[Senate Hearing 117-244]
[From the U.S. Government Publishing Office]


                                                        S. Hrg. 117-244

                        PREVENTING TRAGEDIES AND
                      PROMOTING SAFE, ACCESSIBLE,
                          AND AFFORDABLE HOMES

=======================================================================

                                HEARING

                               BEFORE THE

                       SPECIAL COMMITTEE ON AGING

                          UNITED STATES SENATE

                    ONE HUNDRED SEVENTEENTH CONGRESS


                             SECOND SESSION

                               __________

                             WASHINGTON, DC

                               __________

                             MARCH 31, 2022

                               __________

                           Serial No. 117-15

         Printed for the use of the Special Committee on Aging
         
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        Available via the World Wide Web: http://www.govinfo.gov
        
                              __________

                    U.S. GOVERNMENT PUBLISHING OFFICE                    
47-366 PDF                 WASHINGTON : 2022                     
          
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                       SPECIAL COMMITTEE ON AGING

              ROBERT P. CASEY, JR., Pennsylvania, Chairman

KIRSTEN E. GILLIBRAND, New York      TIM SCOTT, South Carolina
RICHARD BLUMENTHAL, Connecticut      SUSAN M. COLLINS, Maine
ELIZABETH WARREN, Massachusetts      RICHARD BURR, North Carolina
JACKY ROSEN, Nevada                  MARCO RUBIO, Florida
MARK KELLY, Arizona                  MIKE BRAUN, Indiana
RAPHAEL WARNOCK, Georgia             RICK SCOTT, Florida
                                     MIKE LEE, Utah
                              ----------                              
                 Stacy Sanders, Majority Staff Director
                 Neri Martinez, Minority Staff Director
                         
                         
                         C  O  N  T  E  N  T  S

                              ----------                              

                                                                   Page

Opening Statement of Senator Robert P. Casey, Jr., Chairman......     1
Opening Statement of Senator Tim Scott, Ranking Member...........     2

                           PANEL OF WITNESSES

Anand Parekh, M.D., Chief Medical Advisor, Bipartisan Policy 
  Center, Washington, D.C........................................     5
Denise Cleveland-Leggett, Senior Vice President of Business 
  Development, The Integral Group, Atlanta, Georgia..............     7
Tracey Kelly, US Safer Life at Home Development Manager, IKEA 
  USA, Trappe, Pennsylvania......................................     9
Janet McGee, Director, Parents Against Tip-Overs, Eagan, 
  Minnesota......................................................    10

                                APPENDIX
                      Prepared Witness Statements

Anand Parekh, M.D., Chief Medical Advisor, Bipartisan Policy 
  Center, Washington, D.C........................................    29
Denise Cleveland-Leggett, Senior Vice President of Business 
  Development, The Integral Group, Atlanta, Georgia..............    36
Tracey Kelly, US Safer Life at Home Development Manager, IKEA 
  USA, Trappe, Pennsylvania......................................    39
Janet McGee, Director, Parents Against Tip-Overs, Eagan, 
  Minnesota......................................................    44

                        Questions for the Record

Anand Parekh, M.D., Chief Medical Advisor, Bipartisan Policy 
  Center, Washington, D.C........................................    49
Denise Cleveland-Leggett, Senior Vice President of Business 
  Development, The Integral Group, Atlanta, Georgia..............    53
Tracey Kelly, US Safer Life at Home Development Manager, IKEA 
  USA, Trappe, Pennsylvania......................................    57
Janet McGee, Director, Parents Against Tip-Overs, Eagan, 
  Minnesota......................................................    59

                       Statements for the Record

Consumer Reports Letter..........................................    63

 
                        PREVENTING TRAGEDIES AND
                      PROMOTING SAFE, ACCESSIBLE,
                          AND AFFORDABLE HOMES

                              ----------                              


                        THURSDAY, MARCH 31, 2022

                                       U.S. Senate,
                                Special Committee on Aging,
                                                    Washington, DC.
    The Committee met, pursuant to notice, at 10:04 a.m., via 
Webex, Hon. Robert P. Casey, Jr., Chairman of the Committee, 
presiding.
    Present: Senators Casey, Gillibrand, Blumenthal, Rosen, 
Kelly, Warnock, Tim Scott, Braun, and Rick Scott.

                 OPENING STATEMENT OF SENATOR 
                 ROBERT P. CASEY, JR., CHAIRMAN

    The Chairman. Good morning. The hearing will come to order.
    Today, we will discuss a topic of bipartisan interest: 
promoting home safety for seniors, children and people with 
disabilities, as well as families in general. This has been a 
longstanding priority of the Special Committee on Aging. In 
October 2019, the Committee released a bipartisan report on 
falls and held a hearing on the same topic.
    We know that a quarter of all older adults, one quarter, 
fall every year, and that the majority of these falls occur 
within the home. I witnessed the struggles that accompany a 
fall firsthand when my mother experienced a fall just December 
2021, early December. She is doing well now and recovered, but 
it was two long and difficult months between and among surgery, 
and then rehabilitation, and then returning home, so many 
families have had this experience.
    For some, a fall can be prevented by installing a grab bar 
in their home or making other modifications. For others, it 
might be participating in, for example, evidence-based 
programs, like a program called a Matter of Balance, which 
offers small group activities and exercise training.
    Investments in home modifications and prevention programs 
are a really small price to pay, considering that senior falls 
contribute to $50 billion, that is 50 with a B, $50 billion, in 
medical costs per year and unfortunately lead to 34,000 deaths 
among seniors.
    In some cases, home modifications alone are not enough. 
Every year, emergency rooms across the country treat over 
22,000 preventable injuries caused by falling furniture, like 
dressers or television sets. Annually, over 3,000 of those 
injured by tip-overs are older adults. It is not only seniors, 
of course, who are harmed. Children are also put at great risk, 
and tragically, of those killed by furniture tip-overs, 81 
percent are children.
    My home State of Pennsylvania was touched by these 
devastating losses. We lost Katie Lambert and Curren Collas to 
these tip-overs. Katie was 3 years old when she died due to 
injuries sustained from a furniture tip-over in her family's 
home in Huntingdon Valley, Pennsylvania, just outside of 
Philadelphia, and Curren, from West Chester, Pennsylvania as 
well, close to the city of Philadelphia, outside of the city. 
Curren, when he passed away, was only 2 years old.
    There is no reason for any family to endure this 
unspeakable loss. Compounding the grief and the loss for these 
families and what they experience is the fact that these deaths 
might have been prevented by stronger standards. We will talk 
more about this today. Mandatory stability standards would make 
our homes safer overall, but especially for children.
    I am proud to lead a bipartisan bill, the STURDY Act, 
alongside Senators Klobuchar, Blumenthal and Cotton. This Act 
would require the Consumer Product Safety Commission to create 
a mandatory stability standard for furniture. It would require 
companies to ensure their products are tested for safety before 
that product is sold. It is a simple, commonsense requirement 
that will save lives.
    Today, we will learn more about what Congress can do to 
keep our children, our seniors and our families safer.
    Let me turn now to our Ranking Member for his opening 
remarks.

