BILL ANALYSIS                                                                                                                                                                                                    



                                                                  SB 1471
                                                                  Page  1

          Date of Hearing:   June 27, 2006

                            ASSEMBLY COMMITTEE ON HEALTH
                                  Wilma Chan, Chair
                     SB 1471 (Kuehl) - As Amended:  April 6, 2006

           SENATE VOTE  :   24-14
           
          SUBJECT  :   Sex education programs: requirements. 

           SUMMARY  :   Enacts the California Community Sexual Health  
          Education Act.  Specifically,  this bill  :   

          1)Requires any program that provides instruction or information  
            to prevent adolescent or unintended pregnancy, or to prevent  
            sexually transmitted diseases (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 the following:

             a)   All information is required to be medically accurate,  
               current, and objective;
             b)   Individuals providing instruction or information on  
               pregnancy, sexuality, and sexually transmitted diseases are  
               required to know and use the most current scientific data  
               on human sexuality, human development, pregnancy, and STDs;
             c)   The program content is required to be age appropriate  
               for its targeted population;
             d)   The program is prohibited from teaching or promoting  
               religious doctrine; 
             e)   The program is required to be culturally and  
               linguistically appropriate for its targeted populations;  
               and,
             f)   The program is prohibited from reflecting or promoting  
               bias against any person on the basis of disability, gender,  
               nationality, race or ethnicity, religion, or sexual  
               orientation, as defined in current law.

          2)Requires the program, if it consists of instruction or  
            information that is delivered in a single session, to satisfy  
            all of the criteria in #1) above and:

             a)   If it is directed towards minors and addresses STDs,  
               include information that the only certain way to prevent  








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               STDs is to abstain from activities that have been proven to  
               transmit STDs;
             b)   If it is directed toward minors and addresses pregnancy  
               prevention, include information that the only certain way  
               to prevent unintended pregnancy is to abstain from sexual  
               intercourse;
             c)   If it addresses sexually transmitted diseases, provide  
               information about the effectiveness and safety of one or  
               more drugs or devices approved by the federal Food and Drug  
               Administration (FDA) for reducing the risk of contracting  
               STDs; and,
             d)   If it addresses pregnancy prevention, provide  
               information about the effectiveness and safety of one or  
               more drugs or devices approved by the FDA for preventing  
               pregnancy.

          3)Requires the program, if it consists of instruction or  
            information that is delivered in multiple sessions, to satisfy  
            all of the criteria in subdivision #1) above and paragraphs a)  
            and b) of #2) above and: provide information about skills for  
            refusing unwanted sexual activity and communicating with  
            sexual partners; and, provide information about the  
            effectiveness and safety of all drugs and devices approved by  
            the FDA for reducing the risk of contracting STDs, and  
            information on local resources for testing and treatment of  
            STDs.  Requires the program, if it addresses pregnancy  
            prevention, to provide information about the effectiveness and  
            safety of all drugs and devices approved by the FDA for  
            preventing pregnancy, including, but not limited to, emergency  
            contraception.

          4)Defines "age appropriate" as 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.

          5)Defines "single session" program as a single presentation or  
            contact designed to provide awareness and information about  
            preventing pregnancy, or sexually transmitted diseases,   
            including outreach activities in which educators, outreach  
            workers, or youth peer educators provide oral or written  
            information to individuals during a single encounter.

          6)Defines  "multiple session" program as instruction or an  
            informational presentation about preventing pregnancy or  








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            sexually transmitted diseases that is provided to the same  
            audience over more than one session.

          7)Defines "medically accurate" as 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 (CDC), the American Public  
            Health Association (APHA), the Society for Adolescent Medicine  
            (SAM), the American Academy of Pediatrics (AAP), and the  
            American College of Obstetricians and Gynecologists (ACOG).

          8)Requires an applicant, as a condition of receiving state funds  
            or state-administered funds for any program or activity  
            described in subdivisions # 1), # 2), and # 3) above to attest  
            in writing that its program complies with all conditions of  
            funding, including those enumerated in this bill. 

