H. R. 2678
IN THE HOUSE OF REPRESENTATIVES
July 28, 2011
Ms. Roybal-Allard (for herself, Ms. Norton, Mr. Grijalva, Ms. Lee of California, Mr. Cohen, Mrs. Maloney, and Ms. Bass of California) introduced the following bill; which was referred to the Committee on Energy and Commerce
To amend the Public Health Service Act to authorize the Secretary of Health and Human Services to carry out programs to provide youth in racial or ethnic minority or immigrant communities the information and skills needed to reduce teenage pregnancies.
This Act may be cited as the
Communities of Color Teenage Pregnancy
Prevention Act of 2011.
The Congress finds the following:
Teenage pregnancy is one of the most critical issues facing the Nation today. The United States has the highest teenage pregnancy rate of any developed nation, with nearly 750,000 teenage girls (who are 15 to 19 years of age) becoming pregnant each year, and 82 percent of those pregnancies unplanned.
For the first time in more than a decade, between 2005 and 2006, the teenage pregnancy rate in the United States rose 3 percent. The decrease in teenage pregnancy rates in the 1990s was overwhelmingly the result of more and better use of contraceptives.
Nationally, teenage pregnancy has significant fiscal implications, costing taxpayers at least $10,900,000,000 annually.
Communities of color are disproportionately affected by teenage pregnancy. Fifty-two percent of Latinas and 50 percent of African-American girls will become pregnant at least once before they turn 20. In comparison, only 19 percent of non-Hispanic White teenage girls under the age of 20 become pregnant.
Between 2007 and 2009, the teenage birth rate decreased for most communities of color, however the birth rates for Hispanic, African-American, and Native American teenagers continue to be much higher than other racial and ethnic groups.
Research shows that starting a family too soon may have significant social, educational, and financial impacts on the lives of young people. Less than half of teenage mothers finish high school and less than 2 percent go on to finish college, making it difficult to find and maintain a job.
Research also shows that teenage dating violence and abuse are serious public health problems and are associated with higher levels of teenage pregnancy and unplanned pregnancy. Adolescent girls in physically abusive relationships are three times more likely to become pregnant than non-abused girls.
Promoting and building healthy relationships are fundamental to preventing teenage pregnancies and unplanned pregnancies.
Youth pregnancy prevention
Title III of the Public Health Service Act (42 U.S.C. 241 et seq.) is amended by adding at the end the following new part:
Youth Pregnancy Prevention Programs
It is the purpose of this part to develop and carry out research and demonstration projects on new and existing program interventions to provide youth in racial or ethnic minority or immigrant communities the information and skills needed to reduce teenage pregnancies, build healthy relationships, and improve overall health and well-being.
Demonstration grants to reduce teenage pregnancies
The Secretary shall award competitive grants to eligible entities for establishing or expanding programs to provide youth in racial or ethnic minority or immigrant communities the information and skills needed to avoid teenage pregnancy and develop healthy relationships.
In awarding grants under this section, the Secretary shall give priority to applicants—
proposing to carry out projects in racial or ethnic minority or immigrant communities;
that have a demonstrated history of effectively working with such targeted communities; or
that have a demonstrated history of engaging in a meaningful and significant partnership with such targeted communities.
Programs funded through a grant under subsection (a) shall be provided—
through classroom-based settings, such as school health education, humanities, language arts, or family and consumer science education; after-school programs; community-based programs; workforce development programs; and health care settings; or
in collaboration with systems that serve large numbers of at-risk youth such as juvenile justice or foster care systems.
As a condition of receipt of a grant under this section, an entity shall agree that, with respect to information and skills provided through the grant—
such information and skills will be—
evidence-based or evidence-informed;
provided in accordance with section 399OO–5(b); and
culturally sensitive and relevant to the target populations; and
any information provided about contraceptives shall include the health benefits and side effects of all contraceptives and barrier methods.
Of the total amount made available to carry out this section for a fiscal year, the Secretary, acting through the Director of the Centers for Disease Control and Prevention and other agencies as appropriate, shall allot up to 10 percent of such amount to carry out a rigorous, independent evaluation to determine the extent and the effectiveness of activities funded through this section during such fiscal year in changing attitudes and behavior of teenagers with respect to healthy relationships and childbearing.
Grants for Indian tribes or tribal organizations
Of the total amount made available to carry out this section for a fiscal year, the Secretary shall reserve 5 percent of such amount to award grants under this section to Indian tribes and tribal organizations in such manner, and subject to such requirements, as the Secretary, in consultation with Indian tribes and tribal organizations, determines appropriate.
Eligible entity defined
In this section, the term eligible entity means a State, local, or tribal agency; a school or postsecondary institution; an after-school program; a nonprofit organization; or a community or faith-based organization.
Preventing exclusion of smaller community-based organizations
In carrying out this section, the Secretary shall ensure that the amounts and requirements of grants provided under this section do not preclude receipt of such grants by community-based organizations with a demonstrated history of effectively working with adolescents in racial or ethnic minority or immigrant communities or engaged in meaningful and significant partnership with such communities.
Multimedia campaigns to reduce teenage pregnancies
The Secretary shall award competitive grants to public and private entities to carry out multimedia campaigns to provide public education and increase public awareness regarding teenage pregnancy and related social and emotional issues, such as violence prevention.
In awarding grants under this section, the Secretary shall give priority to applicants proposing to carry out campaigns developed for racial or ethnic minority or immigrant communities.
