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[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[H.R. 1551 Introduced in House (IH)]

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.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Responsible Education About Life 
Act''.

SEC. 2. FINDINGS.

    The Congress finds as follows:
            (1) Leading public health and medical professional 
        organizations, including the American Medical Association 
        (``AMA''), the American Medical Student Association (``AMSA''), 
        the American Nurses Association (``ANA''), the American Academy 
        of Pediatrics (``AAP''), the American College of Obstetricians 
        and Gynecologists (``ACOG''), the American Public Health 
        Association (``APHA''), the Institute of Medicine (``IOM'') and 
        the Society of Adolescent Medicine (``SAM''), stress the need 
        for sexuality education that includes messages about abstinence 
        and provides young people with information about contraception 
        for the prevention of teen pregnancy, HIV/AIDS, and other 
        sexually transmitted infections (``STIs'').
            (2) A 2005 statement from the APHA urged that ``The U.S. 
        Congress should authorize and fully fund legislation that 
        promotes comprehensive sexuality education programs which 
        include information about both abstinence and contraception, 
        include parent-child communications components; and teach goal-
        setting, decision-making, negotiation, and communication 
        skills'' and that ``sexual health information disseminated by 
        federal agencies, be medically and scientifically accurate and 
        based on theories and strategies with demonstrated evidence of 
        effectiveness.'' In a 2006 statement, APHA reiterated that it 
        ``has strongly supported comprehensive sexuality education that 
        includes information about concepts of healthy sexuality, 
        sexual orientation and tolerance, personal responsibility, 
        risks of HIV and other STIs and unwanted pregnancy, access to 
        reproductive health care, and benefits and risks of condoms and 
        other contraceptive methods. Sexuality education should be non-
        judgmental and support parent-child communication and should 
        not impose religious or ideological viewpoints upon 
        students.''.
            (3) The SAM stated in a 2006 position paper that ``SAM 
        supports a comprehensive approach to sexual risk reduction 
        including abstinence as well as correct and consistent use of 
        condoms and contraception among teens who choose to be sexually 
        active.'' In addition, ``Efforts to promote abstinence should 
        be provided within health education programs that provide 
        adolescents with complete and accurate information about sexual 
        health, including information about concepts of healthy 
        sexuality, sexual orientation and tolerance, personal 
        responsibility, risks of HIV and other STIs and unwanted 
        pregnancy, access to reproductive health care, and benefits and 
        risks of condoms and other contraceptive methods.''.
            (4) Most Americans believe that sex education should 
        promote abstinence and provide information about the 
        effectiveness and benefits of contraception. According to the 
        results of a 2005-2006 nationally representative survey of U.S. 
        adults, more than 8 in 10 of those polled support comprehensive 
        sex education.
            (5) There is strong evidence that more comprehensive sex 
        education can effectively help young people delay sexual 
        initiation, even as it increases contraceptive use among 
        sexually active youth. According to a report published by the 
        National Campaign to Prevent Teen and Unplanned Pregnancy, 
        ``two-thirds of the 48 comprehensive programs that supported 
        both abstinence and the use of condoms and contraceptives for 
        sexually active teens had positive behavioral effects''. Many 
        either delayed or reduced sexual activity, reduced the number 
        of sexual partners, or increased condom or contraceptive use.
            (6) There is no evidence that federally funded abstinence-
        only-until-marriage programs are effective in stopping or 
        delaying teen sex. A recent, congressionally mandated 
        evaluation of federally funded abstinence-only programs by 
        Mathematica Policy Research found that these programs have no 
        beneficial impact on whether young people abstain, when they 
        first have sex, or their number of sexual partners.
            (7) Comprehensive sexuality education programs respect the 
        diversity of values and beliefs represented in the community 
        and will complement and augment the sexuality education 
        children receive from their families and faith communities.
            (8) Most young people have sex for the first time at about 
        age 17, but do not marry until their middle or late 20s. This 
        means that young adults are at risk of unwanted pregnancy and 
        STIs for nearly a decade. Therefore, teens need access to full, 
