II 118th CONGRESS 2d Session S. 5023 IN THE SENATE OF THE UNITED STATES September 11, 2024 Mr. King (for himself and Mr. Rounds ) introduced the following bill; which was read twice and referred to the Committee on Health, Education, Labor, and Pensions A BILL To amend the Older Americans Act of 1965 to improve falls prevention research and activities, and for other purposes.

1. Short title This Act may be cited as the Stand Strong Falls Prevention Act . 2. Advisory Committee on Falls Prevention of the Administration on Aging Title II of the Older Americans Act of 1965 ( 42 U.S.C. 3011 et seq. ) is amended by inserting after section 203A the following: 203B. Falls Prevention activities (a) Advisory committee on Falls Prevention (1) Establishment There is established an Advisory Committee on Falls Prevention (referred to in this section as the Advisory Committee ) to advise the Assistant Secretary on developing and maintaining the national plan described in paragraph (2)(A) and carrying out the assessments described in paragraph (2)(C). The Advisory Committee shall be headed by a Chair (referred to in this section as the Chair ). (2) Duties of the Advisory Committee The Advisory Committee shall— (A) be responsible for, and oversee, the creation and maintenance of an integrated national plan to address falls prevention, including through accelerating the development of falls prevention programs, modalities, or interventions that aim to prevent falls and reduce the prevalence and severity of injuries resulting from falls; (B) advise and assist the Assistant Secretary in providing information and coordination of falls prevention research and services across all Federal agencies; (C) carry out the assessment under subsection (b)(2)(B), including— (i) an assessment of— (I) all Federal efforts and programs related to falls prevention, including budget requests and approvals; and (II) the progress of the United States in addressing falls prevention; and (D) make recommendations, including implementation steps for priority actions, based on such assessment. (3) Membership The Advisory Committee shall be comprised of the following: (A) Federal members Members of the Advisory Committee shall include the following: (i) One representative from each of the following agencies, appointed by the head of each such agency: (I) The Centers for Disease Control and Prevention. (II) The Centers for Medicare & Medicaid Services. (III) The Indian Health Service. (IV) The National Institutes of Health. (V) The Office of the Assistant Secretary for Health. (VI) The National Science Foundation. (VII) The Department of Veterans Affairs. (VIII) The Food and Drug Administration. (IX) The Agency for Healthcare Research and Quality. (X) The Department of Labor. (XI) The Department of Housing and Urban Development. (XII) The Office of the Assistant Secretary for Planning and Evaluation of the Department of Health and Human Services. (XIII) The Office of Rural Development of the Department of Agriculture. (XIV) The Rehabilitation Services Administration of the Department of Education. (XV) The Weatherization Assistance Program of the Department of Energy. (ii) One designee to be assigned by the Assistant Secretary from other officials described in section 203(c)(2). (B) Non-Federal members Members of the Advisory Committee shall include 12 expert members from outside the Federal Government to be appointed by the Assistant Secretary, including the following: (i) Two consumer advocates with demonstrated experience related to falls prevention. (ii) Two health care providers with falls prevention expertise. (iii) Two representatives of State health departments that have implemented programs specifically related to falls prevention. (iv) Two researchers in falls prevention-related research. (v) Two caregivers that have experience with— (I) patients who fell; or (II) falls prevention. (vi) Two voluntary health association representatives that have demonstrated experience in patient care and research, including patient services, referral, support groups, care consultation, education, and safety services. (vii) Two aging service providers with falls prevention expertise. (viii) Two housing assistance experts that have demonstrated experience with— (I) research; (II) tenant or homeowner assistance; or (III) working with housing nonprofit associations. (ix) Two disability service providers that have experience with assistive technology. (x) Two State falls prevention coalition leaders. (C) Chair The Assistant Secretary shall appoint one member of the Advisory Committee to serve as Chair. (D) Period of appointment; vacancies (i) In general A member of the Advisory Committee appointed under subparagraph (A) or (B) shall be appointed for a term of 5 years. (ii) Vacancies A vacancy in the Advisory Committee— (I) shall not affect the powers of the Advisory Committee; and (II) shall be filled in the same manner as the original appointment. (4) Meetings The Advisory Committee shall meet every 4 months, beginning 2 months after all