group of SC ophthalmologists opposes a non-profit organization that wants to provide free glasses to students | Health

A national nonprofit that wants to provide free prescription eyeglasses to thousands of low-income college students in Charleston has been thwarted by a group of eye doctors in South Carolina and an obscure state law that limits places where mobile clinics are allowed to operate.

Vision to Learn, which already runs nonprofit mobile clinics in 10 states and has provided 240,000 free pairs of glasses to children across the country since 2012, has already encountered opposition from optometrists in other states. But the obstacles she faces in South Carolina are unique due to an existing state law that prohibits a mobile van from performing simple eye exams on a school campus.

Henry Blackford is a retired Charleston banker who has raised hundreds of thousands of dollars since 2018 to launch Vision to Learn in the Lowcountry after he and his wife Sherry watched a segment about the organization on PBS. Blackford wants the state law changed even as the South Carolina Optometric Physicians Association has lobbied lawmakers to maintain the status quo.

Henry Blackford. Provided

“What appeals to me is that the program is working very successfully in Charlotte and Atlanta. It’s frustrating,” Blackford said. “Optometrists were a huge stumbling block. Then we hit the pandemic.”

In a prepared statement provided to The Post and Courier, the state optometrist association said it objects to Vision to Learn not dilating a student’s eyes during an exam.

“While we are not opposed to the idea of ​​mobile clinics, it raises serious concerns about the quality of care that would be provided,” the group wrote. “Without a dilated exam, the chances of missing serious medical conditions and issuing inaccurate eyeglass prescriptions increase dramatically.”

Jackie Rivers, executive director of the SC Optometric Physicians Association, said no one from the association or its board was available to be interviewed for this story. The statement prepared by the association went on to call Vision to Learn “unwilling to compromise” and said: “No child, especially our most vulnerable, deserves substandard care, simply because of the where they live or their socio-economic status”.

But Blackford, and others associated with Vision to Learn, have argued that the students he seeks to help are falling through the cracks of the existing healthcare system.

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“Honestly, I don’t think (optometrists) care about those 7,500 low-income Title 1 students who need glasses but don’t have them. No one is serving them,” Blackford said.

He thinks the doctors’ group is more concerned about a future that would allow for-profit mobile clinics to locate outside retirement communities and nursing homes, which could squeeze optometrists’ margins down the line. .

“It’s just my suspicion,” he said. “I don’t see what else it could be.”

Joan Chu Reese is the Executive Director of Vision to Learn. Like Blackford, she said the organization should not be seen as a threat to the business model of optometrists. In fact, she says, Vision to Learn identifies patients who are likely to need lifelong eye care – the future clientele of physicians.

“There’s a natural fear that we’re going to take clients to an optometrist,” said Reese, who is based in Los Angeles. “Vision to Learn’s job is not to see these kids forever. We seek out kids who are outside of the world of optometry and bring them in. … It’s so unfortunate that we got hung up here in Carolina from the South with this problem.”

Clippers Glasses Basketball

Nasir Lucas, 11, watches NBA player Blake Griffin while talking about what it was like to receive glasses for the first time at Lovelia P. Flournoy Elementary School in 2018, in Los Angeles, where the Clippers announced a partnership with Vision to Learn and the Los Angeles Unified School District to provide eyewear to students. File/Mark J. Terrill/AP

Eye dilation

It’s not just the state optometrist association that believes dilation is necessary during every eye exam. The SC Board of Examiners in Optometry, made up mostly of optometrists, in 2019 refused to license the Vision to Learn mobile clinic for the same reason.

This does not mean that all doctors agree on the matter. Dr. Soyung Ailene Kim, a staff optometrist who works for Vision to Learn in Atlanta, said exams performed at Vision to Learn mobile clinics are usually sufficient to determine the level of prescription a student with vision issues needs. . Also, because these exams take place on the school campus during the school day, dilating a student’s eyes would impair their vision for several hours, Kim said.

“The reason we don’t dilate the kids in the van is because over time it doesn’t work,” she said. “Their near vision will also disappear for the rest of the day.”

That said, Kim sees around 20 students each day and said at least a few of them inevitably need a more comprehensive review than Vision to Learn is able to provide. When this is the case, she refers them to an outside optometrist in the community. “If I have any doubts…I always refer them.”

