[Congressional Record Volume 151, Number 105 (Thursday, July 28, 2005)]
[Senate]
[Pages S9294-S9296]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]

      By Mr. ENZI (for himself, Ms. Mikulski, Mr. Cochran, Mr. Baucus, 
        Mr. Grassley, Mrs. Murray, and Mrs. Dole):
  S. 1531. 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. ENZI. Mr. President, these people all have something in common: 
the former Queen Mother of Britain; diet guru Dr. Robert Atkins; former 
Tonight Show co-host Ed McMahon; former first lady Nancy Reagan; and 
former Senator Bob Dole. What is it? They are all famous seniors who 
have suffered a fall during the past three years that had serious 
repercussions on their lives.
  Queen Elizabeth's mother had a history of falling. She underwent a 
major operation in 1995 to replace her right hip and had a second hip 
replacement in 1998 when she broke her left hip. In 2000, she tripped 
and fell in her sitting room and fractured the left-hand side of her 
collarbone. Then, in 2002 at 101-years-old, she stumbled again in her 
sitting room while getting up from a chair and cut her arm.
  Dr. Robert Atkins, the creator of the high-protein, low-carbohydrate 
Atkins diet, suffered a severe head trauma in 2003 when an accidental 
fall outside his New York office left him comatose. Although surgeons 
removed a blood clot to relieve the pressure on his brain, the 72-year-
old died eight days later.
  In March of this year, former Tonight Show co-host Ed McMahon spent 
his 82nd birthday in the hospital after a fall in his Beverly Hills 
home left him with a mild concussion and a gash in his head that 
required stitches.
  Just last month, former first lady Nancy Reagan slipped and fell in 
her London hotel room. Fortunately, she was not seriously injured, but 
was told by doctors to limit her activities for two weeks until the 
pain subsided and full mobility returned.
  The final story hits even closer to home. In January of this year, 
81-year-old former Senator and presidential candidate Bob Dole felt 
light-headed and suffered a near fatal fall while putting away a 
suitcase. After a quick trip to the hospital to stitch up a cut from 
his eyeglasses, he was taken back home. Later, he felt ill and had to 
be taken back to Walter Reed Army Medical Center. Doctors worked fast 
to save his life. In the fall he had severely damaged his left ``good'' 
arm, and he suffered bleeding in his head which was worsened by the 
blood thinners he was given a month earlier after a hip replacement 
operation. After spending 22 days at Walter Reed, he told a reporter 
that he was ``getting better slowly'' and that the recovery was 
``humiliating'' at times.
  As evidenced, falling is a very common and serious problem for older 
persons. These stories demonstrate the fact that falls can happen to 
anyone--even the rich and famous. A new report finds that although the 
life expectancy for Americans has reached an all-time high and senior 
citizens are more active than previous generations were, they are also 
reporting to emergency rooms in greater numbers for fall-related 
injuries. Falls can result in decreased physical function and mobility, 
disability, reduced independence, and a diminished quality of life. 
Loss of confidence and fear of falling can lead to further functional 
decline, depression, feelings of helplessness, and social isolation.
  The statistics are overwhelming. More than one-third of adults age 65 
years and older fall each year. Falls are the leading cause of injury 
deaths among individuals in that age group. In 2002, falls among older 
adults accounted for 12,800 deaths and 1,640,000 emergency department 
visits.
  Hospital admissions for hip fractures among the elderly have 
increased from 231,000 in 1988 to 327,000 in 2001. One in 5 older 
Americans who suffer a hip fracture die within a year, and 1 in 5 
people with a hip fracture end up in a nursing home within a year. 
Among people 75 years and older, those who fall are four to five times 
more likely to be admitted to a long-term care facility for a year or 
longer.
  Annually, more than 80,000 individuals who are over 65 years of age 
sustain a traumatic brain injury as a result of a fall.
  A recent study of people age 72 and older found that the average 
health care cost of a fall injury was $19,440. This figure does not 
include physician services. The total medical cost of all fall injuries 
for people age 65 and older was calculated in 2000 to be $19.5 billion. 
By 2020, the cost of fall injuries is expected to reach $43.8 billion, 
in current dollars.
  Given our aging population, by the year 2040, the number of hip 
fractures is expected to exceed 500,000--the annual cost of which is 
projected to be a shocking $240 billion.
  To make matters worse, given the aging baby boomers, more and more 
elderly will be susceptible to falls. By the year 2040, the 65 and 
older population will more than double to about 77.2 million, and the 
relative growth rate is even faster for people over 85.
  It seems that we've come to expect that a fall by an older relative 
is just a natural part of aging, when it is not. As the old adage says 
so well: ``An ounce of prevention is worth a pound of cure.'' Almost 
without exception, these falls are preventable. Older adults who have 
fallen previously or who stumble frequently are two to three times more 
likely to fall within the next year. We need to take action to ensure 
that doesn't happen.
  Last year, Senator Mikulski and I introduced the ``Keeping Seniors 
Safe From Falls Act of 2004,'' which passed the Senate by unanimous 
consent. Today, we are reintroducing this legislation, and we look 
forward to working with our colleagues so that it not only passes the 
Senate, but is signed into law.
  Our bill will direct the Department of Health and Human Services to 
oversee

