BILL ANALYSIS                                                                                                                                                                                                    






                                 SENATE HEALTH
                               COMMITTEE ANALYSIS
                        Senator Sheila J . Kuehl, Chair


          BILL NO:       AB 629                                       
          A
          AUTHOR:        Brownley                                     
          B
          AMENDED:       April 16, 2007
          HEARING DATE:  June 27, 2007                                
          6
          REFERRAL:      Health & Education                           
          2
          FISCAL:        Appropriations                               
          9
                                                                     
          CONSULTANT:                                                
          Diaz/Tadeo/cjt
                                         

                                    SUBJECT
                                         
                     Sex education programs:  requirements

                                     SUMMARY  

          This bill would require sexual health education programs  
          that are funded or administered, directly or indirectly, by  
          the state, to provide information that is age appropriate,  
          medically accurate, current and objective, and to fulfill  
          other requirements as specified.

                             CHANGES TO EXISTING LAW  

          Existing law 
          Existing law, the Comprehensive Sexual Health and HIV/AIDS  
          Prevention Education Act, authorizes school districts to  
          offer age-appropriate comprehensive sexual health education  
          in kindergarten through grade 12.  Commencing in grade  
          seven, a sexual health education program must offer  
          information on sexually transmitted diseases (STDs),  
          including HIV/AIDS, and their prevention, and information  
          on the prevention of unintended pregnancy, as specified.

          Existing law requires instructional materials for a  
                                                         Continued---



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          comprehensive sexual health education program to be age  
          appropriate, medically accurate, and objective.  The  
          materials must be accessible to English learner pupils and  
          must not teach or promote religious doctrine, or bias  
          against any person on the basis of race or ethnicity,  
          gender, sexual orientation, or disability, as specified. 

          Existing law requires a school district to notify a parent  
          or guardian that his or her child will receive  
          comprehensive sexual health education and HIV/AIDS  
          prevention, and empowers a parent or guardian to excuse his  
          or her child from all or part of that instruction.

          Existing law changes the name of the Department of Health  
          Services (DHS) to the Department of Health Care Services  
          (DHCS) and transfers certain public health responsibilities  
          to the newly established Department of Public Health (DPH)  
          as of July 1, 2007.
          
          This bill:
          This bill would require that any sexual health education  
          program conducted, operated, or administered by any state  
          agency, or that receives financial assistance from state  
          funds, adhere to the following: 

           Provides age appropriate, culturally and linguistically  
            appropriate, medically accurate, current, and objective  
            information, using the most current scientific data on  
            human sexuality, human development, pregnancy, and  
            sexually transmitted diseases;  
           Does not teach or promote religious doctrine, or promote  
            bias against any person on the basis of disability,  
            gender, nationality, race or ethnicity, religion, or  
            sexual orientation;
           Provides information about the effectiveness and safety  
            of at least one or more drug or device approved by the  
            Food and Drug Administration for the prevention of  
            pregnancy and for reducing the risk of contracting  
            sexually transmitted diseases.  This information may be  
            included, but is not required, in programs directed  
            toward minors under the age of 12; and
           For programs directed at minors, include information on  
            abstinence as the only certain way to prevent unintended  
            pregnancies, and that the only certain way to prevent  
            sexually transmitted diseases (STDs) is to abstain from  




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            activities that have been proven to transmit sexually  
            transmitted diseases.

          This bill would exempt from these provisions, any program  
          offered by a school district, a county superintendent of  
          schools, or a community college district.  The bill also  
          exempts from these provisions one-on-one interactions  
          between a health practitioner and his or her patient in a  
          clinical setting. 

          This bill would require an outside agency that is receiving  
          state funding, and that is teaching a sexual health  
          education program at a publicly funded school, to indicate  
          in writing that the program meets the requirements of the  
          California Comprehensive Sexual Health and HIV/AIDS  
          Prevention Education Act.  For the purposes of this bill, a  
          "publicly funded school" includes a charter school.
           
          This bill states that compliance with these requirements  
          would be integrated into the grant monitoring and  
          compliance procedures of the state agency.  This bill  
          authorizes a state agency to terminate the contract or take  
          other appropriate action if a grantee is not in compliance  
          with any requirements of this bill. 

