II
119THCONGRESS
1
STSESSION S. 668
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
FEBRUARY20, 2025
Mr. K
ING(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 Representa-1
tives of the United States of America in Congress assembled, 2
SECTION 1. SHORT TITLE. 3
This Act may be cited as the ‘‘Supporting Access to 4
Falls Education and Prevention and Strengthening Train-5
ing Efforts and Promoting Safety Initiatives for Veterans 6
Act of 2025’’ or the ‘‘SAFE STEPS for Veterans Act of 7
2025’’. 8
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SEC. 2. ESTABLISHMENT OF OFFICE OF FALLS PREVEN-1
TION OF DEPARTMENT OF VETERANS AF-2
FAIRS. 3
(a) E
STABLISHMENT OF OFFICE.— 4
(1) I
N GENERAL.—Subchapter I of chapter 73 5
of title 38, United States Code, is amended by in-6
serting after section 7310A the following new sec-7
tion: 8
‘‘§ 7310B. Office of Falls Prevention 9
‘‘(a) O
FFICE.— 10
‘‘(1) E
STABLISHMENT AND OPERATION .—The 11
Under Secretary for Health shall establish and oper-12
ate in the Veterans Health Administration the Office 13
of Falls Prevention (in this section referred to as the 14
‘Office’). 15
‘‘(2) L
OCATION OF OFFICE.—The Office shall 16
be located at the Central Office of the Department. 17
‘‘(3) L
EADERSHIP.— 18
‘‘(A) H
EAD.—The head of the Office is the 19
Chief Officer of Falls Prevention (in this sec-20
tion referred to as the ‘Chief Officer’). 21
‘‘(B) R
EPORTING.—The Chief Officer shall 22
report to the Under Secretary for Health. 23
‘‘(4) S
TAFFING AND SUPPORT .—The Under 24
Secretary for Health shall provide the Office with 25
such staff and other support as may be necessary 26
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for the Office to carry out effectively the functions 1
of the Office under this section. 2
‘‘(5) R
EORGANIZATION.—The Under Secretary 3
for Health may reorganize existing offices within the 4
Veterans Health Administration as of the date of 5
the enactment of this section in order to avoid dupli-6
cation with the functions of the Office. 7
‘‘(b) F
UNCTIONS.—The functions of the Office in-8
clude the following: 9
‘‘(1) To provide a central office for monitoring 10
and encouraging the activities of the Veterans 11
Health Administration with respect to the provision, 12
evaluation, and improvement of health care services 13
relating to falls prevention provided to veterans by 14
the Department, with the goal of averting costly 15
health care utilization while decreasing the incidence 16
of falls. 17
‘‘(2) To develop and implement standards of 18
care for the provision by the Department of health 19
care services relating to falls prevention. 20
‘‘(3) To monitor and identify deficiencies in 21
standards of care for the provision of health care 22
services relating to falls prevention, to provide tech-23
nical assistance to medical facilities of the Depart-24
ment, to provide technical assistance to programs of 25
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the Department that support veterans in their own 1
homes, to address and remedy deficiencies of such 2
facilities and programs, and to perform oversight of 3
implementation of such standards of care. 4
‘‘(4) To monitor and identify deficiencies in 5
standards of care for the provision of health care 6
services relating to falls prevention through the com-7
munity pursuant to this title and to provide rec-8
ommendations to the appropriate office to address 9
and remedy any deficiencies. 10
‘‘(5) To oversee distribution of resources and 11
information related to falls prevention for veterans 12
under this title. 13
‘‘(6) To promote the expansion and improve-14
ment of clinical, research, and educational activities 15
of the Veterans Health Administration with respect 16
to health care services relating to falls prevention, 17
including research activities on falls prevention con-18
ducted between the Office of Research and Develop-19
ment of the Department and the National Institute 20
on Aging. 21
‘‘(7) To promote the development or expansion 22
of rigorous quality assessment or improvement proc-23
esses designed to prevent falls, including through co-24
ordination and collaboration with offices within the 25
