1     
REPRODUCTIVE HEALTH AMENDMENTS

2     
2016 GENERAL SESSION

3     
STATE OF UTAH

4     
Chief Sponsor: Brian S. King

5     
Senate Sponsor: ____________

6     

7     LONG TITLE
8     General Description:
9           This bill enacts provisions related to reproductive health services and education.
10     Highlighted Provisions:
11          This bill:
12          ▸      defines terms;
13          ▸     directs the Division of Health Care Financing to seek a waiver for family planning
14     services;
15          ▸     establishes requirements for comprehensive human sexuality education;
16          ▸     requires the State Instructional Materials Commission to consult with parents and
17     others when evaluating comprehensive human sexuality curriculum;
18          ▸     prohibits a school from receiving federal abstinence education funding;
19          ▸     repeals certain criminal provisions regarding contraceptive and abortion services;
20     and
21          ▸     makes technical and conforming corrections.
22     Money Appropriated in this Bill:
23          None
24     Other Special Clauses:
25          This bill provides a special effective date.
26     Utah Code Sections Affected:
27     AMENDS:
28          53A-13-101, as last amended by Laws of Utah 2004, Chapter 196
29          76-7-324, as last amended by Laws of Utah 2004, Chapter 271
30     ENACTS:
31          26-18-411, Utah Code Annotated 1953
32     REPEALS:
33          76-7-321, as last amended by Laws of Utah 1995, Chapter 20
34          76-7-322, as last amended by Laws of Utah 1988, Chapter 50
35          76-7-323, as last amended by Laws of Utah 1988, Chapter 50
36          76-7-325, as enacted by Laws of Utah 1983, Chapter 94
37     

