[Congressional Bills 109th Congress]
[From the U.S. Government Publishing Office]
[S. 1531 Reported in Senate (RS)]
Calendar No. 667
109th CONGRESS
2d Session
S. 1531
[Report No. 109-362]
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
July 28, 2005
Mr. Enzi (for himself, Ms. Mikulski, Mr. Cochran, Mr. Baucus, Mr.
Grassley, Mrs. Murray, Mrs. Dole, Mr. Isakson, and Mr. Durbin)
introduced the following bill; which was read twice and referred to the
Committee on Health, Education, Labor, and Pensions
December 5, 2006
Reported by Mr. Enzi, with an amendment and an amendment to the title
[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.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
<DELETED>SECTION 1. SHORT TITLE.</DELETED>
<DELETED> This Act may be cited as the ``Keeping Seniors Safe From
Falls Act of 2005''.</DELETED>
<DELETED>SEC. 2. FINDINGS.</DELETED>
<DELETED> Congress finds the following:</DELETED>
<DELETED> (1) Falls are the leading cause of injury deaths
among individuals who are over 65 years of age.</DELETED>
<DELETED> (2) In 2002, falls among older adults accounted
for 12,800 deaths and 1,640,000 emergency department
visits.</DELETED>
<DELETED> (3) Hospital admissions for hip fractures among
the elderly have increased from 231,000 admissions in 1988 to
327,000 in 2001.</DELETED>
<DELETED> (4) Annually, more than 80,000 individuals who are
over 65 years of age sustain a traumatic brain injury as a
result of a fall.</DELETED>
<DELETED> (5) The total medical cost of all fall injuries
for people age 65 and older was calculated in 2000 to be
$19,500,000,000.</DELETED>
<DELETED> (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.</DELETED>
<DELETED>SEC. 3. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT.</DELETED>
<DELETED> Part J of title III of the Public Health Service Act (42
U.S.C. 280b et seq.) is amended--</DELETED>
<DELETED> (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</DELETED>
<DELETED> (2) by inserting after section 393C (as
redesignated by paragraph (1)) the following:</DELETED>
<DELETED>``SEC. 393D. PREVENTION OF FALLS AMONG OLDER ADULTS.</DELETED>
<DELETED> ``(a) Purposes.--The purposes of this section are--
</DELETED>
<DELETED> ``(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;</DELETED>
<DELETED> ``(2) to intensify services and conduct research
to determine the most effective approaches to preventing and
treating falls among older adults; and</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(b) Public Education.--The Secretary shall--</DELETED>
<DELETED> ``(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</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(c) Research.--</DELETED>
<DELETED> ``(1) In general.--The Secretary shall--</DELETED>
<DELETED> ``(A) conduct and support research to--
</DELETED>
<DELETED> ``(i) improve the identification
of older adults who have a high risk of
falling;</DELETED>
<DELETED> ``(ii) improve data collection and
analysis to identify fall risk and protective
factors;</DELETED>
<DELETED> ``(iii) design, implement, and
evaluate the most effective fall prevention
interventions;</DELETED>
<DELETED> ``(iv) improve strategies that are
proven to be effective in reducing falls by
tailoring these strategies to specific
populations of older adults;</DELETED>
<DELETED> ``(v) conduct research in order to
maximize the dissemination of proven, effective
fall prevention interventions;</DELETED>
<DELETED> ``(vi) intensify proven
interventions to prevent falls among older
adults;</DELETED>
<DELETED> ``(vii) improve the diagnosis,
treatment, and rehabilitation of elderly fall
victims and those at high risk for falls;
and</DELETED>
<DELETED> ``(viii) assess the risk of falls
occurring in various settings;</DELETED>
<DELETED> ``(B) conduct research concerning barriers
to the adoption of proven interventions with respect to
the prevention of falls among older adults;</DELETED>
<DELETED> ``(C) conduct research to develop,
implement, and evaluate the most effective approaches
to reducing falls among high-risk older adults living
in communities and long-term care and assisted living
facilities; and</DELETED>
<DELETED> ``(D) evaluate the effectiveness of
community programs designed to prevent falls among
older adults.</DELETED>
<DELETED> ``(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, and aging service providers in fall prevention,
evaluation, and management.</DELETED>
<DELETED> ``(d) Demonstration Projects.--The Secretary shall carry
out the following:</DELETED>
<DELETED> ``(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:</DELETED>
<DELETED> ``(A) A multistate demonstration project
assessing the utility of targeted fall risk screening
