A bill to direct the Secretary of Health and Human Services to intensify programs with respect to research and related activities concerning falls among older adults.

SECTION 1. SHORT TITLE.

    This Act may be cited as the ``Keeping Seniors Safe From Falls Act 
of 2004''.

SEC. 2. FINDINGS.

    Congress finds the following:
            (1) Falls are the leading cause of injury deaths among 
        individuals who are over 65 years of age.
            (2) In 2000, falls among older adults accounted for 10,200 
        deaths and 1,600,000 emergency department visits.
            (3) Hospital admissions for hip fractures among the elderly 
        have increased from 231,000 admissions in 1988 to 332,000 in 
        1999.
            (4) Annually, more than 64,000 individuals who are over 65 
        years of age sustain a traumatic brain injury as a result of a 
        fall.
            (5) 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).
            (6) 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.

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 appears after section 393B (as added by 
        section 1301 of Public Law 106-310); and
            (2) by inserting after section 393C (as redesignated by 
        paragraph (1)) the following:

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

    ``(a) Purposes.--The purposes of this section are--
            ``(1) to develop effective public education strategies in a 
        national initiative to reduce falls among older adults in order 
        to educate older adults, family members, employers, caregivers, 
        and others;
            ``(2) to intensify services and conduct research to 
        determine the most effective approaches to preventing and 
        treating falls among older adults; and
            ``(3) to require the Secretary to evaluate the effect of 
        falls on health care costs, the potential for reducing falls, 
        and the most effective strategies for reducing health care 
        costs associated with falls.
    ``(b) Public Education.--The Secretary shall--
            ``(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.
    ``(c) Research.--
            ``(1) In general.--The Secretary shall--
                    ``(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;
                            ``(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
                            ``(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 high-risk older adults living in long-term 
                care facilities; and
                    ``(D) evaluate the effectiveness of community 
                programs to prevent assisted living and nursing home 
                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, shall 
        provide professional education for physicians and allied health 
        professionals in fall prevention.
    ``(d) Demonstration Projects.--The Secretary shall 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 newly 
                discharged 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 technology 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.
            ``(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 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 pre-fall 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.
    ``(e) Study of Effects of Falls on Health Care Costs.--
            ``(1) In general.--The Secretary shall 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.--Not later than 36 months after the date of 
        enactment of the Keeping Seniors Safe From Falls Act of 2004, 
        the Secretary shall submit to Congress a report describing the 
        findings of the Secretary in conducting the review under 
        paragraph (1).''.

            Passed the Senate November 18, 2004.

            Attest:

                                             EMILY J. REYNOLDS,

                                                             Secretary.

Summary: Keeping Seniors Safe From Falls Act of 2004 - Amends the Public Health Service Act to require the Secretary of Health and Human Services to: (1) oversee and support a national education campaign focusing on reducing falls among older adults and preventing repeat falls; and (2) award grants, contracts, or cooperative agreements for local education campaigns.

Directs the Secretary to conduct and support research to: (1) improve the identification of older adults who have a high risk of falling; (2) improve data collection and analysis to identify fall risk and protective factors; (3) design, implement, and evaluate the most effective fall prevention interventions; (4) tailor effective strategies to reduce falls to specific populations of older adults; (5) maximize the dissemination of proven, effective fall prevention interventions; (6) improve the diagnosis, treatment, and rehabilitation of elderly fall victims; and (7) assess the risks of falls occurring in various settings.

Requires the Secretary to: (1) conduct research concerning the barriers to the adoption of proven fall prevention interventions; (2) conduct research to develop, implement, and evaluate the most effective approaches to reduce falls among high-risk older adults living in long-term care facilities; and (3) evaluate the effectiveness of community programs to prevent assisted living and nursing home falls among older adults.

Requires the Secretary to provide professional education for physicians and allied health professionals in fall prevention.

Directs the Secretary to oversee and support certain demonstration and research projects by qualified organizations, institutions, or consortia of qualified organizations and institutions, including: (1) a multistate demonstration project assessing the utility of targeted fall risk screening and referral programs; (2) programs utilizing multicomponent fall-intervention approaches; (3) programs designed to maximize independence and quality of life for older adults targeted at newly discharged fall victims; and (4) private sector and public-private partnerships to develop technology to prevent falls among older adults and to prevent or reduce injuries if falls occur.

Requires the Secretary to award grants, contracts, or cooperative agreements to: (1) design, implement, and evaluate fall prevention programs using proven intervention strategies in residential and institutional settings; (2) carry out a multistate demonstration project to implement and evaluate fall prevention programs designed for multifamily residential settings with high concentrations of older adults; and (3) conduct evaluations of the effectiveness of such demonstration projects.

Directs the Secretary to review and report to Congress on 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.