SAFE STEPS for Veterans Act of 2025

[Congressional Bills 119th Congress]
[From the U.S. Government Publishing Office]
[H.R. 3183 Introduced in House (IH)]

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119th CONGRESS
  1st Session
                                H. R. 3183

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 HOUSE OF REPRESENTATIVES

                              May 5, 2025

 Ms. Budzinski (for herself, Ms. Lois Frankel of Florida, Mrs. Kiggans
 of Virginia, Mr. Bergman, and Mr. Bilirakis) introduced the following
bill; which was referred to the Committee on Veterans' Affairs, and in
 addition to the Committee on Education and Workforce, for a period to
      be subsequently determined by the Speaker, in each case for
consideration of such provisions as fall within the jurisdiction of the
                          committee concerned

_______________________________________________________________________

                                 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 2025'' or the ``SAFE STEPS for Veterans
Act of 2025''.

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) 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) The Office shall be located at the Central Office of the
Department.
    ``(3)(A) The head of the Office is the Chief Officer of Falls
Prevention (in this section referred to as the `Chief Officer'). (B)
The Chief Officer shall report to the Under Secretary for Health.
    ``(4) 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) 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) 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) 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)(A) 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) 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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