Text: H.R.3312 — 111th Congress (2009-2010)All Bill Information (Except Text)

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Introduced in House (07/23/2009)


111th CONGRESS
1st Session
H. R. 3312

To provide for programs that reduce the number of unplanned pregnancies, reduce the need for abortion, help women bear healthy children, and support new parents.


IN THE HOUSE OF REPRESENTATIVES
July 23, 2009

Mr. Ryan of Ohio (for himself, Ms. DeLauro, Ms. Herseth Sandlin, Mr. Perriello, Mr. Smith of Washington, Mr. Farr, Mr. Crowley, Mr. McGovern, Mr. Obey, Mr. Meek of Florida, Mr. Davis of Alabama, Mr. Doyle, and Mr. Langevin) introduced the following bill; which was referred to the Committee on Energy and Commerce, and in addition to the Committees on Education and Labor, Ways and Means, the Judiciary, and Agriculture, for a period to be subsequently determined by the Speaker, in each case for consideration of such provisions as fall within the jurisdiction of the committee concerned


A BILL

To provide for programs that reduce the number of unplanned pregnancies, reduce the need for abortion, help women bear healthy children, and support new parents.

Be it enacted by the Senate and House of Representatives of the United States of America in Congress assembled,

SECTION 1. Short title; table of contents.

(a) Short Title.—This Act may be cited as the “Preventing Unintended Pregnancies, Reducing the Need for Abortion, and Supporting Parents Act”.

(b) Table of Contents.—The table of contents for this Act is as follows:


Sec. 1. Short title; table of contents.

Sec. 2. Findings; purpose.

Sec. 3. Definitions.

Sec. 4. Eligibility of Indian tribes for awards.

Sec. 101. Findings.

Sec. 102. Education programs for preventing teen pregnancies.

Sec. 201. Findings.

Sec. 202. Reauthorization of certain after-school programs.

Sec. 301. Teen pregnancy prevention incentive grants.

Sec. 302. Establishing national goal to prevent teen pregnancy.

Sec. 401. Demonstration grants to encourage creative approaches to teen pregnancy prevention.

Sec. 501. Findings.

Sec. 502. Creating a national initiative to enlist parents of adolescents in preventing teen pregnancy; provision of challenge grants for state and local programs.

Sec. 601. Findings.

Sec. 602. Demonstration grants to prevent unplanned pregnancy among community college students.

Sec. 701. Clarification of continue Medicaid coverage of family planning services.

Sec. 801. Expand Medicaid eligibility for family planning services.

Sec. 901. Extending postpartum coverage for Medicaid and CHIP.

Sec. 902. Coordination with the maternal and child health program.

Sec. 903. Increase in SCHIP income eligibility.

Sec. 904. Outreach program to encourage those eligible for services to enroll.

Sec. 1001. Short title.

Sec. 1002. Authorization of appropriations.

Sec. 1101. Removal of pregnancy as a preexisting condition under individual health insurance coverage.

Sec. 1102. Coverage of maternity care in the individual market.

Sec. 1201. Grants to health centers for purchase of ultrasound equipment.

Sec. 1301. Findings.

Sec. 1302. Separate program to identify and treat women who are victims of or at risk of domestic violence, dating violence, sexual assault, sexual coercion, or stalking.

Sec. 1303. Additional authorization of appropriations for public campaign to increase public awareness.

Sec. 1401. Support services for students.

Sec. 1402. Child care access means parents in school program.

Sec. 1501. Grants for a national information campaign on adoption.

Sec. 1601. Expansion of adoption credit and adoption assistance programs.

Sec. 1701. Increased support for WIC program.

Sec. 1702. Nutritional support for low-income parents.

Sec. 1703. Increased funding for the child care and development block grant program.

Sec. 1704. Free home visits by trained home visitors for education on health and developmental needs of infants and toddlers for low-income families.

Sec. 1705. Grants to increase public awareness of resources available to new parents.

Sec. 1801. Report on responses to unintended pregnancy.

SEC. 2. Findings; purpose.

(a) Findings.—Congress makes the following findings:

(1) 49 percent of all pregnancies in America are unintended. Excluding miscarriages, 42 percent of unintended pregnancies end in abortion.

(2) There are approximately 1,200,000 abortions annually in America and one in five pregnancies ends in abortion.

(3) 57 percent of women who have abortions have incomes below 200 percent of the poverty level.

(4) Rates of unintended pregnancy in the United States increased by nearly 30 percent among low-income women between 1994 and 2001, and a low-income woman today is about 4 times as likely to have an unintended pregnancy as her higher income counterpart.

(5) Levels of contraceptive use among low-income women at risk of unintended pregnancy declined significantly between 1994 and 2001, from 92 percent to 86 percent.

(6) By helping couples avoid unintended pregnancy, Medicaid-funded and title X contraceptive services are highly cost-effective, and every public dollar spent on family planning saves $4 in the cost of pregnancy-related care alone.

(7) Abortion rates decreased among higher income women but increased among low-income women between 1994 and 2001, and a low-income woman is more than 4 times as likely to have an abortion as her higher income counterpart.

(8) Most women cite more than one reason for their decision to have an abortion. The most frequently cited reasons were: “having a baby would dramatically change my life” (74 percent) by interfering with educational and job prospects and responsibilities towards existing children and “cannot afford a baby now” (73 percent).

(b) Purpose.—The purpose of this Act is to provide a comprehensive initiative to—

(1) reduce the need for abortion by reducing the number of unintended pregnancies and supporting women facing unplanned pregnancies;

(2) prevent unintended pregnancies from occurring in the first place—

(A) by reducing teen pregnancy through comprehensive education, after-school and other programs, and involving parents; and

(B) by increasing support for family planning services under title X of the Public Health Service Act and extending Medicaid family planning services to more low-income women and men; and

(3) support pregnant women, new parents, and their children, through measures that address domestic violence and sexual assault, provide health care services, information about pregnancy, and other supportive services for pregnant women, and provide supportive services for new parents.

SEC. 3. Definitions.

For purposes of this Act:

(1) The term “Secretary” means the Secretary of Health and Human Services.

(2) Except as specified, the term “State” includes the 50 States, the District of Columbia, the Commonwealth of Puerto Rico, the Commonwealth of the Northern Mariana Islands, American Samoa, Guam, the Virgin Islands, and any other territory or possession of the United States.

SEC. 4. Eligibility of Indian tribes for awards.

(a) In General.—In the case of programs carried out pursuant to this Act that make awards of grants, cooperative agreements, or contracts, Indian tribes are eligible for awards under the programs in accordance with such criteria as the Secretary may establish.

(b) Definitions.—For purposes of this Act, the term “Indian tribe” has the meaning given such term in section 4 of the Indian Self-Determination and Education Assistance Act (25 U.S.C. 450b).

SEC. 101. Findings.

The Congress finds as follows:

(1) The United States has the highest teen pregnancy rate and teen birth rate among comparable countries, costing the United States at least $9,000,000,000 annually.

(2) Three out of ten young women in America become pregnant before they reach the age of 20.

(3) According to the National Center on Health Statistics, the teen birth rate increased 5 percent between 2005 and 2007, reversing a 14-year decline. Teen birth rates increased significantly in over half of states, representing nearly every region of the country.

(4) Teen pregnancy has serious consequences for young parents, their children, and communities as a whole. Too-early childbearing increases the likelihood that a young woman will drop out of high school and that she and her child will live in poverty.

(5) Statistically, the sons of teen mothers are more likely to be incarcerated. The daughters of teen mothers are more likely to become teen mothers too.

(6) Teens that grow up in disadvantaged economic, social, and family circumstances are more likely to engage in risky behavior and have a child during adolescence.

(7) In a national survey on teen attitudes towards teen pregnancy, 7 in 10 girls and 6 in 10 boys report that they wish they had waited until they were older to have sex.

(8) Programs comprehensive in scope are effective in reducing risk behaviors by delaying or reducing sexual activity, reducing the number of sexual partners or increasing condom or contraceptive use. Reducing risky behaviors leads to reductions in unintended pregnancy and abortion and transmission of sexually transmitted diseases (STDs), including HIV.

(9) According to the results of a 2005–2006 nationally representative survey of U.S. adults, more than 8 of 10 of those polled support comprehensive education.

(10) Ethnic and racial minority groups have been disproportionately affected by early pregnancy and parenthood. Fifty-three percent of Latina teens and 51 percent of African-American young women will become pregnant at least once before they turn 20, as compared to only 19 percent of non-Hispanic White young women.

(11) Recent estimates suggest that while 15- to 24-year-olds represent 25 percent of the sexually active population, they acquire nearly half of all new STIs. Each year, one in four sexually active teenagers contracts a sexually transmitted infection.

(12) Nearly 15 percent of the 56,000 annual new cases of HIV infections in the United States occurred in youth ages 13 through 24 in 2006. An average of one young person every hour of every day is infected with HIV in the United States.

(13) African-American and Latino youth have been disproportionately affected by the HIV/AIDS epidemic. Although African-American adolescents ages 13 through 19 represent only 17 percent of the adolescent population in the United States, they accounted for 70 percent of new HIV/AIDS cases reported among teens in 2005. Latino adolescents ages 13 through 19 accounted for 17 percent of AIDS cases among teens, the same as their proportion of the U.S. population in 2005.

