[Congressional Record Volume 148, Number 9 (Thursday, February 7, 2002)]
[Senate]
[Pages S493-S494]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. HUTCHINSON (for himself, Ms. Mikulski, and Mr. Enzi):
  S. 1922. 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; to the Committee on Health, 
Education, Labor, and Pensions.
  Mr. HUTCHINSON. Mr. President, today, I am pleased to introduce the 
Elder Fall Prevention Act of 2002, along with my colleagues Senator 
Mikulski and Senator Enzi.
  Many people do not realize that over 60 percent of fall-related 
deaths in our country occur among persons 75 or older. Fall victims, 
especially the elderly, are prone to sustain hip fractures which can be 
devastating to their health--in fact, 25 percent of individuals who 
sustain hip fractures die within one year from the time the injury 
occurred.
  In Arkansas, falls are the second leading cause of deaths from 
unintentional injuries. Based on data collected by the Centers for 
Disease Control, 91 Arkansans died because of a fall-related injury in 
1998 alone.
  Not only is this a serious public health issue, it is also a fiscal 
issue, because billions of Medicare and Medicaid dollars are spent each 
year to treat fall victims. It is estimated that over $32 billion will 
be spent by the Medicare and Medicaid programs for fall related 
injuries in the year 2020.
  The Elder Fall Prevention Act will provide needed resources for 
education, research and demonstration projects aimed at reducing the 
risk of falls, identifying vulnerable populations, and preventing 
repeat falls. The congressionally chartered National Safety Council, 
which is a leader in fall prevention efforts, will be spearheading 
several of these initiatives, along with the Centers for Disease 
Control, the Administration on Aging, the Agency for Health Research 
and Quality, and other qualified organizations.
  Falls are preventable. I urge my colleagues to support the Elder Fall 
Prevention Act of 2002 in order to make seniors, family members, 
caregivers, and employers more safety conscious, to prevent unnecessary 
deaths, and to provide seniors with peace of mind and a safe 
environment.
  I ask unanimous consent that the text of the bill be printed in the 
Record.
  There being no objection, the bill was ordered to be printed in the 
Record, as follows:

                                S. 1922

       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 ``Elder Fall Prevention Act of 
     2002''.

     SEC. 2. FINDINGS.

       The Congress finds as follows:
       (1) Falls are the leading cause of injury deaths among 
     people over 65.
       (2) Sixty percent of fall-related deaths occur among 
     persons 75 and older.
       (3) Twenty-five percent of elderly persons who sustain a 
     hip fracture die within 1 year.
       (4) Hospital admissions for hip fractures among the elderly 
     have increased from 231,000 admissions in 1988 to 332,000 in 
     1999. The number of hip fractures is expected to exceed 
     500,000 by 2040.
       (5) The costs to the Medicare and Medicaid programs and 
     society as a whole from falls by elderly persons continue to 
     climb much faster than inflation and population growth. 
     Direct costs alone will exceed $32,000,000,000 in 2020.
       (6) The Federal Government should devote additional 
     resources to research regarding the prevention and treatment 
     of falls in residential as well as institutional settings.
       (7) A national approach to reducing elder falls, which 
     focuses on the daily life of senior citizens in residential, 
     institutional, and community settings is needed. The approach 
     should include a wide range of organizations and individuals 
     including family members, health care providers, social 
     workers, architects, employers and others.
       (8) Reducing preventable adverse events, such as elder 
     falls, is an important aspect to the agenda to improve 
     patient safety.

     SEC. 3. PURPOSES.

       The purposes of this Act are--
       (1) to develop effective public education strategies in a 
     national initiative to reduce elder falls in order to educate 
     the elders themselves, family members, employers, caregivers, 
     and others who touch the lives of senior citizens;
       (2) to expand needed services and gain information about 
     the most effective approaches to preventing and treating 
     elder falls; and
       (3) to require the Secretary of Health and Human Services 
     to evaluate the effect of falls on the costs of medicare and 
     medicaid and the potential for reducing costs by expanding 
     services covered under these two programs.

     SEC. 4. PUBLIC EDUCATION.

       Subject to the availability of appropriations, the 
     Administration on Aging within the Department of Health and 
     Human Services shall--
       (1) oversee and support a three-year national education 
     campaign to be carried out by the National Safety Council to 
     be directed principally to elders, their families, and health 
     care providers and focusing on ways of reducing the risk of 
     elder falls and preventing repeat falls; and
       (2) provide grants to 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 ways of 
     reducing the risk of elder falls and preventing repeat falls.

     SEC. 5. RESEARCH.

