II 

108TH CONGRESS 

2D SESSION S. 2336

To expand access to preventive health care services and education programs 

that help reduce unintended pregnancy, reduce infection with sexually 

transmitted disease, and reduce the number of abortions. 

IN THE SENATE OF THE UNITED STATES 

APRIL 22, 2004

Mr. REID (for himself, Mr. CHAFEE, Mrs. BOXER, Mrs. MURRAY, Mrs. CLINTON, Mr. CORZINE, and Mr. LAUTENBERG) introduced the following bill; 

which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

A BILL

To expand access to preventive health care services and education programs that help reduce unintended pregnancy, 

reduce infection with sexually transmitted disease, and 

reduce the number of abortions.

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; TABLE OF CONTENTS. 

4 (a) SHORT TITLE.—This Act may be cited as the 

5 ‘‘Putting Prevention First Act’’. 

6 (b) TABLE OF CONTENTS.—The table of contents for 

7 this Act is as follows:
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•S 2336 IS 

Sec. 1. Short title; table of contents. 

Sec. 2. Findings. 

TITLE I—TITLE X OF PUBLIC HEALTH SERVICE ACT 

Sec. 101. Short title. 

Sec. 102. Authorization of appropriations. 

TITLE II—FAMILY PLANNING STATE EMPOWERMENT 

Sec. 201. Short title. 

Sec. 202. State option to provide family planning services and supplies to additional low-income individuals. 

Sec. 203. State option to extend the period of eligibility for provision of family 

planning services and supplies. 

TITLE III—EQUITY IN PRESCRIPTION INSURANCE AND 

CONTRACEPTIVE COVERAGE 

Sec. 301. Short title. 

Sec. 302. Amendments to Employee Retirement Income Security Act of 1974. 

Sec. 303. Amendments to Public Health Service Act relating to the group market. 

Sec. 304. Amendment to Public Health Service Act relating to the individual 

market. 

TITLE IV—EMERGENCY CONTRACEPTION EDUCATION AND 

INFORMATION 

Sec. 401. Short title. 

Sec. 402. Emergency contraception education and information programs. 

TITLE V—COMPASSIONATE ASSISTANCE FOR RAPE 

EMERGENCIES 

Sec. 501. Short title. 

Sec. 502. Survivors of sexual assault; provision by hospitals of emergency contraceptives without charge. 

TITLE VI—FAMILY LIFE EDUCATION 

Sec. 601. Short title. 

Sec. 602. Findings. 

Sec. 603. Assistance to reduce teen pregnancy, HIV/AIDS, and other sexually 

transmitted diseases and to support healthy adolescent development. 

Sec. 604. Sense of Congress. 

Sec. 605. Evaluation of programs. 

Sec. 606. Definitions. 

Sec. 607. Appropriations. 

TITLE VII—TEENAGE PREGNANCY PREVENTION 

Sec. 701. Short title. 

Sec. 702. Teenage pregnancy prevention.
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1 SEC. 2. FINDINGS. 

2 The Congress finds as follows: 

3 (1) Although the Centers for Disease Control 

4 and Prevention (‘‘CDC’’) included family planning in 

5 its published list of the ‘‘Ten Great Public Health 

6 Achievements in the 20th Century’’, the United 

7 States still has one of the highest rates of unin8 tended pregnancies among industrialized nations. 

9 (2) Each year, three million pregnancies, nearly 

10 half of all pregnancies, in the United States are un11 intended; and half of unintended pregnancies end in 

12 abortion. 

13 (3) In 2000, 34 million women—half of all 

14 women of reproductive age (ages 15–44)—were in 

15 need of contraceptive services and supplies to help 

16 prevent unintended pregnancy, and half of those 

17 were in need of public support for such care. 

18 (4) The United States also has the highest rate 

19 of infection with sexually transmitted diseases 

20 (‘‘STDs’’) of any industrialized country: in 2000 

21 there were approximately 18.9 million new cases of 

22 STDs. 

23 (5) Increasing access to family planning serv24 ices will improve women’s health and reduce the 

25 rates of unintended pregnancy, abortion, and infec26 tion with STDs. Contraceptive use saves public 
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1 health dollars: every dollar spent on providing family 

2 planning services saves an estimated $3 in expendi3 tures for pregnancy-related and newborn care for 

4 Medicaid alone. 

5 (6) Contraception is basic health care that im6 proves the health of women and children by enabling 

7 women to plan and space births. 

8 (7) Women experiencing unintended pregnancy 

9 are at greater risks for physical abuse and women 

10 having closely spaced births are at greater risk of 

11 maternal death. 

12 (8) The child born from an unintended preg13 nancy is at greater risk of low birth weight, dying 

14 in the first year of life, being abused, and not receiv15 ing sufficient resources for healthy development. 

16 (9) The ability to control fertility also allows 

17 couples to achieve economic stability by facilitating 

18 greater educational achievement and participation in 

19 the workforce. 

20 (10) The average American woman desires two 

21 children and spends five years of her life pregnant 

22 or trying to get pregnant and roughly 30 years try23 ing to prevent pregnancy; without contraception, a 

24 sexually active woman has an 85 percent chance of 

25 becoming pregnant within a year. 
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•S 2336 IS 

1 (11) Many poor and low-income women cannot 

2 afford to purchase contraceptive services and sup3 plies on their own. 12.1 million or 20 percent of all 

4 women aged 15–24 were uninsured in 2002, and 

5 that proportion has increased by 10 percent since 

6 1999. 

7 (12) Public health programs like Medicaid and 

8 Title X, the national family planning program, pro9 vide high-quality family planning services and other 

10 preventive health care to underinsured or uninsured 

11 individuals who may otherwise lack access to health 

12 care. 

13 (13) Medicaid is the single largest source of 

14 public funding for family planning services and HIV/

15 AIDS care in the United States. Half of all public 

16 dollars spent on contraceptive services and supplies 

17 in the United States are provided through Medicaid 

18 and approximately 5.5 million women of reproduc19 tive age—nearly one in ten women between the ages 

20 of 15 and 44—rely on Medicaid for their basic 

21 health care needs. 

22 (14) Each year, Title X services enable Ameri23 cans to prevent approximately one million unin24 tended pregnancies, and one in three women of re25 productive age who obtains testing or treatment for
6

•S 2336 IS 

1 STDs does so at a Title X-funded clinic. In 2002, 

2 Title X-funded clinics provided three million Pap 

3 tests, 5.2 million STD tests, and 494,000 HIV tests. 