(14) Parental involvement is critical to any healthy relationship program. A major study showed that adolescents who reported feeling connected to parents and family were more likely than other teens to delay initiating sexual intercourse. Another study found that teens who reported previous discussions of sexuality with parents were seven times more likely to feel able to communicate with a partner about HIV/AIDS than those who did not have such discussions with their parents. Parental involvement is a leading protective factor for dating violence prevention.

(15) Comprehensive education programs respect the diversity of values and beliefs represented in the community and will complement and augment the education children receive from their families and faith communities.

(16) Incorporating teen dating violence prevention into health education and comprehensive education is imperative given the widespread experience of violence in dating relationships. Approximately one in three teens reports some kind of abuse in a romantic relationship, including emotional and verbal abuse. Young women who experience dating violence have sex earlier than their peers; are much less likely to use birth control; and engage in a wide variety of high-risk behaviors including multiple partners, sex with older men, and drug and alcohol abuse. Young women who are victims of dating violence are four to six times more likely than non-abused girls to become pregnant.

SEC. 102. Education programs for preventing teen pregnancies.

(a) In General.—The Secretary shall make grants to local educational agencies, State and local public health agencies, and nonprofit private entities for the purpose of carrying out projects to provide comprehensive education on preventing teen pregnancies.

(b) Preference in Making Grants.—In making grants under subsection (a), the Secretary shall give preference to applicants that will carry out the projects under such subsection in communities for which the rate of teen pregnancy is significantly above the average rate of such pregnancies.

(c) Certain Requirements.—A grant may be made under subsection (a) only if the applicant for the grant meets the following conditions with respect to the project involved:

(1) The applicant agrees that information provided by the project will be age-appropriate, factually and medically accurate and complete, and scientifically based.

(2) The applicant agrees that strategies replicate or substantially incorporate the elements of one or more comprehensive education programs that have been proven effective on the basis of rigorous scientific research to—

(A) delay sexual intercourse or sexual activity;

(B) improve contraceptive use;

(C) reduce the number of partners among those who are sexually active; or

(D) reduce teenage pregnancy.

(3) The applicant agrees that the project will not teach or promote religion.

(4) The applicant agrees that the project will substantially incorporate the following elements—

(A) encourage teens to delay sexual activity;

(B) provide comprehensive educational services and interventions, including information about the risks and benefits of all contraceptives as a means to prevent pregnancy and reduce the risk of contracting sexually transmitted diseases, including HIV/AIDS;

(C) educate both young men and women about the responsibilities and pressures that come along with parenting;

(D) encourage family communication about sexuality;

(E) teach young people the skills to make responsible decisions about sexuality, including how to avoid unwanted verbal, physical, and sexual advances and how avoid making unwanted verbal, physical, and sexual advances that are not wanted by the other party;

(F) develop healthy relationships, including the prevention of dating and sexual violence; and

(G) teach young people how alcohol and drug use can affect responsible decisionmaking.

(d) Optional Additional Activities.—In carrying out a comprehensive education program, a grant under this section may be expended to carry out, in addition to the services specified in subsection (c), educational and motivational activities that help young people to—

(1) gain knowledge about the physical, emotional, biological, and hormonal changes of adolescence and subsequent stages of human maturation;

(2) develop the knowledge and skills necessary to ensure and protect their sexual and reproductive health from unintended pregnancy and sexually transmitted disease, including HIV/AIDS throughout their lifespan;

(3) gain knowledge about the specific involvement and responsibility of each individual in sexual decision making;

(4) develop healthy attitudes and values about adolescent growth and development, body image, racial and ethnic diversity, and other related subjects;

(5) develop and practice healthy life skills, including goal-setting, decision making, negotiation, communication, and stress management;

(6) promote self-esteem and positive interpersonal skills focusing on relationship dynamics, including, but not limited to, friendships, dating, romantic involvement, marriage, and family interactions; and

(7) prepare for the adult world by focusing on educational and career success, including developing skills for employment, job seeking, independent living, financial self-sufficiency, and workplace productivity.

(e) Matching Funds.—

(1) IN GENERAL.—With respect to the costs of the project to be carried out under subsection (a) by an applicant, a grant may be made under such subsection only if the applicant agrees to make available (directly or through donations from public or private entities) non-Federal contributions toward such costs in an amount that is not less than 25 percent of such costs ($1 for each $3 of Federal funds provided in the grant).

(2) DETERMINATION OF AMOUNT CONTRIBUTED.—Non-Federal contributions required in paragraph (1) may be in cash or in kind, fairly evaluated, including plant, equipment, or services. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of such non-Federal contributions.

(f) Supplementation of Funds.—An applicant to which a grant is made under subsection (a) for a fiscal year shall use the grant to supplement and not supplant funds that would otherwise be available to the applicant for carrying out the purpose described in such subsection.

(g) Data reporting.—A State to which a grant is made under this paragraph for a fiscal year shall cooperate with the Secretary to collect information and report on outcomes of programs funded under the grant, as specified by the Secretary.

(h) Application for Grant.—A grant may be made under subsection (a) only if an application for the grant is submitted to the Secretary and the application is in such form, is made in such manner, and contains such agreements, assurances, and information, including the agreement under subsection (e), as the Secretary determines to be necessary to carry out this section.

(i) Evaluation.—

(1) IN GENERAL.—The Secretary shall commission a random assignment evaluation conducted by a third party of the programs of a few selected grantees under this section.

(2) ALLOCATION.—Of the amount appropriated to carry out this section, the Secretary may use not more than 10 percent of such amount for the purpose of carrying out clause (i) for fiscal year 2010. Funds allocated under this paragraph are authorized to be appropriated to remain available for expenditure through fiscal year 2015.

(j) Report to Congress.—Not later than April 1, 2015, the Secretary shall submit to the Congress a report describing the extent to which projects under subsection (a) have been successful in reducing teen pregnancy and achieving other evaluation outcomes in the communities in which the projects have been carried out.

(k) Definitions.—For purposes of this section:

(1) The term “age-appropriate”, with respect to the information in pregnancy prevention, means 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.

(2) The term “factually and medically accurate and complete” means verified or supported by the weight of research conducted in compliance with accepted scientific methods and—

(A) published in peer-reviewed journals, where applicable; or

(B) comprising information that leading professional organizations and agencies with relevant expertise in the field recognize as accurate, objective, and complete.

(3) The term “HIV/AIDS” means the human immunodeficiency virus, and includes acquired immune deficiency syndrome.

(4) The term “local educational agency” has the meaning given such term in section 9101 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7801).

(l) Authorization of Appropriations.—For the purpose of carrying out this section, there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2010 through 2015.

SEC. 201. Findings.

The Congress finds as follows:

(1) The likelihood of teens having sex for the first time increases with the number of unsupervised hours teens have during a week.

(2) After-school programs can reduce teen risky behavior. Teenage girls who play sports, for instance, are more likely to delay sex and have fewer partners and less likely to become pregnant.

(3) After-school programs can help prevent teen pregnancy by advancing good decisionmaking skills and providing teens with health education and positive role models in a supervised setting.

SEC. 202. Reauthorization of certain after-school programs.

(a) 21st Century Community Learning Centers.—Section 4206 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7176) is amended—

(1) in paragraph (5), by striking “and”;

(2) in paragraph (6), by striking the period at the end and inserting a semicolon; and

(3) by adding at the end the following:

“(7) $2,750,000,000 for fiscal year 2010; and

“(8) $2,750,000,000 for fiscal year 2011.”.

(b) Carol M. White Physical Education Program.—Section 5401 of the Elementary and Secondary Education Act of 1965 (20 U.S.C. 7241) is amended by adding at the end the following:

“(7) $755,000,000 for fiscal year 2010, of which $80,000,000 is for carrying out subpart 10.

“(8) $755,000,000 for fiscal year 2011, of which $80,000,000 is for carrying out subpart 10.”.

(c) Federal TRIO Programs.—Section 402A(g) of the Higher Education Act of 1965 (20 U.S.C. 1070a–11(g)) is amended by striking “$900,000,000 for fiscal year 2009 and such sums as may be necessary for each of the five succeeding fiscal years” and inserting “$980,000,000 for fiscal year 2010 and such sums as may be necessary for each of the 5 succeeding fiscal years”.

(d) Gearup.—Section 404H of the Higher Education Act of 1965 (20 U.S.C. 1070a–28) is amended by striking “$400,000,000 for fiscal year 2009 and such sums as may be necessary for each of the five succeeding fiscal years” and inserting “$450,000,000 for fiscal year 2010 and such sums as may be necessary for each of the 5 succeeding fiscal years”.

SEC. 301. Teen pregnancy prevention incentive grants.

