PA House Health — 2026-03-25

Chair Frankel. Here.

Borowski.

handbidge designation Howard here

Kozarowski designation

Mays designation

Sanchez here

Venkat here

Representative Bonner

Brown Designation

Krupa

Rossi

Tordzik

Zimmerman

House Bill 1077 creates the Commission on Children's Vision housed jointly under the Department of Education and the Department of Health, and includes designees of both the Secretary of Education and the Secretary of Health, as well as 12 vision care professionals. professionals. The Commission is tasked with reviewing data related to eye care access to create a statewide plan to provide continuity of care for children failing vision screening, and issue an annual report on vision care plans and programs. Vision care professionals will serve for three-year terms, and the initial composition of membership will serve staggered terms. The Commission will have an executive director jointly appointed by the Department of Health and Department of Education Any funding required must be appropriated by the General Assembly The question is will the committee report House Bill 1077 I am offering Amendment A on behalf of Representative Kahn

amendment a zero two six nine nine six six nine makes substantive changes to streamline the bill and balance the experts who will provide guidance the purpose of the bill remains same to ensure that once a child fails a vision screen to plan for a system that connects children's continuity children to continuity of care and eyeglasses this amendment removes the requirement for an ongoing departmental commission placing the entire ongoing multi-departmental commission placing the entire commission under the Department of Health and removing the need for ongoing staffing. A02669 adds additional expertise to the commission, including the chief of the Division of School Health within the Bureau of Community Health Systems, three school nurses, community or and community organizations that connect children to eyeglasses. The amendment reduces the number of vision care professionals to six and requires that they represent diverse specialties. The commission still must look at data and create a vision care plan, which shall be disseminated to the governor and the leaders and relevant chairs in both chambers. The commission will revisit the issue in six years when it can evaluate any impact of the vision care plan. Thank you.

Actually, I'll defer to talk about the bill. Thank you.

on the amendment? Not the amendment, sir, but I'll make comments on the bill. Thank you.

Chair Frankel. Aye.

Representative Barowski.

Hanbridge. Designation aye. Howard.

Kozlowski. Designation aye.

Mays. Designation aye.

Sanchez.

Venkat. Aye.

Representative Bonner.

Designation no.

Designation yes.

Designation yes.

Roy.

Stare.

Walsh.

22-4.

Thank you. Amendment.

Good morning and thank you for bringing House Bill 1077 to this committee. So thank you Chairman Frankel, Chairwoman Rapp. At its core this bill is about something simple but incredibly powerful making sure our children can see clearly so they can learn grow and thrive Right now across Pennsylvania there are thousands of students sitting in our classrooms who cannot see the board, cannot read their books comfortably, and are quietly falling behind. Not because they lack ability, but because they lack access to basic vision care. And here's the hard truth. For too many families, getting an eye exam or a pair of glasses is still out of reach. This legislation creates a commission on children's vision, bringing together departments of education and health along with professionals on the ground to finally take a coordinated statewide approach. So this is not theoretical. It's grounded in real world experience with people who are already doing the work. Because right now services exist, but they're fragmented. Some schools have support, others don't. Some children get help, and others slip through the cracks. This bill fixes that. it directs the development of a statewide plan to ensure children receive screenings, follow-up exams, and glasses at little to no cost to families, while also requiring accountability through data and annual reporting. And colleagues, I want to be very clear about something we don't often talk about. When a child can't see, it doesn't just affect their health, it affects how they perform in the classroom. And too often, what happens is that the child struggles to read, struggles to focus, falls behind, and then may be referred for evaluation for an individualized education program. But in some cases, that child doesn't need an IEP. They need intensive, and they don't need intensive intervention. They just need glasses. In Pennsylvania, we're already identifying the issue. Over 80% of children receive vision screenings in school, but more than half of those who fail never receive follow-up care. So we are catching the problem, or we're trying to catch the problem, but we're not solving it, obviously. And when we miss that, we're not only failing that child, we are also placing unnecessary strain on our education system because IEP valuations, services, and long-term supports come at a significant cost to our schools and to the Commonwealth. This bill helps us get it right on the front end. By identifying vision issues early and ensuring access to care, we can support students in real time, prevent misidentification, and use our educational resources where they are truly needed. Now, I also recognize that in the vision care field, there can be differing perspectives on what approaches are best for children. We can have differences in approach, but we cannot have delays in care. Because while adults debate, children are sitting in classrooms unable to see. This commission ensures those conversations lead to action, not inaction. So colleagues, this is really about getting it right the first time. We should not be placing children into systems they don't need, when what they needed all along was something as simple as a pair of glasses. So that's not just a missed opportunity, that's a preventable failure. House Bill 1077 helps us fix that. So the question before us is simple. Are we going to keep reacting after children fall behind, or are we going to act now to help them succeed from the start? They say it takes a village to raise a child. So today let's prove that our village shows up when it truly matters. I respectfully ask for an informative vote. Thank you so much for your time.

