[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[H.R. 5608 Introduced in House (IH)]








109th CONGRESS
  2d Session
                                H. R. 5608

   To amend the Public Health Service Act to direct the Secretary of 
    Health and Human Services to intensify programs with respect to 
  research and related activities concerning falls among older adults.


_______________________________________________________________________


                    IN THE HOUSE OF REPRESENTATIVES

                             June 14, 2006

 Mr. Hall (for himself and Mr. Pallone) introduced the following bill; 
       which was referred to the Committee on Energy and Commerce

_______________________________________________________________________

                                 A BILL


 
   To amend the Public Health Service Act to direct the Secretary of 
    Health and Human Services to intensify programs with respect to 
  research and related activities concerning falls among older adults.

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

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Keeping Seniors Safe From Falls Act 
of 2006''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) One third of older adults over age 65 fall each year. 
        Falls are the leading cause of injury deaths among individuals 
        for this population with risk of falling and injury rates 
        increasingly common with advanced age.
            (2) Older adults are hospitalized for fall-related injuries 
        five times more often than for injuries from other causes.
            (3) In 2003, falls among older adults accounted for 12,900 
        deaths, 1,800,000 emergency department visits, and 421,000 
        hospitalizations.
            (4) In 2003, unintentional falls accounted for more than 
        62.7 percent of nonfatal injuries for people age 65 or older.
            (5) 87 percent of all fractures among older adults are due 
        to falls.
            (6) Among older adults who fall, 20 to 30 percent suffer 
        moderate to severe injuries such as hip fractures or head 
        traumas that reduce mobility and independence, increase the 
        risk of premature death, and lead to serious health problems.
            (7) Hospital admissions for hip fractures among the elderly 
        have increased from 231,000 admissions in 1988 to 338,000 in 
        1999, with an average hospital stay of one week.
            (8) From 2000 to 2040, the number of people age 65 or older 
        is projected to increase from 34.8 million to 77.2 million. 
        Given our aging population, by the year 2040, the number of hip 
        fractures is expected to exceed 500,000.
            (9) 25 percent of older adults who sustain hip fractures 
        remain institutionalized for at least one year and 50 percent 
        of all older people hospitalized for hip fractures cannot 
        return home or live independently after their injury, never 
        returning to their prior level of mobility.
            (10) 25 percent of adults age 65 or older who sustain a hip 
        fracture die within a year.
            (11) Annually, more than 64,000 individuals who are over 65 
        years of age sustain a traumatic brain injury as a result of a 
        fall.
            (12) The total cost of all fall injuries for people age 65 
        and older was calculated in 1994 to be $27,300,000,000 (in 2004 
        dollars). By 2020 the cost of fall injuries is expected to 
        reach $43,800,000,000 annually.
            (13) A national approach to reducing falls among older 
        adults, which focuses on the daily life of senior citizens in 
        residential, institutional, and community settings, is needed.

SEC. 3. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT.

    Part J of title III of the Public Health Service Act (42 U.S.C. 
280b et seq.) is amended--
            (1) by redesignating section 393B (as added by section 1401 
        of Public Law 106-386) as section 393C and transferring such 
        section so that it appears after section 393B (as added by 
        section 1301 of Public Law 106-310); and
            (2) by inserting after section 393C (as redesignated and 
        transferred by paragraph (1)) the following:

``SEC. 393D. PREVENTION OF FALLS AMONG OLDER ADULTS.

