I 

108TH CONGRESS 

2D SESSION H. R. 4192 

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 HOUSE OF REPRESENTATIVES 

APRIL 21, 2004 

Ms. SLAUGHTER (for herself, Ms. DEGETTE, Mr. GREENWOOD, Mrs. JOHNSON of Connecticut, Mr. ALLEN, Mr. BAIRD, Ms. BALDWIN, Ms. BERKLEY, Mr. BISHOP of New York, Mr. BLUMENAUER, Mr. BROWN of Ohio, 

Mrs. CAPPS, Mr. CARDIN, Mrs. CHRISTENSEN, Mr. CROWLEY, Mr. DAVIS

of Illinois, Mrs. DAVIS of California, Mr. DEFAZIO, Ms. DELAURO, Mr. 

DOGGETT, Mr. DOOLEY of California, Mr. EMANUEL, Mr. FILNER, Mr. 

FRANK of Massachusetts, Mr. FROST, Mr. GONZALEZ, Mr. GRIJALVA, 

Ms. HARMAN, Mr. HINCHEY, Mr. HOEFFEL, Ms. NORTON, Mr. HOLT, 

Mr. HONDA, Ms. HOOLEY of Oregon, Mr. INSLEE, Mr. ISRAEL, Ms. 

JACKSON-LEE of Texas, Mr. JACKSON of Illinois, Mr. KENNEDY of 

Rhode Island, Ms. KILPATRICK, Mr. LARSEN of Washington, Ms. LEE, 

Ms. LOFGREN, Mrs. LOWEY, Mrs. MALONEY, Ms. MAJETTE, Mrs. 

MCCARTHY of New York, Ms. MCCARTHY of Missouri, Ms. MCCOLLUM, 

Mr. MCDERMOTT, Ms. MILLENDER-MCDONALD, Mr. MORAN of Virginia, 

Mr. NADLER, Mr. OLVER, Ms. PELOSI, Mr. ROTHMAN, Ms. ROYBAL-ALLARD, Ms. LINDA T. SA ́NCHEZ of California, Mr. SANDERS, Ms. 

SCHAKOWSKY, Mr. SCOTT of Virginia, Mr. SERRANO, Mr. SHAYS, Mr. 

SIMMONS, Ms. SOLIS, Mr. TIERNEY, Mrs. JONES of Ohio, Mr. UDALL of 

Colorado, Mr. VAN HOLLEN, Ms. WATERS, Ms. WATSON, Mr. WAXMAN, 

Mr. WEINER, Mr. WEXLER, Ms. WOOLSEY, Mr. WU, and Mr. WYNN) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and 

the Workforce and Ways and Means, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions 

as fall within the jurisdiction of the committee concerned 
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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: 

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. 
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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. 

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 
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1 prevent unintended pregnancy, and half of those 

2 were in need of public support for such care. 

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

4 of infection with sexually transmitted diseases 

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

6 there were approximately 18.9 million new cases of 

7 STDs. 

8 (5) Increasing access to family planning serv9 ices will improve women’s health and reduce the 

10 rates of unintended pregnancy, abortion, and infec11 tion with STDs. Contraceptive use saves public 

12 health dollars: every dollar spent on providing family 

13 planning services saves an estimated $3 in expendi14 tures for pregnancy-related and newborn care for 

15 Medicaid alone. 

16 (6) Contraception is basic health care that im17 proves the health of women and children by enabling 

18 women to plan and space births. 

19 (7) Women experiencing unintended pregnancy 

20 are at greater risks for physical abuse and women 

21 having closely spaced births are at greater risk of 

22 maternal death. 

23 (8) The child born from an unintended preg24 nancy is at greater risk of low birth weight, dying 
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1 in the first year of life, being abused, and not receiv2 ing sufficient resources for healthy development. 

3 (9) The ability to control fertility also allows 

4 couples to achieve economic stability by facilitating 

5 greater educational achievement and participation in 

6 the workforce. 

7 (10) The average American woman desires two 

8 children and spends five years of her life pregnant 

9 or trying to get pregnant and roughly 30 years try10 ing to prevent pregnancy; without contraception, a 

11 sexually active woman has an 85 percent chance of 

12 becoming pregnant within a year. 

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

14 afford to purchase contraceptive services and sup15 plies on their own. 12.1 million or 20 percent of all 

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

17 that proportion has increased by 10 percent since 

18 1999. 

19 (12) Public health programs like Medicaid and 

20 Title X, the national family planning program, pro21 vide high-quality family planning services and other 

22 preventive health care to underinsured or uninsured 

23 individuals who may otherwise lack access to health 

24 care. 
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1 (13) Medicaid is the single largest source of 

2 public funding for family planning services and HIV/ 

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

4 dollars spent on contraceptive services and supplies 

5 in the United States are provided through Medicaid 

6 and approximately 5.5 million women of reproduc7 tive age—nearly one in ten women between the ages 

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

9 health care needs. 

10 (14) Each year, Title X services enable Ameri11 cans to prevent approximately one million unin12 tended pregnancies, and one in three women of re13 productive age who obtains testing or treatment for 

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

15 Title X-funded clinics provided three million Pap 

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

17 (15) The increasing number of uninsured, stag18 nant funding, health care inflation, new and expen19 sive contraceptive technologies, and improved but ex20 pensive screening and treatment for cervical cancer 

21 and STDs, have diminished the ability of Title X 

22 funded clinics to adequately serve all those in need. 

