BILL ANALYSIS                                                                                                                                                                                                    



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          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








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             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.











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          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  








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               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









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             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.








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          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  








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            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  








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          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  








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          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  








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          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  








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               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."











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          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.










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          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:









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          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








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          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










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          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











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