2000 
[DOCID: f:s1922is.txt]






107th CONGRESS
  2d Session
                                S. 1922

  To direct the Secretary of Health and Human Services to expand and 
  intensify programs with respect to research and related activities 
                        concerning elder falls.


_______________________________________________________________________


                   IN THE SENATE OF THE UNITED STATES

                            February 7, 2002

Mr. Hutchinson (for himself, Ms. Mikulski, and Mr. Enzi) introduced the 
 following bill; which was read twice and referred to the Committee on 
                 Health, Education, Labor, and Pensions

_______________________________________________________________________

                                 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.

    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 qualifie
a96
d organizations and 
        institutions to design and carry out fall prevention programs 
        in residential and institutional settings.
            (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.
                                 <all>

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