23 Taking inflation into account, funding for the Title 

24 X program declined 57 percent between 1980 and 

25 2003. 
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1 (16) While Medicaid is the largest source of 

2 subsidized family planning services, many States 

3 have had to make significant cuts in their Medicaid 

4 programs due to budget pressures putting many 

5 women at risk of losing coverage for family planning 

6 services. 

7 (17) In addition, eligibility for Medicaid in 

8 many States is severely restricted leaving family 

9 planning services financially out of reach for many 

10 poor women. Many States have demonstrated tre11 mendous success with Medicaid family planning 

12 waivers that allow them to expand access to Med13 icaid family planning services. However, the admin14 istrative burden of applying for a waiver poses a sig15 nificant barrier to States that would like to expand 

16 their Medicaid family planning programs. 

17 (18) Many private health plans still do not 

18 cover contraceptive services and supplies. The lack 

19 of contraceptive coverage in health insurance plans 

20 places many effective forms of contraception beyond 

21 the financial reach of many women. 

22 (19) Including contraceptive coverage in private 

23 health care plans saves employers money: not cov24 ering contraceptives in employee health plans costs 
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1 employers 15 to 17 percent more than providing 

2 such coverage. 

3 (20) Emergency contraception is a safe and ef4 fective way to prevent unintended pregnancy after 

5 unprotected sex. It is estimated that the use of 

6 emergency contraception could cut the number of 

7 unintended pregnancies in half, thereby reducing the 

8 need for abortion. 

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

10 by use of emergency contraception; increased use of 

11 emergency contraception accounted for up to 43 per12 cent of the total decline in abortions between 1994 

13 and 2000. 

14 (22) Access to comprehensive sex education is 

15 critical to reducing rates of unintended pregnancy, 

16 abortion, and STD infection among teens. Over 60 

17 percent of teens have had sex before they graduate 

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

19 before they get married. 822,000 teenagers become 

20 pregnant each year; 35 percent of teen girls become 

21 pregnant at least once before turning 20; and 78 

22 percent of teenage pregnancies are unintended. 

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

24 among people ages 15–24, even though these youth 
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1 make up only a quarter of the sexually active popu2 lation. 

3 (23) The American Medical Association, the 

4 American Nurses Association, the American Acad5 emy of Pediatrics, the American College of Obstetri6 cians and Gynecologists, the American Public Health 

7 Association, and the Society for Adolescent Medi8 cine, support responsible sexuality education that in9 cludes information about both abstinence and con10 traception. 

11 (24) Comprehensive sex education protects ado12 lescent health. A recent survey found that only 15 

13 percent of American parents believe that schools 

14 should just teach about abstinence. 

15 (25) A recent study showed that teens who took 

16 pledges to remain virgins until marriage were just as 

17 likely to contract STDs as teens who did not take 

18 virginity pledges and that although teens taking the 

19 pledges delayed sexual debut, they were less likely to 

20 use condoms once they were sexually active. 

21 (26) Teens who receive sex education that in22 cludes discussion of contraception are more likely 

23 than those who receive abstinence-only messages to 

24 delay sex and to have fewer partners and use contra25 ceptives when they do become sexually active. 
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1 TITLE I—TITLE X OF PUBLIC 

2 HEALTH SERVICE ACT 

3 SEC. 101. SHORT TITLE. 

4 This title may be cited as the ‘‘Title X Family Plan5 ning Services Act of 2004’’. 

6 SEC. 102. AUTHORIZATION OF APPROPRIATIONS. 

7 For the purpose of making grants and contracts 

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

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

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

11 subsequent fiscal year. 

12 TITLE II—FAMILY PLANNING 

13 STATE EMPOWERMENT 

14 SEC. 201. SHORT TITLE. 

15 This title may be cited as the ‘‘Family Planning State 

16 Empowerment Act’’. 

17 SEC. 202. STATE OPTION TO PROVIDE FAMILY PLANNING 

18 SERVICES AND SUPPLIES TO ADDITIONAL 

19 LOW-INCOME INDIVIDUALS. 

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

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

22 (1) by redesignating section 1935 as section 

23 1936; and 

24 (2) by inserting after section 1934 the fol25 lowing: 
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1 ‘‘STATE OPTION TO PROVIDE FAMILY PLANNING SERV2 ICES AND SUPPLIES TO ADDITIONAL LOW-INCOME

3 INDIVIDUALS

4 ‘‘SEC. 1935. 

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

6 State plan amendment) to make medical assistance de7 scribed in section 1905(a)(4)(C) available to any indi8 vidual not otherwise eligible for such assistance— 

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

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

11 exceed the greatest of— 

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

13 poverty line (as defined by the Office of Man14 agement and Budget, and revised annually in 

15 accordance with section 673(2) of the Commu16 nity Services Block Grant Act) applicable to a 

17 family of the size involved; 

18 ‘‘(B) in the case of a State that has in ef19 fect (as of the date of the enactment of this sec20 tion) a waiver under section 1115 to provide 

21 such medical assistance to individuals based on 

22 their income level (expressed as a percent of the 

23 poverty line), the eligibility income level as pro24 vided under such waiver; or 
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1 ‘‘(C) the eligibility income level (expressed 

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

3 specified under the plan (including under sec4 tion 1902(r)(2)), for eligibility of pregnant 

5 women for medical assistance; and 

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

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

8 which level is not more restrictive than the resource 

9 level applicable under the waiver described in para10 graph (1)(B) or to pregnant women under para11 graph (1)(C). 

