To provide for the reduction of adolescent pregnancy, HIV rates, and other sexually transmitted diseases, and for other purposes.

Ms. LEE (for herself, Mr. GREENWOOD, and Ms. WOOLSEY) introduced the following bill; which was referred to the Committee on Energy and Commerce

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 `Family Life Education Act'.

SEC. 2. FINDINGS.

The Congress finds as follows:

• (1) The American Medical Association (`AMA'), 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'), and the Society of Adolescent Medicine (`SAM'), support responsible sexuality education that includes information about both abstinence and contraception.
  
• (2) Recent scientific reports by the Institute of Medicine, the American Medical Association and the Office on National AIDS Policy stress the need for sexuality education that includes messages about abstinence and provides young people with information about contraception for the prevention of teen pregnancy, HIV/AIDS and other sexually transmitted diseases (`STDs').
  
• (3) Research shows that teenagers who receive sexuality education that includes discussion of contraception are more likely than those who receive abstinence-only messages to delay sexual activity and to use contraceptives when they do become sexually active.
  
• (4) 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.
  
• (5) The median age of puberty is 13 years and the average age of marriage is nearly 26 years old. American teens need access to full, complete, and medically and factually accurate information regarding sexuality, including contraception, STD/HIV prevention, and abstinence.
  
• (6) Although teen pregnancy rates are decreasing, there are still nearly 900,000 teen pregnancies each year. Nearly 80 percent of teen pregnancies among 15- to 19-year olds are unintended.
  
• (7) Research shows that 75 percent of the decrease in teen pregnancy between 1988 and 1995 was due to improved contraceptive use, while 25 percent was due to increased abstinence.
  
• (8) More than eight out of ten Americans believe that young people should have information about protecting themselves from unplanned pregnancies and sexually transmitted diseases.
  
• (9) United States teens acquire an estimated 4,000,000 sexually transmitted infections each year. By age 24, at least one in three sexually active people will have contracted a sexually transmitted disease.
  
• (10) An average of two young people in the United States are infected with HIV every hour of every day. African Americans and Hispanic youth have been disproportionately affected by the HIV/AIDS epidemic. Although less than 16 percent of the adolescent population in the United States is African American, nearly 50 percent of AIDS cases through June 2000 among 13- to 19-year olds were among Blacks. Hispanics comprise 13 percent of the population and 20 percent of the reported adolescent AIDS cases though June 2000.
  

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

(a) IN GENERAL- Each eligible State shall be entitled to receive from the Secretary of Health and Human Services, for each of the fiscal years 2003 through 2007, a grant to conduct programs of family life education, including education on both abstinence and contraception for the prevention of teenage pregnancy and sexually transmitted diseases, including HIV/AIDS.

(b) REQUIREMENTS FOR FAMILY LIFE PROGRAMS- For purposes of this Act, a program of family life education is a program that--

• (1) is age-appropriate and medically accurate;
  
• (2) does not teach or promote religion;
  
• (3) teaches that abstinence is the only sure way to avoid pregnancy or sexually transmitted diseases;
  
• (4) stresses the value of abstinence while not ignoring those young people who have had or are having sexual intercourse;
  
• (5) provides information about the health benefits and side effects of all contraceptives and barrier methods as a means to prevent pregnancy;
  
• (6) provides information about the health benefits and side effects of all contraceptives and barrier methods as a means to reduce the risk of contracting sexually transmitted diseases, including HIV/AIDS;
  
• (7) encourages family communication about sexuality between parent and child;
  
• (8) teaches young people the skills to make responsible decisions about sexuality, including how to avoid unwanted verbal, physical, and sexual advances and how not to make unwanted verbal, physical, and sexual advances; and
  
• (9) teaches young people how alcohol and drug use can effect responsible decisionmaking.
  

(c) ADDITIONAL ACTIVITIES- In carrying out a program of family life education, a State may expend a grant under subsection (a) to carry out educational and motivational activities that help young people--

• (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 of and male responsibility 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 while States are not required to provide matching funds, they are encouraged to do so.

SEC. 5. EVALUATION OF PROGRAMS.

(a) IN GENERAL- For the purpose of evaluating the effectiveness of programs of family life education carried out with a grant under section 3, evaluations of such program 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 family life education carried out with grants under section 3. A condition for the receipt of such a grant is that the State involved agree to cooperate with the evaluation. The purposes of the national evaluation 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 in subparagraphs (A) through (D).
    
• (2) REPORT- A report providing the results of the national evaluation under paragraph (1) shall be submitted to the Congress not later than March 31, 2008, with an interim report provided on a yearly basis at the end of each fiscal year.
  

(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 family 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) USE OF GRANT- A condition for the receipt of a grant under section 3 is that the State involved agree that not more than 10 percent of the grant will be expended for the evaluation under paragraph (1).
  

SEC. 6. DEFINITIONS.

For purposes of this Act:

(1) 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.

(2) The term `HIV/AIDS' means the human immunodeficiency virus, and includes acquired immune deficiency syndrome.

(3) 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.

(4) The term `Secretary' means the Secretary of Health and Human Services.

SEC. 7. APPROPRIATIONS.

(a) IN GENERAL- For the purpose of carrying out this Act, there is authorized to be appropriated $100,000,000 for each of the fiscal years 2002 through 2006.

(b) ALLOCATIONS- Of the amounts appropriated under subsection (a) for a fiscal year--

• (1) not more than 7 percent may be used for the administrative expenses of the Secretary in carrying out this Act for that fiscal year; and
  
• (2) not more than 10 percent may be used for the national evaluation under section 5(b).
  