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Department determined appropriate by the Sec-1
retary. 2
‘‘(8) To coordinate home modification and ad-3
aptation programs administered by the Under Sec-4
retary for Benefits under chapter 21 of this title and 5
the Under Secretary for Health under section 6
1717(a)(2) of this title. 7
‘‘(9) To carry out such other duties as the 8
Under Secretary for Health may require. 9
‘‘(c) P
UBLICEDUCATIONCAMPAIGN.—The Chief Of-10
ficer shall— 11
‘‘(1) oversee and support a national education 12
campaign that— 13
‘‘(A) is directed principally to veterans de-14
termined to be at risk for falls, their families, 15
and their health care providers; and 16
‘‘(B) focuses on— 17
‘‘(i) reducing falls, falls with major in-18
jury, and repeat falls for veterans receiving 19
care under the laws administered by the 20
Secretary; and 21
‘‘(ii) increasing awareness of available 22
benefits, grants, devices, or services pro-23
vided by the Department that would aid 24
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veterans in reducing falls and preventing 1
repeat falls; and 2
‘‘(2) award grants or contracts to qualified or-3
ganizations for the purpose of supporting local edu-4
cation campaigns focusing on reducing falls, falls 5
with major injury, and repeat falls for veterans re-6
ceiving care under the laws administered by the Sec-7
retary. 8
‘‘(d) R
ESEARCH ONFALLSPREVENTIONPROGRAMS 9
FORVETERANPOPULATIONS.— 10
‘‘(1) I
N GENERAL.—The Chief Officer shall 11
work with the Office of Research and Development 12
of the Department and the National Institute on 13
Aging to develop research for evidence-based falls 14
prevention programs that will benefit veterans, in-15
cluding— 16
‘‘(A) programs that overlap with the prior-17
ities of the Department; 18
‘‘(B) programs that may focus on or be of 19
particular benefit to veterans; and 20
‘‘(C) programs that may include partici-21
pants with multiple comorbidities. 22
‘‘(2) M
ATTERS TO BE INCLUDED .—The re-23
search required under paragraph (1) shall include 24
the following: 25
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‘‘(A) Research in supporting veterans with 1
and without service-connected disabilities receiv-2
ing home modification grants under section 3
1717 or 2101 of this title. 4
‘‘(B) Development of recommendations for 5
falls prevention interventions for veterans with 6
service-connected disabilities, including home 7
modification interventions. 8
‘‘(C) Research addressing medication man-9
agement and polypharmacy as risk factors for 10
falls prevention and developing recommenda-11
tions for providers and electronic health records 12
systems of the Department to monitor for vet-13
erans at risk of falls based on use of certain 14
medications. 15
‘‘(D) Research on improvements for safe 16
patient handling and mobility among veterans, 17
particularly in facilities (both medical and non- 18
medical) that are not spinal cord injury centers. 19
‘‘(3) S
UBJECT MATTER EXPERT PANEL .— 20
‘‘(A) I
N GENERAL.—The Secretary and the 21
Director of the National Institute on Aging 22
shall establish a joint subject matter expert 23
panel to develop recommendations as required 24
under paragraph (2)(B). 25
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‘‘(B) MEMBERSHIP.—The subject matter 1
expert panel required under subparagraph (A) 2
shall be comprised of eight members, of 3
which— 4
‘‘(i) four shall be appointed by the 5
Secretary; and 6
‘‘(ii) four shall be appointed by the 7
Director of the National Institute on 8
Aging.’’. 9
(2) E
STABLISHMENT OF JOINT SUBJECT MAT -10
TER EXPERT PANEL.—Not later than 180 days after 11
the date of the enactment of this Act, the Secretary 12
of Veterans Affairs and the Director of the National 13
Institute on Aging shall establish the joint subject 14
matter expert panel required under section 15
7310B(d)(3) of title 38, United States Code, as 16
added by paragraph (1). 17
(3) C
LERICAL AMENDMENT .—The table of sec-18
tions at the beginning of such chapter is amended 19
by inserting after the item relating to section 7310A 20
the following new item: 21
‘‘7310B. Office of Falls Prevention.’’.