12 ‘‘(b) FLEXIBILITY.—A State may exercise the au13 thority under subsection (a) with respect to one or more 

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

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

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

17 before paragraph (1)— 

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

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

20 and 

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

22 new clause: 

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

24 only with respect to items and services described in 

25 paragraph (4)(C),’’. 
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1 (c) EFFECTIVE DATE.—The amendments made by 

2 this section apply to medical assistance provided on and 

3 after October 1, 2004. 

4 SEC. 203. STATE OPTION TO EXTEND THE PERIOD OF ELIGI5 BILITY FOR PROVISION OF FAMILY PLAN6 NING SERVICES AND SUPPLIES. 

7 (a) IN GENERAL.—Section 1902(e) of the Social Se8 curity Act (42 U.S.C. 1396a(e)) is amended by adding at 

9 the end the following new paragraph: 

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

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

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

13 but who no longer qualifies for such assistance because 

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

15 expiration of a post-partum period, the individual may re16 main eligible for such assistance for such period as the 

17 State may specify, but the period of extended eligibility 

18 under this paragraph shall not exceed a continuous period 

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

20 previous sentence to one or more classes of individuals and 

21 may vary the period of extended eligibility with respect 

22 to different classes of individuals.’’. 

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

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

25 after October 1, 2004. 
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1 TITLE III—EQUITY IN PRESCRIP2 TION INSURANCE AND CON3 TRACEPTIVE COVERAGE 

4 SEC. 301. SHORT TITLE. 

5 This title may be cited as the ‘‘Equity in Prescription 

6 Insurance and Contraceptive Coverage Act’’. 

7 SEC. 302. AMENDMENTS TO EMPLOYEE RETIREMENT IN8 COME SECURITY ACT OF 1974. 

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

10 B of title I of the Employee Retirement Income Security 

11 Act of 1974 (29 U.S.C. 1185 et seq.) is amended by add12 ing at the end the following: 

13 ‘‘SEC. 714. STANDARDS RELATING TO BENEFITS FOR CON14 TRACEPTIVES. 

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

16 health plan, and a health insurance issuer providing health 

17 insurance coverage in connection with a group health plan, 

18 may not— 

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

20 contraceptive drugs or devices approved by the Food 

21 and Drug Administration, or generic equivalents ap22 proved as substitutable by the Food and Drug Ad23 ministration, if such plan or coverage provides bene24 fits for other outpatient prescription drugs or de25 vices; or 
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1 ‘‘(2) exclude or restrict benefits for outpatient 

2 contraceptive services if such plan or coverage pro3 vides benefits for other outpatient services provided 

4 by a health care professional (referred to in this sec5 tion as ‘outpatient health care services’). 

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

7 health insurance issuer providing health insurance cov8 erage in connection with a group health plan, may not— 

9 ‘‘(1) deny to an individual eligibility, or contin10 ued eligibility, to enroll or to renew coverage under 

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

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

13 that are covered in accordance with the requirements 

14 of this section; 

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

16 a covered individual to encourage such individual to 

17 accept less than the minimum protections available 

18 under this section; 

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

20 reimbursement of a health care professional because 

21 such professional prescribed contraceptive drugs or 

22 devices, or provided contraceptive services, described 

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

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

25 to a health care professional to induce such profes-
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1 sional to withhold from a covered individual contra2 ceptive drugs or devices, or contraceptive services, 

3 described in subsection (a). 

4 ‘‘(c) RULES OF CONSTRUCTION.— 

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

6 shall be construed— 

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

8 and a health insurance issuer providing health 

9 insurance coverage in connection with a group 

10 health plan from imposing deductibles, coinsur11 ance, or other cost-sharing or limitations in re12 lation to— 

13 ‘‘(i) benefits for contraceptive drugs 

14 under the plan or coverage, except that 

15 such a deductible, coinsurance, or other 

16 cost-sharing or limitation for any such 

17 drug shall be consistent with those imposed 

18 for other outpatient prescription drugs oth19 erwise covered under the plan or coverage; 

20 ‘‘(ii) benefits for contraceptive devices 

21 under the plan or coverage, except that 

22 such a deductible, coinsurance, or other 

23 cost-sharing or limitation for any such de24 vice shall be consistent with those imposed 

25 for other outpatient prescription devices 
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1 otherwise covered under the plan or cov2 erage; and 

3 ‘‘(iii) benefits for outpatient contra4 ceptive services under the plan or coverage, 

5 except that such a deductible, coinsurance, 

6 or other cost-sharing or limitation for any 

7 such service shall be consistent with those 

8 imposed for other outpatient health care 

9 services otherwise covered under the plan 

10 or coverage; 

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

12 a health insurance issuer providing health in13 surance coverage in connection with a group 

14 health plan to cover experimental or investiga15 tional contraceptive drugs or devices, or experi16 mental or investigational contraceptive services, 

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

18 that the plan or issuer provides coverage for 

19 other experimental or investigational outpatient 

20 prescription drugs or devices, or experimental 

21 or investigational outpatient health care serv22 ices; or 

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

24 the rights or protections of an individual under 

25 any other Federal law. 
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1 ‘‘(2) LIMITATIONS.—As used in paragraph (1), 

2 the term ‘limitation’ includes— 

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

4 device, restricting the type of health care pro5 fessionals that may prescribe such drugs or de6 vices, utilization review provisions, and limits on 

7 the volume of prescription drugs or devices that 

8 may be obtained on the basis of a single con9 sultation with a professional; or 

10 ‘‘(B) in the case of an outpatient contra11 ceptive service, restricting the type of health 

12 care professionals that may provide such serv13 ices, utilization review provisions, requirements 

14 relating to second opinions prior to the coverage 

15 of such services, and requirements relating to 

16 preauthorizations prior to the coverage of such 

17 services. 