Yeah, thank you, Mr. Chairman. I guess it my understanding that kids already get screened for vision in schools I think CHIP covers glasses I just don know why this is necessary Pennsylvania has about 500 authorities boards and commissions and that just seems like a lot That's in addition to having a governor and a legislature. We have 500 authorities, boards, and commissions. They all come at a financial cost. I'm just not sure why it's necessary to do it this way. If the CHIP program already covers glasses for low-income kids, kids already get vision screenings at school. I just don't think we need to do this. Thank you.

And I want to thank the prime sponsor of this bill. This is definitely well intended. You know, it pulls on your heartstrings. Like, who doesn't want to make sure that a child that needs glasses has glasses? I'm amazed, though. It seems like we've already identified the problem. If 50% of these kids who are failing their eye exam are not getting the follow-up care that they need, it seems like that the problem's already been identified. At some point, government's just growing wildly. And new commissions, and when I asked about the financial cost, what is this new commission going to cost? Nobody could answer that question. Do you happen to know what it's going to cost the taxpayers to have this new commission?

the list goes on and on and on. And thank you for that thoughtful response. But at some point, all of those things that were just indicated as potential fix for this issue, they can already happen. We don't have to have another government commission funded by the taxpayers to do it. Society needs to get its act together. The leaders in all those different roles in those school settings, in the Department of Human Services, they can already do this. We don't need another commission. I commend the prime sponsor, though, because I absolutely agree. My heart breaks for any child that needs glasses, that isn't getting them because the adults in their life are failing them. But it's not up to government to do that. As the community, we need to step up and fix it. Thank you. Thank you, Chair Rapp. Thank you, Mr. Chairman, and a thank you to my members who weighed in on this bill. I want to thank you, Mr. Chairman, and I want to start by acknowledging that the adopted amendment fixed many of the initial concerns that I had with this bill. The intent of the legislation is very allotable. I think it's important for our students to have the tools they need to succeed in school, which includes access to vision care and eyeglasses. I understand vision screenings already occur in our schools, but I also recognize that there may be gaps in connecting students with follow-up services so that they receive the care they need. This bill may help us better understand where these gaps are occurring so any barriers to vision care access can be addressed. That said, this commission would not be able to operate without funding being appropriated by the General Assembly. Given the Commonwealth's current fiscal outlook, I am not sure if this is the appropriate time to be funding additional commissions, no matter how admirable the intent behind them may be. I also note that we are awaiting updated vision screening regulations from the Department of Health to implement Act 122 of 2020. Act 22 modified the school vision screening schedule and notably required a failed vision screening to be followed up with a comprehensive eye exam conducted by an eye doctor. These anticipated changes may resolve some of the concerns the bill before us is trying to address. I'll be supporting the bill today out of committee, but I will certainly be taking a closer look at fiscal notes and weighing the overall need for this bill prior to its consideration on the House floor. It would be noteworthy if we could hear from Department of Health on Act 122 of 2010. Thank you, Mr. Chairman.

Our statutes and regulations address children getting vision screening, but not what happens after a child is identified as needing glasses. While the law requires that a student receive follow-up care in 120 days, we don't offer clear follow-up guidance on what that means or what continuity of care might look like. That's when the community may need to step in. This bill connects the school nurses, Bureau of Community Health, community organizations, and eye care professionals to help connect the dots to make sure a failed vision screening isn't the end point but the starting point for actual care. Republican Governor Mike DeWine of Ohio instituted such an initiative, the Children's Vision Strike Force, in 2024, including the creation of the Ohio C program to help students who fail vision screens to connect to eye exams. Pennsylvania students deserve eye care just as Ohio students do and I would ask for a yes vote Those in favor of reporting House Bill 1077 is amended We vote aye

Chair Frankel.

Representative Benham.

Horowski.

Designation aye.

Designation aye.

Kahn.

Kosarowski.

Krijuski.

Mays.

Freelotten.

Sanchez.

Designation, aye.

