R384. Health and Human Services, Population Health, Health Promotion and Prevention.
R384-201. School-Based Vision Screening for Students in Public Schools.
R384-201-1. Authority and Purpose.
(1) Sections 26B-1-202 and 53G 9-404 authorize this rule.
(2) This rule provides Department of Health and Human Services (department) oversight of public education vision screening and establishes comprehensive standards, protocols, and reporting requirements for school-based tier one and tier two vision screenings.
R384-201-2. Definitions.
(1) "Designated vision point person" or "DVPP" means:
(a) the school nurse; or
(b) if a local education agency (LEA) does not employ a school nurse, an individual designated by the LEA to coordinate the school vision screening program.
(2) "Eye care professional" means an ophthalmologist or optometrist.
(3) "Health care professional" means the same as defined in Section 53G-9-404.
(4) "Instrument-based screening device" means a department-approved automated tool used to facilitate vision screening for a student who cannot complete a standard chart-based visual acuity test.
(5) "Screening certificate" means written documentation of a vision screening or comprehensive eye examination by a health care professional conducted within one year of a student entering a public school.
(6) "Significant vision impairment" means a visual impairment severe enough to interfere with learning.
(7) "Qualified outside entity" means a department-approved nonprofit entity contracted with an LEA to assist with tier one vision screening.
(8) Tier one screener" means an authorized individual who meets the criteria described in Subsection R384-201-5(8) to conduct a tier one screening for at the school.
(9) "Tier two screener" means a school nurse or health care professional who has completed department-approved training to conduct a tier two vision screening at the school.
(10) "Vision screening" means a process or method used to identify a student whose results may indicate a vision impairment.
(11) "Vision Symptom Questionnaire" or "VSQ" means the questionnaire developed by the department to identify a student who may need a tier two vision screening or referral to an eye care professional based on vision-related symptoms or concerns.
R384-201-3. Screening Criteria and Qualifications.
(1)(a) A tier one vision screener shall conduct a free tier one vision screening for at least each student:
(i) in pre-kindergarten;
(ii) in kindergarten;
(iii) in grade one;
(iv) in grade three;
(v) in grade five;
(vi) in grade seven or eight;
(vii) in grade nine or ten;
(viii) in that student's first year enrolled in public school in the state if the student is under nine years old; and
(ix) referred by school personnel or a parent or guardian to rule out vision as an obstacle for learning.
(b)(i) If a student in grade ten is enrolled in a driver education class, that student may be exempt from the tier one vision screening.
(ii) Any student with a diagnosed significant vision impairment shall be exempt from vision screening.
(2)(a) A student qualifies for a tier two vision screening or referral to an eye care professional if a teacher or a parent or guardian submits a VSQ indicating a vision concern.
(b) A subsequent tier two vision screening or referral to an eye care professional shall be conducted if indicated by the results of the VSQ.
(c) A student who is referred to an eye care professional after a tier one screening does not require a tier two vision screening.
(d) An LEA may refer a student to an eye care professional in lieu of performing a tier two vision screening.
(e) Any LEA without an authorized tier two screener shall automatically refer each student in need of a tier two vision screening to an eye care professional.
R384-201-4. Vision Symptom Questionnaire.
(1)(a) The department shall, in coordination with the State Board of Education, provide the VSQ to each LEA for the classroom teacher to potentially identify a vision problem.
(b) The department shall update the VSQ as needed.
(2) For a student who fails to achieve benchmark status on the benchmark reading assessment in grades one through three:
(a) the LEA shall notify the student's classroom teacher within 30 calendar days of student performance on the benchmark reading assessment; and
(b) the classroom teacher shall complete the VSQ within 45 calendar days of the administration of the benchmark reading assessment and submit the completed VSQ to the DVPP.
(3)(a) For a student who requires a VSQ in accordance with a special education referral or reevaluation and Rule R277-750, incorporated by reference in this rule, and the Special Education Rules manual, incorporated by reference in Rule R277-750, the classroom teacher shall submit a completed VSQ to the DVPP.
(b) The coordination, completion, and evaluation of each special education evaluation or reevaluation VSQ shall be conducted in accordance with Rule R277-750.
(4)(a) For a parent or guardian who has a vision concern for a student, the parent or guardian may complete the VSQ and submit the completed VSQ to the DVPP.
(b) If any school personnel, including a teacher, has a vision concern for a student, the school personnel may complete the VSQ and submit the completed VSQ to the DVPP.
(5) Upon receipt of a completed VSQ, the DVPP shall evaluate the completed VSQ within 30 calendar days for any needed tier two screening or referral to an eye care professional.
(6) An LEA may only require a classroom teacher to complete the VSQ once per student per school year, regardless of how many administrative triggers described in Subsection (2), (3), or (4) apply to the student.
R384-201-5. Training of Screeners.
(1) Each LEA shall ensure each individual who assists with vision screening receives annual training:
(a) through the department's online training course for vision screening, found on the department's school nursing website; or
(b) provided by a school nurse.
(2) The DVPP shall coordinate and verify completion of the training requirements described in Subsection (1) for every individual assisting with vision screening.
(3) The LEA shall provide training in compliance with material developed by the department.
(4) The department shall share vision screening training material with any qualified outside entity contracted by an LEA to provide screenings.
(4) The department, in coordination with the State Board of Education, shall create online training for:
(a) tier one vision screening;
(b) each individual assisting with tier one vision screening; and
(c) each individual who conducts tier two vision screening.
