II 

Calendar No. 99 

110TH CONGRESS 

1ST SESSION S. 845 

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 

MARCH 12, 2007 

Mr. ENZI (for himself, Ms. MIKULSKI, Mr. HATCH, and Mr. KENNEDY) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions 

MARCH 29, 2007 

Reported by Mr. KENNEDY, with an amendment 

[Strike out all after the enacting clause and insert the part printed in italic] 

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. 

1 Be it enacted by the Senate and House of Representa2 tives of the United States of America in Congress assembled, 

3 SECTION 1. SHORT TITLE. 

4 This Act may be cited as the ‘‘Keeping Seniors Safe 

5 From Falls Act of 2007’’. 


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1 SEC. 2. FINDINGS. 

2 Congress finds the following: 

3 (1) Falls are the leading cause of injury deaths 

4 among individuals who are over 65 years of age. 

5 (2) In 2002, falls among older adults accounted 

6 for 12,800 deaths and 1,640,000 emergency depart7 ment visits. 

8 (3) Hospital admissions for hip fractures 

9 among the elderly have increased from 231,000 ad10 missions in 1988 to 327,000 in 2001. 

11 (4) Annually, more than 80,000 individuals who 

12 are over 65 years of age sustain a traumatic brain 

13 injury as a result of a fall. 

14 (5) The total medical cost of all fall injuries for 

15 people age 65 and older was calculated in 2000 to 

16 be $19,500,000,000. 

17 (6) A national approach to reducing falls 

18 among older adults, which focuses on the daily life 

19 of senior citizens in residential, institutional, and 

20 community settings, is needed. 

21 SEC. 3. AMENDMENTS TO THE PUBLIC HEALTH SERVICE 

22 ACT. 

23 Part J of title III of the Public Health Service Act 

24 (42 U.S.C. 280b et seq.) is amended— 

25 (1) by redesignating section 393B (as added by 

26 section 1401 of Public Law 106–386) as section 


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1 393C and transferring such section so that it ap2 pears after section 393B (as added by section 1301 

3 of Public Law 106–310); and 

4 (2) by inserting after section 393C (as redesig5 nated by paragraph (1)) the following: 

6 ‘‘SEC. 393D. PREVENTION OF FALLS AMONG OLDER 

7 ADULTS. 

8 ‘‘(a) PURPOSES.—The purposes of this section are— 

9 ‘‘(1) to develop effective public education strate10 gies in a national initiative to reduce falls among 

11 older adults in order to educate older adults, family 

12 members, employers, caregivers, and others; 

13 ‘‘(2) to intensify services and conduct research 

14 to determine the most effective approaches to pre15 venting and treating falls among older adults; and 

16 ‘‘(3) to require the Secretary to evaluate the ef17 fect of falls on health care costs, the potential for re18 ducing falls, and the most effective strategies for re19 ducing health care costs associated with falls. 

20 ‘‘(b) PUBLIC EDUCATION.—The Secretary shall— 

21 ‘‘(1) oversee and support a national education 

22 campaign to be carried out by a nonprofit organiza23 tion with experience in designing and implementing 

24 national injury prevention programs, that is directed 

25 principally to older adults, their families, and health 


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1 care providers, and that focuses on reducing falls 

2 among older adults and preventing repeat falls; and 

3 ‘‘(2) award grants, contracts, or cooperative 

4 agreements to qualified organizations, institutions, 

5 or consortia of qualified organizations and institu6 tions, for the purpose of organizing State-level coali7 tions of appropriate State and local agencies, safety, 

8 health, senior citizen, and other organizations to de9 sign and carry out local education campaigns, focus10 ing on reducing falls among older adults and pre11 venting repeat falls. 