38     Be it enacted by the Legislature of the state of Utah:
39          Section 1. Section 26-18-411 is enacted to read:
40          26-18-411. Medicaid waiver for limited family planning services for low-income
41     individuals.
42          (1) For purposes of this section:
43          (a) (i) "Family planning services" includes, at a minimum:
44          (A) testing, treatment, and counseling for sexually transmitted infections and
45     HIV/AIDS, including follow-up treatment for diagnosed sexually transmitted infections;
46          (B) well-woman exams, including screening and testing for breast and cervical cancer
47     and other cervical cancer causing abnormalities, and other preventive services related to family
48     planning or provided as part of a family planning visit;
49          (C) sexual health education and family planning counseling;
50          (D) contraceptives; and
51          (E) other medical diagnosis, treatment, or preventive care routinely provided as part of
52     a family planning service visit.
53          (ii) "Family planning services" does not include an abortion, as that term is defined in
54     Section 76-7-301.
55          (b) "Low-income individual" means an individual who has an income level that is
56     equal to or below the highest income level for which a pregnant women is eligible for
57     Medicaid coverage under the state plan.
58          (2) Before July 1, 2016, the division shall seek a waiver that has a duration of at least
59     three years from the Centers for Medicare and Medicaid Services within the United States
60     Department of Health and Human Services to:
61          (a) provide family planning services to low-income individuals who do not qualify for
62     full Medicaid coverage; and
63          (b) receive a federal match rate of 90% of state expenditures for family planning
64     services provided under the waiver.
65          Section 2. Section 53A-13-101 is amended to read:
66          53A-13-101. Definitions -- Instruction in health -- Parental consent requirements
67     -- Political and religious doctrine prohibited.
68          (1) As used in this section:
69          (a) "Age appropriate" means topics, messages, and teaching methods suitable to a
70     particular age or age group, based on developing cognitive, emotional, and behavioral capacity
71     typical for the age or age group.
72          (b) "Board" means the State Board of Education.
73          (c) (i) "Comprehensive human sexuality" or "comprehensive human sexuality
74     education" means evidence-based information about:
75          (A) human reproduction, reproductive anatomy, and reproductive physiology;
76          (B) all methods to prevent unintended pregnancy and sexually transmitted diseases and
77     infections, including HIV and AIDS; and
78          (C) the link between human papillomavirus and cancer, and other types of cancer
79     involving the human reproductive systems, including prostate, testicular, ovarian, and uterine
80     cancer.
81          (ii) "Comprehensive human sexuality" includes information about the correct and
82     consistent use of sexual abstinence, contraception, condoms, and other birth control barrier
83     methods.
84          (d) "Evidence-based information" means information that is evaluated using rigorous
85     research design, including:
86          (i) measuring knowledge, attitude, and behavior;
87          (ii) having an adequate sample size;
88          (iii) using sound research methods and processes;
89          (iv) replicating in different locations and finding similar evaluation results; and
90          (v) publishing results in a peer-reviewed journal.
91          (e) "Positive youth development" means an approach that:
92          (i) is inclusive of all youth, collaborative, and strength-based; and
93          (ii) emphasizes the many positive attributes of young people and focuses on developing
94     inherent strengths and assets to promote health.
95          (f) "Sexual abstinence" means not engaging in oral, vaginal, or anal intercourse or
96     genital skin-to-skin contact.
97          [(1) (a)] (2) The [State Board of Education] board shall establish curriculum
98     requirements under Section 53A-1-402[,] that include health instruction in:
99          [(i)] (a) community and personal health;
100          [(ii)] (b) physiology;
101          [(iii)] (c) personal hygiene; [and]
102          [(iv)] (d) prevention of communicable disease[.]; and
103          (e) subject to Subsection (3), comprehensive human sexuality.
104          [(b) (i) That instruction shall stress:]
105          [(A) the importance of abstinence from all sexual activity before marriage and fidelity
106     after marriage as methods for preventing certain communicable diseases; and]
107          [(B) personal skills that encourage individual choice of abstinence and fidelity.]
108          [(ii) (A) At no time may instruction be provided, including responses to spontaneous
109     questions raised by students, regarding any means or methods that facilitate or encourage the
110     violation of any state or federal criminal law by a minor or an adult.]
111          [(B) Subsection (1)(b)(ii)(A) does not preclude an instructor from responding to a
112     spontaneous question as long as the response is consistent with the provisions of this section.]
113          (3) (a) The comprehensive human sexuality education curriculum established under
114     Subsection (2)(e) shall:
115          (i) encourage parental or guardian involvement and family communication;
116          (ii) include instruction to help students develop skills for making responsible and
