1. How can I find out more about the new legislative requirement for the Early Childhood Vision Care Program?

The North Carolina Early Childhood Vision Care Program was legislated in 2005 by GS 130A-440.1 and the Early Childhood Vision Care Commission (PDF, 18 KB) was created by GS 143B-216.75. In August 2006, the Governor signed HB 2699, which changed both the makeup of the Commission and key points of the Early Childhood Vision Care legislation. The revised legislation requires children entering kindergarten in 2007 to have a vision screening in accordance with vision screening standards (PDF, 22 KB) adopted by the Early Childhood Vision Care Commission within twelve months prior to school entry. Vision screening must be done by a licensed physician, optometrist, physician assistant, nurse practitioner, registered nurse, orthoptist, or a vision screener certified by Prevent Blindness North Carolina.  If a child entering kindergarten has had a comprehensive eye examination performed by an ophthalmologist or optometrist within the past twelve months, the vision screening requirement is considered to have been met. Children from kindergarten through third grade must be referred for comprehensive eye examinations following a vision screening failure.

2. What are the vision screening standards?

The vision screening standards (PDF, 22 KB) were adopted by the Early Childhood Vision Care Commission and are available on this website.

3. What is the definition of comprehensive eye examination? What are the required components of the comprehensive eye examination?

For children who receive and fail to pass a vision screening, a comprehensive eye examination is required.  The minimum components of the comprehensive eye exam by an ophthalmologist or optometrist are specified in the legislation:

"Comprehensive eye examination" shall consist of a complete and thorough examination of the eye and shall include:

(1) Measurement of visual acuity;
(2) Ocular alignment and motility;
(3) Depth perception--stereopsis;
(4) Fusion;
(5) Slit lamp examination of the lid margins, conjunctivae, cornea, anterior chamber, iris, and crystalline lens;
(6) Examination of the ocular adnexa, the anterior segment, and pupils; and
(7) Cycloplegic refraction and dilated fundus examination.

4. How do I document the eye examination for the school system?

Documentation of the comprehensive eye exam must be on the Early Childhood Vision Care Program Eye Examination Transmittal Form (PDF, 129 KB).  This is the only documentation acceptable to school systems.  The provider shall present a signed transmittal form to the parent upon completion of the examination. The parent shall submit the transmittal form to the school.  A copy of this form should also be sent to the child’s regular primary care provider to assure continuity of care and follow-up.

Yes. Medicaid and Health Choice will cover the exam for enrolled children according to their benefits packages and policies and procedures.  Each program has specific requirements for eligibility and reimbursement for the eye exam for children. 

6. How will funds appropriated by the General Assembly to cover services for low-income children be distributed?

ECVC funds are available to cover services for children whose families’ income is less than 250% of the Federal Poverty Level and who are not eligible for Medicaid or enrolled in Health Choice, Vision Service Plan (VSP) or similar services, and who are not covered by private insurance. The School Health Unit within the Children and Youth Branch, Department of Health and Human Services, will administer financial eligibility, issue ECVC authorizations to parents, and process claims for services provided under the Early Childhood Vision Care Program.

Professional services will be compensated at Medicaid rates. Covered services through the Early Childhood Vision Care Program include the comprehensive eye exam and required prescriptive glasses.

7. How is eligibility for the Early Childhood Vision Care Program determined?

The eligibility section of the ECVC Application Form (((PDF, 191 KB))) must be completed to determine eligibility.  Your office staff, or a school nurse, social worker, local health department staff, or a parent may complete the eligibility information. The ECVC Application form must be sent or faxed to the School Health Unit, Division of Public Health to obtain authorization for examination and glasses coverage.  Contact information for the School Health Unit is on the form.

8. How does Prevent Blindness North Carolina and the VSP relate to the ECVC program? 

The Vision Service Plan (VSP) is the nation’s oldest and largest managed vision care plan. The Sight for Students program is a charity program founded by VSP which provides free vision exams and glasses to low-income (family income at or below 200% of the Federal Poverty Level Guidelines), uninsured children who have a Social Security number. Sight for Students operates nationally through a network of community partners, including Prevent Blindness North Carolina, who identify children in need and VSP network doctors who provide the eye care services.

The Early Childhood Vision Care program provides funding to cover vision examinations and glasses for children entering kindergarten through grade three who have had vision screening and need a comprehensive vision examination. Children must be uninsured, not eligible for the VSP program, or any other vision assistance program, and their family income must be at or below 250% of the Federal Poverty Level Guidelines.

9. Is pre-authorization required by the Early Childhood Vision Care Program?

Yes.  Eligibility determination information is on the Application Form (((PDF, 191 KB))).  After review and eligibility determination, the School Health Unit will mail an ECVC authorization to the family or designated person on the Application Form.  When the parent presents the ECVC authorization at the time of their appointment for a comprehensive eye examination, you must ensure that the ECVC authorization number is on the Transmittal Form in order for reimbursement to occur.

10. How long does it take for an ECVC Voucher to be issued?

It takes up to two (2) weeks from the time that Application form is received by the School Health Unit to return a ECVC authorization or denial letter.  The parent or designated person will receive notification of the authorization or denial of the request.

11. How will I be compensated by the Early Childhood Vision Care Program for the services I provide?

Eye care providers will submit a Transmittal form and invoice for the services rendered. Payment for services will be processed and paid within 45 days of receipt of the claim form by the Division of Public Health.

12. Can any ophthalmologist or optometrist participate in the Early Childhood Vision Care Program?

Any licensed ophthalmologist or optometrist can participate in the program.

13. How do I train my staff to do vision screening as required in the ECVC Vision Screening Guidelines and get ready to participate in the Early Childhood Vision Care Program? 

A PowerPoint training module (PDF, 72 KB) and the screening guidelines (PDF, 22 KB) are available on this site for you and your staff to use.

14. Who do I contact if I have additional questions about the Early Childhood Vision Care Program?

For eligibility, ECVC authorization or claims questions, please contact the School Health Unit at 1-888-663-0155. For general information about the Early Childhood Vision Care Program, contact us via email.