I 

111TH CONGRESS 

1ST SESSION H. R. 1551 

To provide for the reduction of adolescent pregnancy, HIV rates, and other 

sexually transmitted diseases, and for other purposes. 

IN THE HOUSE OF REPRESENTATIVES 

MARCH 17, 2009 

Ms. LEE of California (for herself, Mr. MCGOVERN, Mrs. CAPPS, Mr. 

MCDERMOTT, Mr. BERMAN, Ms. HIRONO, Mr. HINCHEY, Mr. CROWLEY, 

Mrs. MALONEY, Ms. DELAURO, Mr. DOYLE, Ms. SLAUGHTER, Mr. FARR, 

Mr. FATTAH, Mr. ACKERMAN, Ms. WASSERMAN SCHULTZ, Mrs. 

NAPOLITANO, Mr. GRIJALVA, Mr. KUCINICH, Mr. LANGEVIN, Mr. 

LARSEN of Washington, Ms. SCHAKOWSKY, Mr. DAVIS of Illinois, Ms. 

NORTON, Mr. BLUMENAUER, Ms. MCCOLLUM, Mr. BRADY of Pennsylvania, and Mrs. DAVIS of California) introduced the following bill; which 

was referred to the Committee on Energy and Commerce 

A BILL 

To provide for the reduction of adolescent pregnancy, HIV 

rates, and other sexually transmitted diseases, and for 

other purposes. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Responsible Education 

5 About Life Act’’. 


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1 SEC. 2. FINDINGS. 

2 The Congress finds as follows: 

3 (1) Leading public health and medical profes4 sional organizations, including the American Medical 

5 Association (‘‘AMA’’), the American Medical Stu6 dent Association (‘‘AMSA’’), the American Nurses 

7 Association (‘‘ANA’’), the American Academy of Pe8 diatrics (‘‘AAP’’), the American College of Obstetri9 cians and Gynecologists (‘‘ACOG’’), the American 

10 Public Health Association (‘‘APHA’’), the Institute 

11 of Medicine (‘‘IOM’’) and the Society of Adolescent 

12 Medicine (‘‘SAM’’), stress the need for sexuality 

13 education that includes messages about abstinence 

14 and provides young people with information about 

15 contraception for the prevention of teen pregnancy, 

16 HIV/AIDS, and other sexually transmitted infections 

17 (‘‘STIs’’). 

18 (2) A 2005 statement from the APHA urged 

19 that ‘‘The U.S. Congress should authorize and fully 

20 fund legislation that promotes comprehensive sexu21 ality education programs which include information 

22 about both abstinence and contraception, include 

23 parent-child communications components; and teach 

24 goal-setting, decision-making, negotiation, and com25 munication skills’’ and that ‘‘sexual health informa26 tion disseminated by federal agencies, be medically 


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1 and scientifically accurate and based on theories and 

2 strategies with demonstrated evidence of effective3 ness.’’ In a 2006 statement, APHA reiterated that 

4 it ‘‘has strongly supported comprehensive sexuality 

5 education that includes information about concepts 

6 of healthy sexuality, sexual orientation and toler7 ance, personal responsibility, risks of HIV and other 

8 STIs and unwanted pregnancy, access to reproduc9 tive health care, and benefits and risks of condoms 

10 and other contraceptive methods. Sexuality edu11 cation should be non-judgmental and support par12 ent-child communication and should not impose reli13 gious or ideological viewpoints upon students.’’. 

14 (3) The SAM stated in a 2006 position paper 

15 that ‘‘SAM supports a comprehensive approach to 

16 sexual risk reduction including abstinence as well as 

17 correct and consistent use of condoms and contra18 ception among teens who choose to be sexually ac19 tive.’’ In addition, ‘‘Efforts to promote abstinence 

20 should be provided within health education programs 

21 that provide adolescents with complete and accurate 

22 information about sexual health, including informa23 tion about concepts of healthy sexuality, sexual ori24 entation and tolerance, personal responsibility, risks 

25 of HIV and other STIs and unwanted pregnancy, 


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1 access to reproductive health care, and benefits and 

2 risks of condoms and other contraceptive methods.’’. 