Information To be provided
As a condition of receipt of a grant under this section, an entity shall agree to use the grant to carry out multimedia campaigns described in subsection (a) that—
at a minimum, shall provide information on—
the prevention of teenage pregnancy; and
healthy relationship development; and
may provide information on the prevention of dating violence.
Research on reducing teenage pregnancies and teenage dating violence and improving healthy relationships
The Secretary, acting through the Director of the Centers for Disease Control and Prevention, shall make grants to public and private entities to conduct, support, or coordinate research on teenage pregnancy, dating violence, and healthy relationships among racial or ethnic minority or immigrant communities that—
improves data collection on—
sexual and reproductive health, including teenage pregnancies and births, among all minority communities and subpopulations in which such data are not collected, including American Indian and Alaska Native youth;
sexual behavior, sexual or reproductive coercion, and teenage contraceptive use patterns at the State level, as appropriate; and
teenage pregnancies among youth in and aging out of foster care or juvenile justice systems and the underlying factors that lead to teenage pregnancy among youth in foster care or juvenile justice systems;
the variance in the rates of teenage pregnancy by—
racial and ethnic group (such as Hispanic, Asian, African-American, Pacific Islander, American Indian, and Alaskan Native); and
socioeconomic status, including as based on the income of the family and education attainment;
factors affecting the risk for youth of teenage pregnancy or dating abuse, including the physical and social environment, level of acculturation, access to health care, aspirations for the future, and history of physical or sexual violence or abuse;
the role that violence and abuse play in teenage sex, pregnancy, and childbearing;
strategies to address the disproportionate rates of teenage pregnancies and dating violence in racial or ethnic minority or immigrant communities;
how effective interventions can be replicated or adapted in other settings to serve racial or ethnic minority or immigrant communities; and
the effectiveness of media campaigns in addressing healthy relationship development, dating violence prevention, and teenage pregnancy; and
tests research-based strategies for addressing high rates of unintended teenage pregnancy through programs that emphasize healthy relationships and violence prevention.
In carrying out this section, the Secretary shall give priority to research that incorporates—
a strong emphasis on community-based participatory research; or
HHS adolescent health work group
Not later than 30 days after the date of the enactment of this part, the Secretary shall direct the interagency adolescent health workgroup within the Office of Adolescent Health of the Department of Health and Human Services to—
include in the work of the group strategies for teenage dating violence prevention and healthy teenage relationships with a particular focus among racial or ethnic minority or immigrant communities; and
with respect to including such strategies, consult, to the greatest extent possible, with the Federal Interagency Workgroup on Teen Dating Violence formed under the leadership of the National Institute of Justice of the Department of Justice.
The Secretary, through the Office of Adolescent Health, shall periodically submit to Congress a report that—
includes a review of the evidence-based programs on preventing teenage pregnancy, which are carried out and identified by the Office; and
identifies the programs of the Department of Health and Human Services that include teenage dating violence prevention and the promotion of healthy teenage relationships as part of a strategy to prevent teenage pregnancy.
General grant provisions
To seek a grant under this part, an entity shall submit an application to the Secretary in such form, in such manner, and containing such agreements, assurances, and information as the Secretary may require.
A grant may be made under this part only if the applicant involved agrees that information, activities, and services provided under the grant—
will be evidence-based or evidence informed;
will be factually and medically accurate and complete; and
if directed to a particular population group, will be provided in an appropriate language and cultural context.
Training and technical assistance
Of the total amount made available to carry out this part for a fiscal year, the Secretary shall use 10 percent to provide, directly or through a competitive grant process, training and technical assistance to the grant recipients under this part, including by disseminating research and information regarding effective and promising practices, providing consultation and resources on a broad array of teenage and unintended pregnancy and violence prevention strategies, and developing resources and materials.
In carrying out this subsection, the Secretary shall collaborate with entities that have expertise in the prevention of teenage pregnancy, healthy relationship development, minority health and health disparities, and violence prevention.
In this part:
Medically accurate and complete
The term medically accurate and complete means, with respect to information, activities, or services, verified or supported by the weight of research conducted in compliance with accepted scientific methods and—
published in peer-reviewed journals, where applicable; or
comprising information that leading professional organizations and agencies with relevant expertise in the field recognize as accurate, objective, and complete.
Racial or ethnic minority or immigrant communities
The term racial or ethnic minority or immigrant communities means communities with a substantial number of residents who are members of racial or ethnic minority groups or who are immigrants.
The term reproductive coercion means, with respect to a person, coercive behavior that interferes with the ability of such person to control the reproductive decisionmaking of such person, such as intentionally exposing such person to sexually transmitted infections; in the case such person is a female, attempting to impregnate such person against her will; intentionally interfering with the person’s birth control; or threatening or acting violent if the person does not comply with the perpetrator’s wishes regarding contraception or the decision whether to terminate or continue a pregnancy.
The term youth means individuals who are 11 to 19 years of age.
Report on use of funds
Not later than 1 year after the date of the enactment of this part, the Secretary shall submit to Congress a report on the use of funds provided pursuant to this part.
Report on impact of programs
Not later than March 1, 2016, the Secretary shall submit to Congress a report on the impact that the programs under this part had on reducing teenage pregnancies.
Authorization of appropriations
There are authorized to be appropriated to carry out this part such sums as may be necessary for each of the fiscal years 2012 through 2016.
Amounts appropriated pursuant to subsection (a)—
are authorized to remain available until expended; and
are in addition to amounts otherwise made available for such purposes.