The Family Life Education Act, H.R. 3469 in the 107th Congress, would provide $100 million per year to allow states to implement a comprehensive approach to sexuality education in the schools that includes information about both abstinence and contraception. The bipartisan bill had 89 co-sponsors in the House of Representatives in the 107th Congress, and will be re-introduced in the 108th Congress.

What Does the Family Life Education Act Do?
The bill would make available to states $100 million per year in federal funds for comprehensive sexuality education that includes information about both abstinence and contraception.

Why is the Family Life Education Act Needed?
More than half of all new HIV infections in this country occur in young people under the age of 25 and the rate of sexually transmitted diseases (STDs) continues to grow among young people in the U.S. with teens acquiring more than four million STDs every year. In spite of recent decreases, teen pregnancy and birth rates in the U.S. are some of the highest in the industrialized world. Each year in the U.S., there are still nearly 900,000 teen pregnancies, nearly 80% of which are unintended.

Teens who receive sexuality education that includes information about contraception are more likely than those who receive abstinence-only-until-marriage messages to delay sexual activity and to use contraceptives when they do become sexually active. Comprehensive sexuality education programs do not encourage teens to start having sexual intercourse, increase the frequency of intercourse, or increase the number of sexual partners.

Background
No federal funding currently exists for comprehensive sexuality education. However, there are three separate federal programs that support abstinence-only-until-marriage programs, for a total federal investment of more than $120 million each year for these programs.

1. Title V of the 1996 welfare reform law established a program that provides $50 million per year for abstinence-only-until-marriage programs. To receive federal funds, states must provide a three to four dollar match. Every state but California accepts this federal money.
   
2. The Adolescent Family Life Act (Title XX of the Public Health Service Act) provides $12 million per year for abstinence-only-until-marriage programs.
   
3. The Maternal and Child Health Block Grant’s Special Projects of Regional and National Significance—Community Based Abstinence Education (SPRANS-CBAE) program provides $55 million in FY03 through HHS for abstinence-only-until-marriage programs.
   

Programs receiving federal funds for abstinence-only-until-marriage programs are prohibited from discussing contraceptives except in the context of failure rates. Congress continues to fund these programs despite research that shows that programs teaching abstinence plus contraception are more effective than abstinence-only-until-marriage programs in helping teens to delay sexual activity and that abstinence-only-until-marriage programs may actually cause harm to young people by making them less likely to use contraception once they become sexually active.

Federal Funding for Abstinence-Only Programs Vs. Comprehensive Sexuality Education

Be it enacted by the Senate and House of Representa- 1
tives of the United States of America in Congress assembled, 2

SECTION 1. SHORT TITLE. 3
This Act may be cited as the ‘‘Medically Accurate Sex 4
Education Act’’. 5

SEC. 2. MEDICALLY ACCURATE SEX EDUCATION. 6

(a) IN GENERAL.—The Elementary and Secondary 7
Education Act of 1965 (20 U.S.C. 6301 et seq.) is amend- 8

2
HR 802 IH
ed by inserting after section 9528 (20 U.S.C. 7908) the 1
following: 2

SEC. 9528A. MEDICALLY ACCURATE SEX EDUCATION. 3

(a) REQUIREMENT.—An elementary school or sec- 4
ondary school receiving funds under this Act shall not pro- 5
vide factual information that is not medically accurate in 6
course material or instruction on human development and 7
sexuality, including any sex education, family life edu- 8
cation, abstinence education, comprehensive health edu- 9
cation, or character education. 10

(b) DEFINITIONS.—In this section: 11

• (1) The term ‘factual information’ includes in- 12
  formation related to medical, psychiatric, psycho- 13
  logical, empirical, or statistical statements. 14
  
• (2) The term ‘medically accurate’ means sup- 15
  ported by research, recognized as accurate and ob- 16
  jective by leading medical, psychological, psychiatric, 17
  and public health organizations and agencies, and, 18
  where relevant, published in peer-reviewed jour- 19
  nals.’’. 20
  
  (b) CONFORMING AMENDMENT.—The table of con- 21
  tents at section 2 of the Elementary and Secondary Edu- 22
  cation Act of 1965 is amended by inserting after the item 23
  relating to section 9528 the following: 24
  Sec. 9528A. Medically accurate sex education’’.
  Æ
  

• Inaccuracy: “At the least, the chances of getting pregnant with a condom are 1 out of 6.” Me, My World, My Future, revised HIV material, p. 257.
  The Truth: When used consistently and correctly, condoms are 98 percent effective in preventing pregnancy and up to 99 percent effective in preventing the transmission of HIV and other STDs, according to R.A. Hatcher et. al.’s Contraceptive Technology.
  

• Inaccuracy: “A specific blood test for Chlamydia can detect the presence of the disease.” Sex Respect, Student Workbook, p. 44.
  The Truth: Chlamydia is a bacterial infection of the cervix or penis. It cannot be detected through a blood test.)
  

• Inaccuracy: There are over 100,000 new cases of syphilis reported to the Centers for Disease Control and Prevention (CDC) each year. Choosing the Best, Student Manual, p. 14.
  Inaccuracy: “Infectious syphilis rates have more than doubled among teens since the mid-1980s.” Sex Respect, Student Workbook, p. 36.
  The Truth: According to the CDC, 6,657 cases of primary and secondary syphilis were reported in 1999, the lowest annual number of cases reported since 1957.