Section 403(a)(2) of the Social Security Act (42 U.S.C. 603(a)(2)) is amended to read as follows:

“(2) INCENTIVE GRANTS TO PREVENT TEEN PREGNANCY.—

“(A) GRANTS TO ELIGIBLE STATES.—

“(i) IN GENERAL.—

“(I) FISCAL YEAR 2010; GRANTS TO STATES WITH COMPLIANT PLANS.—For fiscal year 2010, each State that meets the requirements of clause (ii) of this subparagraph shall be eligible to receive from the Secretary for such year a grant in an amount determined under subparagraph (B)(i)(I).

“(II) SUBSEQUENT FISCAL YEARS; GRANTS TO HIGH-ACHIEVING STATES WITH COMPLIANT PLANS.—For each of fiscal years 2011 through 2014, each high-achieving State that meets the requirements of clause (ii) of this subparagraph shall be eligible to receive from the Secretary for such year a grant in an amount determined under subparagraph (B)(i)(II).

“(III) HIGH-ACHIEVING STATE.—In this paragraph, the term ‘high-achieving State’, with respect to a year, means a State which exceeds the national performance in the teen pregnancy rate.

“(ii) SUBMISSION OF PLAN; REQUIREMENTS.—A plan meets the requirements of this clause if the plan describes—

“(I) the State’s numerical goal for reducing teen pregnancy and teen births;

“(II) the strategies to be used to achieve such goal;

“(III) the efforts the State will make to involve young men, as well as young women, in delaying pregnancy and parenting;

“(IV) efforts to involve parents and other caretakers; and

“(V) efforts to reach communities or populations experiencing rates of teen pregnancy above the State average.

“(iii) SET-ASIDE FOR GRANTS TO INDIAN TRIBES.—An amount equal to 1.5 percent of the amount appropriated under subparagraph (H) for a fiscal year shall be reserved for awarding grants to Indian tribes under this paragraph in such manner, and subject to such requirements, as the Secretary, in consultation with such tribes, determines appropriate.

“(iv) STATE.—In this paragraph, the term ‘State’ means each of the several States of the United States, the District of Columbia, the Commonwealth of Puerto Rico, the United States Virgin Islands, Guam, American Samoa, and the Commonwealth of the Northern Mariana Islands.

“(B) AMOUNT OF GRANT.—

“(i) IN GENERAL.—The amount of a grant under subparagraph (A)(i) to an eligible State for a fiscal year shall be the following amount, as applicable:

“(I) For fiscal year 2010, the amount that bears the same ratio to the amount appropriated under subparagraph (H) for the fiscal year as the proportion of births in the State to teens under age 20 bears to the number of such births in all eligible States in the most recent year for which data is available.

“(II) For each of fiscal years 2011 through 2014, the amount that bears the same ratio to the amount appropriated under subparagraph (H) for the fiscal year as the proportion of teens under age 20 in the State bears to the number of such teens in all eligible States in the most recent year for which data is available.

“(ii) DETERMINATION OF TEEN PREGNANCY RATES.—For purposes of this paragraph, the teen pregnancy rate for a State shall be determined on the basis of the teen pregnancy rate per 1,000 women, ages 15 through 19, who reside in the State. If teen pregnancy data is not available in a particular State, the Secretary may identify alternative sources of data.

“(C) USE OF FUNDS.—

“(i) IN GENERAL.—A State or Indian tribe shall use funds provided under a grant under this paragraph to implement teen pregnancy prevention strategies that meet the following requirements:

“(I) The strategies replicate or substantially incorporate the elements of one or more teen pregnancy prevention programs that have been proven effective on the basis of rigorous scientific research to—

“(aa) delay or decrease sexual intercourse or sexual activity;

“(bb) increase contraceptive use among sexually active teens; or

“(cc) reduce teenage pregnancy.

“(II) The strategies incorporate one or more of the following strategies for preventing teenage pregnancy:

“(aa) Encouraging teenagers to delay sexual activity.

“(bb) Sex and HIV education.

“(cc) Preventive health services.

“(dd) Youth development programs.

“(ee) Service learning programs.

“(ff) Helping parents communicate with teens.

“(gg) Outreach or media programs.

“(III) The strategies provide information that is age-appropriate, factually and medically accurate and complete, and scientifically based.

“(D) SUBGRANT OR CONTRACT RECIPIENTS.—A State to which a grant is made under this paragraph for a fiscal year may award subgrants or contracts to—

“(i) State or local nonprofit coalitions or organizations working to prevent teenage pregnancy;

“(ii) State, local, or tribal agencies;

“(iii) schools;

“(iv) entities that provide after-school programs;

“(v) nonprofit community or faith-based organizations; or

“(vi) other organizations designated by the State.

“(E) SUPPLEMENTATION OF FUNDS.—A State to which a grant is made under this paragraph for a fiscal year shall use funds provided under the grant to supplement and not supplant funds that would otherwise be available to the State for preventing teen pregnancy.

“(F) REQUIREMENT.—As a condition on receipt of funds for activities under this paragraph, a grantee, subgrantee, or contractee shall agree that such activities will not include teaching or promoting religion.

“(G) DATA REPORTING.—A State to which a grant is made under this paragraph for a fiscal year shall cooperate with the Secretary to collect information and report on outcomes of programs funded under the grant, as specified by the Secretary.

“(H) APPROPRIATION.—To carry out this section, there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2010 through 2014.

“(I) EVALUATION.—

“(i) IN GENERAL.—The Secretary shall, by grant or contract, gather and disseminate information on effective practices, programs, and strategies for reducing teen pregnancy rates that are used by States that receive grants under this paragraph in order to allow other States, and leaders in the area of teen pregnancy prevention, to learn from the experiences of successful States. The Secretary shall publish an interim and final report summarizing and synthesizing outcomes and lessons learned pursuant to such grants, including a random-assignment evaluation of selected programs.

“(ii) APPROPRIATION.—The Secretary may use up to 10 percent of the amount appropriated under subparagraph (H) to carry out clause (i) for fiscal year 2010, and the amount shall remain available through fiscal year 2015.”.

SEC. 302. Establishing national goal to prevent teen pregnancy.

Section 905 of the Personal Responsibility and Work Opportunity Reconciliation Act of 1996 (42 U.S.C. 710 note) is amended to read as follows:

“SEC. 905. Establishing national goal to prevent teen pregnancy.

“(a) In General.—Not later than 90 days after the date of the enactment of this Act, the Secretary of Health and Human Services shall establish a national goal of reducing teen pregnancy by at least one-third over the subsequent ten years.

“(b) Report.—Not later than 12 months after the date of the enactment of the Preventing Unintended Pregnancies, Reducing the Need for Abortion, and Supporting Parents Act, and annually thereafter, the Secretary of Health and Human Services shall report to Congress with respect to the progress that has been made in meeting the national goal established under subsection (a) and with respect to State-level progress on reducing teen pregnancy.”.

SEC. 401. Demonstration grants to encourage creative approaches to teen pregnancy prevention.

(a) In General.—The Secretary may make grants to several public or nonprofit private entities for the purpose of assisting the entities in demonstrating innovative approaches to prevent teen pregnancies.

(b) Certain Approaches.—Approaches under subsection (a) may include approaches such as the following:

(1) Encouraging teen-driven approaches to pregnancy prevention.

(2) Exposing teens to realistic simulations of the physical, emotional, and financial consequences of pregnancy and parenting.

(3) Facilitating communication between parents and children, especially using programs that have been evaluated and proven effective.

(4) Reaching teens through innovative uses of media and technology.

(5) Helping teens develop healthy relationships.

(c) Matching Funds.—

(1) IN GENERAL.—With respect to the costs of the project to be carried out under subsection (a) by an applicant, a grant may be made under such subsection only if the applicant agrees to make available (directly or through donations from public or private entities) non-Federal contributions toward such costs in an amount that is not less than 25 percent of such costs ($1 for each $3 of Federal funds provided in the grant).

(2) DETERMINATION OF AMOUNT CONTRIBUTED.—Non-Federal contributions required in paragraph (1) may be in cash or in kind, fairly evaluated, including plant, equipment, or services. Amounts provided by the Federal Government, or services assisted or subsidized to any significant extent by the Federal Government, may not be included in determining the amount of such non-Federal contributions.

(d) Requirement.—As a condition on the receipt of funds for activities under this section, an applicant shall agree that such activities will not include teaching or promoting religion.

(e) Evaluation of Projects.—The Secretary shall establish criteria for the evaluation of projects under subsection (a). A grant may be made under such subsection only if the applicant involved—

(1) agrees to conduct evaluations of the project in accordance with such criteria;

(2) agrees to submit to the Secretary such reports describing the results of the evaluations as the Secretary determines to be appropriate; and

(3) submits to the Secretary, in the application under subsection (f), a plan for conducting the evaluations.

(f) Application for Grant.—A grant may be made under subsection (a) only if an application for the grant is submitted to the Secretary and the application is in such form, is made in such manner, and contains such agreements, assurances, and information, including the agreements under subsections (c) and (e) and the plan under subsection (e)(3), as the Secretary determines to be necessary to carry out this section.

(g) Report to Congress.—Not later than April 1, 2015, the Secretary shall submit to the Congress a report describing the extent to which projects under subsection (a) have been successful in reducing the rate of teen pregnancies in the communities in which the projects have been carried out. Such reports shall describe the various approaches used under subsection (a) and the effectiveness of each of the approaches.

