June 29, 2007

Martha Yeager Walker, Secretary
West Virginia Department of Health and Human Resources State Capitol Complex
Building 3, Room 206
Charleston, West Virginia 25305

Dear Secretary Walker:

I am in receipt of your letter dated April 26, 2007, requesting a Superintendent's Interpretation regarding West Virginia Code 18-5-17 which states in pertinent part:

(a) All children entering public school for the first time in this state shall be given prior to their enrollments screening tests to determine if they might have vision or hearing impairments or speech and language disabilities. County boards of education may provide, upon request, such screening tests to all children entering nonpublic school. County boards of education shall conduct these screening tests for all children through the use of trained personnel. Parents or guardians of children who are found to have vision or hearing impairments or speech and language disabilities shall be notified of the results of these tests and advised that further diagnosis and treatment of the impairment or disabilities by qualified professional personnel is recommended.

(b)County boards of education shall provide or contract with appropriate health agencies to provide, upon the request of a parent or guardian residing within the district, developmental screening for their child or children under compulsory school attendance age: Provided, That a county board is not required to provide such screening to the same child more than once in any one school year. Developmental screening is the process of measuring the progress of children to determine if there are problems or potential problems or advanced abilities in the areas of understanding language, perception through sight, perception through hearing, motor development and hand-eye coordination, health, and psycho-social or physical development. The boards shall coordinate the provision of developmental screening with other public agencies and the interagency plan for exceptional children under section eight [18-20-8], article twenty of this chapter to avoid the duplication of services and to facilitate the referral of children and their parents or guardians who need other services. The county boards shall provide notice to the public of the availability of these services.

Specifically, you asked, "Would it be an acceptable practice for West Virginia public schools to request and accept documented proof of a HealthCheck exam to verify compliance with the required screenings listed in West Virginia Code 18-5-17?"

This would be an acceptable practice. The intent of West Virginia Code 18-5-17 is to ensure that students receive basic and appropriate vision, hearing, speech and language and developmental screenings so that identified deficits can be addressed and treated to optimize educational success for all students. As stated in your letter and verified with HealthCheck documents, the Medicaid Early Periodic Screening, Diagnosis and Treatment (EPSDT) full preventive exam for children ages three to six includes all of the required screening components of West Virginia Code 18-5-17.

West Virginia Code 18-5-17 was passed during a time when many children did not have health insurance and the school system was the most able entity to provide such a population based screening at the point of school entry. As you state in your letter, West Virginia is now a leader in health care coverage for children ages birth to twenty with approximately ninety-five percent of the state's children having health insurance. This significant advancement in health care coverage for children certainly warrants a need for school systems to re-evaluate procedures for meeting the intent of West Virginia Code 18-5-17.

Given that the state is committed to providing the HealthCheck exam to all children covered by Medicaid, the WV Children's Health Insurance Program (WVCHIP) and the Public Employees Insurance Agency (PEIA), it behooves all state agencies to coordinate child health screening efforts to ensure that all children receive quality services while optimizing health care resources in an efficient and responsible manner. As with any interagency effort that crosses state and local levels, this will require tremendous collaboration among county school systems, state and local departments of health and human resources, local medical providers, health insurance agencies and, most of all, families.

In an effort to facilitate this collaboration, I am requesting each county superintendent to initiate cooperative memoranda of understanding between the appropriate agencies and health care providers that serve their communities to ensure that every school enterer receives the screening mandated in West Virginia Code 18-5-17 through the collective resources and services of education and health agencies and local health providers. These cooperative memoranda will need to be continually updated to reflect changes in education and health policy as such changes continue to increase the quality of services that we jointly provide to the state's children.

Hoping that I have been of service, I am,

Sincerely,

/s/

Steven L. Paine
State Superintendent of Schools