BILL ANALYSIS Ó AB 329 Page 1 Date of Hearing: April 22, 2015 ASSEMBLY COMMITTEE ON EDUCATION Patrick O'Donnell, Chair AB 329 Weber - As Amended April 13, 2015 SUBJECT: Pupil instruction: sexual health education SUMMARY: Makes instruction in sexual health education a requirement, revises HIV prevention education content, expands topics covered in sexual health education, requires this instruction to be inclusive of different sexual orientations, and clarifies parental consent policy. Specifically, this bill: 1)Renames the Comprehensive Sexual Health and HIV/AIDS Prevention Education Act as the California Healthy Youth Act. 2)Adds to the intended purposes of the Act, to: a) promote understanding of sexuality as a normal part of human development b) provide students with integrated, comprehensive, accurate, and unbiased sexual health and HIV prevention instruction c) provide educators with clear tools and guidance to accomplish that end AB 329 Page 2 d) provide students with the knowledge and skills necessary to have healthy, positive, and safe relationships and behaviors 1)Replaces the term HIV/AIDS with "HIV and AIDS," and replaces "sexually transmitted disease" with "sexually transmitted infection" throughout. 2)Defines the qualifications of instructors to include knowledge of "healthy relationships." 3)Requires instruction under this act to: a) affirmatively recognize that people have different sexual orientations and, when discussing or providing examples of relationships and couples, shall be inclusive of same-sex relationships. b) teach pupils about gender, gender expression, gender identity, and explore the harm of negative gender stereotypes. 1)Revises a requirement that instruction and materials encourage students to communicate with their parents or guardians to also encourage that students communicate with "other trusted adults," and that this instruction also provide students with the knowledge and skills necessary to do so. AB 329 Page 3 2)Revises a requirement that instruction and materials teach respect for marriage to read: "prepare pupils to have and maintain committed relationships such as marriage." 3)Requires that instruction and materials provide students with knowledge and skills they need to form healthy relationships that are based on mutual respect and affection, and are free from violence, coercion, and intimidation. 4)Revises a requirement and makes it apply to all sexual health education (currently in HIV/AIDS prevention education) that instruction and materials provide students with "negotiation" skills (in addition to refusal skills) to assist them in overcoming peer pressure. 5)Requires that instruction on sexual health in grades 7-12 occur at least once during junior high school and once during high school (in addition to HIV prevention education). This includes the requirements in existing law for comprehensive sexual health education and HIV/AIDS prevention education, while also requiring as part of this instruction: a) The effectiveness and safety, as one federal Food and Drug Administration (FDA) approved method to prevent or reduce the risk of contracting HIV and other sexually transmitted infections, of the use of antiretroviral medication, consistent with the federal Centers for Disease Control and Prevention. b) The effectiveness and safety of reducing the risk of HIV AB 329 Page 4 transmission as a result of injection drug use by decreasing needle use and needle sharing. c) The treatment of HIV and other sexually transmitted infections, including how antiretroviral therapy can dramatically prolong the lives of many people living with HIV and reduce the likelihood of transmitting HIV to others. d) The facts that successfully treated HIV-positive individuals have a normal life expectancy, all people are at some risk of contracting HIV, and the only way to know if one is HIV-positive is to get tested. e) Information on students' legal rights to access local resources for sexual and reproductive health care such as testing and medical care for HIV and other sexually transmitted infections and pregnancy prevention and care, as well as local resources for assistance with sexual assault and intimate partner violence. f) Information on pregnancy, including an objective discussion of all legally available pregnancy outcomes, including all of the following: 1. parenting, adoption, and abortion 2. information on the law on surrendering physical custody of a minor child 72 hours of age or younger 3. the importance of prenatal care AB 329 Page 5 a) Information on sexual harassment, sexual assault, adolescent relationship abuse, intimate partner violence, and sex trafficking. 1)Expands, by increasing the topics taught in sexual health education, the number of topics which may be taught to students earlier than grade 7 in an age appropriate and medically accurate manner. 2)Removes the requirements that HIV instruction: a) accurately reflect the recommendations of the U.S. Surgeon General and the National Academy of Sciences b) emphasize compassion for persons living with HIV/AIDS c) emphasize monogamy and avoidance of multiple sexual partners as among the most effective means of preventing HIV infection 1)Requires that outside consultants and guest speakers have knowledge of the most recent medically accurate research on the relevant topics covered in their instruction. 2)Adds sexual health to the requirements for in-service training for teachers of HIV prevention education. 3)Clarifies that active parental consent ("opt in") policies for sexual health instruction and for research and evaluation tools are prohibited. AB 329 Page 6 EXISTING LAW: 1)Permits school districts to provide comprehensive sexual health education, and places a number of requirements on districts choosing to provide that instruction. Among, these requirements, instruction must be age appropriate, medically accurate and objective, teach respect for committed relationships and marriage, encourage students to speak with their parents or guardians about human sexuality, be appropriate and accessible for use with students with disabilities, and be appropriate for students of all races, genders, sexual orientations, and ethnic and cultural backgrounds. 