        complete, and medically and factually accurate information 
        regarding sexuality, including contraception, condoms, STI/HIV 
        prevention, and abstinence.
            (9) From the early 1990s through the early 2000s, rates of 
        teen pregnancy birth and abortion in the United States all 
        declined dramatically--primarily, but not exclusively, because 
        of increased and more effective contraceptive use among 
        sexually active teens. These declines have since stalled, 
        however, and new data from the Centers for Disease Control and 
        Prevention's National Center for Health Statistics (``NCHS'') 
        indicate that teen birthrates are on the rise. NCHS reports a 
        3-percent national increase between 2005 and 2006 (from 40.5 to 
        41.9 births per 1,000 females aged 15-19).
            (10) Teen pregnancy rates are much higher in the United 
        States than in many other developed countries--twice as high as 
        in England and Wales or Canada, and eight times as high as in 
        the Netherlands or Japan.
            (11) The decline in the teen birthrate between 1991 and 
        2004 resulted in saving taxpayers $6,700,000,000 in associated 
        health care, child welfare, and other such costs in 2004 alone, 
        reducing the cost to taxpayers from $15,800,000,000 to 
        $9,100,000,000. Investing in effective programs that improve 
        teen sexual behavior by delaying sexual activity, improving 
        contraceptive use among teens, and reducing teen pregnancies 
        would contribute to reducing the taxpayer costs associated with 
        teen childbearing.
            (12) Ethnic and racial minority groups have been 
        disproportionately affected by early pregnancy and parenthood. 
        Fifty-three percent of Latina teens and 51 percent of African-
        American young women will become pregnant at least once before 
        they turn 20, as compared to only 19 percent of non-Hispanic 
        White young women.
            (13) The United States has one of the highest rates of 
        sexually transmitted infections among industrialized nations. 
        There are approximately 19,000,000 new cases of sexually 
        transmitted infections each year, almost half of them occurring 
        in young people ages 15 to 24. According to the Centers for 
        Disease Control and Prevention, these sexually transmitted 
        diseases impose a tremendous economic burden with direct 
        medical costs as high as $14,100,000,000 per year.
            (14) Recent estimates suggest that while 15- to 24-year-
        olds represent 25 percent of the sexually active population, 
        they acquire nearly half of all new STIs. Each year, one in 
        four sexually active teenagers contracts a sexually transmitted 
        infection.
            (15) Nearly 15 percent of the 56,000 annual new cases of 
        HIV infections in the United States occurred in youth ages 13 
        through 24 in 2006. An average of one young person every hour 
        of every day is infected with HIV in the United States.
            (16) African-American and Latino youth have been 
        disproportionately affected by the HIV/AIDS epidemic. Although 
        African-American adolescents ages 13 through 19 represent only 
        17 percent of the adolescent population in the United States, 
        they accounted for 70 percent of new HIV/AIDS cases reported 
        among teens in 2005. Latino adolescents ages 13 through 19 
        accounted for 17 percent of AIDS cases among teens, the same as 
        their proportion of the U.S. population in 2005. Although 
        Latinos ages 20 through 24 represent only 18 percent of the 
        young adults in the United States, they accounted for 22 
        percent of the new AIDS cases in 2005.
            (17) Parental involvement is critical to any healthy 
        relationship program. A major study showed that adolescents who 
        reported feeling connected to parents and family were more 
        likely than other teens to delay initiating sexual intercourse. 
        Another study found that teens who reported previous 
        discussions of sexuality with parents were seven times more 
        likely to feel able to communicate with a partner about HIV/
        AIDS than those who did not have such discussions with their 
        parents. Parental involvement is a leading protective factor 
        for dating violence prevention.
            (18) Incorporating teen dating violence prevention into 
        health education and sexuality education is imperative given 
        the widespread experience of violence in dating relationships. 
        Approximately one in three teens reports some kind of abuse in 
        a romantic relationship, including emotional and verbal abuse. 
        Young women who experience dating violence have sex earlier 
        than their peers; are much less likely to use birth control; 
        and engage in a wide variety of high-risk behaviors including 
        multiple partners, sex with older men, and drug and alcohol 
        abuse. Young women who are victims of dating violence are four 
        to six times more likely than nonabused girls to become 
        pregnant.

