[Congressional Bills 111th Congress]
[From the U.S. Government Publishing Office]
[S. 611 Introduced in Senate (IS)]
111th CONGRESS
1st Session
S. 611
To provide for the reduction of adolescent pregnancy, HIV rates, and
other sexually transmitted diseases, and for other purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
March 17, 2009
Mr. Lautenberg (for himself, Mr. Kerry, Mr. Durbin, Mr. Menendez, Mr.
Brown, and Mr. Kennedy) introduced the following bill; which was read
twice and referred to the Committee on Health, Education, Labor, and
Pensions
_______________________________________________________________________
A BILL
To provide for the reduction of adolescent pregnancy, HIV rates, and
other sexually transmitted diseases, and for other purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Responsible Education About Life
Act''.
SEC. 2. FINDINGS.
The Congress finds as follows:
(1) Leading public health and medical professional
organizations, including the American Medical Association
(``AMA''), the American Medical Student Association (``AMSA''),
the American Nurses Association (``ANA''), the American Academy
of Pediatrics (``AAP''), the American College of Obstetricians
and Gynecologists (``ACOG''), the American Public Health
Association (``APHA''), the Institute of Medicine (``IOM'') and
the Society of Adolescent Medicine (``SAM''), stress the need
for sex education that includes messages about abstinence and
provides young people with information about contraception for
the prevention of teen pregnancy, HIV/AIDS, and other sexually
transmitted diseases (``STDs'').
(2) A 2005 statement from the APHA urged that ``The U.S.
Congress should authorize and fully fund legislation that
promotes comprehensive sexuality education programs which
include information about both abstinence and contraception,
include parent-child communications components; and teach goal-
setting, decision-making, negotiation, and communication
skills'' and that ``sexual health information disseminated by
federal agencies, be medically and scientifically accurate and
based on theories and strategies with demonstrated evidence of
effectiveness.'' In a 2006 statement, APHA reiterated that it
``has strongly supported comprehensive sexuality education that
includes information about concepts of healthy sexuality,
sexual orientation and tolerance, personal responsibility,
risks of HIV/AIDS and other STDs and unwanted pregnancy, access
to reproductive health care, and benefits and risks of condoms
and other contraceptive methods. Sexuality education should be
non-judgmental and support parent-child communication and
should not impose religious or ideological viewpoints upon
students.''.
(3) The SAM stated in a 2006 position paper that ``SAM
supports a comprehensive approach to sexual risk reduction
including abstinence as well as correct and consistent use of
condoms and contraception among teens who choose to be sexually
active.'' In addition, ``Efforts to promote abstinence should
be provided within health education programs that provide
adolescents with complete and accurate information about sexual
health, including information about concepts of healthy
sexuality, sexual orientation and tolerance, personal
responsibility, risks of HIV and other STDs and unwanted
pregnancy, access to reproductive health care, and benefits and
risks of condoms and other contraceptive methods.''.
(4) Most Americans believe that sex education should
promote abstinence and provide information about the
effectiveness and benefits of contraception. According to the
results of a 2005-2006 nationally representative survey of U.S.
adults, more than 8 in 10 of those polled support comprehensive
sex education.
(5) There is strong evidence that more comprehensive sex
education can effectively help young people delay sexual
initiation, even as it increases contraceptive use among
sexually active youth. According to a report published by the
National Campaign to Prevent Teen and Unplanned Pregnancy,
``two-thirds of the 48 comprehensive programs that supported
both abstinence and the use of condoms and contraceptives for
sexually active teens had positive behavioral effects''. Many
either delayed or reduced sexual activity, reduced the number
of sexual partners, or increased condom or contraceptive use.
(6) There is no evidence that federally funded abstinence-
only-until-marriage programs are effective in stopping or
delaying teen sex. A recent, congressionally mandated
evaluation of federally funded abstinence-only programs by
Mathematica Policy Research found that these programs have no
beneficial impact on whether young people abstain, when they
first have sex, or their number of sexual partners.
