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«SEPTEMBER 24, 2015 Services Provided By: Caption First, Inc. P.O. Box 3066 Monument, CO 80132 1-877-825-5234 +001-719-482-9835 ...»

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SEPTEMBER 24, 2015

Services Provided By:

Caption First, Inc.

P.O. Box 3066

Monument, CO 80132





This text is being provided in a rough-draft Format.

Communication Access Realtime Translation (CART) or captioning are provided in order to facilitate communication accessibility and may not be a totally verbatim record of the proceedings.

*** JULIA LAUSCH: Good afternoon. We have tools and tips to help you establish a strong vision health program.

As a notice to everyone, we're recording today's webinar so that we can have it posted on our website for people to view at a later date.

We will be muting people's lines just to help cut back on any extra noise in the background. This webinar is hosted by the Wyoming vision collaborative. We're funded by the Wyoming Department of Health and donations from the Wyoming lion foundation and the miracle in sight foundation. Today we have a presentation by Kira Baldonado; she is one of our stakeholders in the vision collaborative group. She is the director for The National Center of Children’s Vision and Eye Health the prevent blindness. We have been working hard to inform and guide the development of a statewide screening program infrastructure for Wyoming. She's been very helpful in sharing information about current research and eye health and other nationwide initiatives. In a minute I'll hand the floor over to Miss Baldonado. Note that we'll have time for a brief question and answer period at the end of today's presentation.

If you have any questions, concerns, during the presentation you are able to type into the text box and can either post the question t everyone or directly to me so please feel free to post questions at any time especially if there are any questions or concerns with technology. At the end when we do the question and answers, we'll unmute everybody's lines so that you can go ahead and chime in. Also we have posted in the text box a link to today's captioning services. That's for the event. If you would like to view the caption text please open the link in a separate window on your computer and then you can shrink it down so that you can view the text along with the presentation.

Kira, I would like to hand it over to you. Go ahead;

welcome your presentation on the computer and then you can share your screen.

KIRA BALDONADO: Okay. There we go.

Welcome, everybody to the webinar. I'm the director of the national center for children's vision and eye health and today my goal is to provide some tools and tips to help establish or strengthen your existing children's vision health program. My objectives are to describe the 12 components of a strong vision health system of care, to describe some tips to improve the follow-up component of the vision health program, which is the most critical part of the program and to describe three ways to improve vision screening effectiveness. We want to do things well, make sure that kids are connected to care and make sure that they follow-up with the treatment that is recommended from the eye care professional.

Hopefully today’s presentation will help you get some tips to make it to those steps.

Many times in the conversation we talk about doing a better job of vision screening. Here at the national center we have a line of thought that we want to take it from a better vision screening to a better vision system for children's vision.

Within the scope of a system there are a lot of different things to consider as you put your vision health program in place.

I'll have a trip around the clock here.

First and foremost, caregiver education. If parents don't understand why it is important, they don't understand the results, they don't understand the role that healthy vision can play in the child's education and learning ability then they're not likely to follow-up on recommendations. Making sure that you have parent permission not just to do the screening but also to share results as needed within HIPA and HERPA guidelines.

Use evidence-based practices. Every day there is a lot of cool new stuff coming out on the market. We want to make sure that the tools that you're using for vision screening are the right tool for the ages that you're targeting and that they're the right tool for the developmental stage that the child that you're screening and that they are really designed to do what you want them to do.

Organizational policies are kind of the Keystone of making sure things happen in a consistent way and that the information that comes out of the program is used in a consistent way.

You need to have strong policies in place.

You want to make sure you have a standardized approach to rescreening and referring. Often times we hear this is an area of concern for people that do vision screening. They're not quite sure when they should rescreen a child, when they should refer the child so having a standardized approach to that is important.

Cultural competency is an important consideration for children's vision. There are many cultures that don't believe that children should wear glasses, they think it has a negative connotation on their child's appearance in society. There are many cultures think that it shows a deficit, that their child isn't as strong as the others, so there may be cultural beliefs either to corrective eye wear, or to accessing an eye care provider that need to be overcome to make sure to improve the follow-up. Ensuring follow-up is a key component and making sure that you have a record system in place will help with that.

Linking to resources, not just for the parents, to eye care providers, that's important, but there may need to be linkages to getting free eye glasses or assistance in paying for eye glasses, linking eye care providers with the program and letting them know what you're doing. There are a lot of different types of resources that you want to make sure that you're working to.

Making sure you have exam outcomes on file that comes in the data piece that we talk about later. Making sure that what you're doing in the vision screening program is matching up with the eye exam outcomes. If they're not, what changes do you need to make? Making sure that there is good provider of communication. Vision screening has kind of plagued along the way to live in silos, we do vision screenings in head starts, vision screenings in primary care, vision screenings in public health but everybody does them all on their own thing, holding their own data to themselves and oftentimes that can lead to duplication of services, confusion by the parent of the child that's going through all of the different systems and it is just unnecessary.