12 ‘‘(c) RESEARCH.— 

13 ‘‘(1) IN GENERAL.—The Secretary shall— 

14 ‘‘(A) conduct and support research to— 

15 ‘‘(i) improve the identification of older 

16 adults who have a high risk of falling; 

17 ‘‘(ii) improve data collection and anal18 ysis to identify fall risk and protective fac19 tors; 

20 ‘‘(iii) design, implement, and evaluate 

21 the most effective fall prevention interven22 tions; 

23 ‘‘(iv) improve strategies that are prov24 en to be effective in reducing falls by taiVerDate Aug 31 2005 00:11 Mar 31, 2007 Jkt 059200 PO 00000 Frm 00004 Fmt 6652 Sfmt 6401 E:\BILLS\S845.RS S845

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1 loring these strategies to specific popu2 lations of older adults; 

3 ‘‘(v) conduct research in order to 

4 maximize the dissemination of proven, ef5 fective fall prevention interventions; 

6 ‘‘(vi) intensify proven interventions to 

7 prevent falls among older adults; 

8 ‘‘(vii) improve the diagnosis, treat9 ment, and rehabilitation of elderly fall vic10 tims and those at high risk for falls; and 

11 ‘‘(viii) assess the risk of falls occur12 ring in various settings; 

13 ‘‘(B) conduct research concerning barriers 

14 to the adoption of proven interventions with re15 spect to the prevention of falls among older 

16 adults; 

17 ‘‘(C) conduct research to develop, imple18 ment, and evaluate the most effective ap19 proaches to reducing falls among high-risk older 

20 adults living in communities and long-term care 

21 and assisted living facilities; and 

22 ‘‘(D) evaluate the effectiveness of commu23 nity programs designed to prevent falls among 

24 older adults. 


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1 ‘‘(2) EDUCATIONAL SUPPORT.—The Secretary, 

2 either directly or through awarding grants, con3 tracts, or cooperative agreements to qualified organi4 zations, institutions, or consortia of qualified organi5 zations and institutions, shall provide professional 

6 education for physicians and allied health profes7 sionals, and aging service providers in fall preven8 tion, evaluation, and management. 

9 ‘‘(d) DEMONSTRATION PROJECTS.—The Secretary 

10 shall carry out the following: 

11 ‘‘(1) Oversee and support demonstration and 

12 research projects to be carried out by qualified orga13 nizations, institutions, or consortia of qualified orga14 nizations and institutions, in the following areas: 

15 ‘‘(A) A multistate demonstration project 

16 assessing the utility of targeted fall risk screen17 ing and referral programs. 

18 ‘‘(B) Programs designed for community19 dwelling older adults that utilize multicompo20 nent fall intervention approaches, including 

21 physical activity, medication assessment and re22 duction when possible, vision enhancement, and 

23 home modification strategies. 

24 ‘‘(C) Programs that are targeted to new 

25 fall victims who are at a high risk for second 


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1 falls and which are designed to maximize inde2 pendence and quality of life for older adults, 

3 particularly those older adults with functional 

4 limitations. 

5 ‘‘(D) Private sector and public-private 

6 partnerships to develop technologies to prevent 

7 falls among older adults and prevent or reduce 

8 injuries if falls occur. 

9 ‘‘(2)(A) Award grants, contracts, or cooperative 

10 agreements to qualified organizations, institutions, 

11 or consortia of qualified organizations and institu12 tions, to design, implement, and evaluate fall preven13 tion programs using proven intervention strategies 

14 in residential and institutional settings. 

15 ‘‘(B) Award 1 or more grants, contracts, or co16 operative agreements to 1 or more qualified organi17 zations, institutions, or consortia of qualified organi18 zations and institutions, in order to carry out a 

19 multistate demonstration project to implement and 

20 evaluate fall prevention programs using proven inter21 vention strategies designed for single and multi22 family residential settings with high concentrations 

23 of older adults, including— 

24 ‘‘(i) identifying high-risk populations; 

25 ‘‘(ii) evaluating residential facilities; 


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1 ‘‘(iii) conducting screening to identify high2 risk individuals; 

3 ‘‘(iv) providing fall assessment and risk re4 duction interventions and counseling; 

5 ‘‘(v) coordinating services with health care 

6 and social service providers; and 

7 ‘‘(vi) coordinating post-fall treatment and 

8 rehabilitation. 

9 ‘‘(3) Award 1 or more grants, contracts, or co10 operative agreements to qualified organizations, in11 stitutions, or consortia of qualified organizations and 

12 institutions, to conduct evaluations of the effective13 ness of the demonstration projects described in this 

14 subsection. 

