I 

109TH CONGRESS 

2D SESSION H. R. 5608 

To amend the Public Health Service Act to direct the Secretary of Health 

and Human Services to intensify programs with respect to research 

and related activities concerning falls among older adults. 

IN THE HOUSE OF REPRESENTATIVES 

JUNE 14, 2006 

Mr. HALL (for himself and Mr. PALLONE) introduced the following bill; which 

was referred to the Committee on Energy and Commerce 

A BILL 

To amend the Public Health Service Act to direct the Secretary of Health and Human Services to intensify programs with respect to research and related activities 

concerning falls among older adults. 

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 2006’’. 

6 SEC. 2. FINDINGS. 

7 Congress finds the following: 


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1 (1) One third of older adults over age 65 fall 

2 each year. Falls are the leading cause of injury 

3 deaths among individuals for this population with 

4 risk of falling and injury rates increasingly common 

5 with advanced age. 

6 (2) Older adults are hospitalized for fall-related 

7 injuries five times more often than for injuries from 

8 other causes. 

9 (3) In 2003, falls among older adults accounted 

10 for 12,900 deaths, 1,800,000 emergency department 

11 visits, and 421,000 hospitalizations. 

12 (4) In 2003, unintentional falls accounted for 

13 more than 62.7 percent of nonfatal injuries for peo14 ple age 65 or older. 

15 (5) 87 percent of all fractures among older 

16 adults are due to falls. 

17 (6) Among older adults who fall, 20 to 30 per18 cent suffer moderate to severe injuries such as hip 

19 fractures or head traumas that reduce mobility and 

20 independence, increase the risk of premature death, 

21 and lead to serious health problems. 

22 (7) Hospital admissions for hip fractures 

23 among the elderly have increased from 231,000 ad24 missions in 1988 to 338,000 in 1999, with an aver25 age hospital stay of one week. 


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1 (8) From 2000 to 2040, the number of people 

2 age 65 or older is projected to increase from 34.8 

3 million to 77.2 million. Given our aging population, 

4 by the year 2040, the number of hip fractures is ex5 pected to exceed 500,000. 

6 (9) 25 percent of older adults who sustain hip 

7 fractures remain institutionalized for at least one 

8 year and 50 percent of all older people hospitalized 

9 for hip fractures cannot return home or live inde10 pendently after their injury, never returning to their 

11 prior level of mobility. 

12 (10) 25 percent of adults age 65 or older who 

13 sustain a hip fracture die within a year. 

14 (11) Annually, more than 64,000 individuals 

15 who are over 65 years of age sustain a traumatic 

16 brain injury as a result of a fall. 

17 (12) The total cost of all fall injuries for people 

18 age 65 and older was calculated in 1994 to be 

19 $27,300,000,000 (in 2004 dollars). By 2020 the 

20 cost of fall injuries is expected to reach 

21 $43,800,000,000 annually. 

22 (13) A national approach to reducing falls 

23 among older adults, which focuses on the daily life 

24 of senior citizens in residential, institutional, and 

25 community settings, is needed. 


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1 SEC. 3. AMENDMENTS TO THE PUBLIC HEALTH SERVICE 

2 ACT. 

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

4 (42 U.S.C. 280b et seq.) is amended— 

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

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

7 393C and transferring such section so that it ap8 pears after section 393B (as added by section 1301 

9 of Public Law 106–310); and 

10 (2) by inserting after section 393C (as redesig11 nated and transferred by paragraph (1)) the fol12 lowing: 

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

14 ADULTS. 

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

16 ‘‘(1) to develop effective public education strate17 gies in a national initiative to reduce falls among 

18 older adults and to educate older adults, family 

19 members, employers, caregivers, and others; 

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

21 to determine the most effective approaches to pre22 venting and treating falls among older adults; 

23 ‘‘(3) to support demonstration projects designed 

24 to reduce the risk of falls and/or injuries caused by 

25 falls; and 

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1 ‘‘(4) to require the Secretary to evaluate the ef2 fect of falls on health care costs, the potential for re3 ducing falls, and the most effective strategies for re4 ducing health care costs associated with falls. 

