59–010 

Calendar No. 99 

110TH CONGRESS REPORT " ! SENATE 1st Session 110–110 

SAFETY OF SENIORS ACT OF 2007 

JUNE 28, 2007.—Ordered to be printed 

Mr. KENNEDY, from the Committee on Health, Education, Labor, 

and Pensions, submitted the following 

R E P O R T 

[To accompany S. 845] 

The Committee on Health, Education, Labor, and Pensions, to 

which was referred the bill (S. 845) to direct the Secretary of 

Health and Human Services (HHS) to expand and intensify programs with respect to research and related activities concerning 

elder falls, having considered the same, reports favorably thereon 

with an amendment in the nature of a substitute, and recommends 

that the bill (as amended) do pass. 

CONTENTS 

I. Purpose and need for legislation .................................................................. 1 

II. Summary ........................................................................................................ 2 

III. History of legislation and votes in committee ............................................. 2 

IV. Explanation of bill and committee views ..................................................... 3 

V. Cost estimate .................................................................................................. 4 

VI. Regulatory impact statement ........................................................................ 5 

VII. Application of law to the legislative branch ................................................ 5 

VIII. Section-by-section analysis ............................................................................ 5 

IX. Changes in existing law ................................................................................ 6 

I. PURPOSE AND NEED FOR LEGISLATION

The purpose of ‘‘Safety of Seniors Act of 2007’’ is to direct the 

Secretary of Health and Human Services (HHS) to enhance programs with respect to research and related activities concerning 

elder falls. In older Americans, falling is the leading cause of injury 

and death. According to the Centers for Disease Control and Prevention (CDC), falls among older adults and traumatic brain injuries cost the United States an estimated 80 billion dollars in 2000. 

More than 1⁄3 of adults aged 65 and older fall each year. According to the CDC, in 2002, more than 12,800 people aged 65 and 


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older died from fall-related injuries. More than 1.6 million seniors 

were treated that year in emergency departments for fall-related 

injuries. Hospital admissions for hip fractures among the elderly 

have increased from 321,000 admissions in 1988 to 327,000 in 

2001. Annually, more than 80,000 individuals who are over 65 

years of age sustain a TBI as a result of a fall. 

In addition to their effect on the quality of life of seniors and 

their families, falls also have an impact on healthcare costs due to 

increased physician visits, emergency room use and hospitalization. 

According to the CDC, the direct medical cost totaled $179 million 

dollars for fatal and $19 billion dollars for nonfatal fall injuries in 

2000. 

To address the impact of falls on seniors, their families, and 

healthcare costs, the Safety of Seniors Act of 2007 would focus ongoing Federal efforts to prevent falls among older adults on three 

priorities: (1) Developing a national education campaign to reduce 

falls among older adults; (2) Enhancing services and conducting research to determine the most effective approaches to preventing 

and treating falls among older adults; and (3) Urging the Secretary 

of Health and Human Services (HHS) to evaluate the effect of falls 

on healthcare costs, the potential for reducing falls, and the most 

effective strategies for reducing healthcare costs associated with 

falls. 

II. SUMMARY

The purpose of this legislation is to enhance and improve programs that authorize activities to reduce falls among the elderly. 

Specifically, the legislation directs the Department of Health and 

Human Services (HHS) to: 

(1) Develop public education programs on fall prevention for the 

elderly, family members, caregivers, and others involved with the 

elderly. 

(2) Enhance services and conduct research to determine the most 

effective approaches to preventing and treating falls among older 

adults; and 

(3) Evaluate the effect of falls on health care costs, the potential 

for reducing falls, and the most effective strategies for reducing 

healthcare costs associated with falls. 

III. HISTORY OF LEGISLATION AND VOTES IN COMMITTEE

On March 29, 2007 the Committee considered and approved a 

manager’s amendment to S. 845. Senators Mikulski and Enzi cosponsored the manager’s amendment. Senators Kennedy, Hatch 

and Kohl also sponsored S. 845. 

During the 110th Congress, S. 845, The Safety of Seniors Act of 

2007 was introduced by Senator Enzi for himself and Senator Mikulski on March 12, 2007. Senators Kennedy and Hatch cosponsored the bill. 

