The Start of Falls Policy
Federalism has developed through the years to allow the states that the government to work together to help with healthcare programs that improve public health (Meacham, 2021). The growth of fall prevention policy legislature is an example of how federalism works currently.
The Historical and Current Policy on Falls
National
In November of 2003, the bill HR 3515 was submitted to the House of Representatives for the Elder Fall Prevention Act requesting that public health services increase the interest and activities related to patient falls (Elder Fall Prevention Act, 2003). This bill was followed by the Keeping Seniors Safe From Falls Act of 2004 that was presented to the Senate (Keeping Seniors Safe From Falls Act, 2004). The bill directs public health services to identify risky populations, implement quality improvement measures, and create and implement fall prevention programs to decrease falls (Keeping Seniors Safe From Falls Act, 2004). The bill was passed along from both the Senate and the House of Representatives to the Subcommittee on Health (Elder Fall Prevention Act, 2003; Keeping Seniors Safe From Falls Act, 2004). Funding for these programs was approved by the Senate in 2008 with the approval of the Safety for Seniors Act. (Safety for Seniors Act, 2008; Scotti, 2016). A few short years later, National Falls Prevention Awareness Day was initiated in 2020 (National Falls Prevention Awareness Week, 2020; Scotti, 2016).
The Special Committee on Aging in the United States Senate created ways to better support seniors on the national, state, and local level (Falls Prevention: National, State, and Local Solutions to Better Support Seniors Special Committee on Aging United States Senate, 2019). This includes assessment in the Annual Wellness Visit (AWV) that Medicare provides yearly for all patients. Also, the Centers for Disease Control (CDC) tracts the rates of falls across the country and has identified tools and resources to prevent falls. An example of this is the Stopping, Elderly, Accidents, Deaths, and Injuries (STEADI) tool. The Food and Drug Administration (FDA), Administration for Community Living (ACL), and the United States Housing and Urban Development (HUD) and Veterans Affairs (VA) also have fall specific programs (Falls Prevention: National, State, and Local Solutions to Better Support Seniors Special Committee on Aging United States Senate, 2019).
State
On the state level, several states have received funding from the ACL for fall prevention (Falls Prevention: National, state, and local solutions to better support seniors Special Committee on Aging United States Senate, 2019). Also, in some of these states, there are organized groups whose primary focus is fall prevention (National Conference of State Legislatures, n.d.). In Arizona, the state fall prevention group is the Arizona Falls Prevention Coalition (AFPC). The AFPC’s main goal is to prevent falls by bringing awareness to falls and offering resources to patients and the community on fall prevention (Arizona Falls Prevention Coalition, 2021a).
Key Actors and Stakeholders
Falls Prevention in Arizona: The Key People
One of the major key actors is the governor of Arizona, Doug Ducey. In September 2019, he announced the designation of Falls Prevention Awareness Month (Arizona Department of Health Services, 2019). Other key influences to fall prevention in Arizona are Rachel Mills, the Northern Regional Chapter Chairman of the AFPC, and Steve Wagner, the Policy and Advocacy Committee Chairperson of AFPC.
The key stakeholders and the most affected by falls prevention is the elderly patients that are protected from injury and death from falls. The families of the elderly patients that fall cannot be forgotten. They are so important in the safety of the elderly. They often hold the burden of finding help or placement for their family member after a fall.
Public and Private Sector Institutions
For the community, local hospitals are important for community programs for safety and exercise for the elderly. Health departments are also very involved with community safety and education. On a state level, community partners that are associated with AFPC and the programs that help the elderly get the resources they need for fall prevention. There are many associations, hospital systems, and educational organizations that assist with fall prevention in Arizona (Arizona Falls Prevention Coalition, 2021b). Nationally, the CDC with use of the STEADI tool and the partnership with the Electronic Medical Record (EMR) program EPIC have assisted health care professionals identify people at risk for falls in the community (Falls Prevention: National, State, and Local Solutions to Better Support Seniors Special Committee on Aging United States Senate, 2019).
Policy and Change
Change has to start somewhere. Protecting the elderly from injuries related to falls has improved over the years but we can still do better. Legislative policy can be overwhelming and confusing but it gives us a good base on where we need to start to make things better.
More to come on falls: Stay tuned >>>>>
References
Arizona Department of Health Services. (2019). State of Arizona Proclamation: Falls Prevention Awareness Month. https://azdhs.gov/documents/prevention/tobacco-chronic-disease/healthy-aging/reports-statistics/gov-ducey-proclamation-falls-prevention.pdf
Arizona Falls Prevention Coalition. (2021a). About us. https://www.azstopfalls.org/about-us
Arizona Falls Prevention Coalition. (2021b). Community Partners. https://www.azstopfalls.org/community-partners
Elder Fall Prevention Act, H. R. 3513, 108th Congress, (2003). https://www.congress.gov/bill/108th-congress/house-bill/3513?q=%7B%22search%22%3A%5B%22HR3513+elder+fall+prevention+act%22%2C%22HR3513%22%2C%22elder%22%2C%22fall%22%2C%22prevention%22%2C%22act%22%5D%7D&s=5&r=1
Falls prevention: National, state, and local solutions to better support seniors Special Committee on Aging United States Senate. (2019). https://www.aging.senate.gov/imo/media/doc/SCA_Falls_Report_2019.pdf
Keeping Seniors Safe from Falls Act, S. 1217, 108th Congress, (2004).
Meacham, M. (2021). Longest’s health policymaking in the United States (7th ed.). Foundation of the American College of Healthcare Executives.
National Conference of State Legislatures. (n.d.). Elderly falls prevention legislation and statutes. Retrieved February 12, 2022, from https://www.ncsl.org/research/health/elderly-falls-prevention-legislation-and-statutes.aspx
National Falls Prevention Awareness Week, S. Res 734, 116th Congress, (2020). https://www.congress.gov/bill/116th-congress/senate-resolution/734?q=%7B%22search%22%3A%5B%22s+res+734%22%2C%22s%22%2C%22res%22%2C%22734%22%5D%7D&s=3&r=1
Safety for Seniors Act, S. 845, 110th Congress, (2008). https://www.congress.gov/bill/110th-congress/senate-bill/845?q=%7B%22search%22%3A%5B%22s.+845%22%2C%22s.%22%2C%22845%22%5D%7D&s=5&r=68
Scotti, S. (2016). Preventing elderly falls. www.ncsl.org
HI Shurine,
I enjoyed reading your blog. Initially, I was drawn in to read more based on the clever title. I will admit that I am not too familiar with the policy on the topic of injury related to elderly falls. The Arizona Falls Prevention Coalition (AFPC) appears to be a fantastic resource for learning how to mitigate falls for our state. In my experience with older adults, many are unaware that a few simple changes in the home can make a significant difference is fall prevention. I appreciate that our governor has an active interest in addressing fall prevention by dedicating a month to help educate the public in becoming proactive in this topic.
I came acros…
Shurine, thanks so much for your post. I found this interesting as I became an RN in 2004, right when many of these policies were being put into place. I can remember being trained in the hospital with extra measures to keep our patients safe. I love connecting how these policies impacted my medical practice at the time – very fascinating!
Thanks as well for all of the great resources. I enjoyed looking at the Arizona Falls Prevention Coalition site – I will certainly be going back there for resources in the future when I work with those at risk of falling. About Us | AFPC (azstopfalls.org)
Esther
Thank you for this information. It brings to the forefront that being aware of the little things that could protect the aging in big ways Is vital.
S. Vohs