(b) EXPANSION OF INTERAGENCY COORDINATING 22
C
OMMITTEE ON HEALTHYAGING ANDAGE-FRIENDLY 23
C
OMMUNITIES.—Section 203(c) of the Older Americans 24
Act of 1965 (42 U.S.C. 3013(c)) is amended— 25
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(1) in paragraph (2), by inserting ‘‘the Sec-1
retary of Veterans Affairs,’’ after ‘‘the Commissioner 2
of Social Security,’’; and 3
(2) in paragraph (7), in the matter preceding 4
subparagraph (A)— 5
(A) by inserting ‘‘the Committee on Vet-6
erans’ Affairs of the House of Representatives,’’ 7
after ‘‘the Committee on Ways and Means of 8
the House of Representatives,’’; and 9
(B) by inserting ‘‘the Committee on Vet-10
erans’ Affairs of the Senate,’’ after ‘‘the Com-11
mittee on Health, Education, Labor, and Pen-12
sions of the Senate,’’. 13
(c) S
AFEHANDLINGTRANSFERTECHNIQUES.—Not 14
later than 180 days after the date of the enactment of 15
this Act, the Secretary of Veterans Affairs shall issue or 16
update directives of the Veterans Health Administration 17
for facilities and providers relating to safe patient han-18
dling and mobility policies at the national, Veterans Inte-19
grated Service Network, and health-care system levels, 20
which shall include the following: 21
(1) Requiring biennial training for providers, 22
including that all providers be trained in safe patient 23
handling and use of mobility aids and mobility tech-24
niques. 25
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(2) Requiring that any medical facility where 1
patients may need assistance with transfer or mobil-2
ity have access to safe patient handling and mobility 3
technology appropriate for the setting to enable safe 4
transfer and mobilization for access to care and ac-5
tivities of daily living for veterans who are paralyzed 6
or who need assistance with mobility. 7
(3) Requiring that all emergency settings have 8
immediate access to safe patient handling and mobil-9
ity technology to enable safe transfer, fall recovery, 10
and repositioning. 11
(d) P
ILOTPROGRAM ONFALLSPREVENTIONINTER-12
VENTIONSTIED TORESIDENTIALADAPTATIONS ANDAL-13
TERATIONS.— 14
(1) D
ETERMINATION.—The Secretary of Vet-15
erans Affairs shall determine the feasibility and ad-16
visability of carrying out a pilot program to provide 17
home improvements and structural alterations to 18
prevent falls for all veterans eligible for those serv-19
ices under the laws administered by the Secretary. 20
(2) P
LAN.—Not later than one year after the 21
date of the enactment of this Act, the Secretary 22
shall submit to Congress a report— 23
(A) indicating the plans of the Secretary to 24
carry out a pilot program to provide home im-25
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provements and structural alterations to pre-1
vent falls for all veterans eligible for those serv-2
ices under the laws administered by the Sec-3
retary; or 4
(B) specifying why the Secretary deter-5
mined under paragraph (1) that it is not fea-6
sible or advisable to carry out such a pilot pro-7
gram. 8
(3) R
EPORT ON LESSONS LEARNED .—If the 9
Secretary carries out the pilot program described in 10
paragraph (1), not later than 180 days after the ter-11
mination of the pilot program, the Chief Officer of 12
Falls Prevention of the Department of Veterans Af-13
fairs established under section 7310B(a)(3)(A) of 14
title 38, United States Code, as added by subsection 15
(a)(1), shall submit to Congress a report on lessons 16
learned from the pilot program and any rec-17
ommendations on extending or expanding the pilot 18
program. 19
(e) R
EPORT ONFALLSPREVENTIONINITIATIVES.— 20
(1) I
N GENERAL.—Not later than two years 21
after the date of the enactment of this Act, or one 22
year after the appointment of the Chief Officer of 23
Falls Prevention of the Department of Veterans Af-24
fairs established under section 7310B(a)(3)(A) of 25
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title 38, United States Code, as added by subsection 1
(a)(1), whichever occurs first, the Chief Officer, or 2
