[Congressional Bills 118th Congress]
[From the U.S. Government Publishing Office]
[S. 4556 Introduced in Senate (IS)]
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118th CONGRESS
2d Session
S. 4556
To amend title 38, United States Code, to establish the Office of Falls
Prevention of the Department of Veterans Affairs, and for other
purposes.
_______________________________________________________________________
IN THE SENATE OF THE UNITED STATES
June 17, 2024
Mr. King (for himself and Mr. Rounds) introduced the following bill;
which was read twice and referred to the Committee on Veterans' Affairs
_______________________________________________________________________
A BILL
To amend title 38, United States Code, to establish the Office of Falls
Prevention of the Department of Veterans Affairs, and for other
purposes.
Be it enacted by the Senate and House of Representatives of the
United States of America in Congress assembled,
SECTION 1. SHORT TITLE.
This Act may be cited as the ``Supporting Access to Falls Education
and Prevention and Strengthening Training Efforts and Promoting Safety
Initiatives for Veterans Act of 2024'' or the ``SAFE STEPS for Veterans
Act of 2024''.
SEC. 2. ESTABLISHMENT OF OFFICE OF FALLS PREVENTION OF DEPARTMENT OF
VETERANS AFFAIRS.
(a) Establishment of Office.--
(1) In general.--Subchapter I of chapter 73 of title 38,
United States Code, is amended by inserting after section 7310A
the following new section:
``Sec. 7310B. Office of Falls Prevention
``(a) Office.--
``(1) Establishment and operation.--The Under Secretary for
Health shall establish and operate in the Veterans Health
Administration the Office of Falls Prevention (in this section
referred to as the `Office').
``(2) Location of office.--The Office shall be located at
the Central Office of the Department.
``(3) Leadership.--
``(A) Head.--The head of the Office is the Chief
Officer of Falls Prevention (in this section referred
to as the `Chief Officer').
``(B) Reporting.--The Chief Officer shall report to
the Under Secretary for Health.
``(4) Staffing and support.--The Under Secretary for Health
shall provide the Office with such staff and other support as
may be necessary for the Office to carry out effectively the
functions of the Office under this section.
``(5) Reorganization.--The Under Secretary for Health may
reorganize existing offices within the Veterans Health
Administration as of the date of the enactment of this section
in order to avoid duplication with the functions of the Office.
``(b) Functions.--The functions of the Office include the
following:
``(1) To provide a central office for monitoring and
encouraging the activities of the Veterans Health
Administration with respect to the provision, evaluation, and
improvement of health care services relating to falls
prevention provided to veterans by the Department, with the
goal of averting costly health care utilization while
decreasing the incidence of falls.
``(2) To develop and implement standards of care for the
provision by the Department of health care services relating to
falls prevention.
``(3) To monitor and identify deficiencies in standards of
care for the provision of health care services relating to
falls prevention, to provide technical assistance to medical
facilities of the Department, to provide technical assistance
to programs of the Department that support veterans in their
own homes, to address and remedy deficiencies of such
facilities and programs, and to perform oversight of
implementation of such standards of care.
``(4) To monitor and identify deficiencies in standards of
care for the provision of health care services relating to
falls prevention through the community pursuant to this title
and to provide recommendations to the appropriate office to
address and remedy any deficiencies.
``(5) To oversee distribution of resources and information
related to falls prevention for veterans under this title.
``(6) To promote the expansion and improvement of clinical,
research, and educational activities of the Veterans Health
Administration with respect to health care services relating to
falls prevention, including research activities on falls
prevention conducted between the Office of Research and
Development of the Department and the National Institute on
Aging.
``(7) To promote the development or expansion of rigorous
quality assessment or improvement processes designed to prevent
falls, including through coordination and collaboration with
offices within the Department determined appropriate by the
Secretary.
``(8) To coordinate home modification and adaptation
programs administered by the Under Secretary for Benefits under
chapter 21 of this title and the Under Secretary for Health
under section 1717(a)(2) of this title.
``(9) To carry out such other duties as the Under Secretary
for Health may require.