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

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

7 campaign and award grants, contracts, and coopera8 tive agreements to be carried out by qualified orga9 nizations that focuses on reducing falls among older 

10 adults and preventing repeat falls; and 

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

12 agreements to qualified organizations, institutions, 

13 or consortia of qualified organizations and institu14 tions, for the purpose of organizing State-level coali15 tions of appropriate State and local agencies, safety, 

16 health, senior citizen, city planning, and other orga17 nizations to design and carry out local education 

18 campaigns, focusing on reducing falls among older 

19 adults, preventing repeat falls, and planning and de20 signing safe communities. 

21 ‘‘(c) PROFESSIONAL EDUCATION.—The Secretary 

22 shall— 

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

24 campaign and award grants, contracts, and coopera25 tive agreements to be carried out by qualified orgaVerDate Aug 31 2005 22:34 Jun 15, 2006 Jkt 049200 PO 00000 Frm 00005 Fmt 6652 Sfmt 6201 E:\BILLS\H5608.IH H5608

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1 nizations that focuses on educating physicians, allied 

2 health professionals, and related providers of health 

3 and safety services about falls risk, assessment and 

4 prevention; and 

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

6 agreements to qualified organizations, institutions, 

7 or consortia of qualified organizations and institu8 tions, including nonprofit safety and aging-related 

9 organizations that have a demonstrated interest in 

10 fall prevention, safety and older adult issues, for the 

11 purpose of designing and carrying out State-level 

12 professional education campaigns to educate physi13 cians, allied health professionals, and related pro14 viders of health and safety services about falls risk, 

15 assessment and prevention. 

16 ‘‘(d) RESEARCH.—The Secretary shall award grants, 

17 contracts, or cooperative agreements to qualified organiza18 tions, institutions, or consortia of qualified organizations 

19 and institutions, to— 

20 ‘‘(1) conduct and support research to— 

21 ‘‘(A) improve the identification of older 

22 adults who have a high risk of falling; 

23 ‘‘(B) improve data collection and analysis 

24 to identify fall risk and protective factors; 


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1 ‘‘(C) design, implement, and evaluate the 

2 most effective fall prevention interventions; 

3 ‘‘(D) design, implement, and evaluate 

4 medication management interventions; 

5 ‘‘(E) improve strategies that are proven to 

6 be effective in reducing falls by tailoring these 

7 strategies to specific populations of older adults; 

8 ‘‘(F) conduct research in order to maxi9 mize the dissemination of proven, effective fall 

10 prevention interventions; 

11 ‘‘(G) intensify proven interventions to pre12 vent falls among older adults; 

13 ‘‘(H) improve the diagnosis, treatment, 

14 and rehabilitation of elderly fall victims; and 

15 ‘‘(I) assess the risk of falls occurring in 

16 various settings; to include the role of the envi17 ronment of falls and the effectiveness of envi18 ronment interventions on preventing falls; 

19 ‘‘(2) conduct research concerning barriers to 

20 the adoption of proven interventions with respect to 

21 the prevention of falls among older adults; 

22 ‘‘(3) conduct research to develop, implement, 

23 and evaluate the most effective approaches to reduc24 ing falls among high-risk older adults living in long25 term care facilities; 


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1 ‘‘(4) evaluate the effectiveness of community 

2 programs to prevent assisted living and nursing 

3 home falls among older adults; 

4 ‘‘(5) conduct research to identify effective strat5 egies in home modifications to promote independent 

6 living and a reduction in falls; and 

7 ‘‘(6) identify an existing Web site, or establish 

8 a Web site, to serve as an information clearinghouse 

9 and repository of falls research and activities being 

10 conducted by agencies, organizations, academic insti11 tutions and related groups. 

12 ‘‘(e) DEMONSTRATION PROJECTS.— 

13 ‘‘(1) COLLABORATIONS BETWEEN HEALTH

14 CARE PROVIDERS AND AGING SERVICES NETWORK.— 

15 ‘‘(A) IN GENERAL.—The Secretary shall 

16 oversee and support demonstration projects 

17 through grants, contracts, and cooperative 

18 agreements designed to reduce the risk of falls, 

19 or injuries caused by falls, or both, in frail older 

20 adults, emphasizing projects that foster collabo21 ration between health care providers and the 

22 aging services network, including the following: 

23 ‘‘(i) Demonstrations that target at24 risk older adult populations, particularly 


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1 those with functional limitations, to maxi2 mize their independence and quality of life. 