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

19 imposition of the requirements of this section shall be 

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

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

22 notice of such requirements under the plan, except that 

23 the summary description required to be provided under the 

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

25 modification shall be provided by not later than 60 days 
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1 after the first day of the first plan year in which such 

2 requirements apply. 

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

4 construed to preempt any provision of State law to the 

5 extent that such State law establishes, implements, or con6 tinues in effect any standard or requirement that provides 

7 coverage or protections for participants or beneficiaries 

8 that are greater than the coverage or protections provided 

9 under this section. 

10 ‘‘(f) DEFINITION.—In this section, the term ‘out11 patient contraceptive services’ means consultations, exami12 nations, procedures, and medical services, provided on an 

13 outpatient basis and related to the use of contraceptive 

14 methods (including natural family planning) to prevent an 

15 unintended pregnancy.’’. 

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

17 in section 1 of the Employee Retirement Income Security 

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

19 after the item relating to section 713 the following: 

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

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

21 this section shall apply with respect to plan years begin22 ning on or after January 1, 2005. 
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1 SEC. 303. AMENDMENTS TO PUBLIC HEALTH SERVICE ACT 

2 RELATING TO THE GROUP MARKET. 

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

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

5 300gg–4 et seq.) is amended by adding at the end the 

6 following: 

7 ‘‘SEC. 2707. STANDARDS RELATING TO BENEFITS FOR CON8 TRACEPTIVES. 

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

10 health plan, and a health insurance issuer providing health 

11 insurance coverage in connection with a group health plan, 

12 may not— 

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

14 contraceptive drugs or devices approved by the Food 

15 and Drug Administration, or generic equivalents ap16 proved as substitutable by the Food and Drug Ad17 ministration, if such plan or coverage provides bene18 fits for other outpatient prescription drugs or de19 vices; or 

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

21 contraceptive services if such plan or coverage pro22 vides benefits for other outpatient services provided 

23 by a health care professional (referred to in this sec24 tion as ‘outpatient health care services’). 
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1 ‘‘(b) PROHIBITIONS.—A group health plan, and a 

2 health insurance issuer providing health insurance cov3 erage in connection with a group health plan, may not— 

4 ‘‘(1) deny to an individual eligibility, or contin5 ued eligibility, to enroll or to renew coverage under 

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

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

8 that are covered in accordance with the requirements 

9 of this section; 

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

11 a covered individual to encourage such individual to 

12 accept less than the minimum protections available 

13 under this section; 

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

15 reimbursement of a health care professional because 

16 such professional prescribed contraceptive drugs or 

17 devices, or provided contraceptive services, described 

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

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

20 to a health care professional to induce such profes21 sional to withhold from covered individual contracep22 tive drugs or devices, or contraceptive services, de23 scribed in subsection (a). 

24 ‘‘(c) RULES OF CONSTRUCTION.— 
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1 ‘‘(1) IN GENERAL.—Nothing in this section 

2 shall be construed— 

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

4 and a health insurance issuer providing health 

5 insurance coverage in connection with a group 

6 health plan from imposing deductibles, coinsur7 ance, or other cost-sharing or limitations in re8 lation to— 

9 ‘‘(i) benefits for contraceptive drugs 

10 under the plan or coverage, except that 

11 such a deductible, coinsurance, or other 

12 cost-sharing or limitation for any such 

13 drug shall be consistent with those imposed 

14 for other outpatient prescription drugs oth15 erwise covered under the plan or coverage; 

16 ‘‘(ii) benefits for contraceptive devices 

17 under the plan or coverage, except that 

18 such a deductible, coinsurance, or other 

19 cost-sharing or limitation for any such de20 vice shall be consistent with those imposed 

21 for other outpatient prescription devices 

22 otherwise covered under the plan or cov23 erage; and 

24 ‘‘(iii) benefits for outpatient contra25 ceptive services under the plan or coverage, 
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1 except that such a deductible, coinsurance, 

2 or other cost-sharing or limitation for any 

3 such service shall be consistent with those 

4 imposed for other outpatient health care 

5 services otherwise covered under the plan 

6 or coverage; 

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

8 a health insurance issuer providing health in9 surance coverage in connection with a group 

10 health plan to cover experimental or investiga11 tional contraceptive drugs or devices, or experi12 mental or investigational contraceptive services, 

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

14 that the plan or issuer provides coverage for 

15 other experimental or investigational outpatient 

16 prescription drugs or devices, or experimental 

17 or investigational outpatient health care serv18 ices; or 

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

20 the rights or protections of an individual under 

21 any other Federal law. 