``(c) Public Education Campaign.--The Chief Officer shall--
``(1) oversee and support a national education campaign
that--
``(A) is directed principally to veterans
determined to be at risk for falls, their families, and
their health care providers; and
``(B) focuses on--
``(i) reducing falls, falls with major
injury, and repeat falls for veterans receiving
care under the laws administered by the
Secretary; and
``(ii) increasing awareness of available
benefits, grants, devices, or services provided
by the Department that would aid veterans in
reducing falls and preventing repeat falls; and
``(2) award grants or contracts to qualified organizations
for the purpose of supporting local education campaigns
focusing on reducing falls, falls with major injury, and repeat
falls for veterans receiving care under the laws administered
by the Secretary.
``(d) Research on Falls Prevention Programs for Veteran
Populations.--
``(1) In general.--The Chief Officer shall work with the
Office of Research and Development of the Department and the
National Institute on Aging to develop research for evidence-
based falls prevention programs that will benefit veterans,
including--
``(A) programs that overlap with the priorities of
the Department;
``(B) programs that may focus on or be of
particular benefit to veterans; and
``(C) programs that may include participants with
multiple comorbidities.
``(2) Matters to be included.--The research required under
paragraph (1) shall include the following:
``(A) Research in supporting veterans with and
without service-connected disabilities receiving home
modification grants under section 1717 or 2101 of this
title.
``(B) Development of recommendations for falls
prevention interventions for veterans with service-
connected disabilities, including home modification
interventions.
``(C) Research addressing medication management and
polypharmacy as risk factors for falls prevention and
developing recommendations for providers and electronic
health records systems of the Department to monitor for
veterans at risk of falls based on use of certain
medications.
``(D) Research on improvements for safe patient
handling and mobility among veterans, particularly in
facilities (both medical and non-medical) that are not
spinal cord injury centers.
``(3) Subject matter expert panel.--
``(A) In general.--The Secretary and the Director
of the National Institute on Aging shall establish a
joint subject matter expert panel to develop
recommendations as required under paragraph (2)(B).
``(B) Membership.--The subject matter expert panel
required under subparagraph (A) shall be comprised of
eight members, of which--
``(i) four shall be appointed by the
Secretary; and
``(ii) four shall be appointed by the
Director of the National Institute on Aging.''.
(2) Establishment of joint subject matter expert panel.--
Not later than 180 days after the date of the enactment of this
Act, the Secretary of Veterans Affairs and the Director of the
National Institute on Aging shall establish the joint subject
matter expert panel required under section 7310B(d)(3) of title
38, United States Code, as added by paragraph (1).
(3) Clerical amendment.--The table of sections at the
beginning of such chapter is amended by inserting after the
item relating to section 7310A the following new item:
``7310B. Office of Falls Prevention.''.
(b) Expansion of Interagency Coordinating Committee on Healthy
Aging and Age-Friendly Communities.--Section 203(c) of the Older
Americans Act of 1965 (42 U.S.C. 3013(c)) is amended--
(1) in paragraph (2), by inserting ``the Secretary of
Veterans Affairs,'' after ``the Commissioner of Social
Security,''; and
(2) in paragraph (7), in the matter preceding subparagraph
(A)--
(A) by inserting ``the Committee on Veterans'
Affairs of the House of Representatives,'' after ``the
Committee on Ways and Means of the House of
Representatives,''; and
(B) by inserting ``the Committee on Veterans'
Affairs of the Senate,'' after ``the Committee on
Health, Education, Labor, and Pensions of the
Senate,''.
(c) Safe Handling Transfer Techniques.--Not later than 180 days
after the date of the enactment of this Act, the Secretary of Veterans
Affairs shall issue or update directives of the Veterans Health
Administration for facilities and providers relating to safe patient
handling and mobility policies at the national, Veterans Integrated
Service Network, and health-care system levels, which shall include the
following:
(1) Requiring biennial training for providers, including
that all providers be trained in safe patient handling and use
of mobility aids and mobility techniques.
(2) Requiring that any medical facility where patients may
need assistance with transfer or mobility have access to safe
patient handling and mobility technology appropriate for the
setting to enable safe transfer and mobilization for access to
care and activities of daily living for veterans who are
paralyzed or who need assistance with mobility.
(3) Requiring that all emergency settings have immediate
access to safe patient handling and mobility technology to
enable safe transfer, fall recovery, and repositioning.
(d) Pilot Program on Falls Prevention Interventions Tied to
Residential Adaptations and Alterations.--
(1) Determination.--The Secretary of Veterans Affairs shall
determine the feasibility and advisability of carrying out a
pilot program to provide home improvements and structural
alterations to prevent falls for all veterans eligible for
those services under the laws administered by the Secretary.