SEC. 3. ASSISTANCE TO REDUCE TEEN PREGNANCY, HIV/AIDS, AND OTHER 
              SEXUALLY TRANSMITTED DISEASES AND TO SUPPORT HEALTHY 
              ADOLESCENT DEVELOPMENT.

    (a) In General.--The Secretary of Health and Human Services may 
award a grant to each eligible State, for each of the fiscal years 2010 
through 2014, to conduct programs of sex education described in 
subsection (b), including education on both abstinence and 
contraception for the prevention of teenage pregnancy and sexually 
transmitted diseases, including HIV/AIDS.
    (b) Requirements for Sex Education Programs.--A program of sex 
education described in this subsection is a program that--
            (1) is age appropriate and medically accurate;
            (2) stresses the value of abstinence while not ignoring 
        those young people who have had or are having sexual 
        intercourse;
            (3) provides information about the health benefits and side 
        effects of all contraceptive and barrier methods used--
                    (A) as a means to prevent pregnancy; and
                    (B) to reduce the risk of contracting sexually 
                transmitted disease, including HIV/AIDS;
            (4) encourages family communication between parent and 
        child about sexuality;
            (5) teaches young people the skills to make responsible 
        decisions about sexuality, including how to avoid unwanted 
        verbal, physical, and sexual advances and how to avoid making 
        verbal, physical, and sexual advances that are not wanted by 
        the other party;
            (6) develops healthy relationships, including the 
        prevention of dating and sexual violence;
            (7) teaches young people how alcohol and drug use can 
        affect responsible decisionmaking; and
            (8) does not teach or promote religion.
    (c) Additional Activities.--In carrying out a program of sex 
education, a State may expend funds received under this section to 
carry out educational and motivational activities that help young 
people to--
            (1) gain knowledge about the physical, emotional, 
        biological, and hormonal changes of adolescence and subsequent 
        stages of human maturation;
            (2) develop the knowledge and skills necessary to ensure 
        and protect their sexual and reproductive health from 
        unintended pregnancy and sexually transmitted disease, 
        including HIV/AIDS throughout their lifespan;
            (3) gain knowledge about the specific involvement and 
        responsibility of each individual in sexual decisionmaking;
            (4) develop healthy attitudes and values about adolescent 
        growth and development, body image, gender roles, racial and 
        ethnic diversity, sexual orientation, and other subjects;
            (5) develop and practice healthy life skills including 
        goal-setting, decisionmaking, negotiation, communication, and 
        stress management;
            (6) promote self-esteem and positive interpersonal skills 
        focusing on relationship dynamics, including, but not limited 
        to, friendships, dating, romantic involvement, marriage, and 
        family interactions; and
            (7) prepare for the adult world by focusing on educational 
        and career success, including developing skills for employment 
        preparation, job seeking, independent living, financial self-
        sufficiency, and workplace productivity.

SEC. 4. SENSE OF CONGRESS.

    It is the sense of Congress that, although States are not required 
to provide matching funds to receive a grant under this Act, they are 
encouraged to do so.

SEC. 5. EVALUATION OF PROGRAMS.