117     healthy decisions about human sexuality, personal power, boundary setting, developing safe
118     and healthy relationships, and resisting peer pressure, including:
119          (A) not making unwanted verbal, physical, and sexual advances; and
120          (B) not making assumptions about a person's supposed sexual intentions based on that
121     person's appearance;
122          (iii) teach human sexuality as a normal and healthy aspect of human development;
123          (iv) include information about the physical, social, and emotional changes of
124     adolescence and subsequent stages of human maturation, including how pregnancy happens;
125          (v) include evidence-based information shown to be effective in changing behaviors
126     that contribute to early pregnancy and sexually transmitted diseases and infections, including:
127          (A) sexual abstinence and delaying sexual initiation;
128          (B) reducing the frequency of sexual intercourse;
129          (C) reducing the number of sexual partners; and
130          (D) increasing the use of condoms and other contraceptives;
131          (vi) include discussions and information on how to recognize and respond safely and
132     effectively in situations where sexual or physical violence may be occurring or where there
133     may be a risk for these behaviors to occur;
134          (vii) include discussions of how alcohol and drug use impair responsible and healthy
135     decision making;
136          (viii) be comprehensive, age appropriate, rely on evidence-based information, be
137     inclusive of a positive youth development framework, and be medically accurate; and
138          (ix) provide instruction about the health benefits and potential side effects of using
139     contraceptives and barrier methods to prevent pregnancy, including instruction regarding
140     emergency contraception and the availability of contraceptive methods.
141          [(c)] (b) (i) The board shall recommend instructional materials for use in the [curricula]
142     curriculum required under Subsection [(1)(a)] (2) after considering evaluations of instructional
143     materials by the State Instructional Materials Commission.
144          (ii) The State Instructional Materials Commission shall consult with parents, teachers,
145     school nurses, and community members in evaluating instructional materials for
146     comprehensive human sexuality curriculum that comply with this section.
147          [(ii)] (iii) A local school board or charter school governing board may choose to adopt:
148          (A) the instructional materials recommended under Subsection (1)[(c)](b)(i); or
149          (B) other instructional materials as provided in [state] board rule.
150          [(iii)] (iv) The [state] board rule made under Subsection (1)[(c)(ii)](b)(iii)(B) shall
151     include, at a minimum:
152          (A) that the materials adopted by a local school board or charter school governing
153     board under Subsection (1)[(c)(ii)](b)(iii)(B) shall be based upon recommendations of the
154     school district's [Curriculum Materials Review Committee] or charter school's curriculum
155     materials review committee that comply with state law and [state] board rules [emphasizing
156     abstinence before marriage and fidelity after marriage, and prohibiting instruction in:];
157          [(I) the intricacies of intercourse, sexual stimulation, or erotic behavior;]
158          [(II) the advocacy of homosexuality;]
159          [(III) the advocacy or encouragement of the use of contraceptive methods or devices;
160     or]
161          [(IV) the advocacy of sexual activity outside of marriage;]
162          (B) that the adoption of instructional materials shall take place in an open and regular
163     meeting of the local school board or charter school governing board for which prior notice is
164     given to parents and guardians of students attending schools in the district and an opportunity
165     for them to express their views and opinions on the materials at the meeting;
166          (C) provision for an appeal and review process of the local school board's or charter
167     school governing board's decision; and
168          (D) provision for a report to the board by the local school board [to the State Board of
169     Education] or charter school governing board of the action taken and the materials adopted by
170     the local school board or charter school governing board under Subsections
171     (1)[(c)(ii)](b)(iii)(B) and (1)[(c)(iii)](b)(iv).
172          [(2)] (4) (a) Instruction in the courses described in Subsection [(1)] (2):
173          (i) shall be consistent and systematic in grades [eight] 8 through 12[.]; and
174          (ii) may not be taught in kindergarten through grade 3.
175          (b) At the request of the board, the Department of Health shall cooperate with the board
176     in [developing programs to provide instruction in those areas] establishing curriculum
177     requirements as described in Subsection (2).
178          [(3) (a)] (5) The board shall adopt rules that:
179          [(i)] (a) provide that the parental consent requirements of [Sections 76-7-322 and
180     76-7-323] Section 53A-13-101.2 are complied with; and
181          [(ii)] (b) require a student's parent or legal guardian to be notified in advance and have
182     an opportunity to review the information for which parental consent is required under [Sections
183     76-7-322 and 76-7-323] Section 53A-13-101.2.
184          [(b) The board shall also provide procedures for disciplinary action for violation of
185     Section 76-7-322 or 76-7-323.]
186          [(4) (a) In keeping with the requirements of Section 53A-13-109, and because school