and referral programs.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(C) Programs that are targeted to new
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.</DELETED>
<DELETED> ``(D) Private sector and public-private
partnerships to develop technologies to prevent falls
among older adults and prevent or reduce injuries if
falls occur.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(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 single and
multifamily residential settings with high concentrations of
older adults, including--</DELETED>
<DELETED> ``(i) identifying high-risk
populations;</DELETED>
<DELETED> ``(ii) evaluating residential
facilities;</DELETED>
<DELETED> ``(iii) conducting screening to identify
high-risk individuals;</DELETED>
<DELETED> ``(iv) providing fall assessment and risk
reduction interventions and counseling;</DELETED>
<DELETED> ``(v) coordinating services with health
care and social service providers; and</DELETED>
<DELETED> ``(vi) coordinating post-fall treatment
and rehabilitation.</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(e) Study of Effects of Falls on Health Care Costs.--
</DELETED>
<DELETED> ``(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.</DELETED>
<DELETED> ``(2) Report.--Not later than 36 months after the
date of enactment of the Keeping Seniors Safe From Falls Act of
2005, the Secretary shall submit to Congress a report
describing the findings of the Secretary in conducting the
review under paragraph (1).</DELETED>
<DELETED> ``(f) Authorization of Appropriations.--In order to carry
out this section, there are authorized to be appropriated--</DELETED>
<DELETED> ``(1) to carry out the national public education
provisions described in subsection (b)(1), $3,000,000 for each
of fiscal years 2007 through 2009;</DELETED>
<DELETED> ``(2) to carry out the State public education
campaign provisions of subsection (b)(2), $5,000,000 for each
of fiscal years 2007 through 2009;</DELETED>
<DELETED> ``(3) to carry out research projects described in
subsection (c), $8,000,000 for each of fiscal years 2007
through 2009;</DELETED>
<DELETED> ``(4) to carry out the demonstration projects
described in subsection (d)(1), $4,000,000 for each of fiscal
years 2007 through 2009; and</DELETED>
<DELETED> ``(5) to carry out the demonstration and research
projects described in subsection (d)(2), $5,000,000 for each of
fiscal years 2007 through 2009.''.</DELETED>
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Keeping Seniors Safe from Falls and
Reauthorization of the Traumatic Brain Injury Act''.
SEC. 2. CONFORMING AMENDMENTS RELATING TO RESTRUCTURING.
Part J of title III of the Public Health Service Act (42 U.S.C.
280b et seq.) is amended--
(1) by redesignating the section 393B (42 U.S.C. 280b-1c)
relating to the use of allotments for rape prevention
education, as section 393A and moving such section so that it
follows section 393;
(2) by redesignating existing section 393A (42 U.S.C. 280b-
1b) relating to prevention of traumatic brain injury, as
section 393B; and
(3) by redesignating the section 393B (42 U.S.C. 280b-1d)
relating to traumatic brain injury registries, as section 393C.
SEC. 3. TRAUMATIC BRAIN INJURY PROGRAMS OF THE CENTERS FOR DISEASE
CONTROL AND PREVENTION.
(a) Prevention of Traumatic Brain Injury.--Clause (ii) of section
393B(b)(3)(A) of the Public Health Service Act, as so redesignated, (42
U.S.C. 280b-1b) is amended by striking ``from hospitals and trauma
centers'' and inserting ``from hospitals and emergency departments''.
(b) National Program for Traumatic Brain Injury Surveillance and
Registries.--Section 393C of the Public Health Service Act, as so
redesignated, (42 U.S.C. 280b et seq.) is amended--
(1) in the section heading, by inserting ``surveillance
and'' after ``national program for traumatic brain injury'';
(2) by striking ``(a) In General.--''; and
(3) in the matter preceding paragraph (1), by striking
``may make grants'' and all that follows through ``to collect
data concerning--'' and inserting ``may make grants to States
or their designees to develop or operate the State's traumatic
brain injury surveillance system or registry to determine the
incidence and prevalence of traumatic brain injury and related
disability, to ensure the uniformity of reporting under such
system or registry, to link individuals with traumatic brain
injury to services and supports, and to link such individuals
with academic institutions to conduct applied research that
will support the development of such surveillance systems and
registries as may be necessary. A surveillance system or
registry under this section shall provide for the collection of
data concerning--''.
SEC. 4. STUDY ON TRAUMATIC BRAIN INJURY.