The legislation was first introduced during the 107th Congress, 

on February 7, 2002, by Senator Hutchinson, for himself and Senators Mikulski and Enzi, as S. 1922. Senators Baucus, Miller and 

Murray also cosponsored S. 1922. The Health, Education, Labor, 

and Pensions (HELP) Subcommittee on Aging held a hearing on S. 

1922 on June 11, 2002. 


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The bill was reintroduced as S. 1217 during the 108th Congress 

on June 9, 2003, by Senator Enzi, for himself and Senator Mikulski. Senators Murray, Baucus, Grassley, Cochran, Lautenberg, 

Bingaman, and Bunning also cosponsored S. 1217. On September 

22, 2004, the HELP Committee considered a substitute amendment 

to S. 1217 offered by Senators Enzi and Mikulski, which was approved by unanimous consent. 

During the 109th Congress, the bill was introduced as S. 1531, 

The Keeping Seniors Safe from Falls Act by Senator Enzi for himself and Senator Mikulski on July 28, 2005. Senators Baucus, Dole, 

Grassley, Cochran, Durbin, Isakson and Murray cosponsored the 

bill. On September 20, 2006, the Committee considered and unanimously approved a manager’s amendment to S. 1531. S. 1531, the 

Keeping Seniors Safe from Falls Act and Reauthorization of Traumatic Brain Injury Act was a combination of two bills—The Keeping Seniors Safe from Falls Act and the Traumatic Brain Injury 

Reauthorization. Senators Mikulski, Hatch, Kennedy, DeWine, 

Murray, and Isakson cosponsored the manager’s amendment. 

IV. EXPLANATION OF BILL AND COMMITTEE VIEWS

The Keeping Seniors Safe from Falls Act of 2007 encourages the 

Secretary of HHS to enhance the Department’s efforts to prevent 

and treat injuries. The legislation focuses on reducing and preventing falls among older adults. The committee-reported bill 

would increase funding for elder falls programs administered by 

the Centers for Disease Control and Prevention (CDC). 

The legislation directs the Secretary of HHS to refocus the Department’s efforts to prevent falls among older adults through public education and research, and to assess the impact that falls have 

on healthcare costs. The committee directs the Secretary to carry 

out his authority through agencies, such as the CDC and its National Center for Injury Prevention and Control (NCIPC), which 

have the necessary experience and expertise to conduct and support such work. 

The committee expects the public education campaign to be directed principally to older adults, their families, and healthcare 

providers, and to be focused on the twin goals of reducing falls 

among older adults and preventing repeat falls. HHS or its designated agency should consider organizations with expertise in designing and implementing large-scale programs to prevent injuries; 

experience in working in cooperation with government agencies, 

businesses and corporate organizations; and other non-profit organizations and institutions with the capability to carry out major 

public education campaigns on a national basis. 

The committee believes that HHS should utilize the injury prevention and community health education expertise available at colleges and universities in carrying out provisions of this act. The 

committee urges HHS to involve these and other qualified organizations and institutions in the implementation of this legislation. 

The committee reported bill raises the authorization of appropriations level for Part J—Prevention and Control of Activities, 

which is the authorization of appropriations line for injury prevention activities, including Elder Falls Activities, from $50 million to 

$58,361,000 for fiscal year 2008 and such sums from 2009–2010. 


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The increase is to meet the level appropriated by appropriators in 

fiscal year 2007, not to authorize new money. 

CDC is the lead Federal agency for injury prevention and control, 

and its programs are designed to prevent premature death and disability and reduce human suffering and medical costs caused by 

elder falls. Funds are utilized for both intramural and extramural 

research as well as assisting State and local health agencies in implementing injury prevention programs. The committee recognizes 

the vital role CDC serves as a focal point for all Federal injury control activities. 

The committee also recognizes that falls are not only the leading 

cause of injury deaths among Americans over the age of 65, but 

also cost an estimated $19 billion annually in direct medical costs. 

The committee further recognizes that falls among the elderly are 

preventable through proven public health community interventions. 

As more of our citizens grow older, the committee continues to be 

concerned that falls among the elderly are becoming a major public 

health issue and that falls prevention efforts are limited due to 

lack of resources. The committee recognizes the need for Federal 

resources that would be allocated to support falls prevention activities to prevent premature death and disability and reduce human 

suffering and medical costs caused by falls. 