3 (4) Most Americans believe that sex education 

4 should promote abstinence and provide information 

5 about the effectiveness and benefits of contraception. 

6 According to the results of a 2005–2006 nationally 

7 representative survey of U.S. adults, more than 8 in 

8 10 of those polled support comprehensive sex edu9 cation. 

10 (5) There is strong evidence that more com11 prehensive sex education can effectively help young 

12 people delay sexual initiation, even as it increases 

13 contraceptive use among sexually active youth. Ac14 cording to a report published by the National Cam15 paign to Prevent Teen and Unplanned Pregnancy, 

16 ‘‘two-thirds of the 48 comprehensive programs that 

17 supported both abstinence and the use of condoms 

18 and contraceptives for sexually active teens had posi19 tive behavioral effects’’. Many either delayed or re20 duced sexual activity, reduced the number of sexual 

21 partners, or increased condom or contraceptive use. 

22 (6) There is no evidence that federally funded 

23 abstinence-only-until-marriage programs are effec24 tive in stopping or delaying teen sex. A recent, con25 gressionally mandated evaluation of federally funded 


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1 abstinence-only programs by Mathematica Policy Re2 search found that these programs have no beneficial 

3 impact on whether young people abstain, when they 

4 first have sex, or their number of sexual partners. 

5 (7) Comprehensive sexuality education pro6 grams respect the diversity of values and beliefs rep7 resented in the community and will complement and 

8 augment the sexuality education children receive 

9 from their families and faith communities. 

10 (8) Most young people have sex for the first 

11 time at about age 17, but do not marry until their 

12 middle or late 20s. This means that young adults 

13 are at risk of unwanted pregnancy and STIs for 

14 nearly a decade. Therefore, teens need access to full, 

15 complete, and medically and factually accurate infor16 mation regarding sexuality, including contraception, 

17 condoms, STI/HIV prevention, and abstinence. 

18 (9) From the early 1990s through the early 

19 2000s, rates of teen pregnancy birth and abortion in 

20 the United States all declined dramatically—pri21 marily, but not exclusively, because of increased and 

22 more effective contraceptive use among sexually ac23 tive teens. These declines have since stalled, how24 ever, and new data from the Centers for Disease 

25 Control and Prevention’s National Center for Health 


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1 Statistics (‘‘NCHS’’) indicate that teen birthrates 

2 are on the rise. NCHS reports a 3-percent national 

3 increase between 2005 and 2006 (from 40.5 to 41.9 

4 births per 1,000 females aged 15–19). 

5 (10) Teen pregnancy rates are much higher in 

6 the United States than in many other developed 

7 countries—twice as high as in England and Wales 

8 or Canada, and eight times as high as in the Neth9 erlands or Japan. 

10 (11) The decline in the teen birthrate between 

11 1991 and 2004 resulted in saving taxpayers 

12 $6,700,000,000 in associated health care, child wel13 fare, and other such costs in 2004 alone, reducing 

14 the cost to taxpayers from $15,800,000,000 to 

15 $9,100,000,000. Investing in effective programs that 

16 improve teen sexual behavior by delaying sexual ac17 tivity, improving contraceptive use among teens, and 

18 reducing teen pregnancies would contribute to reduc19 ing the taxpayer costs associated with teen child20 bearing. 

21 (12) Ethnic and racial minority groups have 

22 been disproportionately affected by early pregnancy 

23 and parenthood. Fifty-three percent of Latina teens 

24 and 51 percent of African-American young women 

25 will become pregnant at least once before they turn 


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1 20, as compared to only 19 percent of non-Hispanic 

2 White young women. 

3 (13) The United States has one of the highest 

4 rates of sexually transmitted infections among indus5 trialized nations. There are approximately 

6 19,000,000 new cases of sexually transmitted infec7 tions each year, almost half of them occurring in 

8 young people ages 15 to 24. According to the Cen9 ters for Disease Control and Prevention, these sexu10 ally transmitted diseases impose a tremendous eco11 nomic burden with direct medical costs as high as 

12 $14,100,000,000 per year. 