                                  FISCAL IMPACT 

          According to the Assembly Appropriations Committee, there  
          will be an estimated one-time cost of $150,000 to DPH to  
          hire staff for oversight purposes and technical assistance.  
           There will be minor absorbable costs to DPH beyond the  
          first year of program implementation.
                            BACKGROUND AND DISCUSSION  

          The author states that, although California has been the  
          national leader in protecting reproductive health by  
          adopting a comprehensive sex education curriculum,  
          state-funded programs are not currently required to operate  
          under consistent standards with what is required to be  
          taught in schools.  According to the author, all  
          state-funded programs should provide medically accurate,  
          comprehensive, and bias-free information.  AB 629 sets a  
          floor of basic standards for state-funded or administered  
          community-based sexual health education programs.  





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          Teen birth rate and STD prevention
          A study by the Public Health Institute, "No Time for  
          Complacency: Teen Births in California 2006," found that,  
          although California has experienced a decrease in teen  
          birthrates statewide, rates remain high in Senate districts  
          primarily located in Los Angeles County, the Central  
          Valley, and the Imperial Valley.  In addition, California's  
          teen birth rate is still four to ten times higher than  
          rates for France, Spain, Italy, the Netherlands, and Japan.

          While abstinence is accepted as an effective way to prevent  
          pregnancy and sexually transmitted diseases, several  
          studies have shown that abstinence-only education curricula  
          is ineffective, and that teaching about the effectiveness  
          of both abstinence and contraception has proven more  
          effective.  A study commissioned by Congress, released this  
          year by Mathematica Policy Research Inc., concluded that  
          youth in abstinence-only programs were no more likely than  
          youth not participating in these programs to have abstained  
          from sex.  Those who pledged to abstain, when compared to  
          non-pledgers, were less likely to use condoms or other  
          contraception if they had sex, and experienced similar  
          rates of sexually transmitted diseases when compared to  
          their counterparts.  

          California is one of a number of other states that has  
          continually rejected Title V, Section 510 of the Social  
          Security Act funds for abstinence-only programs.  These  
          programs prohibit the dissemination of information on  
          contraception and their exclusive purpose is to teach that  
          a mutually faithful, monogamous relationship in the context  
          of marriage is the expected standard of human sexual  
          activity.

          State-funded sex education programs
          This bill would primarily affect state-funded programs  
          administered directly or indirectly by the DHS Office of  
          Family Planning (OFP), which currently has four different  
          types of community-based programs for teen pregnancy  
          prevention, and other programs for HIV/AIDS prevention that  
          are operated by DHS' Sexually Transmitted Diseases Control  
          Branch and the Office of AIDS Education and Prevention.   
          The four continuing outreach and education programs include  
          the Male Involvement Program, the Community Challenge  
          Grants Program (CCG), the TeenSMART Program, and the  




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          Information and Education Program.  These programs are  
          provided with the goal of reducing teenage pregnancy and  
          STDs, promoting responsible parenting and the involvement  
          of the biological father, and providing enhanced  
          reproductive health care counseling and pregnancy  
          prevention education to equip teens at high risk for  
          pregnancy with the knowledge, understanding, and behavioral  
          skills necessary to make responsible decisions regarding  
          at-risk behavior.  CCG, for example, includes 117  
          community-based grantees located throughout the state.  A  
          majority of these types of programs are taught in either a  
          school setting or other community setting and service  
          historically underserved communities with high teen birth  
          rates.  

          OFP also administers family planning services which include  
          contraceptive methods, natural family planning, abstinence  
          methods, infertility management, preconception counseling,  
          maternal and fetal health counseling, and general  
          reproductive health care, including diagnosis and treatment  
          of infections and conditions, including cancer, that  
          threaten reproductive capability, and other services.

          Related legislation
          AB 708 (Huff), 2006-2007, requires DPH to develop and  
          implement an abstinence education program that would  
          maximize federal financial participation. This bill failed  
          passage in the Assembly Health Committee. 