Yes.

Yes.

Borowitz.

Brown.

Day.

Krupa.

Roy.

Rossi.

Stare.

No.

Zimmerman.

House Bill 1077 is reported as amended.

As noted, House Bill 1077 will be reported as amended. The chair calls up House Bill 2265, printers number 2963, sponsored by Representative TACAC. Erica, would you please explain the bill?

The question is, will the committee report House Bill 2265 on that question? I am offering Amendment A-02699. Amendment A-02699 makes important changes to ensure that House Bill 2265 corresponds to existing regulatory requirements. Specifically, the amendment changes the requirement for the physician on staff to be an emergency physician and defines emergency physician as one that meets the hospital's own requirements for expertise, as determined by the medical staff and governing body. An exception may be granted for any other physician to staff the emergency department should an emergency physician not be available. Finally, the legislation permits any existing teleemergency department model with any physician present to continue, but requires physician presence for future teleemergency department models. Are there any questions or comments on the amendment?

Thank you. This amendment is offered in response to concerns we heard that many different specialties can and do staff emergency departments with doctors that aren't necessarily board-certified in emergency medicine, and that the hospitals themselves set standards for their expectations of expertise The amendment provides wide latitude for hospitals to hire based on the experience that they themselves expect and allows them to get a waiver even of their own standards. With that, would you please take the roll, Devin?

Aye.

Designation aye.

Boyd.

Orwitz

Brown

Day

Krupa

Roy

Rossi

Stare

Yes

Zimmerman

Thank you.

Thank you, Chairman. Good morning. Good morning to you, Chair Rapp, members of the committee. On behalf of my co-prime sponsor, Representative Tina Pickett, and the other co-sponsors of this, I thank you for bringing up this item for consideration. Like many of you who also represent rural districts, I spend a lot of time thinking about access and affordability to high-quality health care and ensuring that everyone has access to that. I think sometimes that third component is overlooked, the high quality. Those that live in or travel through, quite frankly, our rural communities often face significant obstacles and unique challenges in accessing health care. When they are suddenly faced with a potentially life-threatening medical emergency, the first people to respond are often underpaid and under-resourced, largely volunteer EMS providers. They have to traverse significant distances and often in bad weather. And after surmounting all of that, sometimes as much as an hour, They expect and deserve to be met and treated, I believe, by a knowledgeable, well-trained, and experienced team, including a physician who can immediately address and stabilize their condition and potentially save their life. This legislation ensures that that continues to happen and will be the case across Pennsylvania. It reflects current practice, and it protects Pennsylvanians in the future, especially in the face of very significant challenges due to funding. I'd like to just close by thanking my co-prime sponsors, staff, many members of this committee, and other stakeholders who have really worked closely with us on trying to make this a very positive step forward. I look forward to continuing to work with all the stakeholders to explore other options and opportunities to ensure that every Pennsylvanian gets the care and the help that they need. So thank you for your consideration and I be happy to answer any questions Thank you Representative TACAC Representative Venkat Thank you Chair Frankel and thank you Representative TACAC

Thank you, Mr. Chairman. I think this is a well-intended bill, but I guess if I understand it correctly, a hospital like Kane that doesn't have a physician on duty in the emergency room, under this legislation, they would be mandated to have one except they have an exception in this legislation, so they don't have to have one. So if we don't pass this, the Kane Hospital is not going to have a physician in the emergency room. If we do pass this, the Kane Hospital is not going to have a physician in the emergency room. So it just seems like it doesn't really do anything. If it's being done to make a hospital get a doctor, but then there's an exception that that hospital doesn't have to get a doctor. I just don't know what the point is, so I'll be voting no. Thank you.

Thank you very much, and I appreciate your comments. we very often pass legislation and grandfather in existing exceptions. Ideally, they would have a physician on site, and hopefully at some point in the future through other options and opportunities, Opportunities as I mentioned we will be able to do that but given that they have an existing Exception and they have a system that is working there We felt that it was important to allow them to continue to do that and not negatively impact care in that area

Thank you chair and I thank you Representative take hack for this legislation and to represent a picket as well I'm all for anything and everything we do to get more health care professionals to the bedside, get them with our patients, and a whole other issue on how we increase the number of professionals we have available in our state. I'm going to just look at this a little bit for one second from the lens of what I've been dealing with and we are trying to move is around closures and consolidations here in the state. and the sometimes easy route of saying we're just going to, we can't staff it, we're going to close it. And I just want to make sure that this legislation does not intensify that thought. And I appreciate the amendment, which certainly expands who can be the medical professional there, the physician professional, but I just want to make sure that we're considering that as well. with the loss of the waiver, you know, is it something where, you know, and we don't experience this where I am because we have, you know, big tertiary care hospitals. There's plenty of physicians in that. But I do understand and I would love to hear from, and certainly Chair Rapp, I know you have, you know, a lot of perspective on this. From the rural perspective, you know, if they potentially lose a physician in the hospital and don't have one for a certain amount of time, Does this present a problem? And then would the hospital say, well, then we'll just eliminate the service? So I just want to make sure that that's covered in this legislation.