(7) Comprehensive sexuality education programs respect the
diversity of values and beliefs represented in the community
and will complement and augment the sexuality education
children receive from their families and faith communities.
(8) The median age at first intercourse is 16.9 years for
boys and 17.4 years for girls. However, most do not marry until
their middle or late 20s. This means that young adults are at
risk of unwanted pregnancy and STDs for nearly a decade.
Therefore, teens need access to full, complete, and medically
and factually accurate information regarding sexuality,
including contraception, condoms, STD/HIV prevention, and
abstinence.
(9) From the early 1990s through the early 2000s, teen
pregnancy and birth rates in the United States all declined
dramatically--primarily, but not exclusively, because of
increased and more effective contraceptive use among sexually
active teens. These declines have since stalled, however, and
new data from the Centers for Disease Control and Prevention's
National Center for Health Statistics (``NCHS'') indicate that
teen birthrates are on the rise. NCHS reports a 3-percent
national increase between 2005 and 2006 (from 40.5 to 41.9
births per 1,000 females aged 15-19).
(10) Teen pregnancy rates are much higher in the United
States than in many other developed countries--twice as high as
in England and Wales or Canada, and eight times as high as in
the Netherlands or Japan.
(11) The decline in the teen birthrate between 1991 and
2004 resulted in saving taxpayers $6,700,000,000 in associated
health care, child welfare, and other such costs in 2004 alone,
reducing the cost to taxpayers. Investing in effective programs
that improve teen sexual behavior by delaying sexual activity,
improving contraceptive use among teens, and reducing teen
pregnancies would contribute to reducing the taxpayer costs
associated with teen childbearing.
(12) Ethnic and racial minority groups have been
disproportionately affected by early pregnancy and parenthood.
Fifty-three percent of Latina teens and 51 percent of African-
American young women will become pregnant at least once before
they turn 20, as compared to only 19 percent of non-Hispanic
White young women.
(13) The United States has one of the highest rates of
sexually transmitted diseases among industrialized nations.
There are approximately 19,000,000 new cases of sexually
transmitted diseases each year, almost half of them occurring
in young people ages 15 to 24. According to the Centers for
Disease Control and Prevention, these sexually transmitted
diseases impose a tremendous economic burden with direct
medical costs as high as $14,100,000,000 per year.
(14) Recent estimates suggest that while 15- to 24-year-
olds represent 25 percent of the sexually active population,
they acquire nearly half of all new STDs. Each year, one in
four sexually active teenagers contracts a sexually transmitted
disease.
(15) Nearly 15 percent of the 56,000 annual new cases of
HIV infections in the United States occurred in youth ages 13
through 24 in 2006. An average of one young person every hour
of every day is infected with HIV in the United States.
(16) African-American and Latino youth have been
disproportionately affected by the HIV/AIDS epidemic. Although
African-American adolescents ages 13 through 19 represent only
17 percent of the adolescent population in the United States,
they accounted for 70 percent of new HIV/AIDS cases reported
among teens in 2005. Latino adolescents ages 13 through 19
accounted for 17 percent of AIDS cases among teens, the same as
their proportion of the U.S. population in 2005. Although
Latinos ages 20 through 24 represent only 18 percent of the
young adults in the United States, they accounted for 22
percent of the new AIDS cases in 2005.
(17) Another study found that teens who reported previous
discussions of sexuality with parents were seven times more
likely to feel able to communicate with a partner about HIV/
AIDS than those who did not have such discussions with their
parents. Parental involvement is also a leading protective
factor for dating violence prevention.
(18) Incorporating teen dating violence prevention into
health education and sexuality education is imperative given
the widespread experience of violence in dating relationships.
Approximately one in three teens reports some kind of abuse in
a romantic relationship, including emotional and verbal abuse.