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

23 the term ‘limitation’ includes— 

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

25 device, restricting the type of health care pro-
24 

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1 fessionals that may prescribe such drugs or de2 vices, utilization review provisions, and limits on 

3 the volume of prescription drugs or devices that 

4 may be obtained on the basis of a single con5 sultation with a professional; or 

6 ‘‘(B) in the case of an outpatient contra7 ceptive service, restricting the type of health 

8 care professionals that may provide such serv9 ices, utilization review provisions, requirements 

10 relating to second opinions prior to the coverage 

11 of such services, and requirements relating to 

12 preauthorizations prior to the coverage of such 

13 services. 

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

15 shall comply with the notice requirement under section 

16 714(d) of the Employee Retirement Income Security Act 

17 of 1974 with respect to the requirements of this section 

18 as if such section applied to such plan. 

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 enrollees that are greater than 

24 the coverage or protections provided under this section. 
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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) EFFECTIVE DATE.—The amendments made by 

8 this section shall apply with respect to group health plans 

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

10 SEC. 304. AMENDMENT TO PUBLIC HEALTH SERVICE ACT 

11 RELATING TO THE INDIVIDUAL MARKET. 

12 (a) IN GENERAL.—Part B of title XXVII of the Pub13 lic Health Service Act (42 U.S.C. 300gg–41 et seq.) is 

14 amended— 

15 (1) by redesignating the first subpart 3 (relat16 ing to other requirements) as subpart 2; and 

17 (2) by adding at the end of subpart 2 the fol18 lowing: 

19 ‘‘SEC. 2753. STANDARDS RELATING TO BENEFITS FOR CON20 TRACEPTIVES. 

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

22 insurance coverage offered by a health insurance issuer 

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

24 to health insurance coverage offered by a health insurance 
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1 issuer in connection with a group health plan in the small 

2 or large group market.’’. 

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

4 this section shall apply with respect to health insurance 

5 coverage offered, sold, issued, renewed, in effect, or oper6 ated in the individual market on or after January 1, 2005. 

7 TITLE IV—EMERGENCY CONTRA8 CEPTION EDUCATION AND IN9 FORMATION 

10 SEC. 401. SHORT TITLE. 

11 This title may be cited as the ‘‘Emergency Contracep12 tion Education Act’’. 

13 SEC. 402. EMERGENCY CONTRACEPTION EDUCATION AND 

14 INFORMATION PROGRAMS. 

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

16 (1) EMERGENCY CONTRACEPTION.—The term 

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

18 (as the terms are defined in section 201 of the Fed19 eral Food, Drug, and Cosmetic Act (21 U.S.C. 321)) 

20 or a drug regimen that is— 

21 (A) used after sexual relations; and 

22 (B) prevents pregnancy, by preventing ovu23 lation, fertilization of an egg, or implantation of 

24 an egg in a uterus. 
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1 (2) HEALTH CARE PROVIDER.—The term 

2 ‘‘health care provider’’ means an individual who is li3 censed or certified under State law to provide health 

4 care services and who is operating within the scope 

5 of such license. 

6 (3) INSTITUTION OF HIGHER EDUCATION.—The 

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

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

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

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

11 the Secretary of Health and Human Services. 

12 (b) EMERGENCY CONTRACEPTION PUBLIC EDU13 CATION PROGRAM.— 

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

15 through the Director of the Centers for Disease 

16 Control and Prevention, shall develop and dissemi17 nate to the public information on emergency contra18 ception. 

19 (2) DISSEMINATION.—The Secretary may dis20 seminate information under paragraph (1) directly 

21 or through arrangements with nonprofit organiza22 tions, consumer groups, institutions of higher edu23 cation, Federal, State, or local agencies, clinics and 

24 the media. 
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1 (3) INFORMATION.—The information dissemi2 nated under paragraph (1) shall include, at a min3 imum, a description of emergency contraception, and 

4 an explanation of the use, safety, efficacy, and avail5 ability of such contraception. 

6 (c) EMERGENCY CONTRACEPTION INFORMATION

7 PROGRAM FOR HEALTH CARE PROVIDERS.— 

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

9 through the Administrator of the Health Resources 

10 and Services Administration and in consultation 

11 with major medical and public health organizations, 

12 shall develop and disseminate to health care pro13 viders information on emergency contraception. 

14 (2) INFORMATION.—The information dissemi15 nated under paragraph (1) shall include, at a min16 imum— 

17 (A) information describing the use, safety, 

18 efficacy and availability of emergency contra19 ception; 

20 (B) a recommendation regarding the use of 

21 such contraception in appropriate cases; and 

22 (C) information explaining how to obtain 

23 copies of the information developed under sub24 section (b), for distribution to the patients of 

25 the providers. 
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1 (d) AUTHORIZATION OF APPROPRIATIONS.—There is 

2 authorized to be appropriated to carry out this section 

3 $10,000,000 for each of the fiscal years 2005 through 

4 2009. 