(h) Authorization of Appropriations.—For the purpose of carrying out this section, there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2010 through 2014.

SEC. 501. Findings.

The Congress finds as follows:

(1) Teens with strong emotional attachments to their parents are more likely to delay becoming sexually active. Seven out of ten teens say that they are prepared to listen to things parents thought the teens were not ready to hear.

(2) Ninety percent of parents of teens report that they know they should talk to their teens about sex but often don’t know what to say, how to say it, or when to start the conversations.

SEC. 502. Creating a national initiative to enlist parents of adolescents in preventing teen pregnancy; provision of challenge grants for state and local programs.

(a) Grant.—The Secretary shall select on the basis of competitive grants, national nonpartisan, nonprofit organizations that meet the requirements of this section to establish and operate a national initiative for parents of adolescents to carry out the purposes and activities described in subsections (b) and (c) (referred to in this section as the “Initiative”).

(b) Requirements.—The Secretary may make a grant under this section only if—

(1) the organization has experience working to reduce teen pregnancy;

(2) the organization has a demonstrated ability to work with and provide assistance to a broad range of individuals and entities, including teens, parents, the entertainment and news media, State, tribal, and local organizations, teen pregnancy prevention practitioners, businesses, faith and community leaders, and researchers;

(3) the organization is research-based;

(4) the organization has comprehensive knowledge and data about teen pregnancy prevention strategies; and

(5) the organization agrees that the activities funded under this section will not include teaching or promoting religion.

(c) Purposes.—The purposes of the Initiative are to—

(1) support parents in their essential role in preventing teen pregnancy by equipping them with information and resources to promote and strengthen communication with their children about sex, values, and healthy relationships;

(2) develop and implement media campaigns to promote positive information and messages for parents about how they can help address teen pregnancy; and

(3) provide challenge grants to States and Native American tribes to promote parent education and involvement.

(d) Activities.—The grantees shall carry out the purposes described in subsection (c) through the following activities:

(1) Providing resources for parents and other adults (such as other family members, teachers, coaches, mentors, and faith leaders) that help to foster strong connections with children, including—

(A) online access to current research;

(B) user-friendly guides for parents;

(C) practical tips and advice from experts;

(D) alerts about new trends among teens;

(E) suggestions for how to use the entertainment media as a discussion-starter; and

(F) information about the rapidly-changing media environment of teens.

In order to efficiently reach and support parents, information shall be provided primarily through technological means, including the Internet.

(2) Using a portion of the funds available through this section to develop and implement media campaigns directly or through grants, contracts, or cooperative agreements with other entities. Such campaigns may include the production and distribution of printed materials and messages for print media, television, and radio broadcast media, the Internet, or such other new technology as may be appropriate for reaching large numbers of parents and other adults involved in the lives of teens. Special efforts shall be made to develop messages that are effective in reaching fathers as well as mothers. To the extent possible, funds used to develop and implement media campaigns under this subsection shall be matched with non-Federal resources, including in-kind contributions, from public and private entities. Such campaigns may also include the grantee providing consultation and serving as a source of factual information to individuals and organizations in the entertainment industry on issues related to teen pregnancy prevention that highlights the role of parents.

(3) Awarding challenge grants on a competitive basis to States and Indian tribes. Applicants shall submit a plan for how they would involve parents and other caregivers (such as grandparents, foster parents, and other guardians) in helping to reduce teen pregnancy through activities such as—

(A) workshops and community meetings;

(B) providing information through employers, civic associations, community and faith-based organizations, parent-teacher organizations, and other organizations that reach large numbers of parents; and

(C) innovative ways to provide education and support for parents through online communities and neighborhood-based activities.

(e) Authorization of Appropriation.—

(1) IN GENERAL.—For the purpose of carrying out this section, there is authorized to be appropriated $30,000,000 for each of fiscal years 2010 through 2014.

(2) CHALLENGE GRANTS.—Of the amount appropriated under paragraph (1) for a fiscal year, not less than $10,000,000 shall be made available for challenge grants under subsection (d)(3).

SEC. 601. Findings.

Congress makes the following findings:

(1) There are 11,500,000 students enrolled in community college and 60 percent of these students are women.

(2) 61 percent of women who have children after enrolling in community college fail to finish their degree. This drop-out rate is 65 percent higher than that of women who don’t have children.

(3) Approximately 15 percent of all community college students are single parents compared to 6 percent at 4-year colleges.

(4) Only two out of ten students at 2-year institutions report receiving information from their college on pregnancy prevention, compared to 33 percent of students at 4-year institutions.

(5) Few community colleges have the resources to provide information, education, or other activities focused on healthy relationships or pregnancy prevention and planning.

(6) For women with some college, 53 percent of pregnancies were unplanned. This is twice as high as the percent of pregnancies that are unplanned for college graduates (26 percent).

SEC. 602. Demonstration grants to prevent unplanned pregnancy among community college students.

(a) In General.—The Secretary of Education shall award demonstration grants under this section on a competitive basis to community colleges for the purpose of developing and implementing innovative approaches to prevent unplanned pregnancy and promote healthy relationships among women and men in community colleges in order to remove a barrier to degree completion by these students, reduce poverty among these students, and improve the success of these students.

(b) Requirements.—A grant may be made under this section only if the applicant for the grant agrees that—

(1) all information provided will be factually and medically accurate and complete, and scientifically based; and

(2) the activities funded under this title will not include teaching or promoting religion.

(c) Activities.—

(1) IN GENERAL.—A grant made under this section may be used for one or more of the following:

(A) Developing educational content to incorporate in first-year orientation or core courses where appropriate.

(B) Creating innovative technology-based approaches to deliver messages and information to students, faculty, and staff.

(C) Training for targeted faculty and staff on how unplanned pregnancy affects student success and ways to help students address this issue.

(D) Creating partnerships with community-based organizations who have expertise in addressing pregnancy prevention or healthy relationships.

(E) Developing and employing peer-outreach and education to generate discussion and raise awareness among students.

(F) Providing campus-based family planning services.

(G) Teaching students about developing healthy relationships, including the prevention of dating and sexual violence.

(H) Providing students with information regarding the dynamics and nature of domestic violence, dating violence, sexual assault, sexual coercion, or stalking; its implications for unintended pregnancy and sexually transmitted infections and HIV; and strategies to manage health in the context of a violent relationship.

(2) INTEGRATION.—Activities funded through a grant under this title should be integrated into the academic or support areas of the community colleges in order to reach a large number of students. Priority should be given to activities that could operate on a sustained basis after the grant ends.

(d) Evaluation of projects.—The Secretary shall establish criteria for the evaluation of projects funded under this section. A grant may be made only if the applicant involved—

(1) agrees to participate in an independent evaluation of the project in accordance with such criteria; and

(2) agrees to submit to the Secretary such data as the Secretary determines to be appropriate.

(e) Definition.—For the purpose of this section, the term “community college” means an institution of higher education (as such term is defined in section 101(a) of the Higher Education Act of 1965 (20 U.S.C. 1001(a))) at which the highest degree offered is predominantly the associate’s degree.

(f) Authorization of appropriations.—

(1) IN GENERAL.—For the purpose of carrying out this section, there is authorized to be appropriated $15,000,000 for each of fiscal years 2010 through 2012.

(2) ALLOCATION.—Of the amount appropriated to carry out this section for a fiscal year—

(A) at least 5 percent shall be made available—

(i) for technical assistance for the projects funded under this section;

(ii) to raise awareness of the issue of pregnancy prevention; and

(iii) to disseminate promising practices among community colleges and other similar postsecondary institutions; and

(B) up to 10 percent shall be made available for evaluations of the projects.

SEC. 701. Clarification of continued medicaid coverage of family planning services.

(a) In General.—Section 1937(b) of the Social Security Act (42 U.S.C. 1396u–7(b)) is amended by adding at the end the following:

“(5) COVERAGE OF FAMILY PLANNING SERVICES AND SUPPLIES.—Notwithstanding the previous provisions of this section, a State may not provide for medical assistance through enrollment of an individual with benchmark coverage or benchmark equivalent coverage under this section unless such coverage includes, for any individual (described in section 1905(a)(4)(C)) medical assistance for family planning and services in accordance with such section.”.

(b) Effective Date.—

(1) IN GENERAL.—The amendment made by this section shall take effect on October 1, 2010.

(2) EXTENSION OF EFFECTIVE DATE FOR STATE LAW AMENDMENT.—In the case of a State plan under title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) which the Secretary of Health and Human Services determines requires State legislation in order for the plan to meet the additional requirements imposed by the amendments made by this section, the State plan shall not be regarded as failing to comply with the requirements of such title solely on the basis of its failure to meet these additional requirements before the first day of the first calendar quarter beginning after the close of the first regular session of the State legislature that begins after the date of enactment of this Act. For purposes of the previous sentence, in the case of a State that has a 2-year legislative session, each year of the session is considered to be a separate regular session of the State legislature.

SEC. 801. Expanded medicaid eligibility for family planning services.