Part J of title III of the Public Health Service Act (42 U.S.C.
280b et seq.) is amended by inserting after section 393C the following:
``SEC. 393C-1. STUDY ON TRAUMATIC BRAIN INJURY.
``(a) Study.--The Secretary, acting through the Director of the
Centers for Disease Control and Prevention with respect to paragraph
(1) and the Director of the National Institutes of Health with respect
to paragraphs (2) and (3), shall conduct a study with respect to
traumatic brain injury for the purpose of carrying out the following:
``(1) In collaboration with appropriate State and local
health-related agencies--
``(A) determining the incidence of traumatic brain
injury and prevalence of traumatic brain injury related
disability in all age groups in the general population
of the United States, including institutional settings,
such as nursing homes, correctional facilities,
psychiatric hospitals, child care facilities, and
residential institutes for people with developmental
disabilities; and
``(B) reporting national trends in traumatic brain
injury.
``(2) Identifying common therapeutic interventions which
are used for the rehabilitation of individuals with such
injuries, and, subject to the availability of information,
including an analysis of--
``(A) the effectiveness of each such intervention
in improving the functioning, including return to work
or school and community participation, of individuals
with brain injuries;
``(B) the comparative effectiveness of
interventions employed in the course of rehabilitation
of individuals with brain injuries to achieve the same
or similar clinical outcome; and
``(C) the adequacy of existing measures of outcomes
and knowledge of factors influencing differential
outcomes.
``(3) Developing practice guidelines for the rehabilitation
of traumatic brain injury at such time as appropriate
scientific research becomes available.
``(b) Dates Certain for Reports.--Not later than 3 years after the
date of the enactment of the Keeping Seniors Safe from Falls and
Reauthorization of the Traumatic Brain Injury Act, the Secretary shall
submit to the Congress a report describing findings made as a result of
carrying out subsection (a).
``(c) Definition.--For purposes of this section, the term
`traumatic brain injury' means an acquired injury to the brain. Such
term does not include brain dysfunction caused by congenital or
degenerative disorders, nor birth trauma, but may include brain
injuries caused by anoxia due to trauma. The Secretary may revise the
definition of such term as the Secretary determines necessary.''.
SEC. 5. TRAUMATIC BRAIN INJURY PROGRAMS OF THE NATIONAL INSTITUTES OF
HEALTH.
Section 1261 of the Public Health Service Act (42 U.S.C. 300d-61)
is amended--
(1) in subparagraph (D) of subsection (d)(4), by striking
``head brain injury'' and inserting ``brain injury''; and
(2) in subsection (i), by inserting ``, and such sums as
may be necessary for each of fiscal years 2007 through 2010''
before the period at the end.
SEC. 6. TRAUMATIC BRAIN INJURY PROGRAMS OF THE HEALTH RESOURCES AND
SERVICES ADMINISTRATION.
(a) State Grants for Demonstration Projects Regarding Traumatic
Brain Injury.--Section 1252 of the Public Health Service Act (42 U.S.C.
300d-52) is amended--
(1) in subsection (a)--
(A) by striking ``may make grants to States'' and
inserting ``may make grants to States and American
Indian consortia''; and
(B) by striking ``health and other services'' and
inserting ``rehabilitation and other services'';
(2) in subsection (b)--
(A) in paragraphs (1), (3)(A)(i), (3)(A)(iii), and
(3)(A)(iv), by striking the term ``State'' each place
such term appears and inserting the term ``State or
American Indian consortium''; and
(B) in paragraph (2), by striking ``recommendations
to the State'' and inserting ``recommendations to the
State or American Indian consortium'';
(3) in subsection (c), by striking the term ``State'' each
place such term appears and inserting ``State or American
Indian consortium'';
(4) in subsection (e), by striking ``A State that
received'' and all that follows through the period and
inserting ``A State or American Indian consortium that received
a grant under this section prior to the date of the enactment
of the Keeping Seniors Safe from Falls and Reauthorization of
the Traumatic Brain Injury Act may complete the activities
funded by the grant.'';
(5) in subsection (f)--
(A) in the subsection heading, by inserting ``and
American Indian Consortium'' after ``State'';
(B) in paragraph (1) in the matter preceding
subparagraph (A), paragraph (1)(E), paragraph (2)(A),
paragraph (2)(B), paragraph (3) in the matter preceding
subparagraph (A), paragraph (3)(E), and paragraph
(3)(F), by striking the term ``State'' each place such
term appears and inserting ``State or American Indian
consortium'';
(C) in clause (ii) of paragraph (1)(A), by striking
``children and other individuals'' and inserting
``children, youth, and adults''; and
(D) in subsection (h)--
(i) by striking ``Not later than 2 years
after the date of the enactment of this
section, the Secretary'' and inserting ``Not
less than bi-annually, the Secretary''; and
(ii) by inserting ``section 1253, and
section 1254,'' after ``programs established
under this section,'';
(6) by amending subsection (i) to read as follows:
``(i) Definitions.--For purposes of this section:
``(1) The terms `American Indian consortium' and `State'
have the meanings given to those terms in section 1253.