4 (15) The increasing number of uninsured, stag5 nant funding, health care inflation, new and expen6 sive contraceptive technologies, and improved but ex7 pensive screening and treatment for cervical cancer 

8 and STDs, have diminished the ability of Title X 

9 funded clinics to adequately serve all those in need. 

10 Taking inflation into account, funding for the Title 

11 X program declined 57 percent between 1980 and 

12 2003. 

13 (16) While Medicaid is the largest source of 

14 subsidized family planning services, many States 

15 have had to make significant cuts in their Medicaid 

16 programs due to budget pressures putting many 

17 women at risk of losing coverage for family planning 

18 services. 

19 (17) In addition, eligibility for Medicaid in 

20 many States is severely restricted leaving family 

21 planning services financially out of reach for many 

22 poor women. Many States have demonstrated tre23 mendous success with Medicaid family planning 

24 waivers that allow them to expand access to Med25 icaid family planning services. However, the admin-
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•S 2336 IS 

1 istrative burden of applying for a waiver poses a sig2 nificant barrier to States that would like to expand 

3 their Medicaid family planning programs. 

4 (18) Many private health plans still do not 

5 cover contraceptive services and supplies. The lack 

6 of contraceptive coverage in health insurance plans 

7 places many effective forms of contraception beyond 

8 the financial reach of many women. 

9 (19) Including contraceptive coverage in private 

10 health care plans saves employers money: not cov11 ering contraceptives in employee health plans costs 

12 employers 15 to 17 percent more than providing 

13 such coverage. 

14 (20) Emergency contraception is a safe and ef15 fective way to prevent unintended pregnancy after 

16 unprotected sex. It is estimated that the use of 

17 emergency contraception could cut the number of 

18 unintended pregnancies in half, thereby reducing the 

19 need for abortion. 

20 (21) In 2000, 51,000 abortions were prevented 

21 by use of emergency contraception; increased use of 

22 emergency contraception accounted for up to 43 per23 cent of the total decline in abortions between 1994 

24 and 2000. 
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1 (22) Access to comprehensive sex education is 

2 critical to reducing rates of unintended pregnancy, 

3 abortion, and STD infection among teens. Over 60 

4 percent of teens have had sex before they graduate 

5 from high school and nine out of ten people have sex 

6 before they get married. 822,000 teenagers become 

7 pregnant each year; 35 percent of teen girls become 

8 pregnant at least once before turning 20; and 78 

9 percent of teenage pregnancies are unintended. 

10 Nearly half (48 percent) of new STD cases are 

11 among people ages 15–24, even though these youth 

12 make up only a quarter of the sexually active popu13 lation. 

14 (23) The American Medical Association, the 

15 American Nurses Association, the American Acad16 emy of Pediatrics, the American College of Obstetri17 cians and Gynecologists, the American Public Health 

18 Association, and the Society for Adolescent Medi19 cine, support responsible sexuality education that in20 cludes information about both abstinence and con21 traception. 

22 (24) Comprehensive sex education protects ado23 lescent health. A recent survey found that only 15 

24 percent of American parents believe that schools 

25 should just teach about abstinence. 
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1 (25) A recent study showed that teens who took 

2 pledges to remain virgins until marriage were just as 

3 likely to contract STDs as teens who did not take 

4 virginity pledges and that although teens taking the 

5 pledges delayed sexual debut, they were less likely to 

6 use condoms once they were sexually active. 

7 (26) Teens who receive sex education that in8 cludes discussion of contraception are more likely 

9 than those who receive abstinence-only messages to 

10 delay sex and to have fewer partners and use contra11 ceptives when they do become sexually active. 

12 TITLE I—TITLE X OF PUBLIC 

13 HEALTH SERVICE ACT 

14 SEC. 101. SHORT TITLE. 

15 This Act may be cited as the ‘‘Title X Family Plan16 ning Services Act of 2004’’. 

17 SEC. 102. AUTHORIZATION OF APPROPRIATIONS. 

18 For the purpose of making grants and contracts 

19 under section 1001 of the Public Health Service Act, there 

20 are authorized to be appropriated $643,000,000 for fiscal 

21 year 2005, and such sums as may be necessary for each 

22 subsequent fiscal year. 
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1 TITLE II—FAMILY PLANNING 

2 STATE EMPOWERMENT 

3 SEC. 201. SHORT TITLE. 

4 This Act may be cited as the ‘‘Family Planning State 

5 Empowerment Act’’. 

6 SEC. 202. STATE OPTION TO PROVIDE FAMILY PLANNING 

7 SERVICES AND SUPPLIES TO ADDITIONAL 

8 LOW-INCOME INDIVIDUALS. 

9 (a) IN GENERAL.—Title XIX of the Social Security 

10 Act (42 U.S.C. 1396 et seq.) is amended— 

11 (1) by redesignating section 1935 as section 

12 1936; and 

13 (2) by inserting after section 1934 the fol14 lowing: 

15 ‘‘STATE OPTION TO PROVIDE FAMILY PLANNING SERV16 ICES AND SUPPLIES TO ADDITIONAL LOW-INCOME

17 INDIVIDUALS

18 ‘‘SEC. 1935. 

19 ‘‘(a) IN GENERAL.—A State may elect (through a 

20 State plan amendment) to make medical assistance de21 scribed in section 1905(a)(4)(C) available to any indi22 vidual not otherwise eligible for such assistance— 

23 ‘‘(1) whose family income does not exceed an 

24 income level (specified by the State) that does not 

25 exceed the greatest of—
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•S 2336 IS 

1 ‘‘(A) 200 percent of the income official 

2 poverty line (as defined by the Office of Man3 agement and Budget, and revised annually in 

4 accordance with section 673(2) of the Commu5 nity Services Block Grant Act) applicable to a 

6 family of the size involved; 

7 ‘‘(B) in the case of a State that has in ef8 fect (as of the date of the enactment of this sec9 tion) a waiver under section 1115 to provide 

10 such medical assistance to individuals based on 

11 their income level (expressed as a percent of the 

12 poverty line), the eligibility income level as pro13 vided under such waiver; or 

14 ‘‘(C) the eligibility income level (expressed 

15 as a percent of such poverty line) that has been 

16 specified under the plan (including under sec17 tion 1902(r)(2)), for eligibility of pregnant 

18 women for medical assistance; and 

19 ‘‘(2) at the option of the State, whose resources 

20 do not exceed a resource level specified by the State, 

21 which level is not more restrictive than the resource 

22 level applicable under the waiver described in para23 graph (1)(B) or to pregnant women under para24 graph (1)(C). 
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•S 2336 IS 

1 ‘‘(b) FLEXIBILITY.—A State may exercise the au2 thority under subsection (a) with respect to one or more 

3 classes of individuals described in such subsection.’’. 