(a) Coverage as Mandatory Categorically Needy Group.—

(1) IN GENERAL.—Section 1902(a)(10)(A)(i) of the Social Security Act (42 U.S.C. 1396a(a)(10)(A)(i)) is amended—

(A) in subclause (VI), by striking “or” at the end;

(B) in subclause (VII), by adding “or” at the end; and

(C) by adding at the end the following new subclause:

“(VIII) who are described in subsection (gg) (relating to individuals who meet the income standards for pregnant women);”.

(2) GROUP DESCRIBED.—Section 1902 of such Act (42 U.S.C. 1396a) is amended by adding at the end the following new subsection:

“(gg)(1) Individuals described in this subsection are individuals who—

“(A) meet at least the income eligibility standards established under the State plan as of January 1, 2009, for pregnant women or such higher income eligibility standard for such women as the State may establish; and

“(B) are not pregnant.

“(2) At the option of a State, individuals described in this subsection may include individuals who are determined to meet the income eligibility standards referred to in paragraph (1)(A) under the terms and conditions applicable to making eligibility determinations for medical assistance under this title under a waiver to provide the benefits described in clause (XV) of the matter following subparagraph (G) of section 1902(a)(10) granted to the State under section 1115 as of January 1, 2007.”.

(3) LIMITATION ON BENEFITS.—Section 1902(a)(10) of the Social Security Act (42 U.S.C. 1396a(a)(10)) is amended in the matter following subparagraph (G)—

(A) by striking “and (XIV)” and inserting “(XIV)”; and

(B) by striking the semicolon at the end and inserting “, and (XV) the medical assistance made available to an individual described in subsection (gg) who is eligible for medical assistance only because of subparagraph (A)(i)(VIII) shall be limited to family planning services and supplies described in section 1905(a)(4)(C) and, at the State’s option, medical diagnosis or treatment services that are provided in conjunction with a family planning service in a family planning setting provided during the period in which such an individual is eligible”.

(4) CONFORMING AMENDMENTS.—Section 1905(a) of the Social Security Act (42 U.S.C. 1396d(a)) is amended in the matter preceding paragraph (1)—

(A) in clause (xii), by striking “or” at the end;

(B) in clause (xiii), by adding “or” at the end; and

(C) by inserting after clause (xiii) the following:

“(xiv) individuals described in section 1902(gg),”.

(b) Presumptive Eligibility.—

(1) IN GENERAL.—Title XIX of the Social Security Act (42 U.S.C. 1396 et seq.) is amended by inserting after section 1920B the following:

PRESUMPTIVE ELIGIBILITY FOR FAMILY PLANNING SERVICES

“Sec. 1920C. (a) State Option.—A State plan approved under section 1902 may provide for making medical assistance available to an individual described in section 1902(gg) (relating to individuals who meet the income eligibility standard for pregnant women in the State) during a presumptive eligibility period. In the case of an individual described in section 1902(gg) who is eligible for medical assistance only because of section 1902(a)(10)(i)(VIII), such medical assistance may be limited to family planning services and supplies described in 1905(a)(4)(C) and, at the State’s option, medical diagnosis or treatment services that are provided in conjunction with a family planning service in a family planning setting provided during the period in which such an individual is eligible.

“(b) Definitions.—For purposes of this section:

“(1) PRESUMPTIVE ELIGIBILITY PERIOD.—The term ‘presumptive eligibility period’ means, with respect to an individual described in subsection (a), the period that—

“(A) begins with the date on which a qualified entity determines, on the basis of preliminary information, that the individual is described in section 1902(gg); and

“(B) ends with (and includes) the earlier of—

“(i) the day on which a determination is made with respect to the eligibility of such individual for services under the State plan; or

“(ii) in the case of such an individual who does not file an application by the last day of the month following the month during which the entity makes the determination referred to in subparagraph (A), such last day.

“(2) QUALIFIED ENTITY.—

“(A) IN GENERAL.—Subject to subparagraph (B), the term ‘qualified entity’ means any entity that—

“(i) is eligible for payments under a State plan approved under this title; and

“(ii) is determined by the State agency to be capable of making determinations of the type described in paragraph (1)(A).

“(B) REGULATIONS.—The Secretary may issue regulations further limiting those entities that may become qualified entities in order to prevent fraud and abuse and for other reasons.

“(C) RULE OF CONSTRUCTION.—Nothing in this paragraph shall be construed as preventing a State from limiting the classes of entities that may become qualified entities, consistent with any limitations imposed under subparagraph (B).

“(c) Administration.—

“(1) IN GENERAL.—The State agency shall provide qualified entities with—

“(A) such forms as are necessary for an application to be made by an individual described in subsection (a) for medical assistance under the State plan; and

“(B) information on how to assist such individuals in completing and filing such forms.

“(2) NOTIFICATION REQUIREMENTS.—A qualified entity that determines under subsection (b)(1)(A) that an individual described in subsection (a) is presumptively eligible for medical assistance under a State plan shall—

“(A) notify the State agency of the determination within 5 working days after the date on which determination is made; and

“(B) inform such individual at the time the determination is made that an application for medical assistance is required to be made by not later than the last day of the month following the month during which the determination is made.

“(3) APPLICATION FOR MEDICAL ASSISTANCE.—In the case of an individual described in subsection (a) who is determined by a qualified entity to be presumptively eligible for medical assistance under a State plan, the individual shall apply for medical assistance by not later than the last day of the month following the month during which the determination is made.

“(d) Payment.—Notwithstanding any other provision of this title, medical assistance that—

“(1) is furnished to an individual described in subsection (a)—

“(A) during a presumptive eligibility period; and

“(B) by a entity that is eligible for payments under the State plan; and

“(2) is included in the care and services covered by the State plan, shall be treated as medical assistance provided by such plan for purposes of clause (4) of the first sentence of section 1905(b).”.

SEC. 901. Extending postpartum coverage for Medicaid and CHIP.

(a) Medicaid coverage extension.—

(1) Section 1902 of the Social Security Act (42 U.S.C. 1306a) is amended—

(A) in subsections (e)(5), (e)(6), and (l)(1)(A), by striking “60-day” and inserting “1-year” each place it appears; and

(B) in the matter in subsection (a)(10) following subparagraph (G)—

(i) in clause (V), by inserting “, except that the limit on medical assistance under this clause does not apply during the 1-year period beginning on the last day of the pregnancy” after “under the State plan”; and

(ii) in clause (VII), by inserting “, except that the limit on medical assistance under this clause does not apply during the 1-year period beginning on the last day of the pregnancy” after “may complicate pregnancy”.

(2) Section 1903(v)(4)(A)(i) of such Act (42 U.S.C. 1396b(v)(4)(A)(i)) is amended by striking “60-day” and inserting “1-year”.

(3) Section 1938(b)(2)(C) of such Act (42 U.S.C. 1396u–8(b)(2)(C)) is amended by striking “60 days” and inserting “1 year”.

(b) SCHIP.—

(1) Section 2112(d)(2)(A) of such Act (42 U.S.C. 1397ll(d)(2)(A)) is amended—

(A) in subsections (d)(2)(A) and (f)(2), by striking “60-day” and inserting “1-year” each place it appears; and

(B) in subsection (f)(2)—

(i) in the heading by striking “postpartum services” and inserting “services postpartum”;

(ii) by striking “may continue” and inserting “shall continue”;

(iii) by striking “, as well as postpartum services,” and “and postpartum services”; and

(iv) by striking “, but only if” and all that follows up to the period at the end.

SEC. 902. Coordination with the maternal and child health program.

(a) In General.—Section 2102(b)(3) of the Social Security Act (42 U.S.C. 1397bb(b)(3)) is amended—

(1) in subparagraph (D), by striking “and” at the end;

(2) in subparagraph (E), by striking the period and inserting “; and”; and

(3) by adding at the end the following new subparagraph:

“(F) that operations and activities under this title are developed and implemented in consultation and coordination with the program operated by the State under title V in areas including outreach and enrollment, benefits and services, service delivery standards, public health and social service agency relationships, and quality assurance and data reporting.”.

(b) Conforming Medicaid Amendment.—Section 1902(a)(11) of such Act (42 U.S.C. 1396a(a)(11)) is amended—

(1) by striking “and” before “(C)”; and

(2) by inserting before the semicolon at the end the following: “, and (D) provide that operations and activities under this title are developed and implemented in consultation and coordination with the program operated by the State under title V in areas including outreach and enrollment, benefits and services, service delivery standards, public health and social service agency relationships, and quality assurance and data reporting”.

(c) Effective Date.—The amendments made by this section take effect on January 1, 2010.

SEC. 903. Increase in SCHIP income eligibility.

(a) Definition of Low-Income Child.—Section 2110(c)(4) of the Social Security Act (42 U.S.C. 1397jj(c)(4)) is amended by striking “200” and inserting “250”.

(b) Effective Date.—The amendment made by subsection (a) applies to child health assistance provided and allotments determined under section 2104 of the Social Security Act (42 U.S.C. 1397dd) for fiscal years beginning with fiscal year 2010.

SEC. 904. Outreach program to encourage those eligible for services to enroll.

The Secretary shall make such funds available as may be necessary to encourage eligible pregnant women to enroll for services under this title.