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Experts estimate that 7,500 low-income students enrolled in Title 1 schools in Charleston would qualify for free eyeglasses if Vision to Learn were allowed to operate a mobile clinic in the Lowcountry. Vision to learn/provided

The dilation issue eventually became so tense in South Carolina that lawmakers asked Attorney General Alan Wilson to intervene. In January 2020, Wilson’s office issued a 13-page notice concluding that Vision to Learn could distribute prescription glasses to students without violating eye care statutes. And while the state Board of Optometric Examiners has established guidelines that call for dilation during a comprehensive eye exam, the legislature has imposed no such requirement, Wilson’s office wrote. .

“It’s not a court order, but it comes from the highest legal office in South Carolina,” Reese said. “He says the type of operation we are proposing should be allowed.”

The SC Society of Ophthalmologists has not publicly expressed an opinion on Vision to Learn. Ophthalmologists, unlike optometrists, are medical doctors. Optometrists attend a school of optometry, not a school of medicine.

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Moment “wow”

After Henry and Sherry Blackford first saw this PBS segment on Vision to Learn in 2018, they wanted to know more.

“It was a ‘wow’ moment for both of us,” said Henry Blackford.

Photo of the interior of the VTL 2 clinic.jpg

A nonprofit with a fleet of mobile eyeglass clinics that provide free prescription glasses to low-income college students wants to come to Charleston, but a state law and a group of eye doctors get in the way. Vision to learn/provided

So they started exploring the idea of ​​launching the program here in Charleston. This process eventually led them to Charlotte, where Hugh McColl III and his wife Renee had already started a branch of Vision to Learn. The McColls invited the Blackfords to attend “Distribution Day” at a Charlotte school, where hundreds of students received their new glasses.

“When you watch one of these kids put on a pair of glasses and they can read a book or see a tree or the school board, it’s life changing,” McColl said. “My wife and I…we’ve both fundraised for a lot of different organizations and I’d say this is probably the easiest I’ve come across.”

Blackford also found it quite easy. In less than a year, he was able to secure more than $600,000 in commitments from state and local funders, including The Post and Courier Foundation, Roper St. Francis Healthcare, and the Storm Eye Institute of the Medical University of South Carolina. MUSC, in fact, made a verbal promise of $110,000 to buy the mobile van and outfit it with equipment.

Blackford said MUSC and other groups withdrew their pledges when the pandemic hit. He estimated he still had about $300,000 in commitments.

It’s an easy mission to follow, Blackford said, because the terrain is straightforward. The need is obvious and the solution is simple.

The latest Tri-County Cradle to Career Collaborative report on education shows deep disparities in academic performance between black and white students, Blackford pointed out.

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By third grade, he said, 68% of white students read at the grade level, compared to just 28% of black students.

“It gets worse in the eighth grade,” he said.

The report doesn’t address any vision-related issues, but Blackford said he couldn’t help but wonder if thousands of free prescription glasses could help close that reading gap.

He is not the only one. School nurses also support the Vision to Learn model.

“It’s one thing to say, ‘I know I need glasses,’ and it’s another to get glasses and have them,” said Ellen Nix, director of nursing services for the school district. of Charleston County. That’s why Vision to Learn works, she says.

“They come in and are able to provide these glasses for the child.”

In a 2019 internal survey of 90 nurses employed by the Charleston County School District, more than 95% agreed that free exams and free glasses provided by a mobile vision clinic would benefit their students. .

It will take a change in state law for that to happen. Existing rules only allow these mobile clinics to operate outside of health facilities.

Representatives Joe Bustos and William Cogswell, both Republicans from Charleston, introduced a bill in February that would make an exception for nonprofit mobile clinics to provide vision services outside of Title 1 schools. was written specifically with Vision to Learn in mind, Cogswell said.

And although it has been referred to a committee for review, the legislative session ends in May and the bill is unlikely to be discussed until next year.

But there is still hope this spring for Vision to Learn. The state Senate this week added an amendment to its version of the annual budget that would provide a one-year pass for mobile eye clinics to operate outside of Title 1 schools. If the amendment passes with budget, it would give Vision to Learn a chance to launch in Charleston this fall, while giving the Legislature more time to permanently change the law in 2022.

But the House must also accept the budget amendment. Negotiations begin in May.

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