5 TITLE V—COMPASSIONATE AS6 SISTANCE FOR RAPE EMER7 GENCIES 

8 SEC. 501. SHORT TITLE. 

9 This title may be cited as the ‘‘Compassionate Assist10 ance for Rape Emergencies Act’’. 

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

12 HOSPITALS OF EMERGENCY CONTRACEP13 TIVES WITHOUT CHARGE. 

14 (a) IN GENERAL.—Federal funds may not be pro15 vided to a hospital under any health-related program, un16 less the hospital meets the conditions specified in sub17 section (b) in the case of— 

18 (1) any woman who presents at the hospital 

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

20 is accompanied by someone who states she is a vic21 tim of sexual assault; and 

22 (2) any woman who presents at the hospital 

23 whom hospital personnel have reason to believe is a 

24 victim of sexual assault. 
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1 (b) ASSISTANCE FOR VICTIMS.—The conditions spec2 ified in this subsection regarding a hospital and a woman 

3 described in subsection (a) are as follows: 

4 (1) The hospital promptly provides the woman 

5 with medically and factually accurate and unbiased 

6 written and oral information about emergency con7 traception, including information explaining that— 

8 (A) emergency contraception does not 

9 cause an abortion; and 

10 (B) emergency contraception is effective in 

11 most cases in preventing pregnancy after un12 protected sex. 

13 (2) The hospital promptly offers emergency 

14 contraception to the woman, and promptly provides 

15 such contraception to her on her request. 

16 (3) The information provided pursuant to para17 graph (1) is in clear and concise language, is readily 

18 comprehensible, and meets such conditions regarding 

19 the provision of the information in languages other 

20 than English as the Secretary may establish. 

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

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

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

24 (c) DEFINITIONS.—For purposes of this section: 
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1 (1) The term ‘‘emergency contraception’’ means 

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

3 (A) used postcoitally; 

4 (B) prevents pregnancy by delaying ovula5 tion, preventing fertilization of an egg, or pre6 venting implantation of an egg in a uterus; and 

7 (C) is approved by the Food and Drug Ad8 ministration. 

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

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

11 including the meaning applicable in such title for 

12 purposes of making payments for emergency services 

13 to hospitals that do not have agreements in effect 

14 under such title. 

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

16 of Health and Human Services. 

17 (4) The term ‘‘sexual assault’’ means coitus in 

18 which the woman involved does not consent or lacks 

19 the legal capacity to consent. 

20 (d) EFFECTIVE DATE; AGENCY CRITERIA.—This sec21 tion takes effect upon the expiration of the 180-day period 

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

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

24 Secretary shall publish in the Federal Register criteria for 

25 carrying out this section. 
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1 TITLE VI—FAMILY LIFE 

2 EDUCATION 

3 SEC. 601. SHORT TITLE. 

4 This title may be cited as the ‘‘Family Life Education 

5 Act’’. 

6 SEC. 602. FINDINGS. 

7 The Congress finds as follows: 

8 (1) The American Medical Association 

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

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

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

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

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

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

15 sexuality education that includes information about 

16 both abstinence and contraception. 

17 (2) Recent scientific reports by the Institute of 

18 Medicine, the American Medical Association and the 

19 Office on National AIDS Policy stress the need for 

20 sexuality education that includes messages about ab21 stinence and provides young people with information 

22 about contraception for the prevention of teen preg23 nancy, HIV/AIDS and other sexually transmitted 

24 diseases (‘‘STDs’’). 
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1 (3) Research shows that teenagers who receive 

2 sexuality education that includes discussion of con3 traception are more likely than those who receive ab4 stinence-only messages to delay sexual activity and 

5 to use contraceptives when they do become sexually 

6 active. 

7 (4) Comprehensive sexuality education pro8 grams respect the diversity of values and beliefs rep9 resented in the community and will complement and 

10 augment the sexuality education children receive 

11 from their families. 

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

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

14 American teens need access to full, complete, and 

15 medically and factually accurate information regard16 ing sexuality, including contraception, STD/HIV 

17 prevention, and abstinence. 

18 (6) Although teen pregnancy rates are decreas19 ing, there are still between 750,000 and 850,000 

20 teen pregnancies each year. Between 75 and 90 per21 cent of teen pregnancies among 15- to 19-year olds 

22 are unintended. 

23 (7) Research shows that 75 percent of the de24 crease in teen pregnancy between 1988 and 1995 
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1 was due to improved contraceptive use, while 25 per2 cent was due to increased abstinence. 

3 (8) More than eight out of ten Americans be4 lieve that young people should have information 

5 about abstinence and protecting themselves from un6 planned pregnancies and sexually transmitted dis7 eases. 

8 (9) United States teens acquire an estimated 

9 4,000,000 sexually transmitted infections each year. 

10 By age 24, at least one in three sexually active peo11 ple will have contracted a sexually transmitted dis12 ease. 

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

14 United States are infected with HIV every hour of 

15 every day. African Americans and Hispanic youth 

16 have been disproportionately affected by the HIV/ 

17 AIDS epidemic. Although less than 16 percent of 

18 the adolescent population in the United States is Af19 rican American, nearly 50 percent of AIDS cases 

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

21 among Blacks. Hispanics comprise 13 percent of the 

22 population and 20 percent of the reported adolescent 

23 AIDS cases though June 2000. 
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1 SEC. 603. ASSISTANCE TO REDUCE TEEN PREGNANCY, HIV/ 

2 AIDS, AND OTHER SEXUALLY TRANSMITTED 

3 DISEASES AND TO SUPPORT HEALTHY ADO4 LESCENT DEVELOPMENT. 

5 (a) IN GENERAL.—Each eligible State shall be enti6 tled to receive from the Secretary of Health and Human 

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

8 a grant to conduct programs of family life education, in9 cluding education on both abstinence and contraception 

10 for the prevention of teenage pregnancy and sexually 

11 transmitted diseases, including HIV/AIDS. 