4 (b) CONFORMING AMENDMENT.—Section 1905(a) of 

5 such Act (42 U.S.C. 1396d(a)) is amended, in the matter 

6 before paragraph (1)— 

7 (1) by striking ‘‘and’’ at the end of clause (xii); 

8 (2) by adding ‘‘and’’ at the end of clause (xiii); 

9 and 

10 (3) by inserting after clause (xiii) the following 

11 new clause: 

12 ‘‘(xiv) individuals described in section 1935, but 

13 only with respect to items and services described in 

14 paragraph (4)(C),’’. 

15 (c) EFFECTIVE DATE.—The amendments made by 

16 this section apply to medical assistance provided on and 

17 after October 1, 2004. 

18 SEC. 203. STATE OPTION TO EXTEND THE PERIOD OF ELIGI19 BILITY FOR PROVISION OF FAMILY PLAN20 NING SERVICES AND SUPPLIES. 

21 (a) IN GENERAL.—Section 1902(e) of the Social Se22 curity Act (42 U.S.C. 1396a(e)) is amended by adding at 

23 the end the following new paragraph: 

24 ‘‘(13) At the option of a State, the State plan may 

25 provide that, in the case of an individual who was eligible 
13

•S 2336 IS 

1 for medical assistance described in section 1905(a)(4)(C), 

2 but who no longer qualifies for such assistance because 

3 of an increase in income or resources or because of the 

4 expiration of a post-partum period, the individual may re5 main eligible for such assistance for such period as the 

6 State may specify, but the period of extended eligibility 

7 under this paragraph shall not exceed a continuous period 

8 of 24 months for any individual. The State may apply the 

9 previous sentence to one or more classes of individuals and 

10 may vary the period of extended eligibility with respect 

11 to different classes of individuals.’’. 

12 (b) EFFECTIVE DATE.—The amendments made by 

13 subsection (a) apply to medical assistance provided on and 

14 after October 1, 2004. 

15 TITLE III—EQUITY IN PRESCRIP16 TION INSURANCE AND CON17 TRACEPTIVE COVERAGE 

18 SEC. 301. SHORT TITLE. 

19 This Act may be cited as the ‘‘Equity in Prescription 

20 Insurance and Contraceptive Coverage Act’’. 

21 SEC. 302. AMENDMENTS TO EMPLOYEE RETIREMENT IN22 COME SECURITY ACT OF 1974. 

23 (a) IN GENERAL.—Subpart B of part 7 of subtitle 

24 B of title I of the Employee Retirement Income Security 
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•S 2336 IS 

1 Act of 1974 (29 U.S.C. 1185 et seq.) is amended by add2 ing at the end the following: 

3 ‘‘SEC. 714. STANDARDS RELATING TO BENEFITS FOR CON4 TRACEPTIVES. 

5 ‘‘(a) REQUIREMENTS FOR COVERAGE.—A group 

6 health plan, and a health insurance issuer providing health 

7 insurance coverage in connection with a group health plan, 

8 may not— 

9 ‘‘(1) exclude or restrict benefits for prescription 

10 contraceptive drugs or devices approved by the Food 

11 and Drug Administration, or generic equivalents ap12 proved as substitutable by the Food and Drug Ad13 ministration, if such plan or coverage provides bene14 fits for other outpatient prescription drugs or de15 vices; or 

16 ‘‘(2) exclude or restrict benefits for outpatient 

17 contraceptive services if such plan or coverage pro18 vides benefits for other outpatient services provided 

19 by a health care professional (referred to in this sec20 tion as ‘outpatient health care services’). 

21 ‘‘(b) PROHIBITIONS.—A group health plan, and a 

22 health insurance issuer providing health insurance cov23 erage in connection with a group health plan, may not— 

24 ‘‘(1) deny to an individual eligibility, or contin25 ued eligibility, to enroll or to renew coverage under 
15

•S 2336 IS 

1 the terms of the plan because of the individual’s or 

2 enrollee’s use or potential use of items or services 

3 that are covered in accordance with the requirements 

4 of this section; 

5 ‘‘(2) provide monetary payments or rebates to 

6 a covered individual to encourage such individual to 

7 accept less than the minimum protections available 

8 under this section; 

9 ‘‘(3) penalize or otherwise reduce or limit the 

10 reimbursement of a health care professional because 

11 such professional prescribed contraceptive drugs or 

12 devices, or provided contraceptive services, described 

13 in subsection (a), in accordance with this section; or 

14 ‘‘(4) provide incentives (monetary or otherwise) 

15 to a health care professional to induce such profes16 sional to withhold from a covered individual contra17 ceptive drugs or devices, or contraceptive services, 

18 described in subsection (a). 

19 ‘‘(c) RULES OF CONSTRUCTION.— 

20 ‘‘(1) IN GENERAL.—Nothing in this section 

21 shall be construed— 

22 ‘‘(A) as preventing a group health plan 

23 and a health insurance issuer providing health 

24 insurance coverage in connection with a group 

25 health plan from imposing deductibles, coinsur-
16

•S 2336 IS 

1 ance, or other cost-sharing or limitations in re2 lation to— 

3 ‘‘(i) benefits for contraceptive drugs 

4 under the plan or coverage, except that 

5 such a deductible, coinsurance, or other 

6 cost-sharing or limitation for any such 

7 drug shall be consistent with those imposed 

8 for other outpatient prescription drugs oth9 erwise covered under the plan or coverage; 

10 ‘‘(ii) benefits for contraceptive devices 

11 under the plan or coverage, except that 

12 such a deductible, coinsurance, or other 

13 cost-sharing or limitation for any such de14 vice shall be consistent with those imposed 

15 for other outpatient prescription devices 

16 otherwise covered under the plan or cov17 erage; and 

18 ‘‘(iii) benefits for outpatient contra19 ceptive services under the plan or coverage, 

20 except that such a deductible, coinsurance, 

21 or other cost-sharing or limitation for any 

22 such service shall be consistent with those 

23 imposed for other outpatient health care 

24 services otherwise covered under the plan 

25 or coverage;
17

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1 ‘‘(B) as requiring a group health plan and 

2 a health insurance issuer providing health in3 surance coverage in connection with a group 

4 health plan to cover experimental or investiga5 tional contraceptive drugs or devices, or experi6 mental or investigational contraceptive services, 

7 described in subsection (a), except to the extent 

8 that the plan or issuer provides coverage for 

9 other experimental or investigational outpatient 

10 prescription drugs or devices, or experimental 

11 or investigational outpatient health care serv12 ices; or 

13 ‘‘(C) as modifying, diminishing, or limiting 

14 the rights or protections of an individual under 

15 any other Federal law. 

