The City of New York Office of the Comptroller
Bureau of Management Audit

Audit Report on the Adherence of the Department of Education and the Department of Health and Mental Hygiene to Student Vision and Hearing Screening Program Regulations

MD06-139A
June 19, 2008

AUDIT REPORT IN BRIEF

Download the Complete Audit Report (pdf 430 kb)

This audit determined whether the New York City Department of Education (DOE) and the Department of Health and Mental Hygiene (DOHMH) provide hearing and vision screenings to New York City public school students in accordance with applicable regulations.

The Schools Chancellor’s Regulation A-701 requires vision and hearing screenings to be conducted for students from pre-kindergarten through grade 3; in grades 5, 7, 10; and for new entrants. The Office of School Health (OSH) is a joint program of DOE and DOHMH comprised of DOE and DOHMH employees that provides health services to DOE students.  Together, DOE and DOHMH provide vision and hearing screenings to DOE students.  By agreement between the agencies, DOHMH is to screen public school students in kindergarten, first grade, and new entrants in elementary schools.  DOE is to screen all students not screened by DOHMH. Regardless of which agency conducts screenings, DOE is ultimately responsible for the vision and hearing screening program and ensuring that all students are screened. 

Audit Findings and Conclusions

                The consolidated vision and hearing screening program of DOE and DOHMH did not provide vision and hearing screenings in accordance with the applicable regulations.  For the period reviewed, the agencies conducted only 66 percent of the required vision screenings, with 42 percent of the required DOE screenings conducted and 94 percent of the required DOHMH screenings conducted. With regard to hearing screenings, the agencies conducted only 54 percent of the required hearing screenings, with 20 percent of the required DOE screenings conducted and 94 percent of the required DOHMH screenings conducted. 

The above results are attributable to a lack of oversight and monitoring of the vision and hearing screening program by DOE, which had no central unit responsible for reviewing screening data during the audited period.  As a result of DOE’s failure to assign oversight and responsibility for monitoring of the program: 

• Vision and hearing screenings are not being provided to New York City public school students in accordance with applicable regulations. 

• There is very limited follow-up to parents of students who fail the vision and hearing screenings to ensure that the students who require the greatest amount of follow-up care receive it.

• DOE cannot ensure that students were screened in the appropriate grades, as defined in the Chancellor’s Regulations, because DOE cannot generate from the Automate the School System (ATS) accurate reports on the number of screenings conducted.

• DOE did not ensure that screenings were conducted at schools that had a School-Based Health Center.

                We were informed by DOE officials that a compliance unit had been created in 2007 to monitor the vision and hearing screening process beginning with the 2007-2008 school year.  

               
Audit Recommendations
 
Based on our findings, we make 13 recommendations, five of which are listed below.  DOE and DOHMH should:

• Immediately take steps to ensure that vision and hearing screenings are conducted for the sampled students noted in this report who have not received screenings.

• Jointly issue a manual on vision and hearing screening that more clearly defines the division of responsibility between DOHMH and DOE and that reflects the agreement between the agencies on the detailed tasks of their respective staff.

DOE should:

• Establish an effective Vision and Hearing Screening oversight unit to monitor screenings and ensure that students are screened for vision and hearing in the appropriate grades, as called for in the Chancellor’s Regulations.

• Require each school to assign individuals to conduct follow-up with parents of all students who fail vision or hearing screenings.

• Require an oversight unit to monitor and review screening information entered in ATS to ensure that all schools are making the required entries.

DOE and DOHMH Response