BILL ANALYSIS
SENATE HEALTH
COMMITTEE ANALYSIS
Senator Deborah V. Ortiz, Chair
BILL NO: SB 1471
S
AUTHOR: Kuehl
B
AMENDED: April 6, 2006
HEARING DATE: April 26, 2006
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FISCAL: Appropriations
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CONSULTANT:
1
Vazquez / ak
SUBJECT
Sex education programs: requirements
SUMMARY
This bill requires any program that provides education to
prevent adolescent or unintended pregnancy or to prevent
sexually transmitted infections and that is conducted,
operated, or administered by the state or any state agency,
or is funded directly or indirectly by the state, or
receives any financial assistance from the state,
including, but not limited to, public schools, to meet
specified requirements that emphasize comprehensive sex
education.
ABSTRACT
Existing law:
1.Establishes requirements for the provision of sex
education under the California Comprehensive Sexual
Health and HIV/AIDS Prevention Education Act, authorizes
school districts to provide comprehensive sexual health
education, as defined, in any kindergarten to grade 12,
inclusive, and ensures that all pupils in grades 7 to 12,
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inclusive, receive HIV/AIDS prevention education, as
defined.
2.Enumerates various requirements for comprehensive sexual
health education and HIV/AIDS prevention education.
3.Requires a school district to notify the parent or
guardian of a pupil about instruction in comprehensive
sexual health education and HIV/AIDS prevention and
empowers a parent or guardian to excuse his or her pupil
from all or part of that instruction.
This bill:
1.Defines the following terms:
a. "Age appropriate" refers to topics, messages, and
teaching methods 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.
b. A "single session" program means a single
presentation or contact designed to provide awareness
and information about preventing pregnancy, or
sexually transmitted diseases (STDs). It includes
outreach activities in which educators, outreach
workers, or youth peer educators provide oral or
written information to individuals during a single
encounter.
c. A "multiple session" program means instruction or
an informational presentation about preventing
pregnancy or STDs that is provided to the same
audience over more than one session.
d. "Medically accurate" means verified or supported by
research conducted in compliance with scientific
methods and published in peer review journals, where
appropriate, and recognized as accurate and objective
by professional organizations and agencies with
expertise in the relevant field, including, but not
limited to, the federal Centers for Disease Control
and Prevention, the American Public Health
Association, the Society for Adolescent Medicine, the
American Academy of Pediatrics, and the American
College of Obstetricians and Gynecologists.
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2.Requires any program that provides instruction or
information to prevent adolescent or unintended
pregnancy, or to prevent STDs, including HIV, that is
conducted, operated, or administered by any state agency
or is funded directly or indirectly by the state, or
receives any financial assistance from state funds or
funds administered by a state agency, to satisfy all of
the following requirements:
a. All information shall be medically accurate,
current, and objective.
b. Individuals providing instruction or information on
pregnancy, sexuality, and STDs shall know and use the
most current scientific data on human sexuality, human
development, pregnancy, and STDs.
c. The program content shall be age appropriate for
its targeted population.
d. The program shall not teach or promote religious
doctrine.
e. The program shall be culturally and linguistically
appropriate for its targeted populations.
f. The program shall not reflect or promote bias
against any person on the basis of disability, gender,
nationality, race or ethnicity, religion, or sexual
orientation.
3.Requires the program, if it consists of instruction or
information that is delivered in a single session, to
satisfy all of the criteria in number 2 above and shall
also satisfy the following conditions:
a. If the program is directed towards minors and
addresses STDs, it shall include information that the
only certain way to prevent STDs is to abstain from
activities that have been proven to transmit STDs.
b. If the program is directed toward minors and
addresses pregnancy prevention, it shall include
information that the only certain way to prevent
unintended pregnancy is to abstain from sexual
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intercourse.
c. If the program addresses STDs, the program shall
provide information about the effectiveness and safety
of one or more drugs or devices approved by the
federal Food and Drug Administration for reducing the
risk of contracting STDs.
d. If the program addresses pregnancy prevention, it
shall provide information about the effectiveness and
safety of one or more drugs or devices approved by the
federal Food and Drug Administration for preventing
pregnancy.