16 ‘‘(2) LIMITATIONS.—As used in paragraph (1), 

17 the term ‘limitation’ includes— 

18 ‘‘(A) in the case of a contraceptive drug or 

19 device, restricting the type of health care pro20 fessionals that may prescribe such drugs or de21 vices, utilization review provisions, and limits on 

22 the volume of prescription drugs or devices that 

23 may be obtained on the basis of a single con24 sultation with a professional; or 
18

•S 2336 IS 

1 ‘‘(B) in the case of an outpatient contra2 ceptive service, restricting the type of health 

3 care professionals that may provide such serv4 ices, utilization review provisions, requirements 

5 relating to second opinions prior to the coverage 

6 of such services, and requirements relating to 

7 preauthorizations prior to the coverage of such 

8 services. 

9 ‘‘(d) NOTICE UNDER GROUP HEALTH PLAN.—The 

10 imposition of the requirements of this section shall be 

11 treated as a material modification in the terms of the plan 

12 described in section 102(a)(1), for purposes of assuring 

13 notice of such requirements under the plan, except that 

14 the summary description required to be provided under the 

15 last sentence of section 104(b)(1) with respect to such 

16 modification shall be provided by not later than 60 days 

17 after the first day of the first plan year in which such 

18 requirements apply. 

19 ‘‘(e) PREEMPTION.—Nothing in this section shall be 

20 construed to preempt any provision of State law to the 

21 extent that such State law establishes, implements, or con22 tinues in effect any standard or requirement that provides 

23 coverage or protections for participants or beneficiaries 

24 that are greater than the coverage or protections provided 

25 under this section. 
19

•S 2336 IS 

1 ‘‘(f) DEFINITION.—In this section, the term ‘out2 patient contraceptive services’ means consultations, exami3 nations, procedures, and medical services, provided on an 

4 outpatient basis and related to the use of contraceptive 

5 methods (including natural family planning) to prevent an 

6 unintended pregnancy.’’. 

7 (b) CLERICAL AMENDMENT.—The table of contents 

8 in section 1 of the Employee Retirement Income Security 

9 Act of 1974 (29 U.S.C. 1001) is amended by inserting 

10 after the item relating to section 713 the following:

‘‘Sec. 714. Standards relating to benefits for contraceptives.’’.

11 (c) EFFECTIVE DATE.—The amendments made by 

12 this section shall apply with respect to plan years begin13 ning on or after January 1, 2005. 

14 SEC. 303. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT 

15 RELATING TO THE GROUP MARKET. 

16 (a) IN GENERAL.—Subpart 2 of part A of title 

17 XXVII of the Public Health Service Act (42 U.S.C. 

18 300gg–4 et seq.) is amended by adding at the end the 

19 following: 

20 ‘‘SEC. 2707. STANDARDS RELATING TO BENEFITS FOR CON21 TRACEPTIVES. 

22 ‘‘(a) REQUIREMENTS FOR COVERAGE.—A group 

23 health plan, and a health insurance issuer providing health 

24 insurance coverage in connection with a group health plan, 

25 may not— 
20

•S 2336 IS 

1 ‘‘(1) exclude or restrict benefits for prescription 

2 contraceptive drugs or devices approved by the Food 

3 and Drug Administration, or generic equivalents ap4 proved as substitutable by the Food and Drug Ad5 ministration, if such plan or coverage provides bene6 fits for other outpatient prescription drugs or de7 vices; or 

8 ‘‘(2) exclude or restrict benefits for outpatient 

9 contraceptive services if such plan or coverage pro10 vides benefits for other outpatient services provided 

11 by a health care professional (referred to in this sec12 tion as ‘outpatient health care services’). 

13 ‘‘(b) PROHIBITIONS.—A group health plan, and a 

14 health insurance issuer providing health insurance cov15 erage in connection with a group health plan, may not— 

16 ‘‘(1) deny to an individual eligibility, or contin17 ued eligibility, to enroll or to renew coverage under 

18 the terms of the plan because of the individual’s or 

19 enrollee’s use or potential use of items or services 

20 that are covered in accordance with the requirements 

21 of this section; 

22 ‘‘(2) provide monetary payments or rebates to 

23 a covered individual to encourage such individual to 

24 accept less than the minimum protections available 

25 under this section; 
21

•S 2336 IS 

1 ‘‘(3) penalize or otherwise reduce or limit the 

2 reimbursement of a health care professional because 

3 such professional prescribed contraceptive drugs or 

4 devices, or provided contraceptive services, described 

5 in subsection (a), in accordance with this section; or 

6 ‘‘(4) provide incentives (monetary or otherwise) 

7 to a health care professional to induce such profes8 sional to withhold from covered individual contracep9 tive drugs or devices, or contraceptive services, de10 scribed in subsection (a). 

11 ‘‘(c) RULES OF CONSTRUCTION.— 

12 ‘‘(1) IN GENERAL.—Nothing in this section 

13 shall be construed— 

14 ‘‘(A) as preventing a group health plan 

15 and a health insurance issuer providing health 

16 insurance coverage in connection with a group 

17 health plan from imposing deductibles, coinsur18 ance, or other cost-sharing or limitations in re19 lation to— 

20 ‘‘(i) benefits for contraceptive drugs 

21 under the plan or coverage, except that 

22 such a deductible, coinsurance, or other 

23 cost-sharing or limitation for any such 

24 drug shall be consistent with those imposed
22

•S 2336 IS 

1 for other outpatient prescription drugs oth2 erwise covered under the plan or coverage; 

3 ‘‘(ii) benefits for contraceptive devices 

4 under the plan or coverage, except that 

5 such a deductible, coinsurance, or other 

6 cost-sharing or limitation for any such de7 vice shall be consistent with those imposed 

8 for other outpatient prescription devices 

9 otherwise covered under the plan or cov10 erage; and 

11 ‘‘(iii) benefits for outpatient contra12 ceptive services under the plan or coverage, 

13 except that such a deductible, coinsurance, 

14 or other cost-sharing or limitation for any 

15 such service shall be consistent with those 

16 imposed for other outpatient health care 

17 services otherwise covered under the plan 

18 or coverage; 

19 ‘‘(B) as requiring a group health plan and 

20 a health insurance issuer providing health in21 surance coverage in connection with a group 

22 health plan to cover experimental or investiga23 tional contraceptive drugs or devices, or experi24 mental or investigational contraceptive services, 

25 described in subsection (a), except to the extent 
23

•S 2336 IS 

1 that the plan or issuer provides coverage for 

2 other experimental or investigational outpatient 

3 prescription drugs or devices, or experimental 

4 or investigational outpatient health care serv5 ices; or 

6 ‘‘(C) as modifying, diminishing, or limiting 

7 the rights or protections of an individual under 

8 any other Federal law. 