``(2) The term `traumatic brain injury' means an acquired
injury to the brain. Such term does not include brain
dysfunction caused by congenital or degenerative disorders, nor
birth trauma, but may include brain injuries caused by anoxia
due to near drowning. The Secretary may revise the definition
of such term as the Secretary determines necessary, after
consultation with States and other appropriate public or
nonprofit private entities.''; and
(7) in subsection (j), by inserting ``, and such sums as
may be necessary for each of the fiscal years 2007 through
2010'' before the period.
(b) State Grants for Protection and Advocacy Services.--Section
1253 of the Public Health Service Act (42 U.S.C. 300d-53) is amended--
(1) in subsections (d) and (e), by striking the term
``subsection (i)'' each place such term appears and inserting
``subsection (l)'';
(2) in subsection (g), by inserting ``each fiscal year not
later than October 1,'' before ``the Administrator shall pay'';
(3) by redesignating subsections (i) and (j) as subsections
(l) and (m), respectively;
(4) by inserting after subsection (h) the following:
``(i) Data Collection.--The Administrator of the Health Resources
and Services Administration and the Commissioner of the Administration
on Developmental Disabilities shall enter into an agreement to
coordinate the collection of data by the Administrator and the
Commissioner regarding protection and advocacy services.
``(j) Training and Technical Assistance.--
``(1) Grants.--For any fiscal year for which the amount
appropriated to carry out this section is $6,000,000 or
greater, the Administrator shall use 2 percent of such amount
to make a grant to an eligible national association for
providing for training and technical assistance to protection
and advocacy systems.
``(2) Definition.--In this subsection, the term `eligible
national association' means a national association with
demonstrated experience in providing training and technical
assistance to protection and advocacy systems.
``(k) System Authority.--In providing services under this section,
a protection and advocacy system shall have the same authorities,
including access to records, as such system would have for purposes of
providing services under subtitle C of the Developmental Disabilities
Assistance and Bill of Rights Act of 2000.''; and
(5) in subsection (l) (as redesignated by this subsection)
by striking ``2005'' and inserting ``2010''.
SEC. 7. AMENDMENTS TO THE PUBLIC HEALTH SERVICE ACT RELATING TO ELDER
FALLS.
Part J of title III of the Public Health Service Act (42 U.S.C.
280b et seq.) is amended by inserting after section 393C-1 (as added by
section 4) the following:
``SEC. 393D. PREVENTION OF FALLS AMONG OLDER ADULTS.
``(a) 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.
``(b) 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
older adults at high risk for falls; 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
communities and long-term care and assisted living
facilities; and
``(D) evaluate the effectiveness of community
programs designed to prevent 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, and aging service providers in fall prevention,
evaluation, and management.
``(c) 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 new 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 technologies 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 single and 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 fall assessment and risk reduction
interventions and 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.
``(d) 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 and
Reauthorization of the Traumatic Brain Injury Act, the
Secretary shall submit to Congress a report describing the
findings of the Secretary in conducting the review under
paragraph (1).''.
SEC. 8. AUTHORIZATION OF APPROPRIATIONS.
Section 394A of the Public Health Service Act (42 U.S.C. 280b-3) is
amended by striking ``$50,000,000'' and all that follows through the
period and inserting ``$58,361,000 for fiscal year 2007, and such sums
as may be necessary for each of fiscal years 2008 through 2010.''.
Amend the title so as to read: ``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 and to
provide for the expansion and improvement of traumatic brain injury
programs, and for other purposes.''.
Calendar No. 667
109th CONGRESS
2d Session
S. 1531
[Report No. 109-362]
_______________________________________________________________________
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.
_______________________________________________________________________
December 5, 2006
Reported with an amendment and an amendment to the title