairment before a child is eligible
for early intervention services.
Sec. 36A.102.  TRAINING.  (a)  The department, in
collaboration with medical schools and other health care
organizations, shall develop a training program for health care
providers to ensure knowledge of and provide necessary skills for
detecting visual impairments and associated risk factors, with a
focus on both ocular and neurological forms of visual impairment.
(b)  Health care providers and certified teachers shall
complete the training course developed under this section to
identify signs and symptoms of a visual impairment, risk factors,
or any other indicator that may necessitate a functional vision
assessment with or without a formal diagnosis.
Sec. 36A.103.  PUBLIC AWARENESS CAMPAIGN.  (a)  The
department shall establish a public awareness campaign to educate
parents, legal guardians, managing conservators, and health care
(1)  types of visual impairments, including cortical
(2)  the importance of early screening;
(3)  the developmental history and risk factors
associated with visual impairment;
(4)  mandatory screening and referral requirements;
(5)  available resources for children with visual
(b)  The department shall provide educational materials and
support for parents, legal guardians, and managing conservators,
including information on methods of advocating for their child's
needs and navigating the early intervention system specifically
designed for blind and visually impaired children.
Sec. 36A.104.  STATEWIDE VISION DATABASE; REPORT.  (a)  To
ensure children with visual impairments receive timely diagnosis
and treatment, the department shall establish and maintain a secure
statewide database to monitor and track children who have a risk
factor for or are diagnosed with a visual impairment.  The database
(1)  screening and functional assessment outcomes,
(A)  the number of children screened; and
(B)  the number of children diagnosed with or
identified as having a visual impairment or risk factors;
(2)  diagnostic follow-up appointments; and
(3)  early intervention services provided, including
the number of children receiving early intervention services for a
(b)  Not later than December 1 of each year, the department
shall provide a written report to the legislature summarizing the
information collected under Subsection (a) and providing
recommendations for legislative or other action.
(c)  The report shall include recommendations for improving
the program's effectiveness, equity, and accessibility.
Sec. 36A.105.  FUNDING.  From money appropriated or
otherwise available for this purpose, the department and commission
shall allocate money to support the implementation of this chapter.
Sec. 36A.106.  ENFORCEMENT.  The department or commission
may impose an administrative penalty in an amount determined by an
administrative law judge to be appropriate based on the seriousness
of the conduct or order a corrective action for a violation of the
screening and referral requirements under this chapter.
SECTION 4.  As soon as practicable after the effective date
of this Act, the executive commissioner of the Health and Human
Services Commission and the Texas Education Agency shall adopt
rules necessary to implement the changes in law made by this Act.
SECTION 5.  This Act takes effect September 1, 2025.