9 ‘‘(2) LIMITATIONS.—As used in paragraph (1), 

10 the term ‘limitation’ includes— 

11 ‘‘(A) in the case of a contraceptive drug or 

12 device, restricting the type of health care pro13 fessionals that may prescribe such drugs or de14 vices, utilization review provisions, and limits on 

15 the volume of prescription drugs or devices that 

16 may be obtained on the basis of a single con17 sultation with a professional; or 

18 ‘‘(B) in the case of an outpatient contra19 ceptive service, restricting the type of health 

20 care professionals that may provide such serv21 ices, utilization review provisions, requirements 

22 relating to second opinions prior to the coverage 

23 of such services, and requirements relating to 

24 preauthorizations prior to the coverage of such 

25 services. 
24

•S 2336 IS 

1 ‘‘(d) NOTICE.—A group health plan under this part 

2 shall comply with the notice requirement under section 

3 714(d) of the Employee Retirement Income Security Act 

4 of 1974 with respect to the requirements of this section 

5 as if such section applied to such plan. 

6 ‘‘(e) PREEMPTION.—Nothing in this section shall be 

7 construed to preempt any provision of State law to the 

8 extent that such State law establishes, implements, or con9 tinues in effect any standard or requirement that provides 

10 coverage or protections for enrollees that are greater than 

11 the coverage or protections provided under this section. 

12 ‘‘(f) DEFINITION.—In this section, the term ‘out13 patient contraceptive services’ means consultations, exami14 nations, procedures, and medical services, provided on an 

15 outpatient basis and related to the use of contraceptive 

16 methods (including natural family planning) to prevent an 

17 unintended pregnancy.’’. 

18 (b) EFFECTIVE DATE.—The amendments made by 

19 this section shall apply with respect to group health plans 

20 for plan years beginning on or after January 1, 2005. 

21 SEC. 304. AMENDMENT TO PUBLIC HEALTH SERVICE ACT 

22 RELATING TO THE INDIVIDUAL MARKET. 

23 (a) IN GENERAL.—Part B of title XXVII of the Pub24 lic Health Service Act (42 U.S.C. 300gg–41 et seq.) is 

25 amended— 
25

•S 2336 IS 

1 (1) by redesignating the first subpart 3 (relat2 ing to other requirements) as subpart 2; and 

3 (2) by adding at the end of subpart 2 the fol4 lowing: 

5 ‘‘SEC. 2753. STANDARDS RELATING TO BENEFITS FOR CON6 TRACEPTIVES. 

7 ‘‘The provisions of section 2707 shall apply to health 

8 insurance coverage offered by a health insurance issuer 

9 in the individual market in the same manner as they apply 

10 to health insurance coverage offered by a health insurance 

11 issuer in connection with a group health plan in the small 

12 or large group market.’’. 

13 (b) EFFECTIVE DATE.—The amendment made by 

14 this section shall apply with respect to health insurance 

15 coverage offered, sold, issued, renewed, in effect, or oper16 ated in the individual market on or after January 1, 2005. 

17 TITLE IV—EMERGENCY CONTRA18 CEPTION EDUCATION AND IN19 FORMATION 

20 SEC. 401. SHORT TITLE. 

21 This Act may be cited as the ‘‘Emergency Contracep22 tion Education Act’’. 

23 SEC. 402. EMERGENCY CONTRACEPTION EDUCATION AND 

24 INFORMATION PROGRAMS. 

25 (a) DEFINITIONS.—For purposes of this section:
26

•S 2336 IS 

1 (1) EMERGENCY CONTRACEPTION.—The term 

2 ‘‘emergency contraception’’ means a drug or device 

3 (as the terms are defined in section 201 of the Fed4 eral Food, Drug, and Cosmetic Act (21 U.S.C. 321)) 

5 or a drug regimen that is— 

6 (A) used after sexual relations; and 

7 (B) prevents pregnancy, by preventing ovu8 lation, fertilization of an egg, or implantation of 

9 an egg in a uterus. 

10 (2) HEALTH CARE PROVIDER.—The term 

11 ‘‘health care provider’’ means an individual who is li12 censed or certified under State law to provide health 

13 care services and who is operating within the scope 

14 of such license. 

15 (3) INSTITUTION OF HIGHER EDUCATION.—The 

16 term ‘‘institution of higher education’’ has the same 

17 meaning given such term in section 1201(a) of the 

18 Higher Education Act of 1965 (20 U.S.C. 1141(a)). 

19 (4) SECRETARY.—The term ‘‘Secretary’’ means 

20 the Secretary of Health and Human Services. 

21 (b) EMERGENCY CONTRACEPTION PUBLIC EDU22 CATION PROGRAM.— 

23 (1) IN GENERAL.—The Secretary, acting 

24 through the Director of the Centers for Disease 

25 Control and Prevention, shall develop and dissemi-
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1 nate to the public information on emergency contra2 ception. 

3 (2) DISSEMINATION.—The Secretary may dis4 seminate information under paragraph (1) directly 

5 or through arrangements with nonprofit organiza6 tions, consumer groups, institutions of higher edu7 cation, Federal, State, or local agencies, clinics and 

8 the media. 

9 (3) INFORMATION.—The information dissemi10 nated under paragraph (1) shall include, at a min11 imum, a description of emergency contraception, and 

12 an explanation of the use, safety, efficacy, and avail13 ability of such contraception. 

14 (c) EMERGENCY CONTRACEPTION INFORMATION

15 PROGRAM FOR HEALTH CARE PROVIDERS.— 

16 (1) IN GENERAL.—The Secretary, acting 

17 through the Administrator of the Health Resources 

18 and Services Administration and in consultation 

19 with major medical and public health organizations, 

20 shall develop and disseminate to health care pro21 viders information on emergency contraception. 

22 (2) INFORMATION.—The information dissemi23 nated under paragraph (1) shall include, at a min24 imum— 
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1 (A) information describing the use, safety, 

2 efficacy and availability of emergency contra3 ception; 

4 (B) a recommendation regarding the use of 

5 such contraception in appropriate cases; and 

6 (C) information explaining how to obtain 

7 copies of the information developed under sub8 section (b), for distribution to the patients of 

9 the providers. 

10 (d) AUTHORIZATION OF APPROPRIATIONS.—There is 

11 authorized to be appropriated to carry out this section 

12 $10,000,000 for each of the fiscal years 2005 through 

13 2009. 