                 OPENING STATEMENT OF SENATOR 
                   TIM SCOTT, RANKING MEMBER

    Senator Tim Scott. Thank you, Chairman Casey, for holding 
another truly important hearing and thank you to each and every 
witness for investing your time, your energy and, frankly, your 
expertise on a topic that is so important to all Americans, but 
specifically our senior population.
    I remember one of my earliest goals in life was to make 
sure that my mother had a safe place to live, with a garage, 
and so I spent a lot of time and energy trying to make sure 
that instead of living in apartments or, as she did growing up, 
in the projects, that she would have an opportunity to own her 
own home, live in it, and feel the safety and the security that 
comes with home ownership.
    In addition to that, I wanted to make sure that not only 
did she have that opportunity, but so many others in 
communities that are too often living from paycheck to paycheck 
or are living in marginalized communities, they would have that 
opportunity as well.
    Over half of public housing today, public housing 
residents, are seniors or people with disabilities, but less 
than 20 percent live in accessible units. All residents deserve 
the choice to have housing that meets their needs.
    I am working on a bill to give older Americans and those 
with disabilities the resources they need to leave their public 
housing units and find a home on the market if they want, also 
releasing a report, this is the report here, Housing for the 
Golden Years, that explores senior housing needs and what we 
can do to help seniors meet those needs that they have in a way 
that shows dignity and respect for our seniors during their 
golden years.
    South Carolina is one of the most popular retirement 
destinations in the country. I am sure that it will continue to 
grow in its popularity, but seniors in our State still face an 
uphill climb in so many ways as it relates to housing and we 
want to find ways to bridge that gap.
    I am inspired by the efforts to help older Americans in my 
home State of South Carolina. A group called Homes of Hope in 
Greenville builds affordable houses for working people in need. 
They strive to integrate seniors and people with disabilities 
into communities with younger adults so they can also help 
support each other. Daniel Holloway was his family's primary 
earner until he, unfortunately, developed kidney failure, 
because of that, he could no longer afford the place that he 
was living, so you can imagine the bread winner, supporting a 
family, no longer being able to do so. Thankfully for him, 
Homes of Hope, they were able to step in to help him out during 
the challenging times that he went through.
    The good news is that he was able to see his health 
improve, and as his health improved, he was able to, once 
again, take on the responsibilities of caring for his family 
and providing the resources necessary for his home.
    Thank God there was an organization, however, that was 
there during the most challenging and difficult times of his 
adult life. There needs to be more organizations like the Homes 
of Hope in Greenville to help support our older Americans.
    For older Americans and people with disabilities, falls are 
one of the largest threats in the home. Over 30,000 folks, 
somewhere around 36,000 falls a year, are seniors and people 
with disabilities experience every single year.
    Home modifications can help prevent this from happening, so 
the focus on making sure that homes are equipped with the 
necessary support systems is so vitally important for longevity 
and health.
    I am so thankful that the Chairman's mother was able to 
overcome the fall and Bob, I am so thankful that she is doing 
well and seems like her recovery has been complete. That is a 
blessing and it is good to hear, Chairman Casey.
    For example, in Charleston, South Carolina, we are now 
building something called the ``granny flats'' which allows for 
people to use a part of their property to build a place 
accommodating their seniors, typically their parents or their 
grandparents, on their property. This actually adds more stock 
to a very scarce resource which, of course, are the homes that 
people can live in.
    I am looking forward to seeing more innovation and more 
creativity in the marketplace so that we can take advantage of 
the opportunity to love and to care for our family members on 
our own property.
    In addition to that, opportunity zones we passed just a few 
years ago now provides another opportunity for the utilization 
of real estate in a cost effective way to provide more senior 
housing. The fact is that in just 2019 we saw nearly $30 
billion invested in opportunity zones in America. That is a 
great opportunity for us to provide senior housing at a lower 
price point and something that I look forward to discussing 
throughout this hearing.
    Thank you, so much, Chairman Casey, for holding this 
hearing and I look forward to hearing the testimonies of our 
witnesses.
    The Chairman. Ranking member Scott, thank you for your 
opening statement. I want folks listening or watching this 
hearing today, as well as our witnesses, to know that we will 
have various senators in and out. It is a day when senators 
have other hearings or other commitments, so they are in and 
out, but I know earlier, and he might still be with us, we were 
joined by Senator Rick Scott and so as we go we will try to 
weave in senators and their questions when they are available.
    I wanted to start with our witness introductions. I will do 
the first one and then I will turn to Ranking Member Scott to 
introduce our second witness. Our first witness is Dr. Anand 
Parekh, who is the Chief Medical Advisor of the Bipartisan 
Policy Center. Dr. Parekh is a board-certified internal 
medicine physician. Prior to joining the Bipartisan Policy 
Center, he served as Deputy Assistant Secretary in the 
Department of Health and Human Services in the Senior Executive 
Service at the Department from 2008 to 2015. Dr. Parekh will 
share his medical and public health expertise today on topics 
of home safety and unintentional injury prevention.
    Ranking Member Scott?
    Senator Tim Scott. Thank you, Chairman Casey. It is my 
privilege to introduce today Ms. Denise Cleveland-Leggett. She 
is the Senior Vice President of Business Development for 
Integral, an Atlanta real estate development organization. 
Integral is an innovative enterprise helping connect people to 
the American dream, as well as focusing some of the time that 
she has and her expertise on seniors reaching their American 
dream, too.
    I am really excited to have her with us today. Ms. 
Cleveland-Leggett previously served as a Southeast Region 
Administrator for Dept of HUD and managed over 800 employees 
while overseeing programs throughout South Carolina and 11 
states. She has wide ranging insights into housing policy at 
every level, from the Federal Government to on-the-ground needs 
and how our policies impact real estate.
    She has also been widely recognized for the many talents 
and gifts she brings to the community. She received in 2021 the 
Women of Influence award and the Justice Robert Benham Award 
for Exemplary and Unparalleled Community Service and was 
recognized in Who's Who in Black Atlanta. Under her thoughtful 
and dedicated guidance, HUD was better able to meet the needs, 
the housing needs, of seniors and people with disabilities 
across the entire region, including the Palmetto State.
    We look forward to hearing your testimony and thank you for 
investing your time in this hearing.
    The Chairman. Thank you, Ranking Member Scott.
    Our third witness today is Ms. Tracey Kelly, who is 
Director of Corporate Communications and Public Affairs for 
IKEA USA. Ms. Kelly leads IDEA's Safer Life at Home Initiative 
focusing on development and innovation related to product 
safety.
    I must acknowledge Ms. Kelly's Pennsylvania connection. She 
graduated from Penn State University and currently lives in 
Trappe, Pennsylvania. She will testify to Ikea's work and 
support of initiatives to increase home safety.
    Our fourth and final witness today is Ms. Janet McGee. 
Janet is joining us from St. Paul, Minnesota. She is the 
director of Parents Against Tip-overs, a nationwide network of 
parents founded in 2018 to advocate for an end to furniture 
tip-overs. Ms. McGee's testimony will shed light on the urgent 
need to pass the STURDY Act to make our children in our homes 
safer.
    Now we will turn to our witnesses for their statements, and 
I will just call on each witness in the order we introduced 
them. I will start with Dr. Parekh.

                STATEMENT OF ANAND PAREKH, M.D.,

               CHIEF MEDICAL ADVISOR, BIPARTISAN

                POLICY CENTER, WASHINGTON, D.C.