V. COST ESTIMATE

S. 845—Safety of Seniors Act of 2007 

S. 845 would modify the Public Health Service Act to authorize 

funding for programs to detect, prevent, and treat injuries. The bill 

would also direct the Secretary of Health and Human Services 

(HHS) to undertake research, education, and other activities aimed 

at reducing the extent and effect of falls among older adults. 

S. 845 would authorize the appropriation of $58.4 million for 

2008 and such sums as may be necessary for fiscal years 2009 and 

2010 for the specified activities. Assuming that the costs in 2009 

and 2010 would be equal to the 2008 authorization adjusted for inflation, CBO estimates that HHS would require $178 million in 

budget authority to carry out those activities over the 2008–2010 

period. Based on historical spending patterns for similar activities, 

and assuming appropriation of the authorized amounts, CBO estimates that implementing S. 845 would cost $22 million in 2008 and 

$172 million over the 2008–2012 period. Enacting S. 845 would not 

affect direct spending or receipts. 

S. 845 contains no intergovernmental or private-sector mandates 

as defined in the Unfunded Mandates Reform Act. State, local, and 

tribal governments could benefit from grants and other assistance 

programs authorized by the bill. 

The estimated budgetary impact of S. 845 is shown in the following table. The costs of this legislation fall within budget function 550 (health). 

By fiscal year, in millions of dollars— 

2007 2008 2009 2010 2011 2012 

CHANGES IN SPENDING SUBJECT TO APPROPRIATIONS 

Estimated Authorization Level .................................................................. 0 58 59 61 0 0 

Estimated Outlays .................................................................................... 0 22 48 56 36 10 


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The costs of this bill to the federal government were estimated 

by Tim Gronniger. The intergovernmental and private-sector impacts were analyzed by Leo Lex and Paige Shevlin, respectively. 

This estimate was approved by Robert A. Sunshine, Assistant Director for Budget Analysis. 

VI. REGULATORY IMPACT STATEMENT

Pursuant to the requirements of paragraph 11(b) of rule XXVI of 

the Standing Rules of the Senate, the committee has determined 

that the bill will not have a significant regulatory impact. 

VII. APPLICATION OF LAW TO THE LEGISLATIVE BRANCH

The committee has determined there is no impact of this law on 

the legislative branch. 

VIII. SECTION-BY-SECTION ANALYSIS

Section 1. Short Title 

Section 1 provides the short title of the bill, the ‘‘Safety of Seniors Act of 2007’’. 

Section 2. Amendments to the Public Health Service Act 

Section 2 amends part J of Title III of the Public Health Service 

Act to add a new section 393 D, Prevention of Falls Among Older 

Adults. 

Subsection (a) authorizes the Secretary of the Department of 

Health and Human Services (HHS) to establish a national public 

education campaign to reduce falls among older adults and prevent 

repeat falls. It also establishes authority for the Secretary of HHS 

to make grants or enter into contracts or cooperative agreements 

to assist State-level coalitions in conducting local education campaigns to reduce falls and prevent repeat falls among older adults. 

Subsection (b) authorizes the Secretary of HHS to conduct and 

support research in areas such as identifying older adults who have 

a high risk of falling; designing, implementing, and evaluating the 

most effective ways to prevent falls among older adults; tailoring 

proven fall reduction strategies to specific populations of older 

adults; improving diagnosis, treatment, and rehabilitation of older 

adults who have fallen and those at high risk for falls; and assessing the risk of falls occurring in various settings. 

This subsection authorizes the HHS Secretary to conduct research concerning barriers to adopting proven fall prevention methods; developing, implementing, and evaluating the most effective 

approaches to reducing falls among high-risk older adults living in 

community settings, including long-term care and assisted living 

facilities; and evaluating the effectiveness of community programs 

designed to prevent falls among older adults. It also authorizes the 

HHS Secretary to make grants or enter into contracts or cooperative agreements to provide professional education for physicians, 

allied health professionals, and aging service providers in fall prevention, evaluation, and management. 

Subsection (c) authorizes the Secretary of HHS to oversee and 

support demonstration programs carried out by qualified organizaVerDate Aug 31 2005 00:56 Jul 03, 2007 Jkt 059010 PO 00000 Frm 00005 Fmt 6659 Sfmt 6602 E:\HR\OC\SR110.XXX SR110

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tions, institutions, or a consortium of qualified organizations to conduct the following—

• a multistate demonstration project assessing the utility of 

targeted fall risk screening and referral programs; 

• programs that use multiple approaches to prevent falls; 

• programs targeting newly discharged fall victims at high 

risk for second falls; and 

• private sector and public-private partnerships to develop 

technology to prevent falls and prevent or reduce fall-related 

injuries. 