4.Requires the program, if it consists of instruction or
information that is delivered in multiple sessions, to
satisfy all of the criteria in number 2 above and shall
also satisfy the following conditions:
a. If the program is directed towards minors and
addresses STDs, it shall include information that the
only certain way to prevent STDs is to abstain from
activities that have been proven to transmit STDs.
b. If the program is directed toward minors and
addresses pregnancy prevention, it shall include
information that the only certain way to prevent
unintended pregnancy is to abstain from sexual
intercourse.
c. The program shall provide information about skills
for refusing unwanted sexual activity and
communicating with sexual partners.
d. The program shall provide information about the
effectiveness and safety of all drugs and devices
approved by the federal Food and Drug Administration
(FDA) for reducing the risk of contracting STDs, and
information on local resources for testing and
treatment of STDs.
e. lf the program addresses pregnancy prevention, it
shall provide information about the effectiveness and
safety of all drugs and devices approved by the FDA
for preventing pregnancy, including, but not limited
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to, emergency contraception.
5.Requires that, as a condition of receiving state funds or
state-administered funds for any program or activity
described in this measure, an applicant to attest in
writing that its program complies with all conditions of
funding and that if the program is conducted at a
publicly-funded school, including charter schools, the
applicant shall indicate in writing how the program fits
in with the school's plan to comply fully with the
requirements of the California Comprehensive Sexual
Health and HIV/AIDS Prevention Education Act of the
Education Code.
6.States that nothing in this section shall be construed to
limit the requirements of the California Comprehensive
Sexual Health and HIV/AIDS Prevention Education Act of
the Education Code.
7.States that nothing in this measure shall apply to
one-on-one interactions between a health practitioner and
his or her patient in a clinical setting.
FISCAL IMPACT
Unknown, but the cost implications for the state are likely
to be minor.
BACKGROUND AND DISCUSSION
Need for the bill
The author states that this bill provides needed guidance
to state agencies that fund or administer community-based
programs or public education campaigns in order to ensure
that California has a consistent and effective approach for
preventing unintended pregnancy and STDs. Research shows
that comprehensive sexual education or programs that teach
about both abstinence and contraception, is more effective
in assisting young people to make healthy decisions about
sex. The American Academy of Pediatrics, American Medical
Association, Office of National AIDS Policy, National
Institutes of Health, Society for Adolescent Medicine, and
the Surgeon General of the United States all have published
research supporting the effectiveness of comprehensive sex
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education.
In addition, the author states that though public health
research and public opinion overwhelmingly support
comprehensive sexual health education, our state still
funds biased and incomplete sexual health education
programs in our communities and leaves people served by
these programs without much needed basic information about
sexuality and reproductive health.
Applicability
This bill will affect all programs that are state-funded or
administered by a state entity and that provide education
to prevent adolescent or unintended pregnancy, or to
prevent sexually transmitted diseases (STDs). According to
the author, the bill would primarily affect programs
operated by the DHS STD Control Branch, Office of Family
Planning (OFP), and Office of AIDS Education and
Prevention. For example, it would affect the STD Control
Branch's trainings to groups and organizations on the
prevention of STDs and its health education services aimed
at teenagers and school-aged youth. OFP's affected
programs would include the Community Challenge Grant
Program, which has 117 community-based grantees across the
state, the Information and Education Program, and the Male
Involvement Program.
Single and multiple sessions
The author states that the two-tier requirements for
"single session" and "multiple session" programs are to
preserve flexibility. Since the bill covers a wide breadth
of activities, from media campaigns to curriculum-based
instruction, the tiered approach adopted in SB 1471 ensures
that more limited activities will not be over-burdened with
too many requirements while more extensive programs will
provide more comprehensive information. For example, a
single-session presentation could be focused on the
effectiveness of emergency contraception without having to
include either information about other FDA-approved drugs
and devices for preventing pregnancy or information about
communication skills, both of which would be required in a
more extensive, multiple-session program.