12 (b) REQUIREMENTS FOR FAMILY LIFE PROGRAMS.— 

13 For purposes of this title, a program of family life edu14 cation is a program that— 

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

16 (2) does not teach or promote religion; 

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

18 to avoid pregnancy or sexually transmitted diseases; 

19 (4) stresses the value of abstinence while not ig20 noring those young people who have had or are hav21 ing sexual intercourse; 

22 (5) provides information about the health bene23 fits and side effects of all contraceptives and barrier 

24 methods as a means to prevent pregnancy; 

25 (6) provides information about the health bene26 fits and side effects of all contraceptives and barrier 
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1 methods as a means to reduce the risk of con2 tracting sexually transmitted diseases, including 

3 HIV/AIDS; 

4 (7) encourages family communication about 

5 sexuality between parent and child; 

6 (8) teaches young people the skills to make re7 sponsible decisions about sexuality, including how to 

8 avoid unwanted verbal, physical, and sexual ad9 vances and how not to make unwanted verbal, phys10 ical, and sexual advances; and 

11 (9) teaches young people how alcohol and drug 

12 use can affect responsible decisionmaking. 

13 (c) ADDITIONAL ACTIVITIES.—In carrying out a pro14 gram of family life education, a State may expend a grant 

15 under subsection (a) to carry out educational and motiva16 tional activities that help young people— 

17 (1) gain knowledge about the physical, emo18 tional, biological, and hormonal changes of adoles19 cence and subsequent stages of human maturation; 

20 (2) develop the knowledge and skills necessary 

21 to ensure and protect their sexual and reproductive 

22 health from unintended pregnancy and sexually 

23 transmitted disease, including HIV/AIDS through24 out their lifespan; 
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1 (3) gain knowledge about the specific involve2 ment of and male responsibility in sexual decision3 making; 

4 (4) develop healthy attitudes and values about 

5 adolescent growth and development, body image, 

6 gender roles, racial and ethnic diversity, sexual ori7 entation, and other subjects; 

8 (5) develop and practice healthy life skills in9 cluding goal-setting, decisionmaking, negotiation, 

10 communication, and stress management; 

11 (6) promote self-esteem and positive inter12 personal skills focusing on relationship dynamics, in13 cluding, but not limited to, friendships, dating, ro14 mantic involvement, marriage and family inter15 actions; and 

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

17 educational and career success, including developing 

18 skills for employment preparation, job seeking, inde19 pendent living, financial self-sufficiency, and work20 place productivity. 

21 SEC. 604. SENSE OF CONGRESS. 

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

23 required to provide matching funds, they are encouraged 

24 to do so. 
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1 SEC. 605. EVALUATION OF PROGRAMS. 

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

3 effectiveness of programs of family life education carried 

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

5 program shall be carried out in accordance with sub6 sections (b) and (c). 

7 (b) NATIONAL EVALUATION.— 

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

9 for a national evaluation of a representative sample 

10 of programs of family life education carried out with 

11 grants under section 603. A condition for the receipt 

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

13 cooperate with the evaluation. The purposes of the 

14 national evaluation shall be the determination of— 

15 (A) the effectiveness of such programs in 

16 helping to delay the initiation of sexual inter17 course and other high-risk behaviors; 

18 (B) the effectiveness of such programs in 

19 preventing adolescent pregnancy; 

20 (C) the effectiveness of such programs in 

21 preventing sexually transmitted disease, includ22 ing HIV/AIDS; 

23 (D) the effectiveness of such programs in 

24 increasing contraceptive knowledge and contra25 ceptive behaviors when sexual intercourse oc26 curs; and 
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1 (E) a list of best practices based upon es2 sential programmatic components of evaluated 

3 programs that have led to success in subpara4 graphs (A) through (D). 

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

6 the national evaluation under paragraph (1) shall be 

7 submitted to the Congress not later than March 31, 

8 2008, with an interim report provided on a yearly 

9 basis at the end of each fiscal year. 

10 (c) INDIVIDUAL STATE EVALUATIONS.— 

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

12 of a grant under section 603 is that the State in13 volved agree to provide for the evaluation of the pro14 grams of family education carried out with the grant 

15 in accordance with the following: 

16 (A) The evaluation will be conducted by an 

17 external, independent entity. 

18 (B) The purposes of the evaluation will be 

19 the determination of— 

20 (i) the effectiveness of such programs 

21 in helping to delay the initiation of sexual 

22 intercourse and other high-risk behaviors; 

23 (ii) the effectiveness of such programs 

24 in preventing adolescent pregnancy; 
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1 (iii) the effectiveness of such pro2 grams in preventing sexually transmitted 

3 disease, including HIV/AIDS; and 

4 (iv) the effectiveness of such programs 

5 in increasing contraceptive knowledge and 

6 contraceptive behaviors when sexual inter7 course occurs. 

8 (2) USE OF GRANT.—A condition for the re9 ceipt of a grant under section 603 is that the State 

10 involved agree that not more than 10 percent of the 

11 grant will be expended for the evaluation under 

12 paragraph (1). 

13 SEC. 606. DEFINITIONS. 

14 For purposes of this title: 

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

16 that submits to the Secretary an application for a 

17 grant under section 603 that is in such form, is 

18 made in such manner, and contains such agree19 ments, assurances, and information as the Secretary 

20 determines to be necessary to carry out this title. 