Thank you again, Chair. I appreciate that. Thanks, Rep. Birovsky. We're certainly open to dealing with emergent situations that change. But I think one of the things we want to protect against is erosion of quality of care based on business decisions. Right? If you are going to say that you're an emergency department and that you provide emergency services, there is an expectation of a level of care. There are other designations. You can do urgent care. As Representative Venkat mentioned, there are federal programs that can be accessed to address those needs. We do not want to impact the access, but we do want to make sure that we maintain the quality of care. So, you know, we're certainly open to continuing dialogue on this, but this, in a sense, protects against future erosion of the quality of care that you are concerned about. Thank you.

Thank you, Mr. Chairman. Thank you, Representative, for your work on the bill. I'm asking for a bit of latitude Mr. Chairman, my comments are lengthy I would appreciate your indulgence, sir

Thank you, sir I know that can be difficult I will be supporting this bill in committee today but I want to make it clear that I'm not committing to supporting the bill on the floor I do recognize the work that went into amending this bill today We had several meetings a lot of work a lot of thinking analyzing so I appreciate the work regarding amending the bill and the important provision that was inserted into the bill to protect any hospital that already has an exception in place. Those factors led me to support the bill in committee. However, more work needs to be done on this bill. With any bill, negotiations take place and compromises are reached. That is the nature of what we do and how our system is structured. One area that I feel needs to be addressed in the prohibition is the prohibition on the use of a tele-ed model if a hospital can demonstrate that it was unable to procure the services of emergency physicians. We have a shortage of doctors in rural Pennsylvania, and my response to many people or say just go hire more doctors is you can't pick doctors like we pick apples off a tree, and they're not there. I've been told on many occasions that there are numerous practitioners out there that can be hired, whether we are talking about physicians, nurses, or another type of practitioner. However, numbers don't mean much if practitioners don't want to locate to a particular area, whether it is because of a pay disparity, more hours being on call, wanting to live in a particular area, or some other reason. When I mention the on call, I have a good friend, legislator, whose daughter just graduated from medical school, had high hopes she would practice in rural PA. Her response to her father was, if I went to rural Pennsylvania, I would be on call 24 hours. 24 hours, on call. If I go to a more urban area, I might be on call once maybe every three months. Each person must decide what is right for them. As a case in point, a hospital in my district recently announced that it is discontinuing labor and delivery services due to clinical staffing challenges. I can tell you unequivocally that the inability to find OBGYN physicians was not due to a lack of trying. And I will summarize some of what the hospital did to try to recruit OBGYNs. They spent more than one year trying to recruit OBGYNs. They contacted 28 OBGYN residency programs nationwide, including all 16 residency programs in Pennsylvania, six in western New York and six in eastern Ohio. They utilized the services of 10 recruiting agencies to try to locate OBGYN candidates. They reached out to available candidates by the nation's leading physician job board. Despite these exhaustive efforts, they were unable to secure the necessary staffing levels to safely maintain a 24-7 labor and delivery unit. And I don't think with the liability that we see in Pennsylvania right now for OBGYNs, OBGYNs, the settlement, you know, and everybody has their own opinion of whether that was the settlement was just. The fact is I would hesitate if I was an OBGYN doctor to practice in Pennsylvania That my opinion ladies and gentlemen Turning to this bill in 2013, the Centers for Medicare and Medicaid Services clarified that its regulations allow critical access hospitals to operate tele-EDs, which allow these hospitals to staff emergency departments with advanced practice practitioners on site with a physician available through telecommunications 24-7. Please note this was 13 years ago. In 2022, our own Department of Health issued guidance regarding the operation of teleemergency department for eligible rural hospitals. I will quote one part of this guidance. The department recognizing that staffing emergency departments full-time with board-certified physicians may be a substantial financial challenge for rural hospitals. Nonetheless, ensuring that rural hospitals can continue to operate emergency departments is crucial for the health of people living in rural Pennsylvania. The use of telehealth in emergency departments has been studied for over two decades. Telemedicines have shown to be a cost-effective alternative for low-volume rural hospitals to continue providing access to local emergency care and help to address health disparities that may exist in rural communities. In light of increased sustainability of tele-eds in rural hospitals across the country, the department is making available a structured exception request for eligible rural hospitals to operate a tele-ed in accordance with this guidance. That is the end of the quote. I will reiterate, the federal government under the Obama administration recognized the telemedicine model. Our Department of Health under the Wolf administration issued guidance to allow eligible hospitals to utilize telemedicine in recognition of the substantial financial challenge for rural hospitals. This bill, as currently drafted, will end the ability of hospitals to use advanced practice practitioners in conjunction with physicians who are available by telemedicine models. Mr. Chairman, on many issues, we have been told to trust the science and to trust the experts. I'll admit that I do not automatically subscribe to that theory. However, there is a recognition at both the federal and state levels that telemedicine services should be made available under certain circumstances as the alternative may be another hospital closure. Under this bill, telemedicine services will be prohibited going forward for any hospital that experiences staffing shortages that they cannot address adequately. The guidance used by the Department of Health a few years ago will essentially be rescinded. I feel this is short as we don know what the future holds even tomorrow I think we can all agree that we prefer in physicians in an emergency department as opposed to physicians who are only available virtually. But I think in some ways that devalues the work of advanced practitioners who can work in concert with physicians who are available by a telemedicine model. Is this a perfect solution? Should it be used by any hospital that wishes to use it? My answer would be no. But to prohibit it entirely with staffing issues, access to care, and hospital financial issues at the forefront is ill-advised in my opinion. I believe there are situations where we need to allow this to be an option. The alternative, which is the possible closing of an emergency department unit or a hospital itself, is a worse outcome. As I stated, I will be supporting the bill today in recognition of the work that has been done through the amendment. I hope we can come together before this bill is considered on the floor to address the circumstances of the tele-ed and how it can be used. Thank you, Mr. Chairman.