14 TITLE V—COMPASSIONATE AS15 SISTANCE FOR RAPE EMER16 GENCIES 

17 SEC. 501. SHORT TITLE. 

18 This Act may be cited as the ‘‘Compassionate Assist19 ance for Rape Emergencies Act’’. 

20 SEC. 502. SURVIVORS OF SEXUAL ASSAULT; PROVISION BY 

21 HOSPITALS OF EMERGENCY CONTRACEP22 TIVES WITHOUT CHARGE. 

23 (a) IN GENERAL.—Federal funds may not be pro24 vided to a hospital under any health-related program, un-
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1 less the hospital meets the conditions specified in sub2 section (b) in the case of— 

3 (1) any woman who presents at the hospital 

4 and states that she is a victim of sexual assault, or 

5 is accompanied by someone who states she is a vic6 tim of sexual assault; and 

7 (2) any woman who presents at the hospital 

8 whom hospital personnel have reason to believe is a 

9 victim of sexual assault. 

10 (b) ASSISTANCE FOR VICTIMS.—The conditions spec11 ified in this subsection regarding a hospital and a woman 

12 described in subsection (a) are as follows: 

13 (1) The hospital promptly provides the woman 

14 with medically and factually accurate and unbiased 

15 written and oral information about emergency con16 traception, including information explaining that— 

17 (A) emergency contraception does not 

18 cause an abortion; and 

19 (B) emergency contraception is effective in 

20 most cases in preventing pregnancy after un21 protected sex. 

22 (2) The hospital promptly offers emergency 

23 contraception to the woman, and promptly provides 

24 such contraception to her on her request. 
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1 (3) The information provided pursuant to para2 graph (1) is in clear and concise language, is readily 

3 comprehensible, and meets such conditions regarding 

4 the provision of the information in languages other 

5 than English as the Secretary may establish. 

6 (4) The services described in paragraphs (1) 

7 through (3) are not denied because of the inability 

8 of the woman or her family to pay for the services. 

9 (c) DEFINITIONS.—For purposes of this section: 

10 (1) The term ‘‘emergency contraception’’ means 

11 a drug, drug regimen, or device that is— 

12 (A) used postcoitally; 

13 (B) prevents pregnancy by delaying ovula14 tion, preventing fertilization of an egg, or pre15 venting implantation of an egg in a uterus; and 

16 (C) is approved by the Food and Drug Ad17 ministration. 

18 (2) The term ‘‘hospital’’ has the meanings given 

19 such term in title XVIII of the Social Security Act, 

20 including the meaning applicable in such title for 

21 purposes of making payments for emergency services 

22 to hospitals that do not have agreements in effect 

23 under such title. 

24 (3) The term ‘‘Secretary’’ means the Secretary 

25 of Health and Human Services.
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1 (4) The term ‘‘sexual assault’’ means coitus in 

2 which the woman involved does not consent or lacks 

3 the legal capacity to consent. 

4 (d) EFFECTIVE DATE; AGENCY CRITERIA.—This sec5 tion takes effect upon the expiration of the 180-day period 

6 beginning on the date of enactment of this Act. Not later 

7 than 30 days prior to the expiration of such period, the 

8 Secretary shall publish in the Federal Register criteria for 

9 carrying out this section. 

10 TITLE VI—FAMILY LIFE 

11 EDUCATION 

12 SEC. 601. SHORT TITLE. 

13 This Act may be cited as the ‘‘Family Life Education 

14 Act’’. 

15 SEC. 602. FINDINGS. 

16 The Congress finds as follows: 

17 (1) The American Medical Association 

18 (‘‘AMA’’), the American Nurses Association 

19 (‘‘ANA’’), the American Academy of Pediatrics 

20 (‘‘AAP’’), the American College of Obstetricians and 

21 Gynecologists (‘‘ACOG’’), the American Public 

22 Health Association (‘‘APHA’’), and the Society of 

23 Adolescent Medicine (‘‘SAM’’), support responsible 

24 sexuality education that includes information about 

25 both abstinence and contraception. 
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1 (2) Recent scientific reports by the Institute of 

2 Medicine, the American Medical Association and the 

3 Office on National AIDS Policy stress the need for 

4 sexuality education that includes messages about ab5 stinence and provides young people with information 

6 about contraception for the prevention of teen preg7 nancy, HIV/AIDS and other sexually transmitted 

8 diseases (‘‘STDs’’). 

9 (3) Research shows that teenagers who receive 

10 sexuality education that includes discussion of con11 traception are more likely than those who receive ab12 stinence-only messages to delay sexual activity and 

13 to use contraceptives when they do become sexually 

14 active. 

15 (4) Comprehensive sexuality education pro16 grams respect the diversity of values and beliefs rep17 resented in the community and will complement and 

18 augment the sexuality education children receive 

19 from their families. 

20 (5) The median age of puberty is 13 years and 

21 the average age of marriage is over 26 years old. 

22 American teens need access to full, complete, and 

23 medically and factually accurate information regard24 ing sexuality, including contraception, STD/HIV 

25 prevention, and abstinence. 
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1 (6) Although teen pregnancy rates are decreas2 ing, there are still between 750,000 and 850,000 

3 teen pregnancies each year. Between 75 and 90 per4 cent of teen pregnancies among 15- to 19-year olds 

5 are unintended. 

6 (7) Research shows that 75 percent of the de7 crease in teen pregnancy between 1988 and 1995 

8 was due to improved contraceptive use, while 25 per9 cent was due to increased abstinence. 

10 (8) More than eight out of ten Americans be11 lieve that young people should have information 

12 about abstinence and protecting themselves from un13 planned pregnancies and sexually transmitted dis14 eases. 

15 (9) United States teens acquire an estimated 

16 4,000,000 sexually transmitted infections each year. 

17 By age 24, at least one in three sexually active peo18 ple will have contracted a sexually transmitted dis19 ease. 

20 (10) An average of two young people in the 

21 United States are infected with HIV every hour of 

22 every day. African Americans and Hispanic youth 

23 have been disproportionately affected by the HIV/

24 AIDS epidemic. Although less than 16 percent of 

25 the adolescent population in the United States is Af-
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1 rican American, nearly 50 percent of AIDS cases 

2 through June 2000 among 13- to 19-year olds were 

3 among Blacks. Hispanics comprise 13 percent of the 

4 population and 20 percent of the reported adolescent 

5 AIDS cases though June 2000. 

6 SEC. 603. ASSISTANCE TO REDUCE TEEN PREGNANCY, HIV/

7 AIDS, AND OTHER SEXUALLY TRANSMITTED 

8 DISEASES AND TO SUPPORT HEALTHY ADO9 LESCENT DEVELOPMENT. 

10 (a) IN GENERAL.—Each eligible State shall be enti11 tled to receive from the Secretary of Health and Human 

12 Services, for each of the fiscal years 2005 through 2009, 

13 a grant to conduct programs of family life education, in14 cluding education on both abstinence and contraception 

15 for the prevention of teenage pregnancy and sexually 

16 transmitted diseases, including HIV/AIDS. 

