II Calendar No. 99 110th CONGRESS 1st Session S. 845 IN THE SENATE OF THE UNITED STATES March 12, 2007 Mr. Enzi (for himself, Ms. Mikulski, Mr. Hatch, and Mr. Kennedy) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions March 29, 2007 Reported by Mr. Kennedy, with an amendment Strike out all after the enacting clause and insert the part printed in italic A BILL To direct the Secretary of Health and Human Services to expand and intensify programs with respect to research and related activities concerning elder falls.

1.

Short title

This Act may be cited as the Keeping Seniors Safe From Falls Act of 2007.

2.

Findings

Congress finds the following: (1)Falls are the leading cause of injury deaths among individuals who are over 65 years of age. (2)In 2002, falls among older adults accounted for 12,800 deaths and 1,640,000 emergency department visits. (3)Hospital admissions for hip fractures among the elderly have increased from 231,000 admissions in 1988 to 327,000 in 2001. (4)Annually, more than 80,000 individuals who are over 65 years of age sustain a traumatic brain injury as a result of a fall. (5)The total medical cost of all fall injuries for people age 65 and older was calculated in 2000 to be $19,500,000,000. (6)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.

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 by paragraph (1)) the following:

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 in order 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; and (3)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 to be carried out by a nonprofit organization with experience in designing and implementing national injury prevention programs, that is directed principally to older adults, their families, and health care providers, and 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, and other organizations to design and carry out local education campaigns, focusing on reducing falls among older adults and preventing repeat falls. (c)

Research

(1)

In general

The Secretary shall— (A)conduct and support research to— (i)improve the identification of older adults who have a high risk of falling; (ii)improve data collection and analysis to identify fall risk and protective factors; (iii)design, implement, and evaluate the most effective fall prevention interventions; (iv)improve strategies that are proven to be effective in reducing falls by tailoring these strategies to specific populations of older adults; (v)conduct research in order to maximize the dissemination of proven, effective fall prevention interventions; (vi)intensify proven interventions to prevent falls among older adults; (vii)improve the diagnosis, treatment, and rehabilitation of elderly fall victims and those at high risk for falls; and (viii)assess the risk of falls occurring in various settings; (B)conduct research concerning barriers to the adoption of proven interventions with respect to the prevention of falls among older adults; (C)conduct research to develop, implement, and evaluate the most effective approaches to reducing falls among high-risk older adults living in communities and long-term care and assisted living facilities; and (D)evaluate the effectiveness of community programs designed to prevent falls among older adults. (2)

Educational support

The Secretary, either directly or through awarding grants, contracts, or cooperative agreements to qualified organizations, institutions, or consortia of qualified organizations and institutions, shall provide professional education for physicians and allied health professionals, and aging service providers in fall prevention, evaluation, and management. (d)

Demonstration Projects

The Secretary shall carry out the following: (1)Oversee and support demonstration and research projects to be carried out by qualified organizations, institutions, or consortia of qualified organizations and institutions, in the following areas: (A)A multistate demonstration project assessing the utility of targeted fall risk screening and referral programs. (B)Programs designed for community-dwelling older adults that utilize multicomponent fall intervention approaches, including physical activity, medication assessment and reduction when possible, vision enhancement, and home modification strategies. (C)Programs that are targeted to new fall victims who are at a high risk for second falls and which are designed to maximize independence and quality of life for older adults, particularly those older adults with functional limitations. (D)Private sector and public-private partnerships to develop technologies to prevent falls among older adults and prevent or reduce injuries if falls occur. (2)(A)Award grants, contracts, or cooperative agreements to qualified organizations, institutions, or consortia of qualified organizations and institutions, to design, implement, and evaluate fall prevention programs using proven intervention strategies in residential and institutional settings. (B)Award 1 or more grants, contracts, or cooperative agreements to 1 or more qualified organizations, institutions, or consortia of qualified organizations and institutions, in order to carry out a multistate demonstration project to implement and evaluate fall prevention programs using proven intervention strategies designed for single and multifamily residential settings with high concentrations of older adults, including— (i)identifying high-risk populations; (ii)evaluating residential facilities; (iii)conducting screening to identify high-risk individuals; (iv)providing fall assessment and risk reduction interventions and counseling; (v)coordinating services with health care and social service providers; and (vi)coordinating post-fall treatment and rehabilitation. (3)Award 1 or more grants, contracts, or cooperative agreements to qualified organizations, institutions, or consortia of qualified organizations and institutions, to conduct evaluations of the effectiveness of the demonstration projects described in this subsection. (e)

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 enactment of the Keeping Seniors Safe From Falls Act of 2007, the Secretary shall submit to Congress a report describing the findings of the Secretary in conducting the review under paragraph (1). (f)

Authorization of Appropriations

In order to carry out this section, there are authorized to be appropriated, $25,000,000 for each of fiscal years 2008 through 2010.