Young women who experience dating violence have sex earlier
than their peers; are much less likely to use birth control;
and engage in a wide variety of high-risk behaviors including
multiple partners, sex with older men, and drug and alcohol
abuse. Young women who are victims of dating violence are four
to six times more likely than nonabused girls to become
pregnant.
SEC. 3. ASSISTANCE TO REDUCE TEEN PREGNANCY, HIV/AIDS, AND OTHER
SEXUALLY TRANSMITTED DISEASES AND TO SUPPORT HEALTHY
ADOLESCENT DEVELOPMENT.
(a) In General.--The Secretary of Health and Human Services may
award a grant to each eligible State, for each of the fiscal years 2010
through 2014, to conduct programs of sex education described in
subsection (b), including education on both abstinence and
contraception for the prevention of teenage pregnancy and sexually
transmitted diseases, including HIV/AIDS.
(b) Requirements for Sex Education Programs.--A program of sex
education described in this subsection is a program that--
(1) is age appropriate and medically accurate;
(2) stresses the value of abstinence while not ignoring
those young people who have had or are having sexual
intercourse;
(3) provides information about the health benefits and side
effects of all contraceptive and barrier methods used--
(A) as a means to prevent pregnancy; and
(B) to reduce the risk of contracting sexually
transmitted disease, including HIV/AIDS;
(4) encourages family communication between parent and
child about sexuality;
(5) teaches young people the skills to make responsible
decisions about sexuality, including how to avoid unwanted
verbal, physical, and sexual advances and how to avoid making
verbal, physical, and sexual advances that are not wanted by
the other party;
(6) develops healthy relationships, including the
prevention of dating and sexual violence;
(7) teaches young people how alcohol and drug use can
affect responsible decisionmaking; and
(8) does not teach or promote religion.
(c) Additional Activities.--In carrying out a program of sex
education, a State may expend funds received under this section to
carry out educational and motivational activities that help young
people to--
(1) gain knowledge about the physical, emotional,
biological, and hormonal changes of adolescence and subsequent
stages of human maturation;
(2) develop the knowledge and skills necessary to ensure
and protect their sexual and reproductive health from
unintended pregnancy and sexually transmitted disease,
including HIV/AIDS, throughout their lifespan;
(3) gain knowledge about the specific involvement and
responsibility of each individual in sexual decisionmaking;
(4) develop healthy attitudes and values about adolescent
growth and development, body image, gender roles, racial and
ethnic diversity, sexual orientation, and other subjects;
(5) develop and practice healthy life skills including
goal-setting, decisionmaking, negotiation, communication, and
stress management;
(6) promote self-esteem and positive interpersonal skills
focusing on relationship dynamics, including, but not limited
to, friendships, dating, romantic involvement, marriage, and
family interactions; and
(7) prepare for the adult world by focusing on educational
and career success, including developing skills for employment
preparation, job seeking, independent living, financial self-
sufficiency, and workplace productivity.
SEC. 4. SENSE OF CONGRESS.
It is the sense of Congress that, although States are not required
to provide matching funds to receive a grant under this Act, they are
encouraged to do so.
SEC. 5. EVALUATION OF PROGRAMS.
(a) In General.--For the purpose of evaluating the effectiveness of
programs of sex education carried out with a grant under section 3,
evaluations shall be carried out in accordance with subsections (b) and
(c).
(b) National Evaluation.--
(1) In general.--The Secretary shall provide for a national
evaluation of a representative sample of programs of sex
education carried out with grants under section 3.
(2) Purposes.--The purpose of the national evaluation under
paragraph (1) shall be the determination of--
(A) the effectiveness of such programs in helping
to delay the initiation of sexual intercourse and other
high-risk behaviors;
(B) the effectiveness of such programs in
preventing adolescent pregnancy;
(C) the effectiveness of such programs in
preventing sexually transmitted disease, including HIV/
AIDS;
(D) the effectiveness of such programs in
increasing contraceptive knowledge and contraceptive
behaviors when sexual intercourse occurs; and
(E) a list of best practices based upon essential
programmatic components of evaluated programs that have
led to success described in subparagraphs (A) through
(D).