17 (b) REQUIREMENTS FOR FAMILY LIFE PROGRAMS.—

18 For purposes of this title, a program of family life edu19 cation is a program that— 

20 (1) is age-appropriate and medically accurate; 

21 (2) does not teach or promote religion; 

22 (3) teaches that abstinence is the only sure way 

23 to avoid pregnancy or sexually transmitted diseases; 
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1 (4) stresses the value of abstinence while not ig2 noring those young people who have had or are hav3 ing sexual intercourse; 

4 (5) provides information about the health bene5 fits and side effects of all contraceptives and barrier 

6 methods as a means to prevent pregnancy; 

7 (6) provides information about the health bene8 fits and side effects of all contraceptives and barrier 

9 methods as a means to reduce the risk of con10 tracting sexually transmitted diseases, including 

11 HIV/AIDS; 

12 (7) encourages family communication about 

13 sexuality between parent and child; 

14 (8) teaches young people the skills to make re15 sponsible decisions about sexuality, including how to 

16 avoid unwanted verbal, physical, and sexual ad17 vances and how not to make unwanted verbal, phys18 ical, and sexual advances; and 

19 (9) teaches young people how alcohol and drug 

20 use can affect responsible decisionmaking. 

21 (c) ADDITIONAL ACTIVITIES.—In carrying out a pro22 gram of family life education, a State may expend a grant 

23 under subsection (a) to carry out educational and motiva24 tional activities that help young people—
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1 (1) gain knowledge about the physical, emo2 tional, biological, and hormonal changes of adoles3 cence and subsequent stages of human maturation; 

4 (2) develop the knowledge and skills necessary 

5 to ensure and protect their sexual and reproductive 

6 health from unintended pregnancy and sexually 

7 transmitted disease, including HIV/AIDS through8 out their lifespan; 

9 (3) gain knowledge about the specific involve10 ment of and male responsibility in sexual decision11 making; 

12 (4) develop healthy attitudes and values about 

13 adolescent growth and development, body image, 

14 gender roles, racial and ethnic diversity, sexual ori15 entation, and other subjects; 

16 (5) develop and practice healthy life skills in17 cluding goal-setting, decisionmaking, negotiation, 

18 communication, and stress management; 

19 (6) promote self-esteem and positive inter20 personal skills focusing on relationship dynamics, in21 cluding, but not limited to, friendships, dating, ro22 mantic involvement, marriage and family inter23 actions; and 

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

25 educational and career success, including developing 
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1 skills for employment preparation, job seeking, inde2 pendent living, financial self-sufficiency, and work3 place productivity. 

4 SEC. 604. SENSE OF CONGRESS. 

5 It is the sense of Congress that while States are not 

6 required to provide matching funds, they are encouraged 

7 to do so. 

8 SEC. 605. EVALUATION OF PROGRAMS. 

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

10 effectiveness of programs of family life education carried 

11 out with a grant under section 603, evaluations of such 

12 program shall be carried out in accordance with sub13 sections (b) and (c). 

14 (b) NATIONAL EVALUATION.— 

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

16 for a national evaluation of a representative sample 

17 of programs of family life education carried out with 

18 grants under section 603. A condition for the receipt 

19 of such a grant is that the State involved agree to 

20 cooperate with the evaluation. The purposes of the 

21 national evaluation shall be the determination of— 

22 (A) the effectiveness of such programs in 

23 helping to delay the initiation of sexual inter24 course and other high-risk behaviors; 
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1 (B) the effectiveness of such programs in 

2 preventing adolescent pregnancy; 

3 (C) the effectiveness of such programs in 

4 preventing sexually transmitted disease, includ5 ing HIV/AIDS; 

6 (D) the effectiveness of such programs in 

7 increasing contraceptive knowledge and contra8 ceptive behaviors when sexual intercourse oc9 curs; and 

10 (E) a list of best practices based upon es11 sential programmatic components of evaluated 

12 programs that have led to success in subpara13 graphs (A) through (D). 

14 (2) REPORT.—A report providing the results of 

15 the national evaluation under paragraph (1) shall be 

16 submitted to the Congress not later than March 31, 

17 2008, with an interim report provided on a yearly 

18 basis at the end of each fiscal year. 

19 (c) INDIVIDUAL STATE EVALUATIONS.— 

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

21 of a grant under section 603 is that the State in22 volved agree to provide for the evaluation of the pro23 grams of family education carried out with the grant 

24 in accordance with the following: 
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1 (A) The evaluation will be conducted by an 

2 external, independent entity. 

3 (B) The purposes of the evaluation will be 

4 the determination of— 

5 (i) the effectiveness of such programs 

6 in helping to delay the initiation of sexual 

7 intercourse and other high-risk behaviors; 

8 (ii) the effectiveness of such programs 

9 in preventing adolescent pregnancy; 

10 (iii) the effectiveness of such pro11 grams in preventing sexually transmitted 

12 disease, including HIV/AIDS; and 

13 (iv) the effectiveness of such programs 

14 in increasing contraceptive knowledge and 

15 contraceptive behaviors when sexual inter16 course occurs. 

17 (2) USE OF GRANT.—A condition for the re18 ceipt of a grant under section 603 is that the State 

19 involved agree that not more than 10 percent of the 

20 grant will be expended for the evaluation under 

21 paragraph (1). 

22 SEC. 606. DEFINITIONS. 

23 For purposes of this title: 

24 (1) The term ‘‘eligible State’’ means a State 

25 that submits to the Secretary an application for a 
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1 grant under section 603 that is in such form, is 

2 made in such manner, and contains such agree3 ments, assurances, and information as the Secretary 

4 determines to be necessary to carry out this title. 

5 (2) The term ‘‘HIV/AIDS’’ means the human 

6 immunodeficiency virus, and includes acquired im7 mune deficiency syndrome. 

8 (3) The term ‘‘medically accurate’’, with respect 

9 to information, means information that is supported 

10 by research, recognized as accurate and objective by 

11 leading medical, psychological, psychiatric, and pub12 lic health organizations and agencies, and where rel13 evant, published in peer review journals. 