13 (14) Recent estimates suggest that while 15- to 

14 24-year-olds represent 25 percent of the sexually ac15 tive population, they acquire nearly half of all new 

16 STIs. Each year, one in four sexually active teen17 agers contracts a sexually transmitted infection. 

18 (15) Nearly 15 percent of the 56,000 annual 

19 new cases of HIV infections in the United States oc20 curred in youth ages 13 through 24 in 2006. An av21 erage of one young person every hour of every day 

22 is infected with HIV in the United States. 

23 (16) African-American and Latino youth have 

24 been disproportionately affected by the HIV/AIDS 

25 epidemic. Although African-American adolescents 


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1 ages 13 through 19 represent only 17 percent of the 

2 adolescent population in the United States, they ac3 counted for 70 percent of new HIV/AIDS cases re4 ported among teens in 2005. Latino adolescents 

5 ages 13 through 19 accounted for 17 percent of 

6 AIDS cases among teens, the same as their propor7 tion of the U.S. population in 2005. Although 

8 Latinos ages 20 through 24 represent only 18 per9 cent of the young adults in the United States, they 

10 accounted for 22 percent of the new AIDS cases in 

11 2005. 

12 (17) Parental involvement is critical to any 

13 healthy relationship program. A major study showed 

14 that adolescents who reported feeling connected to 

15 parents and family were more likely than other teens 

16 to delay initiating sexual intercourse. Another study 

17 found that teens who reported previous discussions 

18 of sexuality with parents were seven times more like19 ly to feel able to communicate with a partner about 

20 HIV/AIDS than those who did not have such discus21 sions with their parents. Parental involvement is a 

22 leading protective factor for dating violence preven23 tion. 

24 (18) Incorporating teen dating violence preven25 tion into health education and sexuality education is 


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1 imperative given the widespread experience of vio2 lence in dating relationships. Approximately one in 

3 three teens reports some kind of abuse in a romantic 

4 relationship, including emotional and verbal abuse. 

5 Young women who experience dating violence have 

6 sex earlier than their peers; are much less likely to 

7 use birth control; and engage in a wide variety of 

8 high-risk behaviors including multiple partners, sex 

9 with older men, and drug and alcohol abuse. Young 

10 women who are victims of dating violence are four 

11 to six times more likely than nonabused girls to be12 come pregnant. 

13 SEC. 3. ASSISTANCE TO REDUCE TEEN PREGNANCY, HIV/ 

14 AIDS, AND OTHER SEXUALLY TRANSMITTED 

15 DISEASES AND TO SUPPORT HEALTHY ADO16 LESCENT DEVELOPMENT. 

17 (a) IN GENERAL.—The Secretary of Health and 

18 Human Services may award a grant to each eligible State, 

19 for each of the fiscal years 2010 through 2014, to conduct 

20 programs of sex education described in subsection (b), in21 cluding education on both abstinence and contraception 

22 for the prevention of teenage pregnancy and sexually 

23 transmitted diseases, including HIV/AIDS. 


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1 (b) REQUIREMENTS FOR SEX EDUCATION PRO2 GRAMS.—A program of sex education described in this 

3 subsection is a program that— 

4 (1) is age appropriate and medically accurate; 

5 (2) stresses the value of abstinence while not ig6 noring those young people who have had or are hav7 ing sexual intercourse; 

8 (3) provides information about the health bene9 fits and side effects of all contraceptive and barrier 

10 methods used— 

11 (A) as a means to prevent pregnancy; and 

12 (B) to reduce the risk of contracting sexu13 ally transmitted disease, including HIV/AIDS; 

14 (4) encourages family communication between 

15 parent and child about sexuality; 

16 (5) teaches young people the skills to make re17 sponsible decisions about sexuality, including how to 

18 avoid unwanted verbal, physical, and sexual ad19 vances and how to avoid making verbal, physical, 

20 and sexual advances that are not wanted by the 

21 other party; 

22 (6) develops healthy relationships, including the 

23 prevention of dating and sexual violence; 

24 (7) teaches young people how alcohol and drug 

25 use can affect responsible decisionmaking; and 


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1 (8) does not teach or promote religion. 