the Under Secretary for Health of the Department 3
of Veterans Affairs if a Chief Officer has not yet 4
been appointed, shall submit to Congress a report on 5
falls prevention initiatives within the Department. 6
(2) E
LEMENTS.—The report required by para-7
graph (1) shall evaluate, for the three-year period 8
preceding the date of the enactment of this Act— 9
(A) screening procedures at facilities of the 10
Veterans Health Administration for risk of falls 11
and the prevalence of resulting falls prevention 12
interventions; 13
(B) the use by the Department of elec-14
tronic health record documentation for risk of 15
falls among veterans; 16
(C) the number of home modification 17
grants provided under either the Home Im-18
provements and Structural Alterations Program 19
of the Department under section 1717 of title 20
38, United States Code, or the Specially Adapt-21
ed Housing Program of the Department under 22
section 2101 of such title; 23
(D) the extent to which grants provided 24
under the programs specified under subpara-25
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graph (C) prevent falls among veterans and any 1
recommendations with respect to such programs 2
in the case of falls among veterans that were 3
not prevented; 4
(E) for veterans eligible for the Home Im-5
provements and Structural Alterations Program 6
of the Department under section 1717 of title 7
38, United States Code, pursuant to subsection 8
(a)(2)(B) of such section, the number of home 9
modification grants provided to each veteran in 10
receipt of such a grant; 11
(F) the types of providers that have con-12
ducted medical assessments leading to a rec-13
ommendation for a home modification tied to 14
medical necessity, and any recommendations for 15
legislative or administrative action to expand 16
the list of providers eligible to conduct medical 17
assessments leading to a recommendation for a 18
home modification; 19
(G) home evaluation processes that are 20
conducted in connection with awards made 21
under the programs specified under subpara-22
graph (C) and any recommendations for im-23
proving the evaluation and review process; 24
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(H) reporting programs and software of 1
the Department used to capture incidences of 2
falls in care sites of the Veterans Health Ad-3
ministration and other veterans’ settings; 4
(I) limitations on uptake and use of cur-5
rent prevention, screening, and intervention 6
programs designed to address falls prevention; 7
and 8
(J) recommendations for the Secretary of 9
Veterans Affairs to work with the Centers for 10
Disease Control and Prevention, or other enti-11
ties determined appropriate by the Secretary, to 12
better capture data on falls by a veteran occur-13
ring in the home or in the community. 14
SEC. 3. ESTABLISHMENT OF FALLS ASSESSMENT AND FALL 15
PREVENTION SERVICE REQUIREMENTS FOR 16
VETERANS. 17
(a) R
EQUIREDNURSINGHOMECARE.—Section 18
1710A of title 38, United States Code, is amended by 19
striking subsection (d) and inserting the following: 20
‘‘(d) In the case of an individual determined by a phy-21
sician to have fallen or to have been at risk of falling dur-22
ing the previous one-year period, the Secretary shall en-23
sure that a licensed physical therapist or a licensed occu-24
pational therapist conducts a falls risk assessment for the 25
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individual and provides fall prevention services during the 1
stay of the individual in the nursing home. 2
‘‘(e) The provisions of subsection (a) shall terminate 3
on September 30, 2028.’’. 4
(b) E
XTENDEDCARESERVICES.—Section 1710B(a) 5
of such title is amended by adding at the end the following 6
new paragraph: 7
‘‘(7) The conduct of an annual falls risk assess-8
ment and the provision of fall prevention services by 9
a licensed physical therapist or licensed occupational 10
therapist.’’. 11
Æ
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