       (a) In General.--Subject to the availability of 
     appropriations, the Secretary of Health and Human Services 
     shall--
       (1) conduct and support research to--
       (A) improve the identification of elders with a high risk 
     of falls;
       (B) improve data collection and analysis to identify fall 
     risk and protective factors;
       (C) improve strategies that are proven to be effective in 
     reducing subsequent falls by elderly fall victims;
       (D) expand proven interventions to prevent elder falls;
       (E) improve the diagnosis, treatment, and rehabilitation of 
     elderly fall victims; and
       (F) assess the risk of falls occurring in various settings;
       (2) conduct research concerning barriers to the adoption of 
     proven interventions with respect to the prevention of elder 
     falls (such as medication review and vision enhancement); and
       (3) evaluate the effectiveness of community programs to 
     prevent assisted living and nursing home falls by elders.
       (b) Administration.--In carrying out subsection (a), the 
     Secretary of Health and Human Services shall--
       (1) conduct research and surveillance activities related to 
     the community-based and populations-based aspects of elder 
     fall prevention through the Director of the Centers for 
     Disease Control and Prevention;
       (2) conduct research related to elder fall prevention in 
     health care delivery settings and clinical treatment and 
     rehabilitation of elderly fall victims through the Director 
     of the Agency for Healthcare Research and Quality; and
       (3) ensure the coordination of the activities described in 
     paragraphs (1) and (2).
       (c) Grants.--The Secretary of Health and Human Services 
     shall award grants to qualified organizations and 
     institutions to enable such organizations and institutions to 
     provide professional education for physicians and allied 
     health professionals in elder fall prevention.

     SEC. 6. DEMONSTRATION PROJECTS.

       Subject to the availability of appropriations, the 
     Secretary of Health and Human Services, acting through the 
     Director of the Centers for Disease Control and Prevention 
     and in consultation with the Director of the Agency for 
     Healthcare Research and Quality, shall carry out the 
     following:
       (1) Oversee and support demonstration and research projects 
     to be carried out by the National Safety Council in the 
     following areas:
       (A) A multi-State demonstration project assessing the 
     utility of targeted fall risk screening and referral 
     programs.
       (B) Programs targeting newly-discharged fall victims who 
     are at a high risk for second falls, which shall include, but 
     not be limited to modification projects for elders with 
     multiple sensory impairments, video and web-enhanced fall 
     prevention programs for caregivers in multifamily housing 
     settings, and development of technology to prevent and detect 
     falls.
       (C) Private sector and public-private partnerships, 
     involving home remodeling, home design and remodeling (in 
     accordance with accepted building codes and standards) and 
     nursing home and hospital patient supervision.
       (2)(A) Provide grants to qualified organizations and 
     institutions to design and carry out fall prevention programs 
     in residential and institutional settings.

[[Page S494]]

       (B) Provide one or more grants to one or more qualified 
     applicants in order to carry out a multi-State demonstration 
     project to implement fall prevention programs targeted toward 
     multi-family residential settings with high concentrations of 
     elders, including identifying high risk populations, 
     evaluating residential facilities, conducting screening to 
     identify high risk individuals, providing pre-fall 
     counseling, coordinating services with health care and social 
     service providers and coordinating post-fall treatment and 
     rehabilitation.
       (C) Provide one or more grants to qualified applicants to 
     conduct evaluations of the effectiveness of the demonstration 
     projects in this section.

     SEC. 7. REVIEW OF REIMBURSEMENT POLICIES.

       (a) In General.--The Secretary of Health and Human Services 
     shall undertake a review of the effects of falls on the costs 
     of the Medicare and Medicaid programs and the potential for 
     reducing costs by expanding services covered by these two 
     programs. This review shall include a review of the 
     reimbursement policies of medicare and medicaid in order to 
     determine if additional fall-related services should be 
     covered or reimbursement guidelines should be modified.
       (b) Report.--Not later than 18 months after the date of the 
     enactment of this Act, the Secretary of Health and Human 
     Services shall submit to the Congress a report describing the 
     findings of the Secretary in conducting the review under 
     subsection (a).

     SEC. 8. AUTHORIZATION OF APPROPRIATION.

       In order to carry out the provisions of this Act, there are 
     authorized to be appropriated--
       (1) to carry out the national public education provisions 
     described in section 4(1), $5,000,000 for each of fiscal 
     years 2003 through 2005;
       (2) to carry out the State public education campaign 
     provisions of section 4(2), $8,000,000 for each of fiscal 
     years 2003 through 2005;
       (3) to carry out research projects described in section 5, 
     $10,000,000 for each of fiscal years 2003 through 2005; and
       (4) to carry out the demonstration projects described in 
     section 6(1), $7,000,000 for each of fiscal years 2003 
     through 2005; and
       (5) to carry out the demonstration and research projects 
     described in section 6(2), $8,000,000 for each of fiscal 
     years 2003 through 2005.
                                 ______