187     employees and volunteers serve as examples to their students, school employees or volunteers
188     acting in their official capacities may not support or encourage criminal conduct by students,
189     teachers, or volunteers.]
190          [(b) To ensure the effective performance of school personnel, the limitations described
191     in Subsection (4)(a) also apply to school employees or volunteers acting outside of their official
192     capacities if:]
193          [(i) they knew or should have known that their action could result in a material and
194     substantial interference or disruption in the normal activities of the school; and]
195          [(ii) that action does result in a material and substantial interference or disruption in the
196     normal activities of the school.]
197          [(c) Neither the State Office of Education nor local school districts may provide
198     training of school employees or volunteers that supports or encourages criminal conduct.]
199          [(d)] (6) The [State Board of Education] board shall adopt rules implementing this
200     section.
201          [(e) Nothing in this section limits the ability or authority of the State Board of
202     Education and local school boards to enact and enforce rules or take actions that are otherwise
203     lawful, regarding educators', employees', or volunteers' qualifications or behavior evidencing
204     unfitness for duty.]
205          [(5)] (7) Except as provided in Section 53A-13-101.1, political, atheistic, sectarian,
206     religious, or denominational doctrine may not be taught in the public schools.
207          [(6)] (8) (a) [Local] A local school [boards] board or charter school governing board
208     and [their] that board's employees shall cooperate and share responsibility in carrying out the
209     purposes of this chapter.
210          (b) Each school district and charter school shall provide appropriate inservice training
211     for its teachers, counselors, and school administrators to enable them to understand, protect,
212     and properly instruct students in the information, values, and character traits referred to in this
213     section and Sections 53A-13-101.1, 53A-13-101.2, 53A-13-101.3, 53A-13-109, 53A-13-301,
214     and 53A-13-302 and distribute appropriate written materials on the information, values,
215     character traits, and conduct to each individual receiving the inservice training.
216          (c) The written materials shall also be made available to classified employees, students,
217     and parents and guardians of students.
218          (d) In order to assist school districts in providing the inservice training required under
219     Subsection [(6)] (8)(b), the [State Board of Education] board shall, as appropriate, contract
220     with a qualified individual or entity possessing expertise in the areas referred to in Subsection
221     [(6)] (8)(b) to develop and disseminate model teacher inservice programs [which] that districts
222     may use to train the individuals referred to in Subsection [(6)] (8)(b) to effectively teach the
223     values and qualities of character referenced in that subsection.
224          [(e) In accordance with the provisions of Subsection (4)(c), inservice training may not
225     support or encourage criminal conduct.]
226          [(7)] (9) If any one or more provision, subsection, sentence, clause, phrase, or word of
227     this section, or the application thereof to any person or circumstance, is found to be
228     unconstitutional, the balance of this section shall be given effect without the invalid provision,
229     subsection, sentence, clause, phrase, or word.
230          (10) (a) A school district or charter school that, before July 1, 2016, is awarded direct
231     or indirect federal funding for the provision of an abstinence education program pursuant to 42
232     U.S.C. Sec. 710 is not required to adopt requirements for comprehensive human sexuality
233     education for the provision of comprehensive human sexuality education as described in this
234     section for the year or years for which the school district or charter school receives the federal
235     funding awarded before July 1, 2016.
236          (b) Except as provided in Subsection (10)(a), on or after July 1, 2016, a school district
237     or charter school:
238          (i) may not use direct or indirect federal funding for the provision of an abstinence
239     education program pursuant to 42 U.S.C. Sec. 710; and
240          (ii) shall provide comprehensive human sexuality education as described in this
241     section.
242          Section 3. Section 76-7-324 is amended to read:
243          76-7-324. Violation of restrictions on public funds for abortion services as
244     misdemeanor.
245          Any agent of a state agency or political subdivision, acting alone or in concert with
246     others, who violates Section [76-7-322, 76-7-323, or] 76-7-331 is guilty of a class B
247     misdemeanor.
248          Section 4. Repealer.
249          This bill repeals:
250          Section 76-7-321, Contraceptive and abortion services -- Funds -- Minor --
251     Definitions.
252          Section 76-7-322, Public funds for provision of contraceptive or abortion services
253     restricted.
254          Section 76-7-323, Public funds for support entities providing contraceptive or
255     abortion services restricted.
256          Section 76-7-325, Notice to parent or guardian of minor requesting contraceptive
257     -- Definition of contraceptives -- Penalty for violation.
258          Section 5. Effective date.
259          This bill takes effect on July 1, 2016.




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