2 (c) ADDITIONAL ACTIVITIES.—In carrying out a pro3 gram of sex education, a State may expend funds received 

4 under this section to carry out educational and motiva5 tional activities that help young people to— 

6 (1) gain knowledge about the physical, emo7 tional, biological, and hormonal changes of adoles8 cence and subsequent stages of human maturation; 

9 (2) develop the knowledge and skills necessary 

10 to ensure and protect their sexual and reproductive 

11 health from unintended pregnancy and sexually 

12 transmitted disease, including HIV/AIDS through13 out their lifespan; 

14 (3) gain knowledge about the specific involve15 ment and responsibility of each individual in sexual 

16 decisionmaking; 

17 (4) develop healthy attitudes and values about 

18 adolescent growth and development, body image, 

19 gender roles, racial and ethnic diversity, sexual ori20 entation, and other subjects; 

21 (5) develop and practice healthy life skills in22 cluding goal-setting, decisionmaking, negotiation, 

23 communication, and stress management; 

24 (6) promote self-esteem and positive inter25 personal skills focusing on relationship dynamics, inVerDate Nov 24 2008 07:17 Mar 18, 2009 Jkt 079200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H1551.IH H1551

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1 cluding, but not limited to, friendships, dating, ro2 mantic involvement, marriage, and family inter3 actions; and 

4 (7) prepare for the adult world by focusing on 

5 educational and career success, including developing 

6 skills for employment preparation, job seeking, inde7 pendent living, financial self-sufficiency, and work8 place productivity. 

9 SEC. 4. SENSE OF CONGRESS. 

10 It is the sense of Congress that, although States are 

11 not required to provide matching funds to receive a grant 

12 under this Act, they are encouraged to do so. 

13 SEC. 5. EVALUATION OF PROGRAMS. 

14 (a) IN GENERAL.—For the purpose of evaluating the 

15 effectiveness of programs of sex education carried out with 

16 a grant under section 3, evaluations shall be carried out 

17 in accordance with subsections (b) and (c). 

18 (b) NATIONAL EVALUATION.— 

19 (1) IN GENERAL.—The Secretary shall provide 

20 for a national evaluation of a representative sample 

21 of programs of sex education carried out with grants 

22 under section 3. 

23 (2) PURPOSES.—The purpose of the national 

24 evaluation under paragraph (1) shall be the deter25 mination of— 


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1 (A) the effectiveness of such programs in 

2 helping to delay the initiation of sexual inter3 course and other high-risk behaviors; 

4 (B) the effectiveness of such programs in 

5 preventing adolescent pregnancy; 

6 (C) the effectiveness of such programs in 

7 preventing sexually transmitted disease, includ8 ing HIV/AIDS; 

9 (D) the effectiveness of such programs in 

10 increasing contraceptive knowledge and contra11 ceptive behaviors when sexual intercourse oc12 curs; and 

13 (E) a list of best practices based upon es14 sential programmatic components of evaluated 

15 programs that have led to success described in 

16 subparagraphs (A) through (D). 

17 (3) GRANT CONDITION.—A condition for the re18 ceipt of a grant under section 3 is that the State in19 volved agree to cooperate with the evaluation under 

20 paragraph (1). 

21 (4) REPORT.—The Secretary shall submit to 

22 the Congress— 

23 (A) not later than the end of each of fiscal 

24 years 2010 through 2013, an interim report on 


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1 the national evaluation under paragraph (1); 

2 and 

3 (B) not later than March 31, 2015, a final 

4 report providing the results of such national 

5 evaluation. 