2)Requires school districts to provide HIV/AIDS prevention education, and specifies what is to be included in that instruction. 3)Permits instruction to be provided by outside consultants and guest speakers at assemblies and requires that this instruction conform to the requirements for school district instruction. 4)Requires in-service training of instructors providing HIV/AIDS prevention education. 5)States that a parent or guardian of a student has the right to AB 329 Page 7 excuse their child from all or part of comprehensive sexual health education, HIV/AIDS prevention education, and related assessments, and requires that parents be notified of this right. FISCAL EFFECT: This bill has been keyed a state-mandated local program by the Office of Legislative Counsel. COMMENTS: Components of this bill. The author explains that this bill is intended to address five areas of policy by: Updating the HIV and AIDS prevention education to reflect today's understanding of HIV and AIDS Ensuring that students are receiving comprehensive and accurate prevention information for HIV, other sexually transmitted infections, and unintended pregnancy, as well as information about local health resources Clarifying and bolstering existing requirements that instruction and materials be appropriate for students of all sexual orientations and genders Clarifying the existing passive consent policy for parental consent Including new language relating to adolescent relationship abuse and sex trafficking, and reinforcing a focus on healthy attitudes, healthy behaviors, and healthy relationships Need for the bill. The author's office states, "HIV prevention education is mandated in California schools. But the law, written in 1992, is outdated and doesn't address the broader context of HIV prevention. For example, instruction that addresses relationship skills and preventing other sexually transmitted infections (STIs) and unintended pregnancy is AB 329 Page 8 fundamental to equipping students to understand and prevent HIV. However, this instruction is currently relegated in the Education Code to non-mandated comprehensive sexual health education. Ninety-three percent of schools teach combined HIV prevention and sexual health education, but the distinction between them in the Education Code generates confusion by schools that often results in students being denied critical information. More than 60% of teens are sexually active at age 18. Rates of STIs are growing in California and are highest in young people ages 15-24. California's teen birth rate remains higher than that of other industrialized countries, and over 80% of births to teens are unintended. Our schools are a critical environment for providing young people with the knowledge and skills that they will need to protect their sexual health at whatever age they become sexually active. Comprehensive sexual health and HIV prevention education has been shown to be effective in both delaying sexual activity and increasing condom and contraceptive use among youth who are already sexually active. LGBT-inclusive education has also been shown to have a positive effect on school climate and make LGBT youth feel safer in school. Research also shows that health education can improve students' academic outcomes, including in reading and math." Making comprehensive sexual health education mandatory. Current law does not mandate sexual health education, but places requirements on instruction that is voluntarily provided to students. While this instruction is voluntary, research has shown that nearly all (96%) school districts offer a program of sexual health education. In contrast, HIV/AIDS prevention AB 329 Page 9 education has been mandated since 1992. This bill proposes to combine sexual health education and the HIV/AIDS prevention education statutes into a single, mandatory program of instruction. Proponents of this bill argue that AB 329 reflects the way that sexual health and HIV prevention education is actually provided in schools - as an integrated program of instruction. Research has found that 93% teach the two topics as one class. Outdated HIV/AIDS provisions. The HIV/AIDS Prevention Education sections of the Education Code were enacted in 1992, when HIV infection was the leading cause of death for men aged 25-44 years (accounting for 20% of all deaths among men that age group) and the fourth leading cause of death for women in that age group. New infections were still rising dramatically in that year - 1992 had the highest annual rate mortality rate recorded to that time, an 11% increase over the prior year. Current law still reflects that context by, for example, combining HIV and AIDS into a single abbreviation, and by encouraging "compassion for those persons living with HIV/AIDS," and by including no mention of antiretroviral treatments. This bill aims to revise the HIV/AIDS prevention statute to reflect advances in prevention and treatment that have occurred since 1992. The bill updates these sections to emphasize that these advances have dramatically prolonged the lives of many people living with HIV and that successfully treated AB 329 Page 10 HIV-positive people have a normal life expectancy. From prohibiting bias to affirmative recognition. Current law prohibits bias in sexual health instruction against people on the basis of sexual orientation, gender, gender identity, and gender expression. This bill seeks to additionally require affirmative recognition of different sexual orientations, require instruction to include topics of gender, gender expression, gender identity, and explore the harm of negative gender stereotypes. Proponents of this bill argue that these requirements are necessary because in practice current instruction does not recognize different sexual orientations. A 2011 study (described below) found, for example, that only 30% of school districts report discussing sexual orientation in both middle and high school. Proponents point to research showing that affirmative recognition of different sexual orientations