    (a) In General.--For the purpose of evaluating the effectiveness of 
programs of sex education carried out with a grant under section 3, 
evaluations shall be carried out in accordance with subsections (b) and 
(c).
    (b) National Evaluation.--
            (1) In general.--The Secretary shall provide for a national 
        evaluation of a representative sample of programs of sex 
        education carried out with grants under section 3.
            (2) Purposes.--The purpose of the national evaluation under 
        paragraph (1) shall be the determination of--
                    (A) the effectiveness of such programs in helping 
                to delay the initiation of sexual intercourse and other 
                high-risk behaviors;
                    (B) the effectiveness of such programs in 
                preventing adolescent pregnancy;
                    (C) the effectiveness of such programs in 
                preventing sexually transmitted disease, including HIV/
                AIDS;
                    (D) the effectiveness of such programs in 
                increasing contraceptive knowledge and contraceptive 
                behaviors when sexual intercourse occurs; and
                    (E) a list of best practices based upon essential 
                programmatic components of evaluated programs that have 
                led to success described in subparagraphs (A) through 
                (D).
            (3) Grant condition.--A condition for the receipt of a 
        grant under section 3 is that the State involved agree to 
        cooperate with the evaluation under paragraph (1).
            (4) Report.--The Secretary shall submit to the Congress--
                    (A) not later than the end of each of fiscal years 
                2010 through 2013, an interim report on the national 
                evaluation under paragraph (1); and
                    (B) not later than March 31, 2015, a final report 
                providing the results of such national evaluation.
    (c) Individual State Evaluations.--
            (1) In general.--A condition for the receipt of a grant 
        under section 3 is that the State involved agree to provide for 
        the evaluation of the programs of sex education carried out 
        with the grant in accordance with the following:
                    (A) The evaluation will be conducted by an 
                external, independent entity.
                    (B) The purposes of the evaluation will be the 
                determination of--
                            (i) the effectiveness of such programs in 
                        helping to delay the initiation of sexual 
                        intercourse and other high-risk behaviors;
                            (ii) the effectiveness of such programs in 
                        preventing adolescent pregnancy;
                            (iii) the effectiveness of such programs in 
                        preventing sexually transmitted disease, 
                        including HIV/AIDS; and
                            (iv) the effectiveness of such programs in 
                        increasing contraceptive knowledge and 
                        contraceptive behaviors when sexual intercourse 
                        occurs.
            (2) Limitation.--A condition for the receipt of grant funds 
        under section 3 is that the State involved agree that not more 
        than 10 percent of such funds will be expended for evaluation 
        under paragraph (1).

SEC. 6. NONDISCRIMINATION CLAUSE.

    Programs funded under section 3 shall not discriminate on the basis 
of sex, race, ethnicity, national origin, disability, religion, sexual 
orientation, or gender identity. Nothing in this Act shall be construed 
to invalidate or limit rights, remedies, procedures, or legal standards 
available to victims of discrimination under any other Federal law or 
any law of a State or a political subdivision of a State, including 
title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.), 
title IX of the Education Amendments of 1972 (20 U.S.C. 1681 et seq.), 
section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), and the 
Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.).

SEC. 7. DEFINITIONS.

    For purposes of this Act:
            (1) The term ``age appropriate'' means, with respect to 
        topics, messages, and teaching methods, those suitable to 
        particular ages or age groups of children and adolescents, 
        based on developing cognitive, emotional, and behavioral 
        capacity typical for the age or age group.
            (2) The term ``eligible State'' means a State that submits 
        to the Secretary an application for a grant under section 3 
        that is in such form, is made in such manner, and contains such 
        agreements, assurances, and information as the Secretary 
        determines to be necessary to carry out this Act.
            (3) The term ``HIV/AIDS'' means the human immunodeficiency 
        virus, and includes acquired immune deficiency syndrome.
            (4) The term ``medically accurate'', with respect to 
        information, means information that is supported by research, 
        recognized as accurate and objective by leading medical, 
        psychological, psychiatric, and public health organizations and 
        agencies, and, where relevant, published in peer review 
        journals.
            (5) The term ``Secretary'' means the Secretary of Health 
        and Human Services.
            (6) The term ``State'' means the 50 States, the District of 
        Columbia, the Commonwealth of Puerto Rico, the Commonwealth of 
        the Northern Mariana Islands, American Samoa, Guam, the Virgin 
        Islands, and any other territory or possession of the United 
        States.

SEC. 8. AUTHORIZATION OF APPROPRIATIONS.

    (a) In General.--For the purpose of carrying out this Act, there is 
authorized to be appropriated $50,000,000 for each of the fiscal years 
2010 through 2014.
    (b) Limitation.--Of the amounts appropriated to carry out this Act 
for a fiscal year, the Secretary may not use more than--
            (1) 7 percent of such amounts for administrative expenses 
        related to carrying out this Act for that fiscal year; and
            (2) 10 percent of such amounts for the national evaluation 
        under section 5(b).
                                 <all>
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