The overall standards that apply to all programs, whether
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single- or multiple-session, establishes a universal
baseline that all activities must meet. Beyond this
standard, the requirements increase as the capacity to
include more information grows. Because there are many
different types of single-session programs, SB 1471 does
not require that they cover a specific type of prevention
method, such as emergency contraception, but rather
requires that they provide information about at least one
FDA-approved drug or device and allows them to select the
drug or device that would be most appropriate for their
program. Programs are permitted to include information on
as many prevention methods as they choose.
Public Policy Institute of California survey
A 2005 Public Policy Institute of California (PPIC)
statewide survey found that, "California adults
overwhelmingly support comprehensive sex education programs
that include information on abstinence, condoms, and
contraception." The report also found, "At a time when
abstinence-only programs are in vogue at the federal level,
the vast majority of Californians (78%), including Latinos
(74%) and evangelical Christians (66%), prefer sex
education programs that also teach children about obtaining
and using contraceptives." Most respondents said that sex
education in schools is at least somewhat effective in
helping teens avoid pregnancy (62%) and STDs (71%), with
public school parents even more likely to hold these views
than the general public."
California's teen pregnancy rate fell by 40% in the 1990's.
Much of this decrease can be attributed to medically
accurate comprehensive sex education. Comprehensive
information gives teens the tool to decide to delay sexual
activity or to otherwise be responsible in their actions.
Prior legislation and intersection with SB 1471
SB 71 (Kuehl, Chapter 650, Statutes of 2003) required
sexual health education taught in public schools to be
comprehensive, medically accurate, bias-free, and age
appropriate. SB 1471 extends the fundamental principles
underlying SB 71, including medical accuracy, freedom from
bias, knowledgeable instructors, FDA-approved prevention
information, and abstinence information for minors, and
applies these to the community health context. The author
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and sponsors state that the measure accomplishes this while
leaving aside the provisions of SB 71 that are more
specific to school-based instruction, such as parental
notification and consent requirements. In addition,
because public school-based instruction is targeted to
youth and consists of what SB 1471 defines as
"multiple-session programs," SB 71 has a more extensive
list of required topics, such as the newborn abandonment
law and parent-child communication. For clarification, SB
1471 would not affect the Education Code sections enacted
by SB 71. However, state-funded programs affected by SB
1471, if they provided instruction in public schools, would
be required to comply with those Education Code sections
(51930-51939).
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Arguments in support
Proponents argue that this bill expands on state law that
requires sexual health and HIV/AIDS prevention education
taught in public schools be medically accurate, bias-free,
and age appropriate, also applying these standards to
community-based organizations that provide sexuality
education programs. They state that the bill provides
needed guidance to state agencies that fund or administer
community-based programs or public education campaigns, in
order to ensure that California has a consistent and
effective approach for preventing unintended pregnancy and
STDs. Proponents cite the PPIC survey and its findings and
further state that to effectively reduce existing
reproductive health disparities and promote access to
sexual health information and services, state funds should
be used to support only programs that provide medically
accurate information with current and unbiased data, in our
communities as well as in our public schools.
Arguments in opposition
Opponents object to the expansion of these requirements in
law. Concerned Women for America (CWA) states that the
bill does not require that programs teach respect for
marriage, an important component in encouraging healthy
sexual behavior. The CWA and the Capitol Resource
Institute both cite criteria in the bill that prohibits a
program from reflecting or promoting bias against a person
on the basis of, among other factors, gender and sexual
orientation. The CWA states that this presents a clear
problem since current research identifies increased health
risks for certain individuals.
POSITIONS
Support: American Civil Liberties Union (co-sponsor)
Planned Parenthood Affiliates of California
(co-sponsor)
ACCESS/Women's Health Rights Coalition
American Association of University Women CA
American College of Obstetricians and
Gynecologists, District IX
California Commission on the Status of Women
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California Family Health Council
California Latinas for Reproductive Justice
California Medical Association
California School Nurses Organization
Latino Issues Forum
NARAL Pro-Choice California
National Association of Social Workers,
California Chapter
Pharmacy Access Partnership
Planned Parenthood Los Angeles
Planned Parenthood Orange and San Bernardino
Counties Southern California HIV Advocacy
Coalition
Oppose: California Family Council
Capitol Resource Institute
Concerned Women of America of California
One Individual
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