.

1.

Short title

This Act may be cited as the Safety of Seniors Act of 2007.

2.

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 by paragraph (1)) the following:

393D.

Prevention of falls among older adults

(a)

Public Education

The Secretary may— (1)oversee and support a national education campaign to be carried out by a nonprofit organization with experience in designing and implementing national injury prevention programs, that is directed principally to older adults, their families, and health care providers, and 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, and other organizations to design and carry out local education campaigns, focusing on reducing falls among older adults and preventing repeat falls. (b)

Research

(1)

In general

The Secretary may— (A)conduct and support research to— (i)improve the identification of older adults who have a high risk of falling; (ii)improve data collection and analysis to identify fall risk and protective factors; (iii)design, implement, and evaluate the most effective fall prevention interventions; (iv)improve strategies that are proven to be effective in reducing falls by tailoring these strategies to specific populations of older adults; (v)conduct research in order to maximize the dissemination of proven, effective fall prevention interventions; (vi)intensify proven interventions to prevent falls among older adults; (vii)improve the diagnosis, treatment, and rehabilitation of elderly fall victims and older adults at high risk for falls; and (viii)assess the risk of falls occurring in various settings; (B)conduct research concerning barriers to the adoption of proven interventions with respect to the prevention of falls among older adults; (C)conduct research to develop, implement, and evaluate the most effective approaches to reducing falls among high-risk older adults living in communities and long-term care and assisted living facilities; and (D)evaluate the effectiveness of community programs designed to prevent falls among older adults. (2)

Educational support

The Secretary, either directly or through awarding grants, contracts, or cooperative agreements to qualified organizations, institutions, or consortia of qualified organizations and institutions, may provide professional education for physicians and allied health professionals, and aging service providers in fall prevention, evaluation, and management. (c)

Demonstration Projects

The Secretary may carry out the following: (1)Oversee and support demonstration and research projects to be carried out by qualified organizations, institutions, or consortia of qualified organizations and institutions, in the following areas: (A)A multistate demonstration project assessing the utility of targeted fall risk screening and referral programs. (B)Programs designed for community-dwelling older adults that utilize multicomponent fall intervention approaches, including physical activity, medication assessment and reduction when possible, vision enhancement, and home modification strategies. (C)Programs that are targeted to new fall victims who are at a high risk for second falls and which are designed to maximize independence and quality of life for older adults, particularly those older adults with functional limitations. (D)Private sector and public-private partnerships to develop technologies to prevent falls among older adults and prevent or reduce injuries if falls occur. (2)(A)Award grants, contracts, or cooperative agreements to qualified organizations, institutions, or consortia of qualified organizations and institutions, to design, implement, and evaluate fall prevention programs using proven intervention strategies in residential and institutional settings. (B)Award 1 or more grants, contracts, or cooperative agreements to 1 or more qualified organizations, institutions, or consortia of qualified organizations and institutions, in order to carry out a multistate demonstration project to implement and evaluate fall prevention programs using proven intervention strategies designed for single and multifamily residential settings with high concentrations of older adults, including— (i)identifying high-risk populations; (ii)evaluating residential facilities; (iii)conducting screening to identify high-risk individuals; (iv)providing fall assessment and risk reduction interventions and counseling; (v)coordinating services with health care and social service providers; and (vi)coordinating post-fall treatment and rehabilitation. (3)Award 1 or more grants, contracts, or cooperative agreements to qualified organizations, institutions, or consortia of qualified organizations and institutions, to conduct evaluations of the effectiveness of the demonstration projects described in this subsection. (d)

Study of Effects of Falls on Health Care Costs

(1)

In general

The Secretary may 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

If the Secretary conducts the review under paragraph (1), the Secretary shall, not later than 36 months after the date of enactment of the Safety of Seniors Act of 2007, submit to Congress a report describing the findings of the Secretary in conducting such review.

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3.

Authorization of appropriations

Section 394A of the Public Health Service Act (42 U.S.C. 280b–3) is amended by striking $50,000,000 and all that follows through the period and inserting $58,361,000 for fiscal year 2008, and such sums as may be necessary for each of fiscal years 2009 and 2010..

March 29, 2007 Reported with an amendment