SEC. 1001. Short title.

This title may be cited as the “Title X Family Planning Services Act of 2009”.

SEC. 1002. Authorization of appropriations.

For the purpose of making grants and contracts under section 1001 of the Public Health Service Act (42 U.S.C. 300), there are authorized to be appropriated $700,000,000 for fiscal year 2010, and such sums as may be necessary for each subsequent fiscal year.

SEC. 1101. Removal of pregnancy as a preexisting condition under individual health insurance coverage.

(a) In General.—Title XXVII of the Public Health Service Act (42 U.S.C. 300gg et seq.) is amended by inserting after section 2753 the following:

“SEC. 2754. Preexisting condition exclusion not applicable to pregnancy.

“Individual health insurance coverage, and a health insurance issuer offering individual health insurance coverage, may not impose any preexisting condition exclusion relating to pregnancy as a preexisting condition.”.

(b) Effective Date.—The amendment made by subsection (a) shall apply to coverage provided on or after January 1, 2010.

SEC. 1102. Coverage of maternity care in the individual market.

(a) In general.—Title XXVII of the Public Health Service Act (42 U.S.C. 300gg et seq.), as amended by section 1101, is further amended by inserting after section 2754 the following:

“SEC. 2755. Coverage of maternity care.

“(a) In general.—A health insurance issuer offering health insurance in the individual market that is issued, amended, renewed, or delivered on or after the date of enactment of this section, shall provide coverage for maternity services.

“(b) Maternity services defined.—In this section the term ‘maternity services’ includes preconception, prenatal care, necessary immunizations, mental health screening and services, ambulatory care maternity services, complications of pregnancy, neonatal care, inpatient hospital maternity care including labor and delivery, including c-sections, and postpartum care including family planning services.

“(c) Non-Preemption.—Nothing in this section shall be construed to preempt any State law in effect as of the date of enactment of this section, with respect to health insurance that requires coverage of maternity services that exceeds the minimum coverage requirements as specified in subsection (a).”.

(b) Effective date.—The amendment made by subsection (a) shall apply to coverage provided on or after January 1, 2010.

SEC. 1201. Grants to health centers for purchase of ultrasound equipment.

Part B of title III of the Public Health Service Act (42 U.S.C. 243 et seq.) is amended by inserting after section 317L the following:

“SEC. 317L–1. Grants for the purchase or upgrade of ultrasound equipment.

“(a) In General.—The Secretary may make grants for the purchase of ultrasound equipment. Such ultrasound equipment shall be used by the recipients of such grants to provide ultrasound examinations to pregnant women consenting to such services.

“(b) Eligibility Requirements.—An entity may receive a grant under subsection (a) only if—

“(1) the entity is a health center eligible to receive a grant under section 330; and

“(2) the entity follows practice standards supported by the American Institute of Ultrasound in Medicine and other professional organizations representing health care providers.

“(c) Application for Grant.—A grant may be made under subsection (a) only if an application for the grant is submitted in such form, in such manner, and containing such agreements, assurances, and information as the Secretary determines to be necessary.

“(d) Annual Report to Secretary.—A grant may be made under subsection (a) only if the applicant for the grant agrees to report on an annual basis to the Secretary, in such form and manner as the Secretary may require, on the ongoing compliance of the applicant with the eligibility conditions established in this section.

“(e) Authorization of Appropriations.—For the purpose of carrying out this section, there are authorized to be appropriated $3,000,000 for fiscal year 2010, and such sums as may be necessary for each of fiscal years 2011 through 2013.”

SEC. 1301. Findings.

The Congress finds as follows:

(1) On average, almost 500 women are raped or sexually assaulted each day in the United States and 4,800,000 intimate partner related physical assaults and rapes are experienced by women each year.

(2) Homicide was found to be a leading cause of pregnancy-associated injury deaths among women from 1991–1999. The pregnancy-associated homicide ratio was 1.7 per 100,000 live births.

(3) Women experiencing abuse in the year prior to and/or during a recent pregnancy are 40 to 60 percent more likely than non-abused women to report high-blood pressure, vaginal bleeding, severe nausea, kidney or urinary tract infections and hospitalization during pregnancy and are 37 percent more likely to deliver preterm.

(4) Children born to abused mothers are 17 percent more likely to be born underweight and more than 30 percent more likely than other children to require intensive care upon birth.

(5) Too few doctors screen their patients for abuse, even though up to one in 12 pregnant women are battered.

(6) Physical violence is linked to STD and HIV transmission, miscarriages, and risky sexual health behavior.

(7) A study found women who experienced intimate partner violence were more likely to report a lack of contraception use due to partner control over contraception.

(8) Two in five adult women who have been abused by partners have experienced an unwanted pregnancy.

SEC. 1302. Separate program to identify and treat women who are victims of or at risk of domestic violence, dating violence, sexual assault, sexual coercion, or stalking.

(a) Allotments.—For the purpose described in subsection (b), the Secretary shall, for fiscal year 2008 and each subsequent fiscal year, allot to each State that has transmitted an application for the fiscal year under section 505(a) of the Social Security Act an amount equal to the product of—

(1) the amount appropriated under subsection (d) for the fiscal year; and

(2) the percentage determined for the State under section 502(c)(1)(B)(ii) of such Act.

(b) Purpose.—The purpose of an allotment under subsection (a) with respect to a State is to enable the State to better identify and treat women who are victims of or at risk of domestic violence, dating violence, sexual assault, sexual coercion, or stalking through training health care professionals and behavioral and public health staff how to identify, assess, treat, and refer such women. Such training shall include—

(1) identifying patients or clients at risk of or experiencing domestic violence, dating violence sexual assault, sexual coercion, or stalking;

(2) assessing the immediate safety of the patient or client, the impact of the abuse on the health of the patient, and assisting the patient in developing a plan to promote her safety;

(3) examining and treating such patients or clients, including providing information regarding the dynamics and nature of domestic violence, dating violence sexual assault, sexual coercion, or stalking;

(4) providing information regarding its implications for unintended pregnancy and sexually transmitted infections and HIV;

(5) emphasizing strategies to manage the patient or client’s health, including unintended pregnancies, in the context of a violent relationship;

(6) maintaining complete medical or forensic records that include the documentation of the examination, treatment given, and referrals made, and establishing mechanisms to ensure the privacy and confidentiality of those medical records;

(7) referring the patient or client to public and private nonprofit entities that provide services for such victims; and

(8) ensuring that all services are provided in a linguistically and culturally relevant manner.

(c) Application of Provisions.—

(1) IN GENERAL.—Sections 503, 507, and 508 of the Social Security Act apply to allotments under subsection (a) to the same extent and in the same manner as such sections apply to allotments under section 502(c) of such Act.

(2) SECRETARIAL DISCRETION.—Sections 505 and 506 of the Social Security Act apply to allotments under subsection (a) to the extent determined by the Secretary to be appropriate.

(d) Authorization of Appropriations.—For the purpose of making allotments under subsection (a), there is authorized to be appropriated $4,000,000 for each of fiscal years 2010 through 2014.

SEC. 1303. Additional authorization of appropriations for public campaign to increase public awareness.

Section 403 of the Violence Against Women and Department of Justice Reauthorization Act of 2005 (42 U.S.C. 14045c) is amended—

(1) in subsection (a), by inserting “women, including” after “against”; and

(2) in subsection (b), by striking “such sums” and all that follows and inserting the following: “$5,000,000 for fiscal year 2010, and such sums as may be necessary for each of fiscal years 2011 through 2014.”.

SEC. 1401. Support services for students.

(a) In General.—The Secretary of Education may make grants to institutions of higher education (as defined in section 102 of the Higher Education Act of 1965 (20 U.S.C. 1002)) that receive Federal financial assistance to carry out demonstration projects for the purpose of providing services to assist students who have decided to carry their pregnancies to term, including those anticipating adoption, and parenting students, in continuing their studies and graduating.

(b) Application.—Each institution of higher education desiring a grant under this section shall submit to the Secretary of Education an application in such form, in such manner, and containing such agreements, assurances, and information as the Secretary determines to be necessary to carry out this section. Such application shall include an assurance that the institution will—

(1) provide the services offered under the demonstration program carried out with such grant through on-campus facilities; and

(2) submit to the Secretary, for each fiscal year for which such grant is awarded, a report describing the activities carried out under the grant and the effects of the activities on the students to whom services are provided.

(c) Limitations on amount of grant.—Each grant awarded under subsection (a) for a fiscal year shall be for an amount that is not more than $25,000.

(d) Authorization of appropriations.—For the purpose of carrying out this section, there are authorized to be appropriated $500,000 for each of fiscal years 2010 through 2014.

SEC. 1402. Child care access means parents in school program.

Section 419N(b)(2)(B) of the Higher Education Act of 1965 (20 U.S.C. 1070e(b)(2)(B)) is amended to read as follows:

“(B) MINIMUM.—A grant under this section shall be awarded in an amount that is not less than $30,000.”.

SEC. 1501. Grants for a national information campaign on adoption.