The Secretary of HHS is authorized to award grants, contracts, 

or cooperative agreements to design, implement, and evaluate fall 

prevention programs using proven intervention strategies in residential and institutional settings; and, to carry out a multistate 

demonstration project to implement and evaluate fall prevention 

programs using these strategies for single and multifamily residences with high concentrations of older adults. 

This subsection also authorizes the HHS Secretary to award 

grants, contracts, or cooperative agreements to conduct evaluations 

of the effectiveness of the demonstration projects in this subsection. 

Subsection (d) authorizes the HHS Secretary to review the effects 

of falls on health care costs, the potential for reducing falls, and 

the most effective strategies for reducing fall-related health care 

costs. If such review is conducted, the Secretary is required to submit to Congress describing the findings. The report must be submitted no later than 36 months after the date of the bill’s enactment. 

Section 3. Authorization of Appropriations 

Section 3 authorizes the appropriation of $58,361,000 for fiscal 

year 2008 and such sums as may be necessary for fiscal years 2009 

and 2010. 

IX. CHANGES IN EXISTING LAW

In compliance with rule XXVI paragraph 12 of the Standing 

Rules of the Senate, the following provides a print of the statute 

or the part or section thereof to be amended or replaced (existing 

law proposed to be omitted is enclosed in black brackets, new matter is printed in italic, existing law in which no change is proposed 

is shown in roman): 

Public Health Service Act 

* * * * * * * 

PART J—PREVENTION AND CONTROL OF INJURIES RESEARCH

SEC. 391. (a) The Secretary, through the Director of the Centers 

for Disease Control and Prevention, shall—

(1) * * * 

* * * * * * * 

(d) * * * 


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NATIONAL PROGRAM FOR TRAUMATIC BRAIN INJURY REGISTRIES

SEC. 393B. (a) IN GENERAL.—The Secretary, acting through the 

Director of the Centers for Disease Control and Prevention, may 

make grants to States or their designees to operate the State’s 

traumatic brain injury registry, and to academic institutions to 

conduct applied research that will support the development of such 

registries, to collect data concerning—

(1) demographic information about each traumatic brain injury; 

(2) information about the circumstances surrounding the injury event associated with each traumatic brain injury; 

(3) administrative information about the source of the collected information, dates of hospitalization and treatment, and 

the date of injury; and 

(4) information characterizing the clinical aspects of the 

traumatic brain injury, including the severity of the injury, 

outcomes of the injury, the types of treatments received, and 

the types of services utilized. 

øSEC. 393B.¿ SEC. 393C. USE OF ALLOTMENTS FOR RAPE PREVENTION 

EDUCATION. 

(a) PERMITTED USE.—The Secretary, acting through the National 

Center for Injury Prevention and Control at the Centers for Disease Control and Prevention, shall award targeted grants to States 

to be used for rape prevention and education programs conducted 

by rape crisis centers, State sexual assault coalitions, and or public 

and private nonprofit entities for—

(1) educational seminars; 

* * * * * * * 

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

(a) PUBLIC EDUCATION.—The Secretary may—

(1) oversee and support a national education campaign to be 

carried out by a nonprofit organization with experience in designing and implementing national injury prevention programs, 

that is directed principally to older adults, their families, and 

health care providers, and that focuses on reducing falls among 

older adults and preventing repeat falls; and 

(2) award grants, contracts, or cooperative agreements to 

qualified organizations, institutions, or consortia of qualified 

organizations and institutions, for the purpose of organizing 

State-level coalitions of appropriate State and local agencies, 

safety, health, senior citizen, and other organizations to design 

and carry out local education campaigns, focusing on reducing 

falls among older adults and preventing repeat falls. 

