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 Sec-
retary of Health and Human Services to intensify pro-
grams with respect to research and related activities 
concerning falls among older adults. 
Be it enacted by the Senate and House of Representa-
tives 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 2006’’. 
SEC. 2. FINDINGS. 
Congress finds the following: 
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(1) One third of older adults over age 65 fall 
each year. Falls are the leading cause of injury 
deaths among individuals for this population with 
risk of falling and injury rates increasingly common 
with advanced age. 
(2) Older adults are hospitalized for fall-related 
injuries five times more often than for injuries from 
other causes. 
(3) In 2003, falls among older adults accounted 
for 12,900 deaths, 1,800,000 emergency department 
visits, and 421,000 hospitalizations. 
(4) In 2003, unintentional falls accounted for 
more than 62.7 percent of nonfatal injuries for peo-
ple age 65 or older. 
(5) 87 percent of all fractures among older 
adults are due to falls. 
(6) Among older adults who fall, 20 to 30 per-
cent suffer moderate to severe injuries such as hip 
fractures or head traumas that reduce mobility and 
independence, increase the risk of premature death, 
and lead to serious health problems. 
(7) Hospital admissions for hip fractures 
among the elderly have increased from 231,000 ad-
missions in 1988 to 338,000 in 1999, with an aver-
age hospital stay of one week. 
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(8) From 2000 to 2040, the number of people 
age 65 or older is projected to increase from 34.8 
million to 77.2 million. Given our aging population, 
by the year 2040, the number of hip fractures is ex-
pected to exceed 500,000. 
(9) 25 percent of older adults who sustain hip 
fractures remain institutionalized for at least one 
year and 50 percent of all older people hospitalized 
for hip fractures cannot return home or live inde-
pendently after their injury, never returning to their 
prior level of mobility. 
(10) 25 percent of adults age 65 or older who 
sustain a hip fracture die within a year. 
(11) Annually, more than 64,000 individuals 
who are over 65 years of age sustain a traumatic 
brain injury as a result of a fall. 
(12) The total cost of all fall injuries for people 
age 65 and older was calculated in 1994 to be 
$27,300,000,000 (in 2004 dollars). By 2020 the 
cost 
of 
fall 
injuries 
is 
expected 
to 
reach 
$43,800,000,000 annually. 
(13) 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. 
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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 ap-
pears after section 393B (as added by section 1301 
of Public Law 106–310); and 
(2) by inserting after section 393C (as redesig-
nated and transferred by paragraph (1)) the fol-
lowing: 
‘‘SEC. 
393D. 
PREVENTION 
OF 
FALLS 
AMONG 
OLDER 
ADULTS. 
‘‘(a) PURPOSES.—The purposes of this section are— 
‘‘(1) to develop effective public education strate-
gies in a national initiative to reduce falls among 
older adults and to educate older adults, family 
members, employers, caregivers, and others; 
‘‘(2) to intensify services and conduct research 
to determine the most effective approaches to pre-
venting and treating falls among older adults; 
‘‘(3) to support demonstration projects designed 
to reduce the risk of falls and/or injuries caused by 
falls; and 
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‘‘(4) to require the Secretary to evaluate the ef-
fect of falls on health care costs, the potential for re-
ducing falls, and the most effective strategies for re-
ducing health care costs associated with falls. 
‘‘(b) PUBLIC EDUCATION.—The Secretary shall— 
‘‘(1) oversee and support a national education 
campaign and award grants, contracts, and coopera-
tive agreements to be carried out by qualified orga-
nizations 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 institu-
tions, for the purpose of organizing State-level coali-
tions of appropriate State and local agencies, safety, 
health, senior citizen, city planning, and other orga-
nizations to design and carry out local education 
campaigns, focusing on reducing falls among older 
adults, preventing repeat falls, and planning and de-
signing safe communities. 
‘‘(c) PROFESSIONAL EDUCATION.—The Secretary 
shall— 
‘‘(1) oversee and support a national education 
campaign and award grants, contracts, and coopera-
tive agreements to be carried out by qualified orga-
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nizations that focuses on educating physicians, allied 
health professionals, and related providers of health 
and safety services about falls risk, assessment and 
prevention; and 
‘‘(2) award grants, contracts, or cooperative 
agreements to qualified organizations, institutions, 
or consortia of qualified organizations and institu-
tions, including nonprofit safety and aging-related 
organizations that have a demonstrated interest in 
fall prevention, safety and older adult issues, for the 
purpose of designing and carrying out State-level 
professional education campaigns to educate physi-
cians, allied health professionals, and related pro-
viders of health and safety services about falls risk, 
assessment and prevention. 
