Elder Fall Prevention Act Strains for Hill Attention

Posted June 4, 2004 at 3:52pm

Forget the overplayed commercial in which an elderly actress calls out, “I’ve fallen and I can’t get up!” To Sen. Mike Enzi (R-Wyo.) and the Congressionally chartered National Safety Council, falls by seniors are no laughing matter.

Quite the contrary: After several years of fruitless efforts, advocates for seniors are lobbying to pass the Elder Fall Prevention Act in the hope that it will improve elders’ longevity and quality of life while also reducing preventable health care costs.

“In today’s world, when so many of us are living longer, it is quite commonplace to hear of elderly friends and relatives who have fallen and faced the challenge of recovering from a broken bone,” Enzi said as he introduced the bill last year. “What is less well known is that 25 percent of the elderly who sustain a hip fracture die within one year. On an annual basis, 40,000 people over age 65.”

It can happen to anyone — even those who work in Congress. Mark Riso, a lobbyist for the National Safety Council — a nonprofit federal corporation focused on reducing unintentional deaths and injuries — said that nearly every staffer or lawmaker he speaks with has a relative, friend or co-worker whose life has been affected by a fall.

Last March, Sen. Arlen Specter (R-Pa.) took a major tumble outside a Philadelphia restaurant. The 74-year-old lawmaker fell nose-first into the sidewalk, ending up with a split lip and two black eyes.

Friends and relatives of the late Rep. Mo Udall (D-Ariz.) recall the problems that dogged the then-69-year-old former Congressman after he fell down a flight of stairs in his Arlington, Va., home. The fall caused Udall to fracture his shoulder bone and several ribs, complicating his struggle with Parkinson’s disease.

Nationally, falls are the leading cause of death from unintentional injuries for persons 65 years of age and older, according to National Safety Council statistics. Young people, by contrast, are generally healthy and tend to recover well from injuries sustained in a fall.

In 2001, more than 11,000 persons age 65 and older died as a result of fall-related injuries, according to the Centers for Disease Control and Prevention. Another 1.6 million seniors sustained nonfatal injuries caused by unintentional falls.

Despite such statistics, the issue is not exactly an easy sell in an era dominated by concerns about defense, homeland security and the domestic economy.

There’s also another not-so-minor problem: How does Congress even go about legislating away the problem of falling down?

Sen. Barbara Mikulski (D-Md.), a lead co-sponsor of S. 1217, explained in a floor speech that the bill would authorize $38 million to create public education campaigns for seniors, their families and health care providers about how to prevent falls. The bill would also direct some of those funds to two agencies that would conduct research on preventing elder falls and improving rehabilitation practices.

The legislation also requires an evaluation of the effect of falls on Medicare and Medicaid, with an eye to reducing costs by expanding coverage to include fall-related services.

The group that could potentially lend the most muscle to the effort — the seniors’ group AARP — supports the bill but hasn’t taken an active role in pushing it, a spokeswoman said.

Rep. Frank Pallone (D-N.J.) has introduced companion legislation in the House, but the bill’s backers acknowledge that they are facing an uphill battle in the Senate, where Sen. Judd Gregg (R-N.H.) — chairman of the Health, Education, Labor and Pensions Committee — has expressed reservations about the measure.

In the bill’s first incarnation — in the 107th Congress — it was sponsored by then-Sen. Tim Hutchinson (R-Ark.) and supported by both the National Safety Council and the American Geriatrics Society. But the bill languished, and observers fear that the same fate could await the latest version of the legislation.

“Senator Gregg’s [modus operandi] is that he usually opposes efforts to legislate by body part,” noted a Democratic aide on the Health, Education, Labor and Pensions Committee who added that a laundry list of bills are also trapped in the committee, ranging from colon cancer to arthritis.

Enzi press secretary Coy Knobel told Roll Call that Gregg “has raised some technical concerns with the legislation as drafted … and Senators Enzi and Mikulski are working together to address those concerns to Chairman Gregg’s satisfaction.”

But Bobby Jackson, senior vice president for the National Safety Council, isn’t giving up yet. He hopes to sell the bill to conservatives, in part by pointing out how the legislation could cut costs down the road.

“What I tried to tell them is this is not just altruistic legislation in trying to reduce the number of deaths of the elderly,” he said. “It’s a financial investment.” Jackson said that if no action is taken by the year 2020, falls alone will cost Medicare $43 billion.

Jackson added that he and other advocates have been talking to Gregg’s aides and “negotiating a few fine points they want to incorporate in there.”

“We’re willing to do anything to get this legislation moved forward,” Jackson said, including cutting the amount of funding in the bill. “We’re not wedded to the amount of money in the bill, we just don’t want it gutted to the point where it doesn’t make any sense.”