3 ‘‘(ii) Demonstrations that assess the 

4 effectiveness of clinical risk factor screen5 ing and management when linked to com6 munity-based programs and services that 

7 support behavior change, activity, and 

8 other appropriate interventions. 

9 ‘‘(iii) Demonstrations that assess the 

10 feasibility and effectiveness of offering evi11 dence-based behavior change and physical 

12 activity interventions that address falls risk 

13 in accessible non-medical settings, with 

14 linkages to health care providers. 

15 ‘‘(iv) Private sector and public-private 

16 partnerships to develop technology to pre17 vent falls among older adults and prevent 

18 or reduce injuries if falls occur, including 

19 technology designed to measure, assess, 

20 and rate the traction of consumer flooring 

21 materials, floor polishes, and walkway 

22 agents. 

23 ‘‘(B) EVALUATIONS.—The Secretary shall 

24 award one or more grants, contracts, or cooper25 ative agreements to a qualified research organiVerDate Aug 31 2005 22:34 Jun 15, 2006 Jkt 049200 PO 00000 Frm 00009 Fmt 6652 Sfmt 6201 E:\BILLS\H5608.IH H5608

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1 zation or university, as determined by the Sec2 retary, to conduct evaluations of the effective3 ness of the demonstration projects described in 

4 subparagraph (A). 

5 ‘‘(2) COLLABORATIONS BETWEEN HEALTH

6 CARE PROVIDERS AND RESIDENTIAL AND INSTITU7 TIONAL SETTINGS.— 

8 ‘‘(A) IN GENERAL.—The Secretary shall 

9 oversee and support demonstration projects de10 signed to reduce the risk of falls, or injuries 

11 caused by falls, or both, in frail older adults, 

12 emphasizing projects that foster collaboration 

13 between health care providers and residential 

14 and institutional settings, including the fol15 lowing: 

16 ‘‘(i) A multi-State demonstration 

17 project to implement and evaluate fall pre18 vention programs using proven interven19 tion strategies designed for multifamily 

20 residential settings with high concentra21 tions of appropriate at-risk populations of 

22 older adults to maximize independence and 

23 quality of life, particularly those with func24 tional limitations. For purposes of carrying 

25 out such project, the Secretary shall award 


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1 one or more grants, contracts, or coopera2 tive agreements to one or more qualified 

3 organizations, institutions, or consortia of 

4 qualified organizations and institutions. 

5 ‘‘(ii) Demonstration projects that as6 sess the effectiveness of clinical risk factor 

7 screening and management and that is in8 tegrated with the Aging Services Network 

9 of residential programs and services capa10 ble of providing long-range supportive envi11 ronments and activity programs to affect 

12 behavior change and falls risk. 

13 ‘‘(iii) Evidence-based, residential and 

14 institutional programs that promote the 

15 adoption of healthy behaviors and en16 hanced physical activity level, and that ad17 dress other appropriate risk factors to re18 duce the risk of falls. 

19 ‘‘(iv) Private sector and public-private 

20 partnerships to develop technology to pre21 vent falls among older adults and prevent 

22 or reduce injuries if falls occur. 

23 ‘‘(B) EVALUATIONS.—The Secretary shall 

24 award one or more grants, contracts, or cooper25 ative agreements to a qualified research organiVerDate Aug 31 2005 22:34 Jun 15, 2006 Jkt 049200 PO 00000 Frm 00011 Fmt 6652 Sfmt 6201 E:\BILLS\H5608.IH H5608

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1 zation or university, as determined by the Sec2 retary, to conduct evaluations of the effective3 ness of the demonstration projects described in 

4 subparagraph (A). 

5 ‘‘(f) STUDY OF EFFECTS OF FALLS ON HEALTH

6 CARE COSTS.— 

7 ‘‘(1) IN GENERAL.—The Secretary shall con8 duct a review of the effects of falls on health care 

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

10 effective strategies for reducing health care costs as11 sociated with falls. 

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

13 the date of the enactment of the Keeping Seniors 

14 Safe From Falls Act of 2006, the Secretary shall 

15 submit to Congress a report describing the findings 

16 of the Secretary in conducting the review under 

17 paragraph (1). 

18 ‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—For the 

19 purpose of carrying out this section, there is authorized 

20 to be appropriated $35,000,000 for each of the fiscal years 

21 2007 through 2010.’’. 

Æ 


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