If we can improve provider communication we can make sure that -- enforcing the referral made to the vision screening, making sure that the kids are connected to eye care and the results from screenings and exams is getting back to the people that need that information.

Making sure that treatment plans are understood not just by the family but by the people that are helping to make sure that the treatment plans are here too. If the child is patching while under the care of an early education provider, they have to be aware of that, that there is a treatment plan on file and that's their system and that that patch is worn in the correct hours under their care. Finally having an annual evaluation.

There is no perfect system for children's vision health. There is always some area that can be improved in. Taking a step at the end of the year and saying hey, how have we done? How are we doing with the vision screening practices, how are with we doing with our connections to parents, do they feel educated, are we reaching all of the cultures we serve within our program and our kids getting the care they need. Making sure you take a moment to evaluate each of these 12 pieces every year is a worthwhile way to improve your program.

One of the things that you can focus on to create a great vision health program, one, making surf sure you participate in actions to support sound policies. That could be a scary thing for some people. When you talk about policies you think, you know, head start does that at the federal level or my boss does that for our organization. Policy development can be at any level along the way.

Consider how do you develop policies about your own workflow? How do you develop policies for the program, for your county, for your region, for the state? How can you contribute to policy development federally?

The voices for everybody, but especially those on the ground doing the vision screening, and have outcomes and impacts of these policies to report especially need those voices to help we need to build that flow up to the federal level saying that this is working, this is not, here is why. How can we change it? There are a lot of great opportunities to participate in forming policies.

You can also take steps to support your family; I'll talk about different ways to do that here in a moment.

Families, they're all over the board with their needs and you never know what will be that one thing that prevents them from taking that step to follow-up to eye care. Trying to have a strong support in place will help prevent some of that lack of follow-up.

Evidence-based approaches to vision, we touched on that.

Ensuring effective communication among all of the stakeholders.

I'll talk about some ways that you can pull in some of the local eye care providers, that you can pull in families, family advocates to improve the outcomes to your vision program and number 5, engage in data sharing opportunities. It sounds maybe scary for some people. There are the heavy silos that are along the way. All of the people that care about children's vision and the more that we can look at opportunities to share data in an appropriate way with appropriate securities in place then we can have a better focus on the child rather than all of our screening procedures and numbers of how many were screened and how many we’ve referred in place, we have to track the child, not how many people we're screening.

Assess your competency as I said. Are you really making a difference? Do you need to make adjustments in how the screenings are followed up and supporting families?

Let's talk a moment about strong policies. I have a couple of different examples there.

So there may be different areas of policy change that you may want to put in place. Your screening methodology and periodicity is a couple of different approaches.

This might be for your program level, or the state. How are we going to screen children in different age groups? What is the evidence that drives practices within those age groups?

How you screen a child in the preschool age is going to be different than how you do it and how often you do it at school age levels.

There are different needs, different reasons for screening and in these different age groups to make sure that you have strong policies in place about why you do something and when you do it.

Policies around data collection approaches. This is -- if any of you are familiar with the early childhood data collaborative; they have a lot of great guidance information around data collection especially early childhood. When you look at putting together some data sharing or collection policies in place, there are a lot of security and user guidelines that need to be put in place. It is really important to stop and take considerations of what data are we going to be collecting, who is going to have access to that data, how do we know is it secure, when we share, what do we share, what are the guidelines in place. Starting with policy development around these issues will stop a lot of questions later on down the road. It is very important.

Having some training approaches as a part of the policy development is also important. So how are you going to train the individuals doing the vision screening? How are we going to train the individuals that are handling the data coming in and going out? What are the different certifications, requirements for people at different levels and how is that built in to employee responsibilities, volunteer responsibilities and what do you have on paper for those individuals to adhere to?

You need to have policies around the non-typically developing child or those that may be at increased risk for a vision problem. There is a lot of alignment around this area between American Academy of Optomology, ALA, the American Academy of Pediatrics, bright futures, prevent blindness in the national center, we all agree that those children who are not typically developing, they may have cerebral palsy, they may have development overlays of some sort or another, or on the autism spectrum or those that have an increased risk because of a strong-family history of vision conditions, those are kids that we know are not asymptomatic. They are going to have much higher likelihood of a vision problem so it’s critical that they get connected to an eye care provider and establish that relationship so that they can maintain the right periodicity for their vision health and their condition. Those are kids that need to be connected to an eye care provider rather than screened according to those policies.

Then make sure that your full system of vision health, I went around the clock, the full system, make sure that that is reflected in the documentation of what you're collecting and the policies. One of the examples I wanted to share of where that full system is developed in a policy is the policy in place by the Administration of Children and Families and the Office of Head Start, and their vision health policy. Many of us are familiar with the fact that in head start and early head start programs, within 45 calendar days of the child's entry into the program is the child's vision; they have to have a vision screening on file for that child.

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