(a) Grants.—The Secretary shall select on the basis of competitive grants, national nonpartisan, nonprofit organizations that meet the requirements of this section to establish national information campaigns to educate the public about adoption, including foster care adoption, and resources available to prospective and current adoptive parents, and to carry out the purposes and activities described in subsections (c) and (d).

(b) Requirements for grant.—The Secretary may award a grant under this section to an entity only if the Secretary determines that—

(1) the organization has experience in the field of adoption and foster care, which includes, but is not limited to, research and education;

(2) the organization is research-based;

(3) the organization has comprehensive knowledge and data about adoption and foster care;

(4) the organization has a demonstrated ability to work with and provide assistance to a broad range of individuals and entities; and

(5) the organization has provided assurances satisfactory to the Secretary that the activities funded under this section will not include teaching or promoting religion.

(c) Purposes.—Purposes under subsection (a) may include the following:

(1) Developing and implementing comprehensive information campaigns to promote accurate positive information and messages on adoption, including foster care adoption, and the benefits it can bring to children and families.

(2) Reaching the public in a linguistically and culturally relevant manner, dispelling negative stereotypes while promoting accurate, comprehensive positive information and messages about adoption, including foster care adoption.

(d) Activities.—Each grantee shall carry out the purposes described in subsection (c) and develop and implement information campaigns directly or through grants, contracts, or cooperative agreements with other entities. Activities may include the following:

(1) Public service announcements.

(2) Paid educational messages for print media.

(3) Public transit advertising.

(4) Radio broadcast media.

(5) Internet.

(6) Other new technology as may be appropriate for reaching a large audience.

(7) Providing information through community and faith-based organizations.

(8) Providing workshops or trainings for media, professionals, and other relevant parties.

(e) Submission of plan.—

(1) IN GENERAL.—To be eligible to receive a grant under this section, a grantee shall submit to the Secretary an application that meets the requirements of paragraph (2).

(2) REQUIREMENTS.—An application under this subsection shall be submitted in such form, in such manner, and containing such information and assurances as the Secretary may prescribe, and shall include the following:

(A) A complete description of applicant’s plan for the proposed public information campaign.

(B) A description of the positive messages for the proposed public information campaign.

(C) An identification of the media organizations and other groups through which the campaign will be carried out.

(D) A description of the nature, amount, distribution, and timing of informational messages to be used in the campaign.

(E) If targeting specific communities and groups, an identification of the specific communities and groups to be educated by the campaign, and a description of how the campaign will educate the communities and groups.

(F) If targeting specific communities and groups, the plans of the applicant with respect to working with organizations that have expertise in developing culturally appropriate informational messages.

(G) A description of the geographic distribution of the campaign.

(H) Such other information and assurances as the Secretary may require.

(f) Evaluation of project.—The Secretary shall establish criteria for the evaluation of projects. A grant may be made only if the grantee involved—

(1) agrees to participate in an independent evaluation of the project in accordance with such criteria; and

(2) agrees to submit to the Secretary such data as the Secretary determines to be appropriate.

(g) Authorization of appropriations.—

(1) IN GENERAL.—For the purpose of carrying out this section, there is authorized to be appropriated $30,000,000 for each of fiscal years 2010 through 2014.

(2) EVALUATION.—Of the total amount appropriated to carry out this section for a fiscal year, not more than 10 percent may be made available for the evaluation of projects.

SEC. 1601. Expansion of adoption credit and adoption assistance programs.

(a) Increase in Dollar Limitation.—

(1) ADOPTION CREDIT.—

(A) IN GENERAL.—Paragraph (1) of section 23(b) of the Internal Revenue Code of 1986 (relating to dollar limitation) is amended by striking “$10,000” and inserting “$15,000”.

(B) CHILD WITH SPECIAL NEEDS.—Paragraph (3) of section 23(a) of such Code (relating to $10,000 credit for adoption of child with special needs regardless of expenses) is amended—

(i) in the text by striking “$10,000” and inserting “$15,000”, and

(ii) in the heading by striking “$10,000” and inserting “$15,000”.

(C) CONFORMING AMENDMENT TO INFLATION ADJUSTMENT.—Subsection (h) of section 23 of such Code (relating to adjustments for inflation) is amended to read as follows:

“(h) Adjustments for Inflation.—

“(1) DOLLAR LIMITATIONS.—In the case of a taxable year beginning after December 31, 2010, each of the dollar amounts in subsections (a)(3) and (b)(1) shall be increased by an amount equal to—

“(A) such dollar amount, multiplied by

“(B) the cost-of-living adjustment determined under section 1(f)(3) for the calendar year in which the taxable year begins, determined by substituting ‘calendar year 2009’ for ‘calendar year 1992’ in subparagraph (B) thereof.

If any amount as increased under the preceding sentence is not a multiple of $10, such amount shall be rounded to the nearest multiple of $10.

“(2) INCOME LIMITATION.—In the case of a taxable year beginning after December 31, 2002, the dollar amount in subsection (b)(2)(A)(i) shall be increased by an amount equal to—

“(A) such dollar amount, multiplied by

“(B) the cost-of-living adjustment determined under section 1(f)(3) for the calendar year in which the taxable year begins, determined by substituting ‘calendar year 2001’ for ‘calendar year 1992’ in subparagraph (B) thereof.

If any amount as increased under the preceding sentence is not a multiple of $10, such amount shall be rounded to the nearest multiple of $10.”.

(2) ADOPTION ASSISTANCE PROGRAMS.—

(A) IN GENERAL.—Paragraph (1) of section 137(b) of the Internal Revenue Code of 1986 (relating to dollar limitation) is amended by striking “$10,000” and inserting “$15,000”.

(B) CHILD WITH SPECIAL NEEDS.—Paragraph (2) of section 137(a) of such Code (relating to $10,000 exclusion for adoption of child with special needs regardless of expenses) is amended—

(i) in the text by striking “$10,000” and inserting “$15,000”, and

(ii) in the heading by striking “$10,000” and inserting “$15,000”.

(C) CONFORMING AMENDMENT TO INFLATION ADJUSTMENT.—Subsection (f) of section 137 of such Code (relating to adjustments for inflation) is amended to read as follows:

“(f) Adjustments for Inflation.—

“(1) DOLLAR LIMITATIONS.—In the case of a taxable year beginning after December 31, 2010, each of the dollar amounts in subsections (a)(2) and (b)(1) shall be increased by an amount equal to—

“(A) such dollar amount, multiplied by

“(B) the cost-of-living adjustment determined under section 1(f)(3) for the calendar year in which the taxable year begins, determined by substituting ‘calendar year 2009’ for ‘calendar year 1992’ in subparagraph (B) thereof.

If any amount as increased under the preceding sentence is not a multiple of $10, such amount shall be rounded to the nearest multiple of $10.

“(2) INCOME LIMITATION.—In the case of a taxable year beginning after December 31, 2002, the dollar amount in subsection (b)(2)(A) shall be increased by an amount equal to—

“(A) such dollar amount, multiplied by

“(B) the cost-of-living adjustment determined under section 1(f)(3) for the calendar year in which the taxable year begins, determined by substituting ‘calendar year 2001’ for ‘calendar year 1992’ in subparagraph thereof.

If any amount as increased under the preceding sentence is not a multiple of $10, such amount shall be rounded to the nearest multiple of $10.”.

(b) Credit Made Refundable.—

(1) CREDIT MOVED TO SUBPART RELATING TO REFUNDABLE CREDITS.—The Internal Revenue Code of 1986 is amended—

(A) by redesignating section 23, as amended by subsection (a), as section 36B, and

(B) by moving section 36B (as so redesignated) from subpart A of part IV of subchapter A of chapter 1 to the location immediately before section 37 in subpart C of part IV of subchapter A of chapter 1.

(2) CONFORMING AMENDMENTS.—

(A) Section 24(b)(3)(B) of such Code is amended by striking “sections 23,”.

(B) Section 25(e)(1)(C) of such Code is amended—

(i) in clause (i) by striking “23, 25D,” and inserting “25D”, and

(ii) in clause (ii) by striking “23,”.

(C) Section 25A(i)(5)(B) of such Code is amended by striking “23, 25D” and inserting “25D”.

(D) Section 25B(g)(2) of such Code is amended by striking “23,”.

(E) Section 26(a)(1) of such Code is amended by striking “23,”.

(F) Section 30(c)(2)(B)(ii) of such Code is amended by striking “23, 25D” and inserting “25D”.

(G) Section 30B(g)(2)(B)(ii) of such Code is amended by striking “23,”.

(H) Section 30D(c)(2)(B)(ii) of such Code is amended by striking “sections 23 and” and inserting “section”.

(I) Section 36B of such Code, as so redesignated, is amended—

(i) by striking paragraph (4) of subsection (b), and

(ii) by striking subsection (c).

(J) Section 137 of such Code is amended—

(i) in subsection (d) by striking “section 23(d)” and inserting “section 36B(d)”, and

(ii) in subsection (e) by striking “section 23” and inserting “section 36B”.

(K) Section 904(i) of such Code is amended by striking “23,”.

(L) Section 1016(a)(26) is amended by striking “23(g)” and inserting “36B(g)”.