initial members of the Advisory Committee have been appointed. (5) Initial report (A) In general Not later than 1 year after the date on which all initial members of the Advisory Committee have been appointed, the Advisory Committee shall provide to the Assistant Secretary and Congress— (i) an initial evaluation of all federally funded efforts in programs related to falls prevention, including educational programs, home- and community-based programs, emergency medical services, and hospital or health system programs, and their outcomes; (ii) initial recommendations for priority actions to expand, eliminate, coordinate, or condense each such program based on the performance, mission, and purpose of each such program; (iii) except as provided in subparagraph (C), a recommendation for developing— (I) under title XVIII of the Social Security Act ( 42 U.S.C. 1395 et seq. ), a pilot or demonstration program to provide— (aa) coverage under such title for not less than 20,000 Medicare beneficiaries of basic home modifications to reduce falls; and (bb) evidence-based falls prevention programs; and (II) under section 1115A of the Social Security Act ( 42 U.S.C. 1315a )— (aa) a broad payment demonstration model to test coverage of basic home modifications to reduce falls; and (bb) evidence-based falls prevention programs; (iv) recommendations on how to increase use by providers, for patients with public or private health insurance plans, of the falls risk screening, assessment, intervention, and follow-up tool developed through the Stopping Elderly Accidents, Deaths, and Injuries (STEADI) initiative of the Centers for Disease Control and Prevention; and (v) (I) a report on the status and success of public education and activation campaigns related to falls prevention; and (II) recommendations for improvements for future federally funded public education and activation campaigns related to falls prevention. (B) Recommendations for Medicare pilot or demonstration programs The recommendation described in subparagraph (A)(iii) may include— (i) a recommendation on how the Administrator of the Centers for Medicare & Medicaid Services could design, develop, and test a payment model under title XVIII of the Social Security Act that combines coverage of basic home modifications with services that are furnished by a qualifying provider determined by such Administrator and are furnished under a health care provider’s supervision; and (ii) a recommendation on coverage under title XVIII of falls prevention services that are evidence-based (within the meaning of such term under section 361(a)) to improve patient care, mitigate mobility and functional deterioration in functional activities, and lower program expenditures under such title. (C) Exception The recommendation required under subparagraph (A)(iii) shall not be required if an Act of Congress, enacted as of the date of enactment of this section, requires the Administrator of the Centers for Medicare & Medicaid Services to develop a program or payment model described in such subparagraph. (6) Powers of Advisory Committee (A) Hearings The Advisory Committee may hold such hearings, sit and act at such times and places, take such testimony, and receive such evidence as the Advisory Committee considers advisable to carry out this subsection. (B) Information from Federal agencies (i) In general The Advisory Committee may secure directly from a Federal department or agency such information as the Advisory Committee considers necessary to carry out this subsection. (ii) Furnishing information On request of the Chair of the Advisory Committee, the head of the department or agency shall furnish the information to the Advisory Committee. (C) Postal services The Advisory Committee may use the United States mails in the same manner and under the same conditions as other departments and agencies of the Federal Government. (D) Gifts The Advisory Committee may accept, use, and dispose of gifts or donations of services or property. (7) Advisory Committee personnel matters (A) Compensation of members A member of the Advisory Committee who is not an officer or employee of the Federal Government shall be compensated at a rate equal to the daily equivalent of the annual rate of basic pay prescribed for level IV of the Executive Schedule under section 5315 of title 5, United States Code, for each day (including travel time) during which the member is engaged in the performance of the duties of the Advisory Committee. (B) Travel expenses A member of the Advisory Committee shall be allowed travel expenses, including per diem in lieu of subsistence, at rates authorized for employees of agencies under subchapter I of chapter 57 of title 5, United States Code, while away from their homes or regular places of business in the performance of services for the Advisory Committee. (8) Staff (A) In general The Chair of the Advisory Committee may, without regard to the civil service laws (including regulations), appoint and terminate an executive director and such other additional