    Dr. Parekh. Chairman Casey, Ranking Member Scott and 
members of the Committee, thank you for the opportunity to 
appear before you.
    I applaud the Committee for hosting this hearing this 
morning to shine a light on preventable harm to vulnerable 
Americans in the home setting.
    My testimony today is based on my perspective as a 
physician, former public servant, and currently Chief Medical 
Advisor at the Bipartisan Policy Center where I, along with my 
colleagues, have spent the last several years concentrating on 
the intersection between housing and health. I have concluded, 
based on my experience, that housing is health, given the 
significant evidence that housing affordability, neighborhood 
conditions, and conditions within the home impact health 
outcomes.
    With respect to the safety and accessibility of the home 
setting, I would like to start out by recognizing that this is 
an important issue across the life span, from childhood to old 
age, and thus I appreciate the Committee's broad focus today. 
That being said, I will concentrate my testimony on the older 
adult population.
    BPC's past report Healthy Aging Begins at Home noted that 
while virtually all seniors would like to stay in their homes 
for as long as possible, only 1 percent of homes today have the 
five universal design features necessary to make them 
accessible for those with impaired mobility: no-step entries, 
single-floor living, accessible electrical controls and 
switches, extra-wide doorways and halls, and lever-style door 
and faucet handles. This is despite 38 percent of households 65 
and older having at least one person living with a disability.
    The reason that home modifications are so important is 
they, as the Chairman said, contribute to reductions of tragic 
events such as falls. Each year millions of Americans over the 
age of 65, more than one out of four, experience a fall. Tens 
of thousands of adults die from falls each year, making it the 
leading cause of injury-related death in older adults. The 
estimated medical costs attributable to fatal and non-fatal 
falls is approximately $50 billion.
    In sum, most falls happen in the home and most falls are 
preventable. In spite of this, there are no comprehensive 
programs or policies currently in place across the Federal 
Government to tackle this public health challenge.
    Given these findings, I offer two recommendations to
    the Committee on how the Federal Government can be a better 
partner to states, localities, families and individuals in 
reducing older adult injuries in the home setting.
    First, the Administration should better coordinate Federal 
home modification programs to maximize their impact. Given that 
multiple departments such as HUD, HHS, USDA, the VA, the 
Department of Energy have a role across the executive branch, 
the White House should take the lead and create a new 
interdepartmental home modification task force.
    In recent years, Congress has authorized home modification 
grants through HUD and directed GAO to conduct a study of 
Federal programs which support home assessments and 
modifications for older individuals and individuals with 
disabilities.
    In addition, the Administration for Community Living at HHS 
awarded a grant to the University of Southern California to 
create and implement a Home Modification Information Network, 
an online searchable data base of home modification tools and 
resources.
    All of these actions align with or were recommended in 
BPC's previous report and we are pleased to see recent progress 
to date. That being said, it will be incumbent upon Congress 
and the Administration to act on the GAO's upcoming findings as 
well as take stock of the work done to date to ensure that 
Federal home modification initiatives are coordinated and 
yielding maximum impact.
    An analysis of these discretionary programs should also be 
coupled with a review of how public insurance programs such as 
Medicare and Medicaid are covering home modifications.
    Finally, a new national partnership with states, 
localities, the national Aging Network, and private sector 
entities offering modification services should also be 
launched. Second, the U.S. Department of Health and Human 
Services should make falls prevention a top departmental 
priority. A coordinated action plan should be developed to 
catalyze research, surveillance, implementation of evidence-
based programs, and a delivery and financing of proven 
interventions. This will require building on existing evidence-
based falls prevention programs and necessitate strengthening 
partnerships between agencies such as ACL, CDC, NIH, and CMS. 
The plan should also include a public awareness component and 
could buildupon the CDC's Still Going Strong campaign and the 
National Council on Aging's National Falls Prevention Resource 
Center.
    In addition to facilitating home modification, there are a 
number of key actions that should be taken, many of which will 
require leadership from CMS. First, CMS should require that 
CDC's STEADI falls prevention screening tool, which assesses 
for difficulty with walking, balance, or vision and reviews 
medication lists, is used by providers conducting an annual 
wellness visit for Medicare beneficiaries. Second, CMS should 
also include the number of falls-related admissions, as opposed 
to simply the number of patients screened, as a quality measure 
for alternative payment models and Medicare Advantage plans. 
This will further incentive health care entities to focus on 
falls prevention, and third, Medicare and Medicaid should 
identify ways to scale evidence-based community falls 
preventions programs such as the CAPABLE model and A Matter of 
Balance through new or existing alternative payment models for 
the Medicare Advantage program.
    In conclusion, thank you for your leadership in addressing 
these issues and I look forward to your questions.
    The Chairman. Doctor, thanks very much. Before turning to 
our second witness, I want to acknowledge Senator Blumenthal 
has joined our hearing. We are grateful for his presence.
    Our next witness, our second witness will be Ms. Cleveland-
Leggett.

             STATEMENT OF DENISE CLEVELAND-LEGGETT,

               SENIOR VICE PRESIDENT OF BUSINESS

       DEVELOPMENT, THE INTEGRAL GROUP, ATLANTA, GEORGIA

    Ms. Cleveland-Leggett. Good morning, Chairman Casey and 
Ranking Member Scott and other members of the Special Committee 
on Aging.
    Thank you for the introduction, Senator Scott. I am very 
proud and happy to be with you today.
    I am happy to be with you for a number of reasons, one of 
which, I lost in December 2021 my 94-year-old mother. She lived 
a life of dignity. Like many people, she met and married the 
love of her life. He, unfortunately, passed in 2007. After 
that, we had to make a decision. My father wanted my mother to 
live in her house as long as she was able to, but as many 
people face, failing health makes you have to make changes and 
makes you make decisions as to where your parents go, and so we 
had to make a decision. We were fortunate as a family to 
provide her with fantastic living arrangements until her death.
    As we stood around her casket, my siblings and I held hands 
and we said we did mom proud. She would have been happy the way 
that we allowed her to live out her life with dignity. 
Unfortunately, there are many Americans who do not have that 
privilege, who do not have the opportunity, not from any fault 
of their own, not from any mistakes that they made, because 
life happens sometimes unfairly, but life happens and does not 
give you the options and the choices that you would want to 
make for your loved ones.
    I want to tell you a little bit about my company, Integral. 
Integral was founded in 1993 by a gentleman by the name of 
Egbert Perry. The thing that is so amazing about Integral is 
that it is a company that is a development company but it is 
one that pushes changing the trajectory and the lives of 
people, not just free houses but it is built to make things 
better and change the lives of the individuals that they serve.
    What they did in 1993 was unparalleled. There was, in this 
country, many people who lived in the cities. There was 
concentrated poverty and people did not know really what to do. 
Through innovation and working with the Housing Authority 
Director Renee Glover, they worked to build public-private 
partnerships that would change people's lives so that you now 
have the public sector and the private sector working together 
to make a change.
    With that change, they created something called the Atlanta 
Model. That Atlanta Model is a community development strategy, 
incorporates multiple public-private partnerships to deliver 
several elements to planned communities. It was such an amazing 
feat that then-Secretary Cisneros took the Atlanta model and 
codified it into HUD's programs and pushed it out to over 3,400 
housing authorities for them to implement.
    At HUD, I was able to see tremendous work that had come 
about, not just from the Atlanta Model but things like the 
Opportunity Zones.
    A non-partisan Joint Committee on Taxation found 42.4 
percent of $24 billion invested in Opportunity Zone funds went 
to low-income housing and developments and communities in 2019.
    I also was able to see the benefits of Choice Neighborhoods 
and what that funding does. It changes the lives of people. I 
have gone from house to house and the opportunities that I have 
had with seniors who have come up to me, given me a hug, and 
said thank you, I never thought that this was possible. I never 
thought these living conditions were possible. They showed me 
their kitchens, where they now can walk in because the kitchens 
were made appropriate. They had hallways that were wide enough 
to get a wheelchair through. They had showers that did not have 
barriers for them to get in and out of.
    We saw a number of different amazing things happen while I 
was at HUD, but despite all of that, and the things that were 
accomplished, $70 billion in backlog repairs still existing in 
most public housing units. Much of the public infrastructure is 
more than 80 years old and has been utilized for decades and 
has weathered many years of normal wear and tear with 
fluctuating levels of funding for maintenance and 
rehabilitation. Only 20 percent of housing units are accessible 
to persons who use walkers, canes and wheelchairs.
    We are on a collision course with reality. In 1950, when 
much of the Nation's current public housing stock was 
constructed, only 8 percent of the U.S. population was 65 or 
older. By 2019, the number more than doubled, to 16.5 percent. 
By 2050, the population over the age of 65 is expected to be at 
least 22 percent. In the next 30 years, one in five Americans 
will be a senior citizen and a significant portion of them will 
be on fixed incomes.
    Some estimates calculate 53 percent of all of today's 
public housing residents are either elderly or disabled. It is 
becoming increasingly apparent that our Nation's public housing 
asset, as fragile as it is, has become one of the Nation's 
largest senior housing programs and catering to the market 
niche of low-income housing. I am speaking of the many 
teachers, of clerks, mechanics, and others who find themselves 
in their communities and their governments, their tax dollars 
to support when they retire.
    Many of them, as I said earlier, this is nothing due to any 
negative things that they did or they did not do. There are so 
many things such as health, loss of job, loss of income, lower 
income that allows these circumstances to overtake our seniors. 
It is up to us to make a difference.
    Older adults are looking for safe homes on private markets 
where onerous zoning regulations sometimes prevent that housing 
from occurring. For seniors on fixed incomes looking to age in 
place, these regulations can leave them with too few options.
    I believe that these individuals look to us, look to you as 
their legislators, look to us who participate today as their 
voice. We are the voice of the voiceless. We are the voice of 
those people who need assistance and there are many mechanisms 
that we can utilize to make things better. Working together 
collectively public-private partnerships can make a difference, 
can make a change, which I have seen through my time at HUD and 
now in the private sector. I believe that we, again, have to be 
the voice of the voiceless.
    Thank you very much.
    The Chairman. Thank you, Ms. Cleveland-Leggett, for your 
testimony.
    We will turn next to Ms. Kelly.