(M) Section 1400C(d) of such Code is amended by striking “23,”.

(N) The table of sections for subpart A of part IV of subchapter A of chapter 1 of such Code of 1986 is amended by striking the item relating to section 23.

(O) Paragraph (2) of section 1324(b) of title 31, United States Code, is amended by inserting “36B,” after “36A,”.

(P) The table of sections for subpart C of part IV of subchapter A of chapter 1 of the Internal Revenue Code of 1986 is amended by striking the last item and inserting the following new items:


“Sec. 36B. Adoption expenses.”.

(c) Modifications Made by EGTRRA to Adoption Credit Made Permanent.—Title IX of the Economic Growth and Tax Relief Reconciliation Act of 2001 shall not apply to the amendments made by section 202 of such Act.

(d) Effective Date.—The amendments made by this section shall apply to taxable years beginning after December 31, 2009.

SEC. 1701. Increased support for WIC program.

(a) Findings.—Congress finds the following:

(1) The special supplemental nutrition program for women, infants, and children (WIC) authorized by section 17 of the Child Nutrition Act of 1966 (42 U.S.C. 1786) serves over 9,000,000 women, infants, and children.

(2) Over half of all infants in the United States and 1 in 4 young children under age 5 get crucial health and nutrition benefits from the WIC Program.

(3) It is estimated that every dollar spent on WIC results in between $1.92 and $4.21 in Medicaid savings for newborns and their mothers.

(4) The WIC program has been proven to increase the number of women receiving prenatal care, reduce the incidence of low birth weight and fetal mortality, reduce anemia, and enhance the nutritional quality of the diet of mothers and children.

(5) The WIC program’s essential, effective nutrition services include nutrition assessment, counseling and education, obesity prevention, breastfeeding support and promotion, prenatal and pediatric health care referrals and follow-up, spousal and child abuse referral, drug and alcohol abuse referral, immunization screening, assessment and referral, and a host of other services for mothers and children.

(6) One in 10 people eligible to participate in the WIC program are unable to receive WIC services.

(b) Extending certification period.—Section 17(d)(3)(A) of the Child Nutrition Act of 1966 (42 U.S.C. 1786(d)(3)(A)) is amended by adding at the end the following:

“(iii) CHILDREN.—A State may elect to certify children for a period of 1 year.”.

(c) Promoting and supporting breastfeeding.—

(1) The second sentence of section 17(a) of the Child Nutrition Act of 1966 (42 U.S.C. 1786(a)) is amended to read as follows: “It is, therefore, the purpose of the program authorized by this section to provide, up to the authorization levels set forth in subsection (g) of this section, supplemental foods, nutrition education, and breastfeeding support and promotion through any eligible local agency that applies for participation in the program.”

(2) Section 17(h)(10)(B)(iii) of the Child Nutrition Act of 1966 (42 U.S.C. 1786(h)(10(B)(iii)) is amended to read as follows:

“(iii) $40,000,000 shall be used for special nutrition education such as breastfeeding peer counselors and other related activities.”.

(3) Section 17(h)(1)(C)(ii) of the Child Nutrition Act of 1966 (42 U.S.C. 1786(h)(1)(C)(ii)) is amended to read as follows:

“(ii) BREAST PUMPS.—A State agency may, without restriction, use amounts available under clause (i) for the provision of breast pumps needed to serve participants.”.

(d) Appropriating funding for WIC.—Section 17(g)(1)(A) of the Child Nutrition Act of 1966 (42 U.S.C. 1786(g)(1)(A)) is amended to read as follows:

“(A) AUTHORIZATION.—There are authorized to be appropriated to carry out this section—

“(i) $7,777,000,000 for fiscal year 2010, of which—

“(I) $40,000,000 shall be made available for breastfeeding peer counselors;

“(II) $40,000,000 shall be made available for infrastructure needs;

“(III) $60,000,000 shall be made available for management information systems; and

“(IV) $5,000,000 shall be made available to support rigorous health outcomes research and evaluation.

“(ii) such sums as may be necessary for fiscal year 2011.”.

SEC. 1702. Nutritional support for low-income parents.

Section 5(c)(2) of the Food and Nutrition Act of 2008 (7 U.S.C. 2014(c)(2)) is amended by striking “30 percentum” and inserting “85 percent”.

SEC. 1703. Increased funding for the child care and development block grant program.

Section 658B of the Child Care and Development Block Grant Act of 1990 (42 U.S.C. 9858) is amended by striking “$1,000,000,000 for each of fiscal years 1996 through 2002” and inserting “$4,127,000,000 for each of fiscal years 2010 through 2016”.

SEC. 1704. Free home visits by trained home visitors for education on health and developmental needs of infants and toddlers for low-income families.

(a) In general.—The Secretary may make grants to health departments and schools to provide to eligible families, without charge, education on the health and developmental needs of their infants through visits to their homes by trained home visitors.

(b) Definitions.—In this section:

(1) ELIGIBLE FAMILY.—The term “eligible family” means a family that—

(A) has low income; and

(B) includes the parents or caregivers of a child who has not yet entered kindergarten.

(2) LOW INCOME.—

(A) IN GENERAL.—The term “low income” means income not exceeding 200 percent of the poverty line for a family of the size involved.

(B) SPECIAL RULE.—For purposes of this section, a family that has low income when the provision of home visitation services to the family commences shall be considered to have low income throughout the course of receiving the services.

(3) POVERTY LINE.—The term “poverty line” has the meaning given the term in section 673(2) of the Community Services Block Grant Act (42 U.S.C. 9902(2)), including any revision required by such section.

(c) Certain requirements.—A grant may be made under subsection (a) only if the applicant involved agrees as follows:

(1) The program carried out under subsection (a) by the applicant will be designed to instill in eligible families confidence in their abilities to provide for the health needs of their newborns, including through—

(A) providing information on child development; and

(B) soliciting questions from the families.

(2) The trained home visitors who make home visits under subsection (a) will, as needed, provide referrals for health and social services.

(3) The period during which the visits will be available to an eligible family will not be less than 1 year.

(4) An eligible family will receive no less than 2 visits each month, with more frequent visits provided for families with high needs.

(5) The program is proven effective on the basis of rigorous scientific research.

(d) Authorized services.—

(1) REQUIREMENTS.—A grant may be made under subsection (a) only if the applicant involved agrees that the following services will be provided by trained home visitors in home visits under subsection (a):

(A) Research based information on child health and age appropriate development, including suggestions for child-developmental activities.

(B) Advice on parenting, including information on how to develop a strong parent-child relationship and realistic expectations of age-appropriate child behaviors.

(C) Information on parenting, including identifying books, videos and parenting workshops in the local region.

(D) Information on programs that facilitate parent-to-parent support services.

(E) Factually and medically accurate and complete information about contraception.

(F) In the case of an eligible entity who is a student, information on resources that may assist the mother in completing the educational courses involved.

(G) Child health and developmental screening.

(2) ADDITIONAL SERVICES.—A grant under subsection (a) may be expended to provide services under such subsection in addition to the services specified in paragraph (1). The services may include—

(A) providing the necessary hygiene products for children, such as diapers, that allow a parent to provide for the basic needs of the child; or

(B) an effort to recruit low-income pregnant women who are in their third trimester and have decided to carry their pregnancy to term.

(e) Limitations on authorization of appropriations.—To carry out this section, there are authorized to be appropriated $150,000,000 for fiscal year 2010, $250,000,000 for fiscal year 2011, $350,000,000 for fiscal year 2012, $450,000,000 for fiscal year 2013, and $550,000,000 for fiscal year 2014.

SEC. 1705. Grants to increase public awareness of resources available to new parents.

(a) Grants.—The Secretary may make grants to States to increase public awareness of resources available to new parents.

(b) Use of funds.—The Secretary may make a grant to a State under this section only if the State agrees to use the grant for all the following:

(1) Identification of resources available to new parents.

(2) Conducting an advertising campaign to increase public awareness of the resources.

(3) Establishing and maintaining a toll-free telephone line to direct people to—

(A) adoption centers; and

(B) organizations that provide support services to new parents.

(c) Prohibition.—The Secretary shall prohibit each State receiving a grant under this section from using the grant to direct people to an organization or adoption center that is operated for profit.

(d) Certifications required as condition of grant.—As a condition of providing a grant to a State under this section, the Secretary shall require the State to certify to the Secretary that the State will—

(1) use the grant to direct people to an organization that provides mandatory full disclosure as to which services and referrals the organization will or will not provide; and

(2) make publicly available by means of the Internet (in electronic and paper form) a list of—

(A) the resources identified by the State pursuant to subsection (b)(1); and

(B) the organizations and adoption centers to which people are directed pursuant to an advertising campaign or telephone line funded under this section.

SEC. 1801. Report on responses to unintended pregnancy.

(a) In General.—The Secretary shall enter into an agreement with the Institute of Medicine to study the range of choices women make in response to unintended pregnancy. The Secretary shall ensure that a report from the Institute describing the findings of the study is submitted to the Congress not later than January 10, 2013. Names may not be collected for purposes of the study.

(b) Authorization of Appropriations.—To carry out this section, there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2010 through 2013.