          9)Requires the applicant, if the program is conducted at a  
            publicly funded school, including charter schools, to 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. 

          10)Prohibits anything in this bill from being construed to limit  
            the requirements of the California Comprehensive Sexual Health  
            and HIV/AIDS Prevention Education Act, as specified.

          11)Prohibits anything in this bill from applying to one-on-one  
            interactions between a health practitioner and his or her  
            patient in a clinical setting.

           EXISTING LAW  :

          1)Establishes and provides funding for DHS to administer various  
            programs related to women's health around adolescent  
            reproductive health and pregnancy prevention, maternal and  
            child health, disease prevention, detection, and treatment,  
            and domestic violence prevention.  There are a variety of  
            funding sources for these programs, including federal funds,  
            state general fund, and tobacco tax revenue. 









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          2)Authorizes under the California Comprehensive Sexual Health  
            and HIV/AIDS Prevention Education Act, 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, inclusive, receive HIV/AIDS  
            prevention education, as defined.

          3)Enumerates various requirements for comprehensive sexual  
            health education and HIV/AIDS prevention education.  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.

           FISCAL EFFECT  :   According to the Senate Appropriations  
          Committee analysis:

                            Fiscal Impact (in thousands)

             Major Provisions              2006-07   2007-08   2008-09    
            Fund           
             
            DHS enforcement          $ 400          $ 300     $ 300  
            General Fund 

           COMMENTS  :   

           1)PURPOSE OF THIS BILL  .  According to the author, programs that  
            include information about both contraception and abstinence  
            reduce rates of unintended pregnancies and STDs, while  
            abstinence-only programs have never been proven to be  
            effective.  California, a national leader in promoting and  
            protecting reproductive health, is committed to comprehensive,  
            medically accurate sexual health education.  Despite this  
            successful policy, scarce state dollars for teen pregnancy  
            prevention are funding programs and activities that do not  
            meet the basic, common sense guidelines that schools must  
            follow.  Currently, no statutory standards exist for programs  
            outside of public schools.  This bill expands upon SB 71  
            (Kuehl), Chapter 650, Statutes of 2003 and provides much  
            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 pregnancies and STDs.  This  
            bill applies basic standards that are now required in our  








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            schools to publicly funded sexual health programs in  
            California communities.   

           2)SB 71  .  In 2004, SB 71 was signed into law by the Governor and  
            enacted the California Comprehensive Sexual Health and  
            HIV/AIDS Prevention Education Act. The Act revises,  
            streamlines, clarifies, expands upon and deletes primarily  
            redundant or obsolete provisions of current law related to sex  
            and HIV/AIDS prevention education.  Specifically, SB 71, among  
            other things: 

             a)   Revises and simplifies the HIV/AIDS and sex education  
               parent notification requirements;
             b)   Authorizes school districts which provide sexual health  
               education to also provide in-service training for all  
               school personnel that provide this education, as specified;
             c)   Defines for purposes of this act a variety of terms  
               including "age appropriate", "comprehensive sexual health  
               education", "HIV/AIDS prevention education", "trained  
               instructors" and "medically accurate;" and, 
             d)   Specifies legislative intent to encourage pupils to  
               communicate with their parents or guardians about human  
               sexuality and HIV/AIDS and to respect the rights of parents  
               or guardians to supervise their children's education on  
               these subjects. 

           3)TEEN BIRTHS  .  According to the Public Health Institute's (PHI)  
            "  No Time for Complacency: Teen Births in California 2006  ,"  
            despite recent improvements, California's teen birth rate is  
            hardly exemplary.  In 2004 more than 50,000 teens (4% of all  
            female teens aged 15 to 19) gave birth in California, and many  
            more became pregnant.  PHI states that the tendency to use the  
            national teen birth rate as the comparative norm might be  
            encouraging policymakers and advocates to set California's  
            goal short of a more ambitious reduction that reflects our  
            true potential.  Instead, it would be more inspiring to  
            compare California's teen birth rate to other industrialized  
            societies.  California's teen birth rate is four to ten times  
            higher than rates for France, Spain, Italy, the Netherlands,  
            and Japan.  The report concluded by saying that it would be  
            naive to assume that there is any single solution to resolve  
            the complex issue of teen childbearing. Nevertheless, there  
            can be little doubt that California's unprecedented investment  
            in teen pregnancy prevention has contributed to its  
            achievement over the last decade of the largest decline in  