            STATEMENT OF TRACEY KELLY, US SAFER LIFE

             AT HOME DEVELOPMENT MANAGER, IKEA USA,

                      TRAPPE, PENNSYLVANIA

    Ms. Kelly. Thank you, Chairman Casey, Ranking Member Scott, 
and the Senate Special Committee on Aging, for inviting IKEA to 
join in this important conversation.
    We share your commitment to creating a safer home for 
everyone, especially the most vulnerable: young children and 
seniors. That is why we support the STURDY Act. This 
legislation will decrease the risk of furniture-related tip-
over incidents and make homes safer by strengthening safety 
standards for clothing storage units, and it will accomplish 
two important objections.
    First, it encourages industry to invest in research and the 
development of furniture safety innovations and it ensures that 
safety and testing standards can be adapted to incorporate such 
innovations in the future. That is a vital component of a 
comprehensive approach to reduce the risk of tip-over.
    Second, STURDY provides a rulemaking process that has 
proven to produce final rules at the Consumer Product Safety 
Commission without delay. By avoiding delays of 2 years or 
more, brands like IKEA will be able to introduce new safety 
innovations and bring new products to market with confidence.
    In short, the STURDY Act promotes innovation and regulatory 
clarity. This will be good for families, parents, children, and 
seniors. This will be good for business, for our business and 
other businesses. Most importantly, this will be good for 
safety.
    IKEA has been engaged in the prevention of furniture tip-
over for years. This is not just an issue for IKEA. It is an 
industry-wide issue. It is a worldwide issue and it is an issue 
for all ages.
    When we look at furniture related accidents across all age 
groups, more children tragically lose their lives, but as was 
mentioned before, far too many people age 60 and over also 
fatally are injured by falling furniture and appliances. From 
2000 to 2019, seniors were the second largest age group who 
sustained a fatal injury caused by tip-over accidents, 14 
percent of all reported fatalities. A total of 3,200 seniors, 
an average of 60 a week, were seriously injured by tip-over 
accidents and required medical attention.
    At IKEA, we believe that everyone has the right to feel 
safe at home, from children to seniors and everyone in between. 
We are investing in research, innovation, product development, 
and testing for furniture stability. For us, as for so many 
others, our interest and our innovations are intensely 
personal.
    When one of our furniture designers was recovering from a 
debilitating stroke, she gained a new perspective on 
maintaining an independent life at home. Her life-altering 
event inspired our collection OMT'NKSAM. That is a mouthful, 
but it is Swedish for caring. The products in this collection 
are designed to help seniors to remain in their homes and 
includes a beautiful wing-backed chair that would look great in 
any house. The hidden feature is in the design, as the chair 
makes it easier to both sit and to stand.
    Promoting safety is a big job and none of us can do it 
alone. IKEA has a long history of collaborating with others on 
challenging topics. To introduce another Swedish word, our term 
for togetherness is KRAFTSAMLA. We collaborate with others on 
standard-setting, solution development, and with STURDY, 
advocating for important legislation.
    We are grateful for our partnership with organizations such 
as Parents Against Tip-Overs, Kids in Danger, and the Consumer 
Federation of America who share the same goal to make homes 
safer.
    From our retail stores and website, through to our social 
media channels, we regularly update and inform our customers on 
how we can help them reduce safety risks in the homes.
    During this pandemic, we have all been reminded that 
everyone deserves a home where they are safe and where their 
loves ones are safe. Let us work together to pass the STURDY 
Act and let us continue to work together to create a safer home 
for everyone, from children to seniors.
    Thank you for your time today and for bringing us together 
around this important topic.
    The Chairman. Ms. Kelly, thanks for your testimony.
    We will turn now to our fourth and final witness, Janet 
McGee. Ms. McGee, you may begin.