          AB 1511 (Leno), 2006-2007, requires DPH to establish a  
          statewide continuing public education program, to encourage  
          parents to talk with their teens about sex and sexual  
          health to promote well-informed decision making by teens.   
          This bill is set to be heard in the Senate Health Committee  
          on June 27, 2007.
          
          Previous legislation
          SB 71 (Kuehl), Chapter 650, Statutes of 2003 enacted the  
          California Comprehensive Sexual Health Education and  
          HIV/AIDS Act, which requires sexual health education that  
          is taught in public schools kindergarten through grade 12,  
          inclusive, to be comprehensive, bias-free, medically  
          accurate, and age appropriate.  
           
          SB 1471 (Kuehl), 2005-2006, would have expanded upon SB 71  




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          (Kuehl) to provide further guidance for state-funded or  
          administered sexual health education programs to comply  
          with specified requirements.  This bill was vetoed.  The  
          veto message stated that this bill would impose  
          restrictions on community-based pregnancy prevention  
          programs and would encroach on local decision making.

          Arguments in support
          The American Civil Liberties Union (ACLU), Planned  
          Parenthood Affiliates of California, and the American  
          Association of University Women, the sponsors of this bill,  
          state that, although California has made great strides in  
          promoting comprehensive sex education, a significant  
          percentage of state-funded programs are providing biased,  
          incomplete, and medically inaccurate information, putting  
          young people's health at risk.  The ACLU cites an analysis  
          showing that at least 25 percent of the CCG programs  
          sampled provided "abstinence-focused" instruction in public  
          school settings and included misleading information about  
          abortion, condom effectiveness, and STDs, and promoted bias  
          relating to sexual orientation.  Supporters contend that  
          state-funded programs are directed to local communities  
          that have high rates of unintended pregnancies and sexually  
          transmitted diseases, which are the communities most in  
          need of accurate and effective information.  Furthermore,  
          supporters state that health care costs due to teen  
          pregnancy and sexually transmitted diseases cost California  
          taxpayers $1.5 billion each year.
          
          Arguments in opposition
          Concerned Women for America of California (CWA) believes  
          that including information on the "effectiveness and  
          safety" of at least one contraceptive would discriminate  
          against parents who would expect schools to emphasize  
          abstinence.  CWA further contends that no contraceptive or  
          STD-reducing device makes sex "safe" for teens.  According  
          to CWA, the bill would need to include an opt-in provision  
          to provide for adequate parental notification.   
          Additionally, CWA expresses concerns that charter schools  
          would be impacted by this bill, resulting in less local  
          control over decision making and limiting parents' rights  
          to tailor their child's education.

                                  PRIOR ACTIONS





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           Assembly Health Committee:12-5  Pass
          Assembly Appropriations: 12-5  Pass
          Assembly Floor:           47-32  Pass
           
                                   POSITIONS  

          Support:       Planned Parenthood Affiliates of California  
          (sponsor)
                         American Civil Liberties Union (sponsor)
                         American Association of University Women  
          (sponsor)
                         ACCESS/Women's Health Rights Coalition
                         Ally Action
                         American College of Obstetricians and  
          Gynecologists, District IX
                         Asian Communities for Reproductive Justice
                         California Commission on the Status of Women
                         California Latinas for Reproductive Justice 
                         California Medical Association
                         California National Organization for Women
                         California Nurses Association
                         California Women Lawyers
                         Center for Research on Gender and Sexuality
                         Family Violence Law Center
                         Family Violence Prevention Fund
                         Gay and Lesbian Adolescent Social Services,  
          Inc.
                         Gay-Straight Alliance Network
                         Los Angeles Free Clinics
                         NARAL Pro-Choice California
                         National Asian Pacific American Women's  
          Forum
                         National Sexuality Research Center
                         Pharmacy Access Partnership
                         Physicians for Reproductive Choice and  
          Health
                         Planned Parenthood, Shasta-Diablo
                         Planned Parenthood of San Diego & Riverside  
          Counties
                         Project 10, Inc.
                         Public Health Institute
                         Southern California HIV Advocacy Coalition
                         Women's Foundation of California
                         
          Oppose:   Concerned Women for America of California




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