6 (c) INDIVIDUAL STATE EVALUATIONS.— 

7 (1) IN GENERAL.—A condition for the receipt 

8 of a grant under section 3 is that the State involved 

9 agree to provide for the evaluation of the programs 

10 of sex education carried out with the grant in ac11 cordance with the following: 

12 (A) The evaluation will be conducted by an 

13 external, independent entity. 

14 (B) The purposes of the evaluation will be 

15 the determination of— 

16 (i) the effectiveness of such programs 

17 in helping to delay the initiation of sexual 

18 intercourse and other high-risk behaviors; 

19 (ii) the effectiveness of such programs 

20 in preventing adolescent pregnancy; 

21 (iii) the effectiveness of such pro22 grams in preventing sexually transmitted 

23 disease, including HIV/AIDS; and 

24 (iv) the effectiveness of such programs 

25 in increasing contraceptive knowledge and 


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1 contraceptive behaviors when sexual inter2 course occurs. 

3 (2) LIMITATION.—A condition for the receipt of 

4 grant funds under section 3 is that the State in5 volved agree that not more than 10 percent of such 

6 funds will be expended for evaluation under para7 graph (1). 

8 SEC. 6. NONDISCRIMINATION CLAUSE. 

9 Programs funded under section 3 shall not discrimi10 nate on the basis of sex, race, ethnicity, national origin, 

11 disability, religion, sexual orientation, or gender identity. 

12 Nothing in this Act shall be construed to invalidate or 

13 limit rights, remedies, procedures, or legal standards avail14 able to victims of discrimination under any other Federal 

15 law or any law of a State or a political subdivision of a 

16 State, including title VI of the Civil Rights Act of 1964 

17 (42 U.S.C. 2000d et seq.), title IX of the Education 

18 Amendments of 1972 (20 U.S.C. 1681 et seq.), section 

19 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), 

20 and the Americans with Disabilities Act of 1990 (42 

21 U.S.C. 12101 et seq.). 

22 SEC. 7. DEFINITIONS. 

23 For purposes of this Act: 

24 (1) The term ‘‘age appropriate’’ means, with re25 spect to topics, messages, and teaching methods, 


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1 those suitable to particular ages or age groups of 

2 children and adolescents, based on developing cog3 nitive, emotional, and behavioral capacity typical for 

4 the age or age group. 

5 (2) The term ‘‘eligible State’’ means a State 

6 that submits to the Secretary an application for a 

7 grant under section 3 that is in such form, is made 

8 in such manner, and contains such agreements, as9 surances, and information as the Secretary deter10 mines to be necessary to carry out this Act. 

11 (3) The term ‘‘HIV/AIDS’’ means the human 

12 immunodeficiency virus, and includes acquired im13 mune deficiency syndrome. 

14 (4) The term ‘‘medically accurate’’, with respect 

15 to information, means information that is supported 

16 by research, recognized as accurate and objective by 

17 leading medical, psychological, psychiatric, and pub18 lic health organizations and agencies, and, where rel19 evant, published in peer review journals. 

20 (5) The term ‘‘Secretary’’ means the Secretary 

21 of Health and Human Services. 

22 (6) The term ‘‘State’’ means the 50 States, the 

23 District of Columbia, the Commonwealth of Puerto 

24 Rico, the Commonwealth of the Northern Mariana 

25 Islands, American Samoa, Guam, the Virgin Islands, 


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1 and any other territory or possession of the United 

2 States. 

3 SEC. 8. AUTHORIZATION OF APPROPRIATIONS. 

4 (a) IN GENERAL.—For the purpose of carrying out 

5 this Act, there is authorized to be appropriated 

6 $50,000,000 for each of the fiscal years 2010 through 

7 2014. 

8 (b) LIMITATION.—Of the amounts appropriated to 

9 carry out this Act for a fiscal year, the Secretary may not 

10 use more than— 

11 (1) 7 percent of such amounts for administra12 tive expenses related to carrying out this Act for 

13 that fiscal year; and 

14 (2) 10 percent of such amounts for the national 

15 evaluation under section 5(b). 

Æ 


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