              STATEMENT OF JANET McGEE, DIRECTOR,

          PARENTS AGAINST TIP-OVERS, EAGAN, MINNESOTA

    Ms. McGee. Chairman Casey, Ranking Member Scott, and 
members of the Special Committee on Aging, thank you for 
allowing me to share my story with you today.
    My name is Janet McGee and I am a mom from Minnesota.
    When I was 20 years old, I graduated from the University of 
Minnesota with my degree in Mortuary Science. I served families 
for many years as a mortician. You might imagine the schedule 
of night calls, embalmings, night and weekend funerals.
    When the call schedule became too much for me, a single mom 
at the time, I decided to change careers to create a more 
consistent and stable lifestyle for my son.
    I started working at a Fortune 500 company, worked my way 
through attaining my MBA, and grew a whole new career. By 2016, 
I finally had what I had always wanted, a stable career, a 
balanced life, a husband, and a precious new child, Ted, who 
was born in 2014. Life was finally good.
    On Sunday, February 14, 2016, I put Teddy down for a nap 
while the rest of our family went about our quiet Sunday 
afternoon. I was checking on him every 15 to 20 minutes, 
waiting for him to finally fall asleep. When I did not hear him 
after a while, I went into his room to confirm he had finally 
drifted off. What I saw next is something I cannot unsee. Ted 
was not in his bed and the dresser in this bedroom had fallen 
forward.
    In a panic, I screamed for someone to call 911, somehow 
stood the dresser back up, and started digging through a pile 
of drawers and clothes. My dear 22-month-old son Ted was at the 
bottom of the pile. His face was purple. He had blood coming 
out of his nose and mouth and his feet were starting to feel 
cold.
    I started CPR immediately while my 11-year-old son, the one 
that I had worked so hard to create a better life for, ran into 
the room, saw Ted in this State, and called 911. Despite being 
near his room this whole time, I did not hear his dresser fall 
and I could not understand how this happened.
    The paramedics got Ted to the hospital and while they found 
a faint heartbeat, there was simply nothing more that could be 
done. Ted died that day, about 4 hours after I found him, from 
what I came to know as a furniture tip-over incident.
    Being a former mortician, I put on his last diaper, I 
dressed him, I put on his Thomas the Train light-up shoes, and 
I placed him in his casket at the funeral home. His shoes would 
never light up again and all I could think is that I should be 
planning his second birthday party, not his funeral.
    While I thought Ted's death was a completely isolated 
incident, I learned shortly after he died that he was not 
alone. His dresser did not meet the safety standard for 
clothing storage units and, worse yet, it did not have to 
because it is a voluntary standard.
    Thousands of children, adults, and seniors are sent to the 
ER every year from tip-over related incidents and sadly, over 
570 people have died from tip-overs in the last two decades. 
According to the Consumer Product Safety Commission, 82 percent 
of these fatalities were children and 14 percent were seniors.
    In 2014, I helped form a national parent coalition called 
Parents Against Tip-Overs, which is comprised of parents from 
across the Nation who have all lost their children to tip-
overs. Each one of us thought our child was the only one this 
had happened to, and each one of us learned shortly after their 
death that they were not.
    While you are hearing my story today, I hope you can 
understand my voice is one of many. Today, I represent the 
parents out there who cannot bring themselves to speak publicly 
about their tip-over incident or have been shamed, sometimes 
publicly, by others to believe they are somehow responsible for 
their child's death.
    I represent all the parents out there who are now full-time 
caregivers for their children because of a brain trauma or loss 
of oxygen caused by a tip-over, and I represent adults who are 
helping care for their elderly parents due to medical issues 
stemming from a tip-over.
    While the ASTM F15.42 Subcommittee that sets the safety 
standard for clothing storage units has been in existence for 
over two decades, very little has changed with the way these 
units are tested. The safety standard remains voluntary, not 
mandatory. The testing does not account for real-world use 
scenarios such as multiple drawers being open at once or a unit 
being used on a carpeted surface.
    Additionally, it does not test for drawers being loaded 
with clothing and does not account for the dynamic force a 
child might put on a dresser while they yank out drawers to get 
dressed.
    Today, I come before you to ask for your support in passing 
the STURDY Act. This piece of legislation would require these 
gaps between real-world use and current testing to be accounted 
for and would finally make the safety standard mandatory. It 
would give power back to the CPSC to do what it was designed to 
do, which is protect the public from unreasonable risks of 
injury or death associated with consumer products, especially 
when the standard setting process has proven to be 
insufficient.
    We are on a race against the clock to get more stable 
clothing storage units on the market. Since my son died in 
2016, 52 more people that we know of have been killed by a tip-
over and this, unfortunately, will continue to happen until 
clothing storage units can be designed inherently stable 
following the passage of the STURDY Act. After years of hard 
work, all stakeholders are finally in agreement on the language 
of the STURDY Act. We have done the legwork for you, now I urge 
you to offer your full support for this life saving bill.
    Thank you for hearing my testimony today.
    The Chairman. Ms. McGee, thank you for your testimony and 
your courage in coming forward to talk not only today but I 
know on many other days to stand up for other children and to 
stand up for families.
    The fact that you are willing to share your son Ted's story 
I know will give and continue to give inspiration to other 
families, but it has also helped us with policy changes and 
advancing legislation so I want to thank you for that.
    I cannot even begin to imagine what you and your family 
have lived through but we are grateful to you for your 
willingness to be here today and on so many other days to help 
move this legislation forward.
    I know that just last night I was talking to one of my 
colleagues here, one of your two home State senators, Senator 
Klobuchar, who has been working with us since the beginning of 
this legislation to move it forward and I want to thank you for 
working with her and working with so many others to make this 
happen.
    As you said in your statement, you said that you hoped that 
we could understand that ``my voice is one of many.'' And that 
is true. Your voice and the voices of those families have not 
been fully heard yet, but they are about to be because we are 
going to get this legislation passed.
    I wanted to ask you just a basic question about the nature 
of the bill and why passage of the legislation is important. I 
know you have addressed that already in your statement, but 
what passage of this bill would mean to you and the families 
you work with through Parents Against Tip-Overs.
    Ms. McGee. Thank you for that question, Chairman Casey.
    For all of us parents in PAT, passing the STURDY Act would 
be a huge milestone in the fight to finally stop tip-overs. 
Some of the parents in our group have been advocating for tip-
over prevention for well over a decade, some almost two, and it 
would mean we finally will have a timeline for when we can 
expect to see more stable clothing storage units on the market.
    It would mean that we can finally rest, knowing that all 
manufacturers are going to be held accountable to the new 
mandatory standard, so essentially, it will finally mean that 
we can see a light at the end of the tunnel.
    The Chairman. Again, I want to thank you. As you and others 
will note today, we have had a breakthrough recently to get 
agreement so we are working with senators in both parties. The 
House has already acted, as you know.
    We are on a pathway. We are not done yet, but we are going 
to get there. Again, I want to thank you for that help.
    I wanted to turn, in the remaining time that I have in this 
block of questions to Dr. Parekh. As you know, it is estimated 
that a quarter of all adults ages 65 and older will fall each 
year. As I mentioned, the death number that is related to these 
falls among seniors is 34,000 seniors pass away due to 
complications from falls every year. We know that most of the 
falls occur within the home. We also know that evidence-based 
programs can prevent the harms that result from these falls.
    I am a cosponsor of a piece of legislation introduced by 
Senator Angus King of Maine, the Preventive Home Visit Act, 
Senate Bill 2175, which would enable people with Medicare to 
receive personalized home and safety recommendations from a 
trained medical professional and it may reduce falls.
    Doctor, in your written testimony you State that ``housing 
is health.'' Why is it important for us to promote home safety 
for older adults.
    Dr. Parekh. Senator, thank you so much for that question.
    You know, I think the answer is this is an opportunity for 
all of us to save lives, to save lives, reduce suffering, 
increase independence. The demographics warranted with the rise 
of seniors, aging of the U.S. population, more seniors living 
alone, more seniors living in rural America, more seniors with 
disabilities needing long-term services and supports, home 
modifications is just so critical to reduce injury and to save 
lives.
    I think home modifications and falls prevention go 
together. Low-come, high-impact home modifications can reduce 
falls. Community-based programs like A Matter of Balance, which 
you alluded to, the Capable Program, those can also reduce 
falls, and then there are things that we can terms in terms of 
clinically, better screening and assessing individuals at high 
risk for falls.
    The legislation that you have mentioned, I think that can 
be important, particularly having qualified providers like an 