[[Page S9295]]

and support national and local education campaigns focusing on reducing 
falls among older adults and preventing repeat falls. It also calls for 
research in areas such as identifying older adults at high risk for 
falling; designing, implementing and evaluating the most effective fall 
prevention interventions; improving diagnosis, treatment, and 
rehabilitation of older adults who have fallen; tailoring effective 
strategies to specific populations; and eliminating barriers to 
adopting proven fall prevention strategies. In addition, the bill 
supports demonstration and research projects to improve the science 
behind preventing falls. It also requires the Secretary to evaluate the 
effect of falls on health care costs, the potential for reducing falls, 
and the most effective strategies for reducing fall-related health care 
costs. Finally, the bill authorizes the appropriation of funds for each 
of fiscal years 2007 through 2009 in order to carry out its provisions.
  I look forward to working again with Senator Mikulski, my colleagues 
on the HELP Committee, and the wide variety of groups who support this 
bill. I urge you to support this legislation that will help to keep our 
nation's seniors--ourselves, our family members, and our friends--safe 
from falls so that they may have a chance to fully enjoy and savor 
their ``golden years'' in a safer and healthier fashion.
  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. 1531

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

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Keeping Seniors Safe From 
     Falls Act of 2005''.

     SEC. 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.

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

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

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

       ``(a) Purposes.--The purposes of this section are--
       ``(1) to develop effective public education strategies in a 
     national initiative to reduce falls among older adults 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 2005, 
     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--
       ``(1) to carry out the national public education provisions 
     described in subsection (b)(1), $3,000,000 for each of fiscal 
     years 2007 through 2009;
       ``(2) to carry out the State public education campaign 
     provisions of subsection (b)(2), $5,000,000 for each of 
     fiscal years 2007 through 2009;
       ``(3) to carry out research projects described in 
     subsection (c), $8,000,000 for each of fiscal years 2007 
     through 2009;

[[Page S9296]]

       ``(4) to carry out the demonstration projects described in 
     subsection (d)(1), $4,000,000 for each of fiscal years 2007 
     through 2009; and
       ``(5) to carry out the demonstration and research projects 
     described in subsection (d)(2), $5,000,000 for each of fiscal 
     years 2007 through 2009.''.
  Ms. MIKULSKI. Mr. President, I am pleased to join Senator Enzi in 
introducing the Keeping Seniors Safe from Falls Act of 2005. Falls are 
a serious public health problem that affects millions of seniors each 
year. This bill expands research and education on elder falls to help 
keep seniors safe and in their own homes longer.
  The facts are staggering. One out of every three Americans over age 
65 falls every year. In 2002, over 12,800 seniors died and 
approximately 1.6 million seniors visited an emergency department as a 
result of a fall. Falls are the leading cause of injury deaths among 
seniors. It is estimated that annually more than 80,000 individuals 
over 65 years of age sustain a traumatic brain injury as a result of a 
fall. Falls can be financially disastrous for families, and falls place 
a serious financial strain on our health care system. By 2020, senior 
falls are estimated to cost the health care system more than $32 
billion.
  These facts do not begin to tell the story of what falls can mean for 
seniors and their loved ones. Falls don't discriminate. Many of us have 
friends or relatives who have fallen. A fall can have a devastating 
impact on a person's physical, emotional, and mental health. If an 
older woman loses her footing on her front porch steps, falls, and 
suffers a hip fracture, she would likely spend about two weeks in the 
hospital, and there is a 50 percent chance that she would not return 
home or live independently as a result of her injuries.
  With some help, there are simple ways that seniors can improve the 
safety of their homes and make a fall far less likely. Home 
modifications like hand rails in the bathroom, rubber mats on slippery 
tile floors, and cordless telephones that seniors can keep nearby can 
make a big difference. Well trained pharmacists can review medications 
to make sure that two drugs do not interact to cause dizziness and 
throw a senior off balance.
  That is why I teamed up with Senator Enzi to introduce this important 
bill. This legislation is about getting behind our Nation's seniors and 
giving help to those who practice self-help. This bill creates public 
education campaigns for seniors, their families, and health care 
providers about how to prevent falls. It expands research on elder 
falls to develop better ways to prevent falls and to improve the 
treatment and rehabilitation of elder falls victims. This legislation 
also requires an evaluation of the effect of falls on health care 
costs, ways we can reduce falls, and effective solutions that can be 
adopted that can help reduce health care costs associated with falls.
  Reducing the number of falls will help seniors live longer, 
healthier, more independent lives. This bill has the strong support of 
the National Safety Council, the Home Safety Council and the National 
Council on Aging, and has been supported in the past by over 30 
national and local aging and safety organizations. I look forward to 
working with Senator Enzi and my colleagues on the Health, Education, 
Labor, and Pensions Committee to get this bill signed into law.
                                 ______