    ``(a) Purposes.--The purposes of this section are--
            ``(1) to develop effective public education strategies in a 
        national initiative to reduce falls among older adults and to 
        educate older adults, family members, employers, caregivers, 
        and others;
            ``(2) to intensify services and conduct research to 
        determine the most effective approaches to preventing and 
        treating falls among older adults;
            ``(3) to support demonstration projects designed to reduce 
        the risk of falls and/or injuries caused by falls; and
            ``(4) to require the Secretary to evaluate the effect of 
        falls on health care costs, the potential for reducing falls, 
        and the most effective strategies for reducing health care 
        costs associated with falls.
    ``(b) Public Education.--The Secretary shall--
            ``(1) oversee and support a national education campaign and 
        award grants, contracts, and cooperative agreements to be 
        carried out by qualified organizations that focuses on reducing 
        falls among older adults and preventing repeat falls; and
            ``(2) award grants, contracts, or cooperative agreements to 
        qualified organizations, institutions, or consortia of 
        qualified organizations and institutions, for the purpose of 
        organizing State-level coalitions of appropriate State and 
        local agencies, safety, health, senior citizen, city planning, 
        and other organizations to design and carry out local education 
        campaigns, focusing on reducing falls among older adults, 
        preventing repeat falls, and planning and designing safe 
        communities.
    ``(c) Professional Education.--The Secretary shall--
            ``(1) oversee and support a national education campaign and 
        award grants, contracts, and cooperative agreements to be 
        carried out by qualified organizations that focuses on 
        educating physicians, allied health professionals, and related 
        providers of health and safety services about falls risk, 
        assessment and prevention; and
            ``(2) award grants, contracts, or cooperative agreements to 
        qualified organizations, institutions, or consortia of 
        qualified organizations and institutions, including nonprofit 
        safety and aging-related organizations that have a demonstrated 
        interest in fall prevention, safety and older adult issues, for 
        the purpose of designing and carrying out State-level 
        professional education campaigns to educate physicians, allied 
        health professionals, and related providers of health and 
        safety services about falls risk, assessment and prevention.
    ``(d) Research.--The Secretary shall award grants, contracts, or 
cooperative agreements to qualified organizations, institutions, or 
consortia of qualified organizations and institutions, to--
            ``(1) conduct and support research to--
                    ``(A) improve the identification of older adults 
                who have a high risk of falling;
                    ``(B) improve data collection and analysis to 
                identify fall risk and protective factors;
                    ``(C) design, implement, and evaluate the most 
                effective fall prevention interventions;
                    ``(D) design, implement, and evaluate medication 
                management interventions;
                    ``(E) improve strategies that are proven to be 
                effective in reducing falls by tailoring these 
                strategies to specific populations of older adults;
                    ``(F) conduct research in order to maximize the 
                dissemination of proven, effective fall prevention 
                interventions;
                    ``(G) intensify proven interventions to prevent 
                falls among older adults;
                    ``(H) improve the diagnosis, treatment, and 
                rehabilitation of elderly fall victims; and
                    ``(I) assess the risk of falls occurring in various 
                settings; to include the role of the environment of 
                falls and the effectiveness of environment 
                interventions on preventing falls;
            ``(2) conduct research concerning barriers to the adoption 
        of proven interventions with respect to the prevention of falls 
        among older adults;
            ``(3) conduct research to develop, implement, and evaluate 
        the most effective approaches to reducing falls among high-risk 
        older adults living in long-term care facilities;
            ``(4) evaluate the effectiveness of community programs to 
        prevent assisted living and nursing home falls among older 
        adults;
            ``(5) conduct research to identify effective strategies in 
        home modifications to promote independent living and a 
        reduction in falls; and
            ``(6) identify an existing Web site, or establish a Web 
        site, to serve as an information clearinghouse and repository 
        of falls research and activities being conducted by agencies, 
        organizations, academic institutions and related groups.
    ``(e) Demonstration Projects.--
            ``(1) Collaborations between health care providers and 
        aging services network.--
                    ``(A) In general.--The Secretary shall oversee and 
                support demonstration projects through grants, 
                contracts, and cooperative agreements designed to 
                reduce the risk of falls, or injuries caused by falls, 
                or both, in frail older adults, emphasizing projects 
                that foster collaboration between health care providers 
                and the aging services network, including the 
                following:
                            ``(i) Demonstrations that target at-risk 
                        older adult populations, particularly those 
                        with functional limitations, to maximize their 
                        independence and quality of life.
                            ``(ii) Demonstrations that assess the 
                        effectiveness of clinical risk factor screening 
                        and management when linked to community-based 
                        programs and services that support behavior 
                        change, activity, and other appropriate 
                        interventions.
                            ``(iii) Demonstrations that assess the 
                        feasibility and effectiveness of offering 
                        evidence-based behavior change and physical 
                        activity interventions that address falls risk 
                        in accessible non-medical settings, with 
                        linkages to health care providers.
                            ``(iv) Private sector and public-private 
                        partnerships to develop technology to prevent 
                        falls among older adults and prevent or reduce 
                        injuries if falls occur, including technology 
                        designed to measure, assess, and rate the 
                        traction of consumer flooring materials, floor 
                        polishes, and walkway agents.
                    ``(B) Evaluations.--The Secretary shall award one 
                or more grants, contracts, or cooperative agreements to 
                a qualified research organization or university, as 
                determined by the Secretary, to conduct evaluations of 
                the effectiveness of the demonstration projects 
                described in subparagraph (A).
            ``(2) Collaborations between health care providers and 
        residential and institutional settings.--
                    ``(A) In general.--The Secretary shall oversee and 
                support demonstration projects designed to reduce the 
                risk of falls, or injuries caused by falls, or both, in 
                frail older adults, emphasizing projects that foster 
                collaboration between health care providers and 
                residential and institutional settings, including the 
                following:
                            ``(i) A multi-State demonstration project 
                        to implement and evaluate fall prevention 
                        programs using proven intervention strategies 
                        designed for multifamily residential settings 
                        with high concentrations of appropriate at-risk 
                        populations of older adults to maximize 
                        independence and quality of life, particularly 
                        those with functional limitations. For purposes 
                        of carrying out such project, the Secretary 
                        shall award one or more grants, contracts, or 
                        cooperative agreements to one or more qualified 
                        organizations, institutions, or consortia of 
                        qualified organizations and institutions.
                            ``(ii) Demonstration projects that assess 
                        the effectiveness of clinical risk factor 
                        screening and management and that is integrated 
                        with the Aging Services Network of residential 
                        programs and services capable of providing 
                        long-range supportive environments and activity 
                        programs to affect behavior change and falls 
                        risk.
                            ``(iii) Evidence-based, residential and 
                        institutional programs that promote the 
                        adoption of healthy behaviors and enhanced 
                        physical activity level, and that address other 
                        appropriate risk factors to reduce the risk of 
                        falls.
                            ``(iv) Private sector and public-private 
                        partnerships to develop technology to prevent 
                        falls among older adults and prevent or reduce 
                        injuries if falls occur.
                    ``(B) Evaluations.--The Secretary shall award one 
                or more grants, contracts, or cooperative agreements to 
                a qualified research organization or university, as 
                determined by the Secretary, to conduct evaluations of 
                the effectiveness of the demonstration projects 
                described in subparagraph (A).
    ``(f) Study of Effects of Falls on Health Care Costs.--
            ``(1) In general.--The Secretary shall conduct a review of 
        the effects of falls on health care costs, the potential for 
        reducing falls, and the most effective strategies for reducing 
        health care costs associated with falls.
            ``(2) Report.--Not later than 36 months after the date of 
        the enactment of the Keeping Seniors Safe From Falls Act of 
        2006, the Secretary shall submit to Congress a report 
        describing the findings of the Secretary in conducting the 
        review under paragraph (1).
    ``(g) Authorization of Appropriations.--For the purpose of carrying 
out this section, there is authorized to be appropriated $35,000,000 
for each of the fiscal years 2007 through 2010.''.
                                 <all>