Three boys and one girl sit outside the Mercedes Sprinter parked on the Centinela Elementary School playground. They each hold a piece of paper indicating that a brief screening showed that they might need glasses. So now they’re waiting their turn outside the mobile vision clinic, where optician Stephanie Romero will do a more extensive exam and they’ll get to pick out some frames.
Operated by nonprofit Vision to Learn, the clinic is one of six — and soon to be eight — vans that travel throughout Los Angeles County to bring vision care services to students at school.
“The kids are no more than a half hour out of class, and the parents spend no time out of work,” Damian Carroll, the national director and chief of staff for Vision to Learn, said in an interview. He added that his elevator speech takes about 10 seconds: “When children can see better, they do better in school.”
In about two weeks, a member of the Vision to Learn team will return to the school to dispense the glasses and make sure they are a good fit. And until he became superintendent of the Los Angeles Unified School District (LAUSD) last month, Austin Beutner, founder of the organization, often attended those events.
Beutner, who has now resigned as Vision to Learn’s chairman and from the its board of directors, learned that many children were not getting the glasses they needed when he was serving as deputy mayor of Los Angeles under Antonio Villaraigosa. In 2012, he purchased an RV that was converted into a mobile clinic, hired an optician, an optometrist and a program manager, and they began conducting exams at a school in Northridge, in the San Fernando Valley.
Since then, the program has spread rapidly to cities in 11 more states, supported by local funders, especially professional sports teams, who connect the cause to success in athletics. During the summer, the mobile providers continue to provide services at summer camps, Boys and Girls Clubs, and libraries. “We are guided by a desire to serve more kids and establish this as a national organization,” Carroll said.
Setting 'a tone'
How the district works with community partners to improve outcomes for students will be just one of several issues the Los Angeles education community will be watching as Beutner — a non-educator, a former investment banker and the choice of the charter school advocates on the school board — further unveils his priorities as leader of the nation’s second-largest school district.
Education Dive made several attempts to interview Beutner for his views on partnership, his responses to the union's demands and his plans to learn from superintendents of other large, urban districts.
"I’m optimistic that because he values partnership, that he will set a tone in the district that there is a role that partners can play," Ellen Pais, the executive director of the Los Angeles Education Partnership (LAEP), said in an interview. "Partnership without purpose is not going to move schools. He needs to be a leader around figuring out what L.A. expects a good school to look like."
While Pais said Vision to Learn is a valuable program, she added that it’s also important for such programs to be "really interconnected with teaching and learning."
LAEP is one of several organizations leading community school and other partnership-type efforts in LAUSD. Others include the Youth Policy Institute and the L.A. Promise Fund. In fact, a year ago, the LAUSD school board passed a community schools resolution, directing district staff members to "craft a proposal to create an initial cohort of schools that would become not only the local educational institution, but a center of community life."
United Teachers of Los Angeles (UTLA) — which has called the choice of Beutner an "insult to educators and to public education" and is threatening to authorize a strike in the fall — has its own agenda for community schools and wraparound services, as stated in its Reclaim Our Schools L.A. "vision document."
On May 24, roughly 12,000 members held a rally to advocate for a broad array of changes, including lower class sizes, salary increases, arts education, more counselors, psychologists and librarians, and an "investment in the community schools model."
"This is the vision that will save public education in Los Angeles — and I challenge Austin Beutner to embrace it," UTLA President Alex Caputo-Pearl wrote in this post. According to a district spokesperson, the next bargaining meeting with the union is in late July. With a projected deficit to tackle — one reason why the board chose Beutner — the question will be whether negotiations lead to a compromise around issues important to teachers.
School choice advocates, however, are more optimistic about the board's choice of Beutner.
"He is focused and strategic while also humble and open to new ideas, I think in part because he doesn’t have the scar tissue rooted in decades of struggle in the internecine world of education politics," Ben Austin, the executive director of Kids Coalition, which aims to give parents and students a greater role in issues affecting their schools, said in an email. "I think he needs to focus on strategies to reorient the incentive structures of the district bureaucracy to serve the interests of students."
Connecting with superintendents
Vision to Learn faces many of the same challenges as other organizations that want to work through schools to provide their services to students. Those include trying to form relationships with busy school leaders, securing sustainable funding and gathering evidence that their model leads to higher student achievement.
For Beutner, Carroll said, it was important that all students in a school have an opportunity to receive the services, and for six years, the program worked with private funders to provide the exams and glasses. But to keep up the same pace in LAUSD, Vision to Learn and the district, under former Superintendent Michelle King, negotiated to create a public-private partnership, with the district paying half of the costs. But the contact got "tied up in the politics" over the search for a new superintendent and was delayed for six months, Carroll said.