(3) Grant condition.--A condition for the receipt of a
grant under section 3 is that the State involved agree to
cooperate with the evaluation under paragraph (1).
(4) Report.--The Secretary shall submit to the Congress--
(A) not later than the end of each of fiscal years
2010 through 2013, an interim report on the national
evaluation under paragraph (1); and
(B) not later than March 31, 2015, a final report
providing the results of such national evaluation.
(c) Individual State Evaluations.--
(1) In general.--A condition for the receipt of a grant
under section 3 is that the State involved agree to provide for
the evaluation of the programs of sex education carried out
with the grant in accordance with the following:
(A) The evaluation will be conducted by an
external, independent entity.
(B) The purposes of the evaluation will be the
determination of--
(i) the effectiveness of such programs in
helping to delay the initiation of sexual
intercourse and other high-risk behaviors;
(ii) the effectiveness of such programs in
preventing adolescent pregnancy;
(iii) the effectiveness of such programs in
preventing sexually transmitted disease,
including HIV/AIDS; and
(iv) the effectiveness of such programs in
increasing contraceptive knowledge and
contraceptive behaviors when sexual intercourse
occurs.
(2) Limitation.--A condition for the receipt of grant funds
under section 3 is that the State involved agree that not more
than 10 percent of such funds will be expended for evaluation
under paragraph (1).
SEC. 6. NONDISCRIMINATION CLAUSE.
Programs funded under section 3 shall not discriminate on the basis
of sex, race, ethnicity, national origin, disability, religion, sexual
orientation, or gender identity. Nothing in this Act shall be construed
to invalidate or limit rights, remedies, procedures, or legal standards
available to victims of discrimination under any other Federal law or
any law of a State or a political subdivision of a State, including
title VI of the Civil Rights Act of 1964 (42 U.S.C. 2000d et seq.),
title IX of the Education Amendments of 1972 (20 U.S.C. 1681 et seq.),
section 504 of the Rehabilitation Act of 1973 (29 U.S.C. 794), and the
Americans with Disabilities Act of 1990 (42 U.S.C. 12101 et seq.).
SEC. 7. DEFINITIONS.
For purposes of this Act:
(1) The term ``age appropriate'' means, with respect to
topics, messages, and teaching methods, those suitable to
particular ages or age groups of children and adolescents,
based on developing cognitive, emotional, and behavioral
capacity typical for the age or age group.
(2) The term ``eligible State'' means a State that submits
to the Secretary an application for a grant under section 3
that is in such form, is made in such manner, and contains such
agreements, assurances, and information as the Secretary
determines to be necessary to carry out this Act.
(3) The term ``HIV/AIDS'' means the human immunodeficiency
virus, and includes acquired immune deficiency syndrome.
(4) The term ``medically accurate'', with respect to
information, means information that is supported by research,
recognized as accurate and objective by leading medical,
psychological, psychiatric, and public health organizations and
agencies, and, where relevant, published in peer review
journals.
(5) The term ``Secretary'' means the Secretary of Health
and Human Services.
(6) The term ``State'' means the 50 States, the District of
Columbia, the Commonwealth of Puerto Rico, the Commonwealth of
the Northern Mariana Islands, American Samoa, Guam, the Virgin
Islands, and any other territory or possession of the United
States.
SEC. 8. AUTHORIZATION OF APPROPRIATIONS.
(a) In General.--For the purpose of carrying out this Act, there is
authorized to be appropriated $50,000,000 for each of the fiscal years
2010 through 2014.
(b) Limitation.--Of the amounts appropriated to carry out this Act
for a fiscal year, the Secretary may not use more than--
(1) 7 percent of such amounts for administrative expenses
related to carrying out this Act for that fiscal year; and
(2) 10 percent of such amounts for the national evaluation
under section 5(b).
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