personnel as may be necessary to enable the Advisory Committee to perform its duties, except that the employment of an executive director shall be subject to confirmation by the Advisory Committee. (B) Compensation The Chair of the Advisory Committee may fix the compensation of the executive director and other personnel without regard to chapter 51 and subchapter III of chapter 53 of title 5, United States Code, relating to classification of positions and General Schedule pay rates, except that the rate of pay for the executive director and other personnel may not exceed the rate payable for level V of the Executive Schedule under section 5316 of that title. (9) Detail of government employees A Federal Government employee may be detailed to the Advisory Committee without reimbursement, and such detail shall be without interruption or loss of civil service status or privilege. (10) Procurement of temporary and intermittent services The Chair of the Advisory Committee may procure temporary and intermittent services under section 3109(b) of title 5, United States Code, at rates for individuals that do not exceed the daily equivalent of the annual rate of basic pay prescribed for level V of the Executive Schedule under section 5316 of that title. (11) Coordination of public education campaigns The Director shall share recommendations developed by the Advisory Committee with entities that receive Federal funding for public education campaigns relating to falls prevention, including under section 393D(a) of the Public Health Service Act (42 U.S.C. 280b–1f(a)). (12) Termination The Advisory Committee shall terminate on the date that is 10 years after the date on which all initial members are appointed. (b) Reports relating to falls prevention (1) Data sharing Agencies within the Department of Health and Human Services, and other Federal agencies, that have data relating to falls prevention shall share such data with the Assistant Secretary, to enable the Assistant Secretary to complete the reports under paragraph (2). (2) Regular reports The Assistant Secretary shall submit to Congress a report, not later than 1 year after the date of enactment of the Stand Strong Falls Prevention Act and every 4 years thereafter, that includes— (A) an evaluation of all federally funded programs and efforts in falls prevention (including education programs, home and community-based programs, and hospital programs and any such programs or efforts included in budget requests and approvals), including an evaluation with respect to the outcomes (including program performance), mission, and purpose of such programs related to falls prevention; (B) an assessment of the progress of the United States in addressing falls prevention, as reported by the Advisory Committee under subsection (a)(2)(B); (C) an evaluation of the implementation of any pilot or demonstration program or model recommended under subsection (a)(5)(B) or any other pilot or demonstration program described in such subsection that has otherwise been initiated by the Administrator of the Centers for Medicare & Medicaid Services; (D) a description of the outcomes of the recommendations of the Advisory Committee under subsection (a)(5), including priorities, if necessary, through an updated national plan under subsection (a)(2)(A); (E) recommendations, based on the evaluations, assessment, and outcomes described in subparagraphs (A) through (D), for— (i) priority actions to— (I) reduce the financial impact of falls on expenditures under the Medicare program under title XVIII of the Social Security Act ( 42 U.S.C. 1395 et seq. ), the Medicaid program under title XIX of such Act ( 42 U.S.C. 1396 et seq. ), and other federally funded programs through falls prevention initiatives; and (II) improve health outcomes through such initiatives; (ii) priority actions to improve screening, referral, and interventions to address falls prevention; (iii) expanding pilot or demonstration programs or models described in subsection (a)(5)(B) towards implementation on a nationwide basis in accordance with section 1115A(c) of the Social Security Act ( 42 U.S.C. 1315a(c) ) by 2030; and (iv) steps to implement each recommendation described in this paragraph; and (F) (i) a report on the status and success of public education campaigns related to falls prevention; and (ii) recommendations for improvements for future federally funded public education campaigns related to falls prevention. (c) Funding (1) Authorization of appropriations To carry out this section, there are authorized to be appropriated such sums as may be necessary for each of fiscal years 2025 through 2029. (2) Existing amounts In addition to any amounts appropriated pursuant to paragraph (1), the Assistant Secretary may carry out this section using amounts otherwise made available to the Assistant Secretary. (d) Definition In this section, the term falls prevention means prevention of injury from falls that focuses on reducing fall risk factors, preventing repeat falls, and preventing falls with injuries. .