SB105 SD2.DOC

SECTION 1. The legislature finds that falls and fall-related injuries among the elderly impact individuals, families, the community, and the State's health care system. Fall prevention is a major concern for the safety and well-being of the State's elderly residents, the fastest-growing segment of Hawaii's population.

Among the elderly in Hawaii, falls are the leading cause of fatal injuries (an average of forty-four per cent) and injury-related hospitalizations (an average of eighty-three per cent). On average, every five hours in Hawaii an elderly person is injured so severely in a fall that hospitalization is necessary. Falls among Hawaii's elderly also result in a yearly average of eighty-two deaths and nearly one thousand eight hundred hospitalizations.

The legislature further finds that hospital costs associated with fall-related injuries average over $65,000,000 each year. This total does not include the additional significant costs associated with skilled nursing care and rehabilitation. Among Hawaii seniors hospitalized for a fall, forty-three per cent are discharged to skilled nursing facilities for additional care, and twelve per cent are moved to rehabilitation facilities.

The legislature additionally finds that access to fall prevention services and programs would significantly reduce these costs. In addition, the early detection of fall occurrences would reduce both costs and suffering by expediting treatment, minimizing serious long-term consequences, reducing the extent of the injury, and in some instances, avoiding death.

Falls among the elderly are a significant public health issue. Yet, currently, there are insufficient resources to develop a coordinated statewide approach to reduce and promptly detect falls among the elderly. The legislature therefore finds that the department of health's emergency medical services and injury prevention system branch should be required to establish and maintain a program dedicated to fall prevention and early detection for the elderly. This program shall serve as a focal point for statewide injury prevention and detection efforts to ensure multidisciplinary support, coordination of prevention and detection efforts, and continuity of implementation and accountability.

The purpose of this Act is to require the department of health's emergency medical services and injury prevention system branch to establish and maintain a statewide fall prevention and early detection program and to make an appropriation for this program.

SECTION 2. Chapter 321, Hawaii Revised Statutes, is amended by adding a new section to part II to be appropriately designated and to read as follows:

"§321- Fall prevention and early detection program. (a) The department of health shall establish and maintain, within the emergency medical services and injury prevention system branch, a fall prevention and early detection program to serve as a focal point for statewide injury prevention and detection efforts. The department may dedicate a position to fall prevention and early detection in support of this program.

(b) The statewide fall prevention and early detection program shall develop a statewide approach to falls among the elderly by:

(1) Investigating and examining the immediate and long-term dangers of fall injuries on the elderly;

(2) Examining the fiscal impact of falls by the elderly on the State's medical system and health care costs;

(3) Recommending appropriate interventions and prevention programs to reduce falls by the elderly;

(4) Investigating and implementing the most effective means to enhance public awareness that falls are preventable;

(5) Reviewing and developing the potential for increasing for the elderly and their caregivers, on a statewide basis, the availability and accessibility of fall prevention programs that effectively use community resources;

(6) Recommending measures that will promote early detection of falls, particularly for those who live alone or in circumstances where the likelihood of not being discovered soon after a fall is great; and

(7) Investigating and recommending the best way to expand the role of medical and health care professionals in screening, educating, and referring the elderly to fall prevention and early detection services and programs.

For purposes of this subsection, the statewide fall prevention and early detection program shall collaborate with interested stakeholders, including health care facilities, community coalitions, government agencies, and organizations concerned with protecting the elderly and preventing and detecting elderly falls.

(c) The department shall submit a report to the legislature no later than twenty days prior to the convening of each regular session, beginning with the regular session of 2015, on the statewide fall prevention and early detection program, describing the progress made in implementing subsection (b), including the review of fall prevention data and the impact of falls by the elderly on the State's medical system and health care costs.

(d) For the purposes of this section, "the elderly" means persons who are age sixty-five or older."

SECTION 3. There is appropriated out of the general revenues of the State of Hawaii the sum of $ or so much thereof as may be necessary for fiscal year 2013-2014 and the same sum or so much thereof as may be necessary for fiscal year 2014-2015 for the department of health's emergency medical services and injury prevention system branch to establish and maintain a statewide fall prevention and early detection program.

The sums appropriated shall be expended by the department of health for the purposes of this Act.

SECTION 4. New statutory material is underscored.

SECTION 5. This Act shall take effect on July 1, 2050.

THE SENATE	S.B. NO.	105
TWENTY-SEVENTH LEGISLATURE, 2013		S.D. 2
STATE OF HAWAII