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

22 immunodeficiency virus, and includes acquired im23 mune deficiency syndrome. 

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

25 to information, means information that is supported 
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1 by research, recognized as accurate and objective by 

2 leading medical, psychological, psychiatric, and pub3 lic health organizations and agencies, and where rel4 evant, published in peer review journals. 

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

6 of Health and Human Services. 

7 SEC. 607. APPROPRIATIONS. 

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

9 this title, there is authorized to be appropriated 

10 $100,000,000 for each of the fiscal years 2005 through 

11 2009. 

12 (b) ALLOCATIONS.—Of the amounts appropriated 

13 under subsection (a) for a fiscal year— 

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

15 the administrative expenses of the Secretary in car16 rying out this title for that fiscal year; and 

17 (2) not more than 10 percent may be used for 

18 the national evaluation under section 605(b). 

19 TITLE VII—TEENAGE 

20 PREGNANCY PREVENTION 

21 SEC. 701. SHORT TITLE. 

22 This title may be cited as the ‘‘Preventing Teen Preg23 nancy Act’’. 
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1 SEC. 702. TEENAGE PREGNANCY PREVENTION. 

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

3 (42 U.S.C. 280g et seq.) is amended by inserting after 

4 section 399N the following section: 

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

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

7 competitive basis grants to public and private entities to 

8 establish or expand teenage pregnancy prevention pro9 grams. 

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

11 this section may include State and local not-for-profit coa12 litions working to prevent teenage pregnancy, State, local, 

13 and tribal agencies, schools, entities that provide after14 school programs, and community and faith-based groups. 

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

16 this section, the Secretary shall give— 

17 ‘‘(1) highest priority to applicants seeking as18 sistance for programs targeting communities or pop19 ulations in which— 

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

21 higher than the corresponding State average; or 

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

23 increasing; and 

24 ‘‘(2) priority to applicants seeking assistance 

25 for programs that— 
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1 ‘‘(A) will benefit underserved or at-risk 

2 populations such as young males or immigrant 

3 youths; or 

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

5 resources and be coordinated with other pro6 grams that serve youth, such as workforce de7 velopment and after school programs. 

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

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

10 that— 

11 ‘‘(1) replicate or substantially incorporate the 

12 elements of one or more teenage pregnancy preven13 tion programs that have been proven (on the basis 

14 of rigorous scientific research) to delay sexual inter15 course or sexual activity, increase condom or contra16 ceptive use (without increasing sexual activity), or 

17 reduce teenage pregnancy; and 

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

19 strategies for preventing teenage pregnancy: encour20 aging teenagers to delay sexual activity; sex and 

21 HIV education; interventions for sexually active 

22 teenagers; preventive health services; youth develop23 ment programs; service learning programs; and out24 reach or media programs. 
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1 ‘‘(e) COMPLETE INFORMATION.—Programs receiving 

2 funds under this section that choose to provide informa3 tion on HIV/AIDS or contraception or both must provide 

4 information that is complete and medically accurate. 

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

6 Funds under this section are not intended for use by absti7 nence-only education programs. Abstinence-only education 

8 programs that receive Federal funds through the Maternal 

9 and Child Health Block Grant, the Administration for 

10 Children and Families, the Adolescent Family Life Pro11 gram, and any other program that uses the definition of 

12 ‘abstinence education’ found in section 510(b) of the So13 cial Security Act are ineligible for funding. 

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

15 under this section shall submit an application to the Sec16 retary at such time and in such manner as the Secretary 

17 may require. 

18 ‘‘(h) MATCHING FUNDS.— 

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

20 award a grant to an applicant for a program under 

21 this section unless the applicant demonstrates that 

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

23 sources, at least 25 percent of the cost of the pro24 gram. 
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1 ‘‘(2) APPLICANT’S SHARE.—The applicant’s 

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

3 cash or in kind. 

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

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

6 funds to supplement and not supplant funds that would 

7 otherwise be available to the entity for teenage pregnancy 

8 prevention. 

9 ‘‘(j) EVALUATIONS.— 

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

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

12 evaluation of 10 percent of programs for which 

13 a grant is awarded under this section; 

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

15 for which a grant is awarded under this section; 

16 and 

17 ‘‘(C) upon completion of the evaluations 

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

19 Congress a report that includes a detailed state20 ment on the effectiveness of grants under this 

21 section. 

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

23 recipient under this section shall provide such infor24 mation and cooperation as may be required for an 

25 evaluation under paragraph (1). 
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1 ‘‘(k) DEFINITION.—For purposes of this section, the 

2 term ‘rigorous scientific research’ means based on a pro3 gram evaluation that: 

4 ‘‘(1) Measured impact on sexual or contracep5 tive behavior, pregnancy or childbearing. 

6 ‘‘(2) Employed an experimental or quasi-experi7 mental design with well-constructed and appropriate 

8 comparison groups. 

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

10 100 in the combined treatment and control group) 

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

12 months) to draw valid conclusions about impact. 

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

14 are authorized to be appropriated to carry out this section 

15 $20,000,000 for fiscal year 2005, and such sums as may 

16 be necessary for each subsequent fiscal year. In addition, 

17 there are authorized to be appropriated for evaluations 

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

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

Æ