‘‘(d) RESEARCH.—The Secretary shall award grants, 
contracts, or cooperative agreements to qualified organiza-
tions, institutions, or consortia of qualified organizations 
and institutions, to— 
‘‘(1) conduct and support research to— 
‘‘(A) improve the identification of older 
adults who have a high risk of falling; 
‘‘(B) improve data collection and analysis 
to identify fall risk and protective factors; 
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‘‘(C) design, implement, and evaluate the 
most effective fall prevention interventions; 
‘‘(D) design, implement, and evaluate 
medication management interventions; 
‘‘(E) improve strategies that are proven to 
be effective in reducing falls by tailoring these 
strategies to specific populations of older adults; 
‘‘(F) conduct research in order to maxi-
mize the dissemination of proven, effective fall 
prevention interventions; 
‘‘(G) intensify proven interventions to pre-
vent falls among older adults; 
‘‘(H) improve the diagnosis, treatment, 
and rehabilitation of elderly fall victims; and 
‘‘(I) assess the risk of falls occurring in 
various settings; to include the role of the envi-
ronment of falls and the effectiveness of envi-
ronment interventions on preventing falls; 
‘‘(2) conduct research concerning barriers to 
the adoption of proven interventions with respect to 
the prevention of falls among older adults; 
‘‘(3) conduct research to develop, implement, 
and evaluate the most effective approaches to reduc-
ing falls among high-risk older adults living in long- 
term care facilities; 
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‘‘(4) evaluate the effectiveness of community 
programs to prevent assisted living and nursing 
home falls among older adults; 
‘‘(5) conduct research to identify effective strat-
egies in home modifications to promote independent 
living and a reduction in falls; and 
‘‘(6) identify an existing Web site, or establish 
a Web site, to serve as an information clearinghouse 
and repository of falls research and activities being 
conducted by agencies, organizations, academic insti-
tutions and related groups. 
‘‘(e) DEMONSTRATION PROJECTS.— 
‘‘(1) 
COLLABORATIONS
BETWEEN
HEALTH 
CARE PROVIDERS AND AGING SERVICES NETWORK.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
oversee and support demonstration projects 
through grants, contracts, and cooperative 
agreements designed to reduce the risk of falls, 
or injuries caused by falls, or both, in frail older 
adults, emphasizing projects that foster collabo-
ration between health care providers and the 
aging services network, including the following: 
‘‘(i) Demonstrations that target at- 
risk older adult populations, particularly 
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those with functional limitations, to maxi-
mize their independence and quality of life. 
‘‘(ii) Demonstrations that assess the 
effectiveness of clinical risk factor screen-
ing and management when linked to com-
munity-based programs and services that 
support behavior change, activity, and 
other appropriate interventions. 
‘‘(iii) Demonstrations that assess the 
feasibility and effectiveness of offering evi-
dence-based behavior change and physical 
activity interventions that address falls risk 
in accessible non-medical settings, with 
linkages to health care providers. 
‘‘(iv) Private sector and public-private 
partnerships to develop technology to pre-
vent falls among older adults and prevent 
or reduce injuries if falls occur, including 
technology designed to measure, assess, 
and rate the traction of consumer flooring 
materials, floor polishes, and walkway 
agents. 
‘‘(B) EVALUATIONS.—The Secretary shall 
award one or more grants, contracts, or cooper-
ative agreements to a qualified research organi-
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zation or university, as determined by the Sec-
retary, to conduct evaluations of the effective-
ness of the demonstration projects described in 
subparagraph (A). 
‘‘(2) 
COLLABORATIONS
BETWEEN
HEALTH 
CARE PROVIDERS AND RESIDENTIAL AND INSTITU-
TIONAL SETTINGS.— 
‘‘(A) IN
GENERAL.—The Secretary shall 
oversee and support demonstration projects de-
signed to reduce the risk of falls, or injuries 
caused by falls, or both, in frail older adults, 
emphasizing projects that foster collaboration 
between health care providers and residential 
and institutional settings, including the fol-
lowing: 
‘‘(i) 
A 
multi-State 
demonstration 
project to implement and evaluate fall pre-
vention programs using proven interven-
tion strategies designed for multifamily 
residential settings with high concentra-
tions of appropriate at-risk populations of 
older adults to maximize independence and 
quality of life, particularly those with func-
tional limitations. For purposes of carrying 
out such project, the Secretary shall award 
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one or more grants, contracts, or coopera-
tive agreements to one or more qualified 
organizations, institutions, or consortia of 
qualified organizations and institutions. 
‘‘(ii) Demonstration projects that as-
sess the effectiveness of clinical risk factor 
screening and management and that is in-
tegrated with the Aging Services Network 
of residential programs and services capa-
ble of providing long-range supportive envi-
ronments and activity programs to affect 
behavior change and falls risk. 
‘‘(iii) Evidence-based, residential and 
institutional programs that promote the 
adoption of healthy behaviors and en-
hanced physical activity level, and that ad-
dress other appropriate risk factors to re-
duce the risk of falls. 
‘‘(iv) Private sector and public-private 
partnerships to develop technology to pre-
vent falls among older adults and prevent 
or reduce injuries if falls occur. 
‘‘(B) EVALUATIONS.—The Secretary shall 
award one or more grants, contracts, or cooper-
ative agreements to a qualified research organi-
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zation or university, as determined by the Sec-
retary, to conduct evaluations of the effective-
ness of the demonstration projects described in 
subparagraph (A). 
‘‘(f) STUDY OF EFFECTS OF FALLS ON HEALTH 
CARE COSTS.— 
‘‘(1) IN GENERAL.—The Secretary shall con-
duct 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 as-
sociated with falls. 
‘‘(2) REPORT.—Not later than 36 months after 
the date of the enactment of the Keeping Seniors 
Safe From Falls Act of 2006, the Secretary shall 
submit to Congress a report describing the findings 
of the Secretary in conducting the review under 
paragraph (1). 
‘‘(g) AUTHORIZATION OF APPROPRIATIONS.—For the 
purpose of carrying out this section, there is authorized 
to be appropriated $35,000,000 for each of the fiscal years 
2007 through 2010.’’. 
Æ 
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