With all districts, Carroll said they’ve learned to first make connections with superintendents or other district-level leaders who can create a memorandum of understanding and help roll the program out to schools. That’s because when school leaders hear about the services, Carroll said, they sometimes think it’s too good to be true.
“Schools are overloaded,” he said. “It is extra work for the schools, but not as much as they think it is.”
Nurses — if schools have them — do the initial vision screenings mandated by law in kindergarten, 2nd, 5th and 8th grades. But nurses, he said, are often split between multiple schools or handling other student needs. That's why the nonprofit also works with volunteers, such as Rotary Club members, to conduct the initial exams using a Welch Allyn Spot Vision Screener, a hand-held device that looks similar to a ViewMaster. When possibly 50 students at a school are receiving glasses, there is also less of a stigma, Carroll said.
Parents often don’t know that a child’s vision needs to be corrected because what they need to see in the classroom is often different than at home. “Some of them didn’t even know they needed glasses,” Centinela Principal Oscar Rodriguez said in an interview. He added that the program meets a need because parents often can’t afford the prescription.
Because vision changes as children grow, Vision to Learn provides follow-up visits to each school and warranties the glasses for a year. Carroll said that in about 5% of exams, the opticians and optometrists — who work part time for the organization — detect other, more serious issues, such as a lazy eye. The program also provides referrals to vision care providers in their community for ongoing services.
Vision to Learn uses donated lenses, and gets good deals from vendors on modern frames — some with a Dodgers or a Clippers theme.
In Baltimore, Vision to Learn works with Warby Parker, which is providing the glasses free for Baltimore City elementary and middle school students for two years through its Pupils Project. So far, the company has donated 1,000 pairs of glasses to Baltimore students.
Warby Parker’s larger — and growing — partnership with the New York City Department of Education’s community schools program began in 2015. Now serving all 227 community schools across the five boroughs, the company expects to have distributed a total of 40,000 pairs of glasses by the end of this school year.
Ava Rojo, a spokeswoman for the company, said in an email that the partnership is changing the traditional model in which students who fail a vision screening are typically sent home with a letter telling their parents to seek further vision care. “Significant barriers often prevent students from getting this follow-up care, including inadequate transportation, lack of awareness of uncorrected vision, cost and parent’s inability to take time off from work to take their child for an eye exam,” she said.
Baltimore City Public Schools is also participating in a randomized trial of Vision to Learn services. Johns Hopkins University (JHU) researchers, led by psychologist and Success for All co-founder Robert Slavin, are conducting the study, in which 123 schools serving elementary or middle grades, or both, were chosen and then matched with two similar schools.
The schools in each “trio” were randomly selected to receive vision services either in the 2016-17, 2017-18 or 2018-19 school year and some are receiving services for two years instead of one, allowing the researchers to compare outcomes among the different groups of students. In addition to collecting standardized tests scores, the researchers will also look at the effects of the program on absenteeism rates, grade retention and special education placement.
An earlier evaluation of Vision to Learn in 2013 by researchers at the University of California Los Angeles looked at changes in academic performance in a sample of Latino and black students at 30 public schools in Los Angeles. Comparing their math and reading grades before and after they received glasses, the researchers found that students on average “had a downward trajectory in their math grades,” but after they received glasses, their grades improved by about 4%. Students’ performance in English also improved, but the change was not statistically significant.
The researchers also found that the improvement was greater among boys than girls. They said that future research should examine this difference, as well as whether students’ achievement continues to improve over time and whether there is an impact on standardized test scores and attendance, which the JHU study is doing.
Planning for the future
One of the biggest challenges for Vision to Learn is collecting consent forms from parents. Currently, an opt-in process is used, meaning that parents have to sign a form in order for their children to receive the initial screening. That results, Carroll said, in about 30% of students never being screened because the forms weren’t signed. The organization is piloting an opt-out process in a few cities, including Atlanta, Charlotte and Newark, N.J., and hopes to eventually move to that system in all locations.
Another challenge, particularly in California is Medicaid reimbursement, Carroll added. Most families that receive the services qualify for Medi-Cal, which covers health costs for low-income families and is important for the sustainability of the program, Carroll said.
While insurance companies in some other Vision to Learn states work with mobile providers on Medicaid reimbursement, California’s largest vision insurance company doesn’t. Therefore, Vision to Learn can’t submit claims for reimbursement. The organization worked with the governor’s office to create a pilot program for Los Angeles County in which two insurance providers have recognized Vision to Learn as provider, but Carroll said that’s a short-term fix.
“It’s for all of our benefit if we transition from this special plan to a more traditional reimbursement program,” he said. “It’s a big part of our future.”
As students, some of them wearing glasses, chased after balls on the playground at Centinela, Carroll said it’s common to hear students say they can now see leaves on the trees when they get their glasses. And one boy told him, “Rice has bumps on it.”