15 ‘‘(e) STUDY OF EFFECTS OF FALLS ON HEALTH

16 CARE COSTS.— 

17 ‘‘(1) IN GENERAL.—The Secretary shall con18 duct a review of the effects of falls on health care 

19 costs, the potential for reducing falls, and the most 

20 effective strategies for reducing health care costs as21 sociated with falls. 

22 ‘‘(2) REPORT.—Not later than 36 months after 

23 the date of enactment of the Keeping Seniors Safe 

24 From Falls Act of 2007, the Secretary shall submit 

25 to Congress a report describing the findings of the 


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1 Secretary in conducting the review under paragraph 

2 (1). 

3 ‘‘(f) AUTHORIZATION OF APPROPRIATIONS.—In 

4 order to carry out this section, there are authorized to be 

5 appropriated, $25,000,000 for each of fiscal years 2008 

6 through 2010.’’. 

7 SECTION 1. SHORT TITLE. 

8 This Act may be cited as the ‘‘Safety of Seniors Act 

9 of 2007’’. 

10 SEC. 2. AMENDMENTS TO THE PUBLIC HEALTH SERVICE 

11 ACT. 

12 Part J of title III of the Public Health Service Act 

13 (42 U.S.C. 280b et seq.) is amended— 

14 (1) by redesignating section 393B (as added by 

15 section 1401 of Public Law 106–386) as section 393C 

16 and transferring such section so that it appears after 

17 section 393B (as added by section 1301 of Public Law 

18 106–310); and 

19 (2) by inserting after section 393C (as redesig20 nated by paragraph (1)) the following: 

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

22 ‘‘(a) PUBLIC EDUCATION.—The Secretary may— 

23 ‘‘(1) oversee and support a national education 

24 campaign to be carried out by a nonprofit organiza25 tion with experience in designing and implementing 


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1 national injury prevention programs, that is directed 

2 principally to older adults, their families, and health 

3 care providers, and that focuses on reducing falls 

4 among older adults and preventing repeat falls; and 

5 ‘‘(2) award grants, contracts, or cooperative 

6 agreements to qualified organizations, institutions, or 

7 consortia of qualified organizations and institutions, 

8 for the purpose of organizing State-level coalitions of 

9 appropriate State and local agencies, safety, health, 

10 senior citizen, and other organizations to design and 

11 carry out local education campaigns, focusing on re12 ducing falls among older adults and preventing re13 peat falls. 

14 ‘‘(b) RESEARCH.— 

15 ‘‘(1) IN GENERAL.—The Secretary may— 

16 ‘‘(A) conduct and support research to— 

17 ‘‘(i) improve the identification of older 

18 adults who have a high risk of falling; 

19 ‘‘(ii) improve data collection and anal20 ysis to identify fall risk and protective fac21 tors; 

22 ‘‘(iii) design, implement, and evaluate 

23 the most effective fall prevention interven24 tions; 


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1 ‘‘(iv) improve strategies that are prov2 en to be effective in reducing falls by tai3 loring these strategies to specific popu4 lations of older adults; 

5 ‘‘(v) conduct research in order to maxi6 mize the dissemination of proven, effective 

7 fall prevention interventions; 

8 ‘‘(vi) intensify proven interventions to 

9 prevent falls among older adults; 

10 ‘‘(vii) improve the diagnosis, treat11 ment, and rehabilitation of elderly fall vic12 tims and older adults at high risk for falls; 

13 and 

14 ‘‘(viii) assess the risk of falls occurring 

15 in various settings; 

16 ‘‘(B) conduct research concerning barriers 

17 to the adoption of proven interventions with re18 spect to the prevention of falls among older 

19 adults; 

20 ‘‘(C) conduct research to develop, imple21 ment, and evaluate the most effective approaches 

22 to reducing falls among high-risk older adults 

23 living in communities and long-term care and 

24 assisted living facilities; and 


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1 ‘‘(D) evaluate the effectiveness of community 

2 programs designed to prevent falls among older 

3 adults. 

4 ‘‘(2) EDUCATIONAL SUPPORT.—The Secretary, 

5 either directly or through awarding grants, contracts, 

6 or cooperative agreements to qualified organizations, 

7 institutions, or consortia of qualified organizations 

8 and institutions, may provide professional education 

9 for physicians and allied health professionals, and 

10 aging service providers in fall prevention, evaluation, 

11 and management. 