14 (4) The term ‘‘Secretary’’ means the Secretary 

15 of Health and Human Services. 

16 SEC. 607. APPROPRIATIONS. 

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

18 this title, there is authorized to be appropriated 

19 $100,000,000 for each of the fiscal years 2005 through 

20 2009. 

21 (b) ALLOCATIONS.—Of the amounts appropriated 

22 under subsection (a) for a fiscal year— 

23 (1) not more than 7 percent may be used for 

24 the administrative expenses of the Secretary in car25 rying out this title for that fiscal year; and
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1 (2) not more than 10 percent may be used for 

2 the national evaluation under section 605(b). 

3 TITLE VII—TEENAGE 

4 PREGNANCY PREVENTION 

5 SEC. 701. SHORT TITLE. 

6 This Act may be cited as the ‘‘Preventing Teen Preg7 nancy Act’’. 

8 SEC. 702. TEENAGE PREGNANCY PREVENTION. 

9 Part P of title III of the Public Health Service Act 

10 (42 U.S.C. 280g et seq.) is amended by inserting after 

11 section 399N the following section: 

12 ‘‘SEC. 399O. TEENAGE PREGNANCY PREVENTION GRANTS. 

13 ‘‘(a) AUTHORITY.—The Secretary may award on a 

14 competitive basis grants to public and private entities to 

15 establish or expand teenage pregnancy prevention pro16 grams. 

17 ‘‘(b) GRANT RECIPIENTS.—Grant recipients under 

18 this section may include State and local not-for-profit coa19 litions working to prevent teenage pregnancy, State, local, 

20 and tribal agencies, schools, entities that provide after21 school programs, and community and faith-based groups. 

22 ‘‘(c) PRIORITY.—In selecting grant recipients under 

23 this section, the Secretary shall give— 
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1 ‘‘(1) highest priority to applicants seeking as2 sistance for programs targeting communities or pop3 ulations in which— 

4 ‘‘(A) teenage pregnancy or birth rates are 

5 higher than the corresponding State average; or 

6 ‘‘(B) teenage pregnancy or birth rates are 

7 increasing; and 

8 ‘‘(2) priority to applicants seeking assistance 

9 for programs that— 

10 ‘‘(A) will benefit underserved or at-risk 

11 populations such as young males or immigrant 

12 youths; or 

13 ‘‘(B) will take advantage of other available 

14 resources and be coordinated with other pro15 grams that serve youth, such as workforce de16 velopment and after school programs. 

17 ‘‘(d) USE OF FUNDS.—Funds received by an entity 

18 as a grant under this section shall be used for programs 

19 that— 

20 ‘‘(1) replicate or substantially incorporate the 

21 elements of one or more teenage pregnancy preven22 tion programs that have been proven (on the basis 

23 of rigorous scientific research) to delay sexual inter24 course or sexual activity, increase condom or contra-
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1 ceptive use (without increasing sexual activity), or 

2 reduce teenage pregnancy; and 

3 ‘‘(2) incorporate one or more of the following 

4 strategies for preventing teenage pregnancy: encour5 aging teenagers to delay sexual activity; sex and 

6 HIV education; interventions for sexually active 

7 teenagers; preventive health services; youth develop8 ment programs; service learning programs; and out9 reach or media programs. 

10 ‘‘(e) COMPLETE INFORMATION.—Programs receiving 

11 funds under this section that choose to provide informa12 tion on HIV/AIDS or contraception or both must provide 

13 information that is complete and medically accurate. 

14 ‘‘(f) RELATION TO ABSTINENCE-ONLY PROGRAMS.—

15 Funds under this section are not intended for use by absti16 nence-only education programs. Abstinence-only education 

17 programs that receive Federal funds through the Maternal 

18 and Child Health Block Grant, the Administration for 

19 Children and Families, the Adolescent Family Life Pro20 gram, and any other program that uses the definition of 

21 ‘abstinence education’ found in section 510(b) of the So22 cial Security Act are ineligible for funding. 

23 ‘‘(g) APPLICATIONS.—Each entity seeking a grant 

24 under this section shall submit an application to the Sec-
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1 retary at such time and in such manner as the Secretary 

2 may require. 

3 ‘‘(h) MATCHING FUNDS.— 

4 ‘‘(1) IN GENERAL.—The Secretary may not 

5 award a grant to an applicant for a program under 

6 this section unless the applicant demonstrates that 

7 it will pay, from funds derived from non-Federal 

8 sources, at least 25 percent of the cost of the pro9 gram. 

10 ‘‘(2) APPLICANT’S SHARE.—The applicant’s 

11 share of the cost of a program shall be provided in 

12 cash or in kind. 

13 ‘‘(i) SUPPLEMENTATION OF FUNDS.—An entity that 

14 receives funds as a grant under this section shall use the 

15 funds to supplement and not supplant funds that would 

16 otherwise be available to the entity for teenage pregnancy 

17 prevention. 

18 ‘‘(j) EVALUATIONS.— 

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

20 ‘‘(A) conduct or provide for a rigorous 

21 evaluation of 10 percent of programs for which 

22 a grant is awarded under this section; 

23 ‘‘(B) collect basic data on each program 

24 for which a grant is awarded under this section; 

25 and 
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1 ‘‘(C) upon completion of the evaluations 

2 referred to in subparagraph (A), submit to the 

3 Congress a report that includes a detailed state4 ment on the effectiveness of grants under this 

5 section. 

6 ‘‘(2) COOPERATION BY GRANTEES.—Each grant 

7 recipient under this section shall provide such infor8 mation and cooperation as may be required for an 

9 evaluation under paragraph (1). 

10 ‘‘(k) DEFINITION.—For purposes of this section, the 

11 term ‘rigorous scientific research’ means based on a pro12 gram evaluation that: 

13 ‘‘(1) Measured impact on sexual or contracep14 tive behavior, pregnancy or childbearing. 

15 ‘‘(2) Employed an experimental or quasi-experi16 mental design with well-constructed and appropriate 

17 comparison groups. 

18 ‘‘(3) Had a sample size large enough (at least 

19 100 in the combined treatment and control group) 

20 and a follow-up interval long enough (at least six 

21 months) to draw valid conclusions about impact. 

22 ‘‘(l) AUTHORIZATION OF APPROPRIATIONS.—There 

23 are authorized to be appropriated to carry out this section 

24 $20,000,000 for fiscal year 2005, and such sums as may 

25 be necessary for each subsequent fiscal year. In addition, 
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1 there are authorized to be appropriated for evaluations 

2 under subsection (j) such sums as may be necessary for 

3 fiscal year 2005 and each subsequent fiscal year.’’.

Æ