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            teen birth rates of all fifty states.  Among the  
            recommendations of PHI are: 

             a)   At a minimum, maintain all program services funding  
               aimed at reducing teen pregnancies and births, with annual  
               adjustments for inflation; 
             b)   Require all state-funded or administered programs,  
               whether school- or community-based, to comply with the  
               provisions of SB 71 to provide comprehensive,  
               age-appropriate, and medically accurate information; 
             c)   Provide for education on and enforcement of SB 71 in  
               terms of comprehensive, age-appropriate, and medically  
               accurate information in school-based sexuality education;
             d)   Begin discussion and development of a legislative  
               mandate for California public middle schools, high schools,  
               and alternative schools to teach research-based  
               comprehensive sexuality education; 
             e)   Provide multi-level comprehensive sexuality education  
               and youth development programs, with school, parent, youth,  
               and community components working in synergy; and, 
             f)   Review and monitor school polices and curricula to  
               assess compliance with SB 71 and bring these policies and  
               curricula into compliance as necessary.

           4)SUPPORT  .  The American Civil Liberties Union and Planned  
            Parenthood Affiliates of California write that this bill  
            provides needed guidance to state agencies that fund or  
            administer community-based sexual health programs and that by  
            applying the basic standards that are now required in our  
            schools, this bill ensures a consistent, effective, and  
            medically accurate approach for preventing unintended  
            pregnancy and sexually transmitted diseases at a minimal cost  
            to the state.  Latino Issues Forum states that California must  
            remain committed to providing quality, comprehensive sexuality  
            education by ensuring all programs provide medically accurate,  
            bias-free, and age-appropriate information.  California School  
            Nurses Organization asserts that this bill ensures that  
            California sex education programs stress the importance of  
            abstinence while providing students with the medically  
            accurate information they need to prevent sexually transmitted  
            infections and unintended pregnancy.   Physicians for  
            Reproductive Choice and Health state that research indicates  
            that comprehensive programs that promote abstinence while  
            providing medically-accurate information about contraception  
            are far more likely to prevent pregnancy and the spread of  








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            disease than abstinence-only education.  

           5)OPPOSE  .  The California Family Council writes that California  
            and federal laws already prohibit the promotion of religion in  
            public education and this bill is totally unnecessary.  The  
            Capitol Resource Institute writes that this bill would subject  
            young students to sex education that would undoubtedly  
            conflict with parental rights and religious convictions.  
            Concerned Women for America asserts that our children need to  
            know the facts in order to make responsible choices and if  
            health and safety program administrators and educators are  
            intimidated into leaving important information out of the sex  
            education curriculum for fear of violating this bill, our  
            children and society will suffer greatly. 

           REGISTERED SUPPORT / OPPOSITION  :

           Support 
           
          American Civil Liberties Union (sponsor) 
          Planned Parenthood Affiliates of California (sponsor)
          ACCESS/Women's Health Rights Coalition
          American Association of University Women
          American College of Obstetricians and Gynecologists
          Bienestar Human Services, Inc.
          California Association of School Health Educators
          California Commission on the Status of Women
          California Latina's for Reproductive Justice
          California Medical Association
          California NOW
          California PTA
          California School Nurses Organization
          Center for Research on Adolescent Health and Development
          Friends of Project 10, Inc.
          Lambda Letters Project
          Latino Issues Forum
          NARAL Pro-Choice California
          National Association of Social Workers
          Pharmacy Access Partnership
          Physicians for Reproductive Choice and Health
          Public Health Institute
          Southern California HIV Advocacy Coalition
          Two Individuals

           Opposition 








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          California Family Council
          Capitol Resource Institute
          Concerned Women of America
          One Individual


           Analysis Prepared by  :    Melanie Moreno / HEALTH / (916)  
          319-2097