Chair Frankel.

Representative Benham.

Borowski. Boyd

Hanbij

Howard

Kahn

Kozarowski

Grudziewski

Mays

Freelotten

Sanchez

Designation aye

Yes

Yes

Borowitz

Brown.

Day.

Krupa.

No.

No.

Tordzik.

Walsh.

17-9.

House Bill 2265 is reported affirmatively out of the House Health Committee. Thank you, members. for that thoughtful discussion. So I'd like to turn to our non-controversial resolutions. In case any of you were worried that we were short on resolutions, I'm glad to tell you we won't be disappointed this week. Now call up a package of 10 resolutions that have been deemed non-controversial by both chairs. As such, we would take one vote on this package without comments. and for any member that wishes to vote no on the package, simply raise your hand when I call for a vote. If you do not raise your hand, your vote will be recorded in the affirmative for all the resolutions. The committee will vote on the following resolutions. House Resolution 404 from Representative Matzi recognizes April 2026 as Limb Loss Awareness Month. House Resolution 405, also from Representative Matzi, recognizes May 5, 2026 as World Asthma Day. House Resolution 414 from Representative Markozyk recognizes May 9 through 15, 2026 as National Stuttering Awareness Week. House Resolution 428 from Representative Tina Davis recognizes April 25, 2026 as Diabetic Eye Screening Day. House Resolution 430 from Representative Deloso designates May 3 through 9, 2026 as Tardic Dyskinesia. Awareness Week. House Resolution 432 from Representative Bizarro designates April 2026 as Donate Life Month and April 10, 2026 as Blue and Green Day. House Resolution 435 from Representative Schusterman recognizes May 2026 as Osteoporosis Awareness Month. House Resolution 443 recognizes May 2026 as Mental Health Awareness Month. House Resolution 447 from Representative Maligari, recognized as April 19th through 25th, 2026 as National Infertility Awareness Week. And finally, House Resolution 458 from Representative Venkat, recognized as April 13th through 19th, 2026 as National Osteopathic Medicine Week. Is there any opposition to the package of non-controversial resolutions? Those objecting, please raise their hands. Seeing none, the package of non-controversial resolutions is reported out of the House Health Committee unanimously. There being no further business before the House Health Committee today, this meeting is adjourned. Thank you, members. Thank you for those in the audience as well.