has a positive effect on school climate, improves student achievement, and makes LGBT youth safer in school. Compliance problems. A 2011 report from the University of California, San Francisco, titled Uneven Progress: Sex Education in California Schools, found that since the last major reform in this area SB 71 (Kuehl), Chapter 650, Statutes of 2003, there have been improvements in instruction, there remain problems regarding school district compliance with current law. Among the findings: 25% of districts discussed the required topic of emergency contraception 58% of districts included required information about AB 329 Page 11 contraception in both middle and high school 25% of districts omitted required HIV prevention topics 16% of districts taught students that condoms are not an effective way to prevent pregnancy and transmission of STIs 19% of districts reported that birth control methods are mentioned but that most of the instructional time was spent on the benefits of abstinence 30% of districts addressed sexual orientation 37% of districts did not provide required teacher training 39% of districts failed to provide required materials in languages other than English 27% of districts failed to provide required materials to make content accessible to students with disabilities The study also found that "materials and curricula used by school districts are often fragmented, outdated, and presented without fidelity or a sufficient amount of instructional time." AB 329 Page 12 CDE changing its interpretation of parental consent law. Contrary to significant Legislative history on this issue, the CDE has advised school districts that the law permits them to adopt an "opt in" policy regarding comprehensive sexual health instruction. The CDE website states, "Districts shall not adopt an active consent or "opt-in" policy for parental consent for required HIV/AIDS prevention instruction. Districts may use either a passive consent ("opt-out") or active consent ("opt-in") policy for comprehensive sexual health education." The CDE has recently informed staff that it is in the process of changing this interpretation, and will be advising that "opt in" policies are prohibited. Charter schools not subject to current law or this bill. Current law regarding sexual health education and HIV/AIDS prevention education (including parental rights to opt out of instruction) does not apply to charter schools, and this bill does not propose to change that. AB 1600 (Kuehl) of the 2007-08 Session proposed to apply these provisions to charter schools. That bill died in the Senate Appropriations Committee. Related legislation. SB 695 (De Leon) of this Session requires the Instructional Quality Commission to consider, when the health curriculum framework is next revised, including a content for grades 9 to 12 on sexual harassment and violence. This bill also requires school districts which require a course in health education to include instruction on sexual assault and violence, including information on the affirmative consent standard. AB 329 Page 13 AB 517 (Gallagher) of this Session, which was heard by this Committee on April 8th, would have prohibited the participation of a student in comprehensive sexual health education or HIV/AIDS prevention education which is taught by outside consultants or through guest speakers at assemblies unless prior written permission of the student's parent or guardian had been provided. This bill failed on a vote of 1-5, and reconsideration was granted. Previous legislation. AB 629 (Brownley), Chapter 602, Statutes of 2007, enacted the Sexual Health Education Accountability Act and requires sexual health education programs to provide information that is medically accurate, current, and objective, include content that is age appropriate for its targeted population, be culturally and linguistically appropriate for its targeted populations, and provide information about the effectiveness and safety of at least one or more drug or device approved by the federal Food and Drug Administration for preventing pregnancy and for reducing the risk of contracting sexually transmitted diseases. AB 1600 (Kuehl) of the 2007-08 Session proposed to apply sexual health education and HIV/AIDS prevention education requirements to charter schools. That bill died in the Senate Appropriations Committee. SB 71 (Kuehl), Chapter 650, Statutes of 2003, established the California Comprehensive Sexual Health and HIV/AIDS Prevention Education Act which consolidated various provisions relating to the instruction in the public schools on AIDS prevention, venereal disease and other sexually transmitted diseases, sex, and abstinence from sexual activity, and the manner in which parents or guardians may excuse their children from this instruction. REGISTERED SUPPORT / OPPOSITION: AB 329 Page 14 Support American Civil Liberties Union of California (sponsor) California Latinas for Reproductive Justice (sponsor) Equality California (sponsor) Forward Together (sponsor) Planned Parenthood Affiliates of California (sponsor) ACCESS Women's Health Justice ACT for Women and Girls American Congress of Obstetricians and Gynecologists, District IX Black Women for Wellness California Association of School Health Educators California Family Health Council California Pan-Ethnic Health Network AB 329 Page 15 California Teachers Association Gay-Straight Alliance Network of California California Family Health Council California Women's Law Center Cardea Services Center on Reproductive Rights and Justice, UC Berkeley School of Law Citizens for Choice Guam Communications Network Health Connected Health Initiatives for Youth Khmer Girls in Action NARAL Pro-Choice California AB 329 Page 16 National Center for Youth Law National Council of Jewish Women - California Oakland Unified School District Physicians for Reproductive Health Public Health Institute, Center for Research on Adolescent Health and Development San Francisco Unified School District Teen Success, Inc. 1 individual Opposition California Right to Life Committee, Inc. Analysis Prepared by:Tanya Lieberman / ED. / (916) 319-2087 AB 329 Page 17