occupational therapist being able to assess inside the home, 
individuals at high risk for falls, you can certainly see how 
that could reduce suffering, reduce falls, as well as save 
lives.
    I think making sure we get the right qualified 
professional, making sure we focus on high-risk individuals, 
and then connecting them with the home modifications they need, 
as well as the medical care they need, I think is critical.
    The Chairman. Doctor, thanks very much.
    I will turn next to Ranking Member Scott.
    Senator Tim Scott. Thank you, Chairman Casey.
    Ms. Cleveland-Leggett, a question for you as relates to 
achieving the American dream. It seems like the American dream 
is synonymous with home ownership and the fact of the matter is 
as we watch down payments, the value of home goes up, therefore 
the amount of the down payment also goes up. We see that, 
without any question, seniors and families who struggle to 
afford a home seem to be heading in the same direction, higher, 
and higher, and higher.
    Can you talk about the critical role Opportunity Zones can 
play in expanding access to safe, affordable housing?
    Ms. Cleveland-Leggett. Yes, Senator.
    The Opportunity Zones can play an absolutely critical role. 
When you have the public and private partnerships, when you 
have private developers at the table trying to do what they can 
in order to increase housing, it makes a difference. I have 
seen it. I have seen housing that has come about through 
Opportunity Zones, allows people to live in a dignified 
location in a manner--not only seniors but non-seniors have 
housing now because of the Opportunity Zones and the investment 
that developers are willing to make into these communities.
    As I said earlier, the finding from the nonpartisan Joint 
Committee found that 24 percent of the $24 billion invested in 
Opportunity Zone Funds went to low-income communities, and it 
is not just low-income communities. I have seen where they are 
invested in workforce housing in a city like Birmingham where 
there is an old factory and an Opportunity Zone developer came 
in, tore well, did not tear it down but revitalized it. It 
became a beautiful workforce housing development.
    Housing is critical and Opportunity Zones allows this to 
happen through developers who are allowed to invest and create 
new housing in these communities.
    Senator Tim Scott. Thank you, ma'am.
    Another question for you. I served on County Council in a 
prior life it feels like at this point in my career. In that 
life, I will say without any question, watching the zoning 
decisions and land use restrictions that are sometimes placed 
from the local level, whether it is the municipal or the county 
levels, really does restrict the amount of homes on the market, 
so to speak. 39 percent of seniors say that unaffordable 
housing is a major problem and a reality, and you cannot have a 
safe home if you cannot afford a home at all.
    Could you explain how land use regulations hurt the poorest 
and most vulnerable Americans and what impact reforms like 
accessory dwelling units can have on vulnerable populations?
    Ms. Cleveland-Leggett. Yes, Senator.
    Zoning which, as you have indicated, is a local issue, it 
is a State and municipal and local issue, they make the zoning 
rules but they can have long-term and wide reaching effects. I 
have seen communities, and particularly when you are dealing 
with low-income and even the homeless population where you have 
restrictions on the type of dwellings that can go in a 
particular location. It does not allow certain multifamily 
housing to come up, which would be beneficial to seniors and, 
as I said, even the homeless population.
    Cities where you see the homeless population burgeoning, 
which could include seniors who no longer have a place to 
dwell, are limited because of the zoning regulations that limit 
what kind of dwelling can be erected, so absolutely.
    It would behoove us to reach out to our local communities, 
local decisionmakers, to understand what wide-reaching effect 
their regulations have on the ability of individuals to sustain 
a life. Housing is critical for our seniors. Everyone is not in 
a position to have their relatives live with them, but the ADUs 
or accessory development units can be beneficial. That also is 
regulated locally, so where you can put them, what you can do--
but for those of you who do not know what they are, they are 
basically additions in your home.
    Say I had a house and I want to widen my house and to 
create new housing for someone to come in and live, those 
accessory dwelling units are permissible if the local 
legislators allow this to happen. More and more, it is an 
option. If you have got the land, or if you can even 
rehabilitate your own existing house where you could create 
something, it could create an ADU, as well.
    Things like that are important. Changing the regulations 
and also expanding the regulations so that they allow for ADUs 
in our communities.
    Senator Tim Scott. Thank you so much.
    Chairman Casey, I turn it back to you, sir.
    The Chairman. Thank you, Ranking Member Scott.
    I know we are awaiting one or two senators right now but in 
the interim, maybe I will get a question and then we will 
transition as we go.
    I wanted to turn to Ms. Kelly regarding the work that you 
have done at IKEA. You made reference in your testimony to 
IKEA's Safer Life at Home initiative, focusing on safety and 
innovation. Part of this work includes IKEA's work to advance 
the legislation I made reference to, the STURDY Act, and 
promote furniture stability.
    As you note in your testimony, IKEA believes the STURDY Act 
promotes ``innovation and regulatory clarity'' and is good for 
families and businesses alike. I want to thank IKEA for the 
work you have done and the partnership in this effort.
    Here is a two-part question. What has driven IKEA's 
interest in leading by example on these product safety issues 
and innovation? That is kind of part one of the question.
    Part two is why is it important for the industry more 
broadly to be involved in this kind of work?
    Ms. Kelly. Thank you, Chairman Casey.
    Our knowledge at IKEA about life at home and the resources 
that we have in product development and design and our 
understanding of how customers engage lets us contribute to 
these topics and, in some cases, we can lead. As a major 
retailer and manufacturer, we feel it is our responsibility to 
do that. We have a reach of millions of customers around the 
world, so when we decide to take action we can actually make a 
meaningful difference, but while we continue to improve in our 
own business, we know that if we want to make change that is 
wider, that is industry wide, then we need to work with other 
stakeholders and we need to work with stakeholders who are 
leaders in this area. We believe that the best solutions happen 
when you bring together a diverse group with different 
perspectives, sometimes unlikely groups of people and 
organizations, but with a common goal.
    We believe that as a business we have an important 
perspective to bring to these conversations and that, by 
working together, we can come to solutions that work to promote 
safety but at the same time work for business.
    Thank you.
    The Chairman. Ms. Kelly, thanks very much.
    I wanted to turn to our next senator, but I also want to 
acknowledge that Senator Warner has joined us.
    I will now turn to Senator Gillibrand.
    Senator Gillibrand. Thank you so much, Mr. Chairman.
    In comparison to the population at large starting at age 
65, older Americans are more than twice as likely to be killed 
or injured by firs. Many older Americans experience poor 
eyesight, loss of hearing, arthritis, dementia, and side 
effects from medicine that can make it difficult to react to a 
fire.
    I have introduced legislation, the Housing Temperature 
Safety Act, which would require the installation of heat 
sensors in federally subsidized housing. I am also a cosponsor 
of the Public Housing Fire Safety Act, which would provide 
funding for public housing agencies to install automatic 
sprinkler systems.
    Dr. Parekh, what impact would requiring installations of 
fire prevention mechanisms such as heat sensors and sprinklers 
have on older Americans? Second, do you believe it would be 
significantly and meaningfully helpful to increase the safety 
of older Americans toward housing fire dangers?
    Dr. Parekh. Senator Gillibrand, thank you for that question 
and this important public health issue.
    I think certainly, there is data to support automatic 
sprinkler systems. Heat sensors also can be a sensitive way to 
detect a fire, so I do think that these interventions should be 
looked at, certainly the feasibility, the cost studies, as 
well.
    I will also say that, more broadly in terms of fire 
prevention if you look at older adults, the most common cause 
of home fire deaths in the elderly still is smoking, so smoking 
cessation I think is critical here, ensuring that their smoke 
alarms are battery operated, ensuring that there is cooking 
safety, space heater safety, the use of space heaters, all of 
these prevention tools in addition to the interventions that 
you are articulating I think could make a big difference in 
reducing fire deaths in the elderly population.
    Senator Gillibrand. Most older adults prefer to remain in 
their homes and communities as they age, yet many older adults 
face significant challenges to safety and independence because 
of modifiable risk factors in their homes. Unintentional home 
injuries cause more than 30,000 deaths and 12 million non-fatal 
injuries annually in the United States. Home improvements, 
modifications, and repairs can enhance home accessibility over 
a person's life span and reduce the risk of unintentional 
injuries.
    These improvements may include addressing unsafe furniture 
or appliances or supporting balance to reduce risk of falls.
    For Ms. McGee, thank you for sharing your story. I know 
that it cannot be easy but I appreciate you bringing the 
awareness to this issue.
    You mentioned the STURDY Act that would help prevent 
injuries and harm from furniture tipping over. Can you please 
describe the standards this legislation would set to stabilize 
furniture and how it would help prevent dangerous incidents of 