(b) RESEARCH.—

(1) IN GENERAL.—The Secretary may—

(A) conduct and support research to—

(i) improve the identification of older adults who 

have a high risk of falling; 

(ii) improve data collection and analysis to identify 

fall risk and protective factors; 

(iii) design, implement, and evaluate the most effective fall prevention interventions; 


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(iv) improve strategies that are proven to be effective 

in reducing falls by tailoring these strategies to specific 

populations of older adults; 

(v) conduct research in order to maximize the dissemination of proven, effective fall prevention interventions; 

(vi) intensify proven interventions to prevent falls 

among older adults; 

(vii) improve the diagnosis, treatment, and rehabilitation of elderly fall victims and older adults at high 

risk for falls; and 

(viii) assess the risk of falls occurring in various settings; 

(B) conduct research concerning barriers to the adoption 

of proven interventions with respect to the prevention of 

falls among older adults; 

(C) conduct research to develop, implement, and evaluate 

the most effective approaches to reducing falls among highrisk older adults living in communities and long-term care 

and assisted living facilities; and 

(D) evaluate the effectiveness of community programs designed to prevent falls among older adults. 

(2) EDUCATIONAL SUPPORT.—The Secretary, either directly or 

through awarding grants, contracts, or cooperative agreements 

to qualified organizations, institutions, or consortia of qualified 

organizations and institutions, may provide professional education for physicians and allied health professionals, and aging 

service providers in fall prevention, evaluation, and management. 

(c) DEMONSTRATION PROJECTS.—The Secretary may carry out the 

following: 

(1) Oversee and support demonstration and research projects 

to be carried out by qualified organizations, institutions, or consortia of qualified organizations and institutions, in the following areas: 

(A) A multistate demonstration project assessing the utility of targeted fall risk screening and referral programs. 

(B) Programs designed for community-dwelling older 

adults that utilize multicomponent fall intervention approaches, including physical activity, medication assessment and reduction when possible, vision enhancement, 

and home modification strategies. 

(C) Programs that are targeted to new fall victims who 

are at a high risk for second falls and which are designed 

to maximize independence and quality of life for older 

adults, particularly those older adults with functional limitations. 

(D) Private sector and public-private partnerships to develop technologies to prevent falls among older adults and 

prevent or reduce injuries if falls occur. 

(2)(A) Award grants, contracts, or cooperative agreements to 

qualified organizations, institutions, or consortia of qualified 

organizations and institutions, to design, implement, and evaluate fall prevention programs using proven intervention strategies in residential and institutional settings. 


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(B) Award 1 or more grants, contracts, or cooperative agreements to 1 or more qualified organizations, institutions, or consortia of qualified organizations and institutions, in order to 

carry out a multistate demonstration project to implement and 

evaluate fall prevention programs using proven intervention 

strategies designed for single and multifamily residential settings with high concentrations of older adults, including—

(i) identifying high-risk populations; 

(ii) evaluating residential facilities; 

(iii) conducting screening to identify high-risk individuals; 

(iv) providing fall assessment and risk reduction interventions and counseling; 

(v) coordinating services with health care and social service providers; and 

(vi) coordinating post-fall treatment and rehabilitation. 

(3) Award 1 or more grants, contracts, or cooperative agreements to qualified organizations, institutions, or consortia of 

qualified organizations and institutions, to conduct evaluations 

of the effectiveness of the demonstration projects described in 

this subsection. 

(d) STUDY OF EFFECTS OF FALLS ON HEALTH CARE COSTS.—

(1) IN GENERAL.—The Secretary may conduct a review of the 

effects of falls on health care costs, the potential for reducing 

falls, and the most effective strategies for reducing health care 

costs associated with falls. 

(2) REPORT.—If the Secretary conducts the review under 

paragraph (1), the Secretary shall, not later than 36 months 

after the date of enactment of the Safety of Seniors Act of 2007, 

submit to Congress a report describing the findings of the Secretary in conducting such review. 

* * * * * * * 

GENERAL PROVISIONS

SEC. 394. (a) The Secretary, acting through the Director of the 

Centers for Disease Control and Prevention, shall establish an advisory committee to advise the Secretary and such Director with respect to the prevention and control of injuries. 

* * * * * * * 

AUTHORIZATIONS OF APPROPRIATIONS

SEC. 394A. For the purpose of carrying out this part, there are 

authorized to be appropriated ø$50,000,000 for fiscal year 1994, 

and 1 such sums as may be necessary for each of the fiscal years 

1995 through 1998, and such sums as may be necessary for each 

of the fiscal years 2001 through 2005.¿ $58,361,000 for fiscal year 

2008, and such sums as may be necessary for each of fiscal years 

2009 and 2010. 

* * * * * * * 

Æ 


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