12 ‘‘(c) DEMONSTRATION PROJECTS.—The Secretary may 

13 carry out the following: 

14 ‘‘(1) Oversee and support demonstration and re15 search projects to be carried out by qualified organi16 zations, institutions, or consortia of qualified organi17 zations and institutions, in the following areas: 

18 ‘‘(A) A multistate demonstration project as19 sessing the utility of targeted fall risk screening 

20 and referral programs. 

21 ‘‘(B) Programs designed for community22 dwelling older adults that utilize multicompo23 nent fall intervention approaches, including 

24 physical activity, medication assessment and reVerDate Aug 31 2005 00:11 Mar 31, 2007 Jkt 059200 PO 00000 Frm 00012 Fmt 6652 Sfmt 6203 E:\BILLS\S845.RS S845

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1 duction when possible, vision enhancement, and 

2 home modification strategies. 

3 ‘‘(C) Programs that are targeted to new fall 

4 victims who are at a high risk for second falls 

5 and which are designed to maximize independ6 ence and quality of life for older adults, particu7 larly those older adults with functional limita8 tions. 

9 ‘‘(D) Private sector and public-private part10 nerships to develop technologies to prevent falls 

11 among older adults and prevent or reduce inju12 ries if falls occur. 

13 ‘‘(2)(A) Award grants, contracts, or cooperative 

14 agreements to qualified organizations, institutions, or 

15 consortia of qualified organizations and institutions, 

16 to design, implement, and evaluate fall prevention 

17 programs using proven intervention strategies in resi18 dential and institutional settings. 

19 ‘‘(B) Award 1 or more grants, contracts, or coop20 erative agreements to 1 or more qualified organiza21 tions, institutions, or consortia of qualified organiza22 tions and institutions, in order to carry out a 

23 multistate demonstration project to implement and 

24 evaluate fall prevention programs using proven inter25 vention strategies designed for single and multifamily 


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1 residential settings with high concentrations of older 

2 adults, including— 

3 ‘‘(i) identifying high-risk populations; 

4 ‘‘(ii) evaluating residential facilities; 

5 ‘‘(iii) conducting screening to identify high6 risk individuals; 

7 ‘‘(iv) providing fall assessment and risk re8 duction interventions and counseling; 

9 ‘‘(v) coordinating services with health care 

10 and social service providers; and 

11 ‘‘(vi) coordinating post-fall treatment and 

12 rehabilitation. 

13 ‘‘(3) Award 1 or more grants, contracts, or coop14 erative agreements to qualified organizations, institu15 tions, or consortia of qualified organizations and in16 stitutions, to conduct evaluations of the effectiveness of 

17 the demonstration projects described in this sub18 section. 

19 ‘‘(d) STUDY OF EFFECTS OF FALLS ON HEALTH CARE

20 COSTS.— 

21 ‘‘(1) IN GENERAL.—The Secretary may conduct 

22 a review of the effects of falls on health care costs, the 

23 potential for reducing falls, and the most effective 

24 strategies for reducing health care costs associated 

25 with falls. 


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1 ‘‘(2) REPORT.—If the Secretary conducts the re2 view under paragraph (1), the Secretary shall, not 

3 later than 36 months after the date of enactment of 

4 the Safety of Seniors Act of 2007, submit to Congress 

5 a report describing the findings of the Secretary in 

6 conducting such review.’’. 

7 SEC. 3. AUTHORIZATION OF APPROPRIATIONS. 

8 Section 394A of the Public Health Service Act (42 

9 U.S.C. 280b–3) is amended by striking ‘‘$50,000,000’’ and 

10 all that follows through the period and inserting 

11 ‘‘$58,361,000 for fiscal year 2008, and such sums as may 

12 be necessary for each of fiscal years 2009 and 2010.’’. 


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Calendar No. 99 

110TH CONGRESS 

1ST SESSION S. 845 

A BILL 

To direct the Secretary of Health and Human 

cerning elder falls. respect to research and related activities conServices to expand and intensify programs with 

MARCH 29, 2007 

Reported with an amendment 


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