future furniture tipping?
    Ms. McGee. Absolutely. Thank you for this question, 
Senator.
    As many people on the call know, the Consumer Product 
Safety Commission released an NPR last year after four-plus of 
investing the tip-over issue. Their 1,200 page document was a 
lot to read but it does say one thing very clearly, and that is 
that the current safety standard is woefully inadequate.
    We, as parents, already knew this. We knew of units that 
meet today's safety standards that have fallen over. We 
actually have a parent in our group who lost her son in 2017 
from a dresser that meets today's safety standard and is still 
being sold in stores today.
    We know that change is coming. Manufacturers know change is 
coming. We stakeholders are all in agreement that STURDY is the 
best way to get this done. The STURDY Act requirements would 
hold manufacturers accountable not only because it would be a 
mandatory standard rather than voluntary, but also because it 
would test for those real-world use scenarios that I had 
mentioned that are not being tested for today, so dressers 
being loaded with clothes, which is how we use them, multiple 
drawers being open at once, dressers being used on carpeted 
surfaces, and the dynamic force being put on dressers during 
real use scenarios.
    Senator Gillibrand. Yes.
    Thank you very much, and thank you, Mr. Chairman, for this 
important hearing.
    The Chairman. Thank you, Senator Gillibrand.
    We will next turn to Senator Braun.
    Senator Braun. Thank you, Mr. Chairman.
    I have had a lot of interaction with builders back in 
Indiana and their main concern, in fact one that is trying to 
find that sweet spot of where you abide by the regulations but 
still can build something affordable, whether it is regular 
housing, elderly, kind of low-income housing.
    I would be interested to hear from each panelist, each 
witness, the one or two regulations out there that you most 
often hear about that well-intended but cause a 
disproportionate amount of expense and cost, and I can think of 
one related to WOTUS, and I am one that is very sensitive about 
taking care of the environment, but in talking to developers, 
that constantly was an issue that could raise the cost of any 
development.
    I would like to start with Ms. Cleveland-Leggett and let us 
go through to where each of you take maybe a minute or so and 
tell me what you hear most often, the regulations that need to 
be maybe changed, that would give us the biggest bang for our 
buck to find a sweeter spot, especially on individual housing 
but I think it would across the board.
    Go ahead, Ms. Cleveland-Leggett, to start off.
    Ms. Cleveland-Leggett. Yes.
    There is not a specific regulation that comes to mind but I 
do think it is so critical that there be public-private 
partnerships involved. One of the things that most developers 
that do low-income housing, the talk about the tax credits. 
That is something that is issued by the Treasury Department and 
ultimately utilized and distributed by the State, so each State 
is allocated a certain number of tax credits. That is a must in 
developing low-income housing. They need those tax credits, so 
that is not really a regulation, but it is a necessary 
component to developing low-income housing.
    I believe that putting our minds together, one of the 
things that we have been able to do in the past is work 
together to come up with what works. There are some situations 
where it does not necessarily work, but most developers who are 
in this space have come up with ways to make it work and that 
primary way is through low-income tax credits.
    Senator Braun. Thank you there. We have got about maybe 30 
to 40 seconds for the other witnesses to chime in, as well. Go 
ahead.
    Dr. Parekh. I will just say very briefly, Senator, our 
Senior Health and Housing Task Force at the Bipartisan Policy 
Center was very much in support of the Low-Income Housing Tax 
Credit and also made a recommendation in line with what Ms. 
Cleveland-Leggett talked about but reforming zoning laws to 
allow for accessory dwelling units.
    The long and the short of it is that seniors, there is a 
dearth of affordable housing out there and we need to look at 
all ways where we can ensure that seniors have accessible, 
affordable housing and looking at those zoning laws locally, I 
think, is one path forward.
    Senator Braun. Anyone else want to weigh in?
    If not, I think that whenever you are looking at 
regulations, zoning ordinances, there is always I think the 
lack of maybe trying to quantify how much that actually costs, 
but it all gets, in kind of a nebulous way, built into the cost 
of trying to get what we are after, something that is more 
practical to make it affordable, so I think that most agencies 
know that it adds to the cost, never take the time to maybe 
figure out exactly how much that is per square foot.
    I think it would be smart to do because a lot of what I 
hear, in terms of getting the sweet spot, especially on entry 
level single-family homes, it is about $30,000 to $40,000 away 
from where it should be. In many instances, they think about 
half of that cost could be due to regulations that they are 
uncertain the value to say the eventual home owner or the 
process and that there needs to be more attention paid on 
actually when we do regulate what it costs even per board foot.
    Observation here and a lot out in the field. Thanks for 
taking the time to respond to the question. I appreciate it.
    The Chairman. Thank you, Senator Braun.
    Before moving to our next Senator, I want to acknowledge 
Senator Kelly has joined the hearing.
    Now we will turn to Senator Rosen.
    Senator Rosen. Well, thank you, Chairman Casey and I am not 
in the room but Ranking Member Scott, if you are there, thank 
you as well for holding, of course, this really important 
hearing, and the witnesses, thank you all for being here today. 
We really appreciate you.
    I just want to talk a little bit about enhancing assistive 
technology for seniors at home. We know it is important to age 
in place and we are increasingly seeing the benefits of new and 
innovative technology changing the way seniors are living, 
aging at home. Technology offers greater security and 
independence for seniors, ultimately really preserving their 
quality of life.
    In Nevada, we are helping to lead the way in some of those 
innovative work. For example, in 2017, members of UNLV's 
student engineering team won first place in an Department of 
Energy competition when they worked directly with Nevada 
seniors to build a home designed to help older adults age in 
place powered entirely by solar energy with smart homes and 
health monitoring technology.
    Dr. Parekh, as a clinician and a public health expert, how 
do you think we can adapt the existing technology we have, 
upgrade it however we need to, to meet the needs of seniors, 
older adults, or as we age in place in our own home how can we 
continue to upgrade?
    Dr. Parekh. Senator, thank you for that question. 
Congratulations to the UNLV team. Certainly technology is a 
solution here. I think we have to meet seniors where they are 
in realizing that many seniors may have vision or balance or 
movement challenges. I think technologies that are easy to use, 
user-friendly, that they can see, they can interface with their 
health care provider or others, I think are going to be 
absolutely critical.
    There are so many technologies out there, so also ensuring 
that we have research so that we know which of these 
interventions and technologies lead to the best outcomes, I 
think is really important.
    Broadband is absolutely going to be critical, as well, 
here, and then we need to increase awareness of those 
technologies, ensure that they are accessible. That could be 
reimbursement through insurance or that could be through tax 
credits or grants in the private sector taking the lead.
    I think there are a number of things here. We have to make 
them user-friendly. We have to make the research is there, make 
sure that there is awareness, and make sure, particularly for 
low-income Americans, that the public and private sector are 
supporting access for them.
    Senator Rosen. That is great.
    I want to build on that because I stepped away from my 
career to take care of my parents and in-laws, and so I want to 
be sure that we have to ensure that families caring for their 
aging relatives like I did have access and aware about the new 
technologies.
    You talked about broadband. It is particularly important 
for low-income families and for telehealth for those families 
that do not have easy access to health care providers.
    Do you have any ideas about what more we can do to help the 
caregivers and ensure that families have access to health care?
    Dr. Parekh. Well, I think the telehealth piece is so 
critical. We have seen the importance of telemedicine during 
this pandemic. Remote monitoring technologies are so important, 
as well. There are many consumer-facing apps that are evidence-
based that promote self-management, so I think we have to 
continue pushing the envelope on telehealth.
    I would say it is not only important from a directed health 
perspective but, Senator, we are also facing a significant 
public health challenge in this country of social isolation and 
loneliness amongst elders, Social isolation increases mortality 
by 29 percent, increases the risk of chronic conditions, leads 
to the cost to the Medicare program. Connectivity through 
broadband, connecting seniors or loved ones with family, 
friends, the resources and supports they need, I think are 
going to be so critical moving forward.
    Senator Rosen. Well, I am actually glad you brought that up 
because that was actually my next question was senior isolation 
and some of the safety issues around senior isolation like 
preventing falls, so you set me right up for the next question 
because falls are the leading safety concern for older 
Americans. A quarter of Americans aged 65 and older fall each 
year, billions of visits to the emergency room, 34,000 deaths 
among adults aged 65 years and older annually from falls.
    We also know COVID, seniors were so isolated. It really has 
an impact on your mental health and then your physical health. 