(2) Plan.--Not later than one year after the date of the
enactment of this Act, the Secretary shall submit to Congress a
report--
(A) indicating the plans of the Secretary to carry
out a pilot program to provide home improvements and
structural alterations to prevent falls for all
veterans eligible for those services under the laws
administered by the Secretary; or
(B) specifying why the Secretary determined under
paragraph (1) that it is not feasible or advisable to
carry out such a pilot program.
(3) Report on lessons learned.--If the Secretary carries
out the pilot program described in paragraph (1), not later
than 180 days after the termination of the pilot program, the
Chief Officer of Falls Prevention of the Department of Veterans
Affairs established under section 7310B(a)(3)(A) of title 38,
United States Code, as added by subsection (a)(1), shall submit
to Congress a report on lessons learned from the pilot program
and any recommendations on extending or expanding the pilot
program.
(e) Report on Falls Prevention Initiatives.--
(1) In general.--Not later than two years after the date of
the enactment of this Act, or one year after the appointment of
the Chief Officer of Falls Prevention of the Department of
Veterans Affairs established under section 7310B(a)(3)(A) of
title 38, United States Code, as added by subsection (a)(1),
whichever occurs first, the Chief Officer, or the Under
Secretary for Health of the Department of Veterans Affairs if a
Chief Officer has not yet been appointed, shall submit to
Congress a report on falls prevention initiatives within the
Department.
(2) Elements.--The report required by paragraph (1) shall
evaluate, for the three-year period preceding the date of the
enactment of this Act--
(A) screening procedures at facilities of the
Veterans Health Administration for risk of falls and
the prevalence of resulting falls prevention
interventions;
(B) the use by the Department of electronic health
record documentation for risk of falls among veterans;
(C) the number of home modification grants provided
under either the Home Improvements and Structural
Alterations Program of the Department under section
1717 of title 38, United States Code, or the Specially
Adapted Housing Program of the Department under section
2101 of such title;
(D) the extent to which grants provided under the
programs specified under subparagraph (C) prevent falls
among veterans and any recommendations with respect to
such programs in the case of falls among veterans that
were not prevented;
(E) for veterans eligible for the Home Improvements
and Structural Alterations Program of the Department
under section 1717 of title 38, United States Code,
pursuant to subsection (a)(2)(B) of such section, the
number of home modification grants provided to each
veteran in receipt of such a grant;
(F) the types of providers that have conducted
medical assessments leading to a recommendation for a
home modification tied to medical necessity, and any
recommendations for legislative or administrative
action to expand the list of providers eligible to
conduct medical assessments leading to a recommendation
for a home modification;
(G) home evaluation processes that are conducted in
connection with awards made under the programs
specified under subparagraph (C) and any
recommendations for improving the evaluation and review
process;
(H) reporting programs and software of the
Department used to capture incidences of falls in care
sites of the Veterans Health Administration and other
veterans' settings;
(I) limitations on uptake and use of current
prevention, screening, and intervention programs
designed to address falls prevention; and
(J) recommendations for the Secretary of Veterans
Affairs to work with the Centers for Disease Control
and Prevention, or other entities determined
appropriate by the Secretary, to better capture data on
falls by a veteran occurring in the home or in the
community.
SEC. 3. ESTABLISHMENT OF FALLS ASSESSMENT AND FALL PREVENTION SERVICE
REQUIREMENTS FOR VETERANS.
(a) Required Nursing Home Care.--Section 1710A of title 38, United
States Code, is amended by striking subsection (d) and inserting the
following:
``(d) In the case of an individual determined by a physician to
have fallen or to have been at risk of falling during the previous one-
year period, the Secretary shall ensure that a licensed physical
therapist or a licensed occupational therapist conducts a falls risk
assessment for the individual and provides fall prevention services
during the stay of the individual in the nursing home.
``(e) The provisions of subsection (a) shall terminate on September
30, 2028.''.
(b) Extended Care Services.--Section 1710B(a) of such title is
amended by adding at the end the following new paragraph:
``(7) The conduct of an annual falls risk assessment and
the provision of fall prevention services by a licensed
physical therapist or licensed occupational therapist.''.
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