R384-201-6. Screening Procedures.
(1) Screening shall be conducted in accordance with department-developed criteria.
(2) Each LEA shall conduct vision screening early in the school year to provide time for adequate referral and follow-up.
(3) The LEA shall notify a student's parent or guardian of scheduled vision screening to provide the parent or guardian an opportunity to opt out of vision screening for the student.
(4) To opt a student out of vision screening, the student's parent or guardian must annually submit a written refusal for the student's participation in vision screening.
(5) An LEA staff member or DVPP shall be present during the entirety of a vision screening, including any screening conducted by a qualified outside entity.
(6)(a) Each vision screening shall be conducted using materials, questionnaires, and procedures approved by the department and developed in coordination with the State Board of Education.
(b) Screening standards and procedures are based on recommendations of the American Academy of Pediatrics, the American Academy of Ophthalmology, the American Optometric Association, the National Center for Children's Vision and Eye Health, and the National Association of School Nurses.
(7) School vision screening includes tier one and tier two screening.
(a) Tier one vision screening is a lower-level vision screening that includes basic distance vision screening.
(b)(i) Tier two vision screening is a higher-level evaluation that:
(A) includes screening of distance and near vision; and
(B) may include evaluation of eye focusing or tracking problems, color screening, and screening for convergence insufficiency, if indicated by results of the VSQ.
(8) An individual may conduct tier one vision screening if that individual:
(a) has completed department-approved training;
(b) is working in coordination with a DVPP; and
(c)(i) is a school nurse;
(ii) is health care professional;
(iii) is a qualified outside entity; or
(iii) is a trained school volunteer.
(9) A school nurse or a health care professional may conduct tier two vision screening if that individual has completed department-approved training for tier two vision screening.
(10) A person assisting with vision screening may not:
(a) profit financially from school vision screening;
(b) market, advertise, or promote a business in connection with assisting with vision screening; and
(c) distribute resource notifications or materials, unless acting as an authorized representative of a qualified outside entity operating in compliance with Subsection (11).
(11)(a) A qualified outside entity:
(i) shall provide the results of each vision screening to the LEA; and
(ii) may send a notification home with a student containing additional resources and instructions on how to obtain follow-up vision care, in accordance with Subsection 53G-9-404(9)(d), at the same time or after the LEA provides the initial referral notification.
(b) For an entity to be considered a qualified outside entity, that entity must have department approval through the department's application process.
(12)(a) A student who is not a candidate for regular vision screening may be screened using an instrument-based screening device.
(b) Only an instrument-based screening device approved by the department may be used for screening.
(c) An instrument-based screening device shall be used only when screening with a chart is not an option.
(13) The LEA shall document each vision screening result, including any referral and follow-up, in the student's permanent school record.
R384-201-7. Requirements for Referral and Follow-up.
(1) A school nurse may verify or confirm failed screening results before notifying a student's parent or guardian of any impairment or recommending further evaluation by an eye care professional.
(2)(a) Within 30 days of vision screening, the LEA shall provide a written initial referral notification, using the department-approved form, to a student's parent or guardian documenting any impairment disclosed by the vision screening and recommending further evaluation by an eye care professional.
(b) Each referral notification shall prominently include the statement: "A screening is not a substitute for a complete eye exam and vision evaluation by an eye doctor."
(3)(a) Each LEA shall implement a distinct follow-up protocol that is separate from, and not a substitute for, the initial referral notification described in Subsection (2).
(b) The follow-up protocol shall, at minimum, require the LEA to:
(i) directly contact the student's parent or guardian by telephone, email, or another LEA-approved method of communication;
(ii) confirm that the parent or guardian received the written initial referral notification; and
(iii) ensure the parent or guardian is provided with information on additional resources and instructions on how to obtain follow-up vision care, including any notification materials provided by a qualified outside entity under Subsection R384-201-6(11).
R384-201-8. Aggregate Reporting Requirements.
(1) Each LEA shall annually report to the department aggregate statistics, including that LEA's:
(a) total number of students who have received tier one vision screening;
(b) total number of students referred to an eye care professional after a tier one vision screening;
(c) total number of students referred to school nurse for tier two screening;
(d) total number of students referred to an eye care professional after a tier two vision screening; and
(e) other information, as requested by the department.
(2) Each LEA shall submit statistical information described in Subsection (1) as part of the annual School Health Workload Report, in accordance with Rule R277-415, no later than June 30 of each year.
(3) An LEA may not collect or report to the department any personally identifiable information under this rule.
R384-201-9. Reporting and Referral for Significant Vision Impairments.
(1) If a student is identified or suspected to have a significant vision impairment that may interfere with the student's ability to learn, the LEA shall promptly initiate the special education referral process in accordance with Rule R277-750.
(2) To coordinate required evaluation resources, including a functional vision assessment completed by a licensed teacher of students with visual impairments (TSVI), the LEA shall contact the Utah Schools for the Deaf and the Blind (USDB) Outreach Vision Services program or the LEA special education director for guidance and support without undue delay.
(3) The LEA shall ensure that any reporting, referral documentation, or student data shared under this section complies with:
(a) Family Educational Rights and Privacy Act (FERPA), 20 U.S.C. Sec. 1232g; and
(b) Title 53E, Chapter 9, Student Privacy and Data Protection.
KEY: eye exams, school vision, vision evaluations
Date of Last Change: October 29, 2026
Notice of Continuation: June 6, 2023
Authorizing, and Implemented or Interpreted Law: 53G-9-404