I am curious to learn a little bit more about the creative ways 
communities are responding the prevent falls in the home and 
also to address the social isolation.
    How do you think--have you seen some research? Or what can 
we do to be sure that we increase the safety from falls 
specifically and really try to decrease that feeling of social 
isolation?
    Dr. Parekh. Yes, I think the most important thing we can do 
is to support seniors in ensuring that they are physically 
active and that they are seen and can be seen.
    The best data I have seen is from the National Poll on 
Healthy Aging out of the University of Michigan. It does appear 
that during the pandemic more seniors were less active, their 
physical conditioning decreased, they experienced more falls. 
This was more common in women and those who lack companionship, 
so all of this social isolation, falls, they are all connected.
    I do not know how families have mitigated this but my 
hypothesis, Senator, would be that what we need to do is ensure 
that they feel connected, that they are seen, that they are 
visited, and they are engaged physically. Physical activity is 
also critical to reducing falls.
    Senator Rosen. Well, improving access to broadband and 
telemedicine and visitation, community, other kind of 
engagement are really important.
    Thank you so much. I yield bank.
    The Chairman. Senator Rosen, thanks very much for your 
questions.
    I will turn next to Ranking Member Scott.
    Senator Tim Scott. Thank you, Mr. Chairman.
    What an interesting hearing, by the way, and I think are 
panelists are doing a really good job of distilling some of the 
important issues, from health care to housing, that we all see 
our seniors facing and looking for ways to overcome them, so 
thank you very much for holding this hearing. I am so thankful 
for the panelists for bringing your expertise to bear against a 
very important issue.
    Ms. Cleveland-Leggett, seniors are a growing share of the 
housing market as our population ages. I think you said 
something that caught my attention, that one out of five 
Americans in the years coming will be seniors. I have also 
heard statistics that we are on the verge of having more people 
becoming seniors than we have births in our Nation. That is a 
challenge for a nation that is not yet replacing ourselves, so 
we have a lot of work that needs to be done.
    The private sector is increasingly recognizing the trend in 
the aging of our population. Some companies are starting to 
offer expanded home modification and assistive technology 
services and expertise.
    Could you help us understand the role of the private sector 
and innovative small businesses in meeting seniors' housing 
needs?
    Ms. Cleveland-Leggett. The private sector is critical for a 
number of different reasons. The public sector does not have 
the wherewithal to bear the burden by itself. You have got HUD, 
you have got HHS, you have got the VA with VASH Vouchers. You 
have got other Federal organizations.
    However, alone they cannot bear the burden, and so it is a 
necessary component, the private sector is critical not only 
for innovation but also their dollars. Them putting forth the 
backbone, the backup financially, and then bringing that to the 
table, because the private sector dollars coupled with the 
public sector dollars makes a difference.
    I have seen from organizations that come to play with 
public dollars, with Choice Neighborhoods grants, $30 million. 
That sounds like a lot of money, but when you start building 
and putting together the kind of communities that we need, the 
$30 million in a Choice Neighborhood grant is also enhanced 
when you have got a private developer coming in and adding to 
that financially and adding their ability to put together 
innovative housing.
    The private sector is critical. We cannot continue and we 
cannot develop the way that we want to just on government 
funding. It really will not work.
    I have seen it time and time again in the places that I 
have visited and it is critical. From every State that I 
oversaw to Puerto Rico to the USVI it is absolutely an 
essential component to have the private sector as partners in 
this.
    As I said earlier, what are some of the things that brings 
them to the table? Bringing them to the table are the tax 
credits. That helps them pencil out, that helps them make sense 
of what they want to do because, of course, they are there to--
they are not non-profit, so they are there to make money, which 
is not a bad thing. However, many of them have come to the 
table with the right mission.
    That is why I am with Integral, because of their mission. 
They are mission oriented. Yes, they are a private developer, 
but they have also incorporated in their mission that they are 
going to change the trajectory of the lives of the people that 
they serve, whether it is elderly, whether it is low-income, no 
matter who it is, and there are other developers who have done 
that, but in my estimation, no one has done it as well as 
Integral.
    Senator Tim Scott. Thank you very much for the answer.
    Mr. Chairman, I will certainly have answers for another 
round perhaps, depending on time. I will use my last 10 seconds 
to just acknowledge the fact that you think about public 
housing for our seniors. The backlog for repairs is over $70 
billion, so we have a lot of work that needs to be done to make 
sure that even accessible and safe public housing is up to code 
for our seniors, so to speak.
    Thank you for the time.
    The Chairman. Ranking Member Scott, thanks very much for 
your questions in the second round. We are going to have to 
conclude but I wanted to just have some closing comments before 
turning again to the Ranking Member.
    Today, in this hearing, our witnesses helped us better 
understanding both health and safety issues within the home. 
Our witnesses of course, and we are grateful for their 
testimony and their presence today, our witnesses demonstrated 
that Congress most do more to prevent tragedies caused by 
unintentional home injuries.
    I believe we must support older adults aging safely in 
their homes through passage of bills like the Preventive Home 
Visit Act that I mentioned earlier, Senator King's legislation.
    We learned that falls can be prevented through common sense 
and cost effective home modifications and evidence-based 
programs.
    We also have to ensure furniture sold to consumers is 
tested for both safety and stability. I believe we owe this to 
children like Teddy McGee, Katie Lambert, Curren Collas, and so 
many other children and to their families, and to every family 
who last lost a loved one from a preventable injury like a fall 
or a furniture tip-over, whether that individual is a child or 
a senior.
    This starts with passage of the bipartisan STURDY Act, a 
bill that will save children's lives. As Ms. McGee noted in her 
testimony, a coalition of consumer groups, parents, and 
industry partners have come to an agreement on advancing the 
STURDY Act legislation. They have done the hard work for us, 
all these months--longer than months now--working on an 
agreement, so now it is time for the Senate to take on its 
responsibility to ensure that our homes are safe.
    I will turn next to Ranking Member Scott for his closing 
remarks.
    Senator Tim Scott. Let me just thank each and every person 
who provided testimony in today's hearing, so valuable was the 
testimonies that we have heard, the answers to the questions 
provided more light into solutions.
    I am always a fan of public-private partnerships to meet 
the problems and the challenges of this country, especially in 
the housing area. I think we heard excellent testimony, heart-
wrenching testimony around the challenges of falls and 
furniture falling on kids particularly and overall falls by 
seniors, more than 36,000 a year.
    You all provided us a number of solutions. I also want to 
note the fact that the use of virtual health or telemedicine is 
becoming an important part of senior living and one that we 
should all be excited about and look forward to having more 
hearings and more discussions around providing excellent 
quality health care without seniors having to necessarily drive 
to appointments but having the opportunity to have those 
appointments from where they live.
    In fact, as we think about where they live, making sure 
that affordable, safe housing is a part of the primary 
responsibility as we think about the golden years of our 
seniors would be an incredibly important part of the 
engagement.
    Thank you all for being here.
    Mr. Chairman, I yield back.
    The Chairman. Ranking Member Scott, thanks very much.
    I want to note, for the record, that we may have set a 
record this month. We have had three Committee hearings. I want 
to thank Ranking Member Scott for his work and his cooperation, 
as well as the staffs of both of our teams, all of the hours 
that they put into have three hearings in a month. Ranking 
Member Scott, I think it is a record but it is probably not a 
record we want to set every month. Scott
    Senator Tim Scott. Some records should lie, they should 
stay set forever.
    The Chairman. But it is, we are grateful for all of the 
work that they did.
    Senator Tim Scott. Indeed.
    The Chairman. For today's hearing, I want to once again 
thank all our witnesses for contributing both their time and 
their expertise and their personal experiences that bring to 
bear on so many of these issues that involve safety.
    For the record, if any Senator has additional questions for 
witnesses or statements to be added to the record, the hearing 
record will be kept open for 7 days until next Thursday, April 
7th.
    Thank you again everyone for participating.
    This concludes today's hearing.
    [Whereupon, at 11:25 a.m., the Committee was adjourned.]
   
      
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                                APPENDIX
     
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                      